The aim of this section is to describe how to remove the 'pluck' (consisting of the tongue, trachea, lungs and heart) from the thoracic cavity.
The oesophagus can be removed with the thoracic organs, or with the intestinal tract — this will be covered later.
Tongue
Begin the procedure by placing the knife in the tissues on the inside of one of the mandibles ('Ma'). The positions where the cuts should be made are shown by the arrows.
Cut through the muscular tissue of the floor of the oral cavity, along the inside of one of the mandibles (in this case, the left side), to expose the oral cavity (arrow).
Reach through the incision, grasp the tongue (top arrow), and pull it through the incision (bottom arrow).
Pull gently on the tongue, at the same time cutting the tissue below the tongue (bottom arrow) at the other side of the mandible (in this case, the left side of the jaw).
Pharynx
Now the tongue has been exposed, we move on the pharynx, at its base.
Cervical region
Having freed the tongue from the oral cavity, pull it gently in a caudal direction.
Thoracic inlet
Having cut through the tissues at the inlet, pull gently on the oesophagus and trachea. Carefully cut the fascia, attaching the thoracic contents to the ventral aspect of the spinal column to the level of the diaphragm. This represents 'the pluck', which contains the trachea, heart, lung, and associated structures such as lymph nodes and thymus.
Removing the 'pluck'
Bearing in mind the history of the case, you can now remove the pluck. You can do this in two ways:
Removing the oesophagus with the alimentary tract. Gently separate the oesophagus from the trachea to the level of the diaphragm. It can then be removed with the abdominal contents.
Removing the oesophagus with the heart and lungs. Lift up the heart and lungs (by the trachea and oesophagus) and cut through the fascia between the pericardium and diaphragm (not shown).
NOTE. Care should be taken to ensure the pericardial sac remains intact (undamaged).
The image below shows the end result, with the trachea, heart (in the pericardium) and lungs intact, ready to be examined further. In this case, the oesophagus (arrow) has been removed along with the 'pluck'.
