Sternotomy

Synonyms

Mediansternotomy; Partial sternotomy; Split-the-sternum

Definition

Sternotomy is an incision in the middle of the anterior chest, made through the middle of the sternum and used to expose structures in the mediastinum or the anterior part of either hemithorax. This incision may be extended or used in association with other incisions to achieve special exposures.

Alternative Concept

An incision may be made transversely through the middle of the body of the sternum, in combination with bilateral transternal anterolateral thoracotomies. This creates what is known as a “clamshell” incision.

Position

For a sternal incision, the patient is placed in the supine position with the arms either extended or tucked at the side.

Instruments

Beside the usual scapels, hemostats, electrocoagulation equipment, scissors, and sutures, an instrument to cut through the bony sternum is required. This is accomplished with either a sternal saw or a Lebsche knife. In the early 1960s, the latter was...