Impact Of Newly Designed Retractor For Partial Sternotomy
Kenji Minatoya1, Kazuhiro Yamazaki1, Hideo Kanemitsu1, Kazuhisa Sakamoto1, Taro Nakatsu1, Yosuke Inoue2, Yoshimasa Seike2, Tadashi Ikeda1, Hitoshi Matsuda2.
1Kyoto University Hospital, Kyoto, Japan, 2National Cerebral and Cardiovascular Center, Osaka, Japan.
OBJECTIVE: Partial sternotomy has been established as one of approaches for cardiac surgery. The approach is also useful for aortic surgery. Regular retractor could be used for the partial sternotomy, however, the stress of the sternum with the regular retractor is sometimes excessive and it damages the sternum. At the same time, protective retractor is too bulky for the rather shorter skin incision. We present a newly developed sternal retractor.
METHODS: Since 2013, over 70 patients underwent aortic root surgery and/or aortic arch surgery through partial sternotomy. Original Dubost blades (Delacroix-Chevalier, Paris, France) were used for the partial sternotomy initially, however, opening was limited due to skin incision. Finochietto retractor (Scanlan, MN, USA) had less limitation of skin opening, but often showed severe damages of lower plate of sternum. The newly designed blades had isthmus which leads wider opening of the skin incision.
RESULTS: The skin incision was 15cm at the beginning; however, it could be safely shortened to 7cm. over 20 patients had aortic root operation or aortic root operation with the retractor.
CONCLUSIONS: All operations through the partial sternotomy were performed safely under fine exposure. Our newly developed retractor makes the aortic root and aortic arch procedures safer and shorter skin incision.
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