A Modified Sternal Retractor Nelson Ancalmo, M.D., a n d John L. Ochsner, M.D. ABSTRACT A modification of the Favaloro sternal retractor is described that allows a single person to operate the apparatus when elevating the sternal plate. The new retractor is also easier on the sternum because of its blunter teeth.
Use of the internal mammary artery (IMA) as a bypass vessel for stenotic coronary arteries has been accepted by most cardiovascular surgeons. The technique for dissection and preparation of this vessel has been described in detail [l,21. Various means of sternal retraction to expose the IMA have been used, the Favaloro retractor being the most common. However, in order to elevate the sternal plate, a strong physical effort is required and two people are needed to properly operate the retractor. We have devised a modification of this retractor* (Figure) that enables a single person to operate the apparatus. The arms of the retractor are provided with a screw system that permits progressive, even tension by turning the screw handle. The teeth of the retractor are blunt in order to avoid injury to the sternal plate. Thus, an easier and more gentle way of retracting the sternal plate is provided, and the surgeon can easily control the amount of traction. From the Department of Surgery, Alton Ochsner Medical Foundation and Ochsner Clinic, New Orleans, LA. Accepted for publication Aug 8, 1975. Address reprint requests to Dr. Ochsner, Ochsner Clinic, 1514 Jefferson Hwy, New Orleans, LA 70121. “Filling Co, Delaware Dr, Fort Washington, PA 19034.
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Favaloro‘s retractor modified with screw type handles f o r easier adjustment of retraction, longer armsfor easier assembly, and blunt tips to prevent injury to the sternum.
References 1. Mills NL, Ochsner JL: Technique of internal mammary-coronary artery bypass. Ann Thorac Surg 17237, 1974 2. Mills NL, Ochsner JL: Preparation of internal mammary arteries for coronary bypass w i t h intraluminal papaverine. J Cardiovasc S u r g (Torino) (in press)
Use of the internal mammary artery (IMA) as a bypass vessel for stenotic coronary arteries has been accepted by most cardiovascular surgeons. The technique for dissection and preparation of this vessel has been described in detail [l,21. Various means of sternal retraction to expose the IMA have been used, the Favaloro retractor being the most common. However, in order to elevate the sternal plate, a strong physical effort is required and two people are needed to properly operate the retractor. We have devised a modification of this retractor* (Figure) that enables a single person to operate the apparatus. The arms of the retractor are provided with a screw system that permits progressive, even tension by turning the screw handle. The teeth of the retractor are blunt in order to avoid injury to the sternal plate. Thus, an easier and more gentle way of retracting the sternal plate is provided, and the surgeon can easily control the amount of traction. From the Department of Surgery, Alton Ochsner Medical Foundation and Ochsner Clinic, New Orleans, LA. Accepted for publication Aug 8, 1975. Address reprint requests to Dr. Ochsner, Ochsner Clinic, 1514 Jefferson Hwy, New Orleans, LA 70121. “Filling Co, Delaware Dr, Fort Washington, PA 19034.
174
Favaloro‘s retractor modified with screw type handles f o r easier adjustment of retraction, longer armsfor easier assembly, and blunt tips to prevent injury to the sternum.
References 1. Mills NL, Ochsner JL: Technique of internal mammary-coronary artery bypass. Ann Thorac Surg 17237, 1974 2. Mills NL, Ochsner JL: Preparation of internal mammary arteries for coronary bypass w i t h intraluminal papaverine. J Cardiovasc S u r g (Torino) (in press)
