Anatomie et physiologie : recherches en cours
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Anatomy of the Thoracic Recurrent Laryngeal Nerves from a Surgeon’s Perspective

Amer K

There is a need for a fresh understanding of the course of the recurrent laryngeal nerves (RLN) in the chest. Thoracic surgeons avoid dissection around the nerves altogether to avoid its injury. This is impacting on how comprehensive nodal dissection can be in lung cancer surgery. It’s imperative to understand the anatomy of the course of the nerves in extreme details before having the confidence to preserve the motor branch. In the chest the course of the right RLN is short and the thoracic surgeon is unlikely to cut it inadvertently. The left RLN is more complex and requires in-depth understanding. Absolute mastery of the RLN anatomy is the best way to preserve it, and we strongly believe that ‘the best way to avoid injuring the RLN is to expose it and note the course of its motor branch'. By improving exposure of the RLN and armed with the knowledge of detailed anatomy it was possible to point out a safe way to harvest nodes in stations 3p, 2-4R, 5-6L, 4L and 2L. RLN palsy should be an historical event for the thoracic surgeon.