Related Experiment Video
Updated: Jun 2, 2025
Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
Published on: May 21, 2017
Simple and safe redo sternotomy technique using the ultrasonic bone scalpel for patients with an embedded calcified
Mohammed Usmaan Siddiqi1, Umar Siddiqi1, Narutoshi Hibino1
1Hibino Laboratory, University of Chicago Medicine, Chicago, IL, USA.
Insights
This video demonstrates a safe technique for redo sternotomies in high-risk patients with adult congenital heart disease. An ultrasonic bone scalpel allows precise cutting near sternal calcifications and vessels, improving safety.
Area of Science:
- Cardiovascular Surgery
- Medical Devices
- Surgical Techniques
Background:
- The incidence of adult congenital heart disease (ACHD) is rising, leading to an increased need for complex surgical procedures.
- Multiple redo sternotomies in ACHD patients pose significant risks due to sternal adhesions, calcified conduits, or adhered great vessels.
Purpose of the Study:
- To present a novel, safe, and effective technique for performing high-risk redo sternotomies in ACHD patients.
- To demonstrate the utility of an ultrasonic bone scalpel in managing challenging sternal dissections.
Main Methods:
- A video tutorial showcasing a simple and safe redo sternotomy technique.
- Utilizing an ultrasonic bone scalpel with a narrow, oscillating blade for precise bone cutting.
- Employing a "hold-quick touch-shave" manipulation technique for safe dissection around sternal structures.
Main Results:
- The ultrasonic bone scalpel enables precise sternal cuts, minimizing risk to adjacent calcified conduits and vessels.
- The "hold-quick touch-shave" technique facilitates effective dissection of soft tissues.
- This method addresses limitations associated with conventional sternotomy in complex ACHD cases.
Conclusions:
- The ultrasonic bone scalpel offers a valuable tool for safe and precise redo sternotomies in high-risk ACHD patients.
- Mastery of specific manipulation techniques enhances the safety and efficacy of this approach.
- This technique can reduce operative risks in challenging re-sternotomy procedures.
Abstract:
With the increase of patients with adult congenital heart disease, the number of high-risk multiple redo sternotomies is increasing. Calcified conduit embedded in the sternum or large vessels attached to the sternum presents an especially challenging case. This video tutorial presents a simple safe redo sternotomy technique using an ultrasonic bone scalpel in such high-risk patients. The ultrasonic bone scalpel has a narrow cutting blade that oscillates longitudinally. Because the movements of the blade have a much smaller amplitude and faster speed than those of the usual saw, making a precise cut is possible when holding the ultrasonic bone scalpel onto the bone, and soft tissue can be dissected out with a quick touch. A narrow blade can shave the sternum on the conduit when the layer between the sternum is identified. A lack of understanding of the character of the ultrasonic bone scalpel often limits its potential. This video tutorial demonstrates the key techniques of the fine manipulation of the blade: "hold-quick touch-shave" for the effective and safe use of an ultrasonic bone scalpel.
