Sternal saw

Sternal saw is a specialized surgical instrument used primarily in cardiothoracic surgery to perform sternotomies, which involves cutting through the sternum or breastbone. This tool allows surgeons to access the heart and lungs for various procedures, including coronary artery bypass grafting (CABG), heart valve repair or replacement, and lung surgeries. The design of the sternal saw ensures precision and safety, minimizing trauma to the patient while providing optimal access to the thoracic cavity.

Design and Function

The sternal saw is an electrically or battery-powered device that resembles a small circular saw. It is specifically engineered to cut through the dense bone of the sternum with minimal damage to surrounding tissues. The saw typically features a safety guard to prevent deep penetration beyond the sternum, reducing the risk of injury to the heart or lungs. Modern sternal saws are equipped with ergonomic handles for ease of use and may include features such as adjustable speed settings to enhance control during the procedure.

Procedure

During a sternotomy, the patient is placed under general anesthesia. The surgeon makes a vertical incision over the sternum and then uses the sternal saw to carefully divide the bone. Once the sternum is split, retractors are used to spread the ribcage open, providing access to the heart and lungs. After the surgical procedure is completed, the sternum is typically reapproximated using wires or a sternal closure device, and the incision is closed.

Safety and Complications

While the use of a sternal saw has significantly improved the outcomes of thoracic surgeries by providing better access to the heart and lungs, there are risks associated with its use. Complications can include bleeding, infection, and injury to the heart, lungs, or major blood vessels. However, with proper technique and safety measures, these risks are minimized.

Postoperative Care

Recovery from a sternotomy involves pain management, monitoring for signs of infection, and physical therapy to regain strength and mobility. Patients are advised to avoid heavy lifting and strenuous activities for several weeks to allow the sternum to heal properly.

Advancements

Technological advancements in sternal saws include the development of oscillating saw blades that reduce thermal damage to the bone and surrounding tissues, and vacuum-assisted devices that collect bone dust and debris, minimizing the risk of contamination and infection.

Conclusion

The sternal saw is a critical instrument in cardiothoracic surgery, enabling surgeons to perform complex procedures with greater precision and safety. Ongoing innovations in design and technology continue to improve the efficacy and outcomes of surgeries involving the thoracic cavity.

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