First of all, you need to understand the human anatomy. The heart, mediastinum, large blood vessels, thymus, etc. are almost partially hidden behind the sternum. It is equivalent to saying that it is basically impossible to bypass the sternum, a big stone blocking the road, to perform surgery. It is better to split the sternum than to break many other bones while taking a detour. The human chest is not without other bones except the sternum. Moreover, this approach is the fastest. Splitting the sternum can quickly expose important organs such as the heart, mediastinum, and large blood vessels. Since you have chosen thoracotomy, the first thing you must do is to ensure that the surgical field is spacious, bright, and thorough, so that the doctor can work quickly and complete the operation as soon as possible. This approach is like choosing a midline incision in the abdomen for laparoscopic surgery. The chest and abdominal cavities can be imagined as sacks. Splitting them in the middle with a knife is the easiest way to see what is inside and what is broken.
When it comes to splitting bones, the orthopedic knife mentioned earlier comes to mind. For a bone as large as a tree trunk, such as the sternum, it is faster for the doctor to just use an electric saw. The electric saw the doctor uses is definitely not the one used on construction sites. If he uses that on stage, he will probably scare people to death.
Orthopedic knives can be made very light, like the electric saws used in surgery, or made like hand drills. As long as the power is enough and the teeth are sharp, the effect is the same. The size of the tool depends on the size of the target. It's just a piece of bone, not a tree, so why use a big tool?
When chopping a tree with an electric saw, the cut is not done randomly. The aim is to make a clean cut, with the two ends split instantly, so that it is easy to clean up the mess afterwards.
When the surgical electric saw is called a sternum saw, it also needs to be planned and purposeful when splitting the sternum. The incision should be made on the median tangent line and the incision should be neat. First, it is aesthetically pleasing. Second, the incised bone needs to be tied back after the operation, which makes it easier to align and heal the incision. Third, the most important thing is that it can standardize the surgical field after exposing the sternum, which is conducive to subsequent visceral surgery. If it is cut crooked, you will not be able to readjust the surgical field after opening the incision, which will cause pain to the patient and the doctor.
The important node is here, and we must cut the center line accurately.
The question is not whether you can accurately feel the midline when you locate the sternum through the skin before the operation. Once you operate the machine and cut the skin, the previously predicted line will definitely be gone, and you will need to redefine the midline position.
After entering the operation, the doctor needs to sort out the midline of the sternum. This process of groping is also the preparation work before splitting the sternum. It is not easy to say how a human bone is. There are skeletal muscles and other things attached to it. When repairing bones, the doctor must use his hands and tools to clear and peel off these attached components like brushing off the dust and wires on the metal components of the machine before he can start. The sternum is a very important large bone in the human body, and there are many muscle groups attached to it.
The surgeon put his gloved hand in and felt around the ribs on both sides to determine the outer edge of the sternum, and then determined two or three midpoints as the midpoint line connecting the upper and lower points. After that, the nurse handed over a middle-curved hemostat, which is what we usually call a middle-curved hemostat.
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This is why cardiothoracic surgery and neurosurgery are known as the two major specialties of surgery. They not only deal with internal organs, but also hard objects such as bones. Orthopedics does not deal with internal organs. Other surgical departments rarely touch bones.
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