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¡¾2401¡¿Cut it right

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    First of all, you need to understand the anatomy of the human body. Almost all of the heart, mediastinum, great vessels, thymus, etc. are hidden behind the sternum.  This is equivalent to saying that it is basically impossible to perform surgery around the sternum, a big stone blocking the road.  It is better to split the sternum than to break countless other bones when bypassing. The human chest does not have 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 great blood vessels.  Since you choose 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 early.  This method is like selecting a midline incision in the abdominal cavity for surgical exploration of the abdominal cavity. The chest and abdominal cavity can be imagined as sacks. Cut open in the middle with a knife. It is easiest to see clearly what is inside and what is broken.

    When it comes to splitting bones, the orthopedic knife mentioned before will naturally come to mind.  To treat a big bone like the sternum, which is like a big tree trunk, it would be faster for doctors to just use a chainsaw.  The electric saw the doctor held was definitely not the one used on construction sites outside. If he took that on stage, he would probably scare people to death first.

    The orthopedic knife can be made very light, just like the electric saw used for surgery, it can be made like a hand drill.  As long as the power is enough and the saw teeth are sharp, the effect will be the same. The size of the tool depends on the size of the target. Just splitting a bone is not a big tree, so why use a big tool.

    When a chainsaw chops down a large tree, it is not a random chop. The cuts must be neat and the two sections split instantly, so that it is easy to clean up the mess afterwards.

    When the surgical electric saw is called a sternum saw, you must also have a plan and purpose when splitting the sternum. Cut on the midline and make the incision neat. First, it is beautiful.  Second, the cut bones need to be re-tied after the operation. Then it will be easy to align and the incision will heal easily.  The third most important thing is that it can standardize the surgical field of exposure behind the sternum, which is beneficial to subsequent visceral surgeries.  If the incision is crooked, you cannot readjust the surgical field after opening the incision. This will cause pain to the patient and pain to the doctor.

    The important node is here, we need to cut the center line accurately.

    ??The question is not to mention whether you can feel the midline accurately when you feel the sternum through the skin before surgery. If you go in and cut the skin, the previously predicted line will definitely be gone, and you need to re-determine the midline position.

    After the operation, the doctor needs to clarify the midline of the sternum all the way. This process of exploration is also the preparation before splitting the sternum.  To say how difficult this process is, a human bone is not just a bone, but has skeletal muscles and other things attached to it.  When repairing bones, it is necessary for the doctor to use hand tools, like brushing off dust and wires from the metal components of a machine, to sort out and peel off these attached components before starting.  The sternum is a very important large bone in the human body, with many muscle groups attached to it.

    The surgeon¡¯s gloved hand reached in and touched the ribs on both sides to determine the outer edges of the sternum, and then determined two or three midpoints as the midpoint line connecting the upper and lower parts.  After that, the nurse handed over a medium-curved hemostat, which is what we usually call a medium-curved hemostat.

    ? ? Here is the reason why cardiothoracic surgery and neurosurgery are known as the two special specialties of surgery.  People have to deal with not only internal organs, but also hard objects like bones.  In orthopedics, there is no need to deal with internal organs.  Other surgical departments rarely come into contact with hard bones.

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