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Sternal Lifting Technique For Sternal Depression In Robotic Mitral Repair
Norihiko Ishikawa, Yuki Kato, Motomu MIyagi, Toru Koakutsu, Takafumi Horikawa, Shigeyuki Tomita, Toshiya Ohtsuka, Go Watanabe;
NewHeart Watanabe Institute, Tokyo, Japan
BACKGROUND: Traditional surgical methods have been difficult for patients with chest wall deformities, but the use of the Electrical Sternum Lifting System (ESLS) has made the surgery easier.
METHODS: Patients with a sternum-to-vertebral distance of less than 80 mm on preoperative CT scan routinely underwent sternal lift using the ESLS.
RESULTS: The ESLS was effective in securing the operative field while suspending the sternum, allowing adequate observation of the left atrium, left ventricle, and the mitral valve, and safe mitral valve plasty. The use of the lifting device did not interfere with the robot arms, and the space between the sternum and vertebrae was widened with only a 3 mm wound to move the mitral valve surface in the sagittal plane, making the repair easy and accurate under robotic assistance. Sixty-three out of 1002 patients (6.3%) underwent sternal elevation using ESLS. There were 19 males and 44 females with a mean age of 50.9±14.0 years. The average of sternum-to-vertebral distance was 72.4±8.9 cm. Two patients had S/V distance of more than 80 mm but ESLS was used because of scoliosis.
CONCLUSIONS: The effort to attach the ESLS was not difficult, and the postoperative cosmetic outcomes were excellent.
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