Following routine cleaning and draping the patient was placed in right lateral decubitus position. 

Chest cavity was accessed through a left posterolateral thoracotomy via the 5th intercoastal space. The mediastinal pleura was opened and the left main bronchus was identified between the descending aorta and left pulmonary artery, and was secured with stay sutures. A longitidinal bronchotomy was done and the foreign body (the metallic tip of a pencil with the cleaner) was mobilised and retrieved. 

Bronchotomy was closed with prolene 4-0. Heostasis secured and lung was expanded with no air leakage. The thoracotomy was closed in layers over a size 30 chest tube. Immediate post-op condition satisfactory.