Simple And Safe Redo Sternotomy Technique Using Ultrasonic Bone Scalpel For The Patient With Calcified Conduit Embedded Into Sternum
Narutoshi Hibino, MD,PhD.
University of Chicago, Advocate Children's Hospital, Chicago, IL, USA.
With the increase of patients with adult congenital heart disease, the number of high-risk multiple redo sternotomy is increasing. Especially calcified conduit embedded into the sternum is a challenging case. This video presents a simple and safe redo sternotomy technique using Ultrasonic Bone Scalpel (UBS) in such high-risk patients. UBS has a narrow cutting blade that oscillates longitudinally. Since the movements of the blade have much smaller amplitude and faster speed than usual saw, a precise cut can be possible when holding on the bone and soft tissue can be dissected out with quick touch. When the layer between the sternum and conduit is identified, a narrow blade can shave the sternum on the conduit. Lack of the understanding of the character of this blade often limits the potential of UBS. This video demonstrates the key technique of fine manipulation of the blade, "hold- quick touch- shave" for effective and safe use of UBS.
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