Sternal Saw: Uses, Types, and Role in Open Heart Surgery
A sternal saw is a surgical tool that cuts through the breastbone, also called the sternum. Surgeons use it during a median sternotomy, the cut that opens the chest so they can reach the heart and nearby structures.
This tool is a core part of many open heart operations. It must cut bone cleanly while protecting the tissue underneath. This guide explains what a sternal saw is, how it works, the main types, how the blades work, and what to know about safety and cost.
This content is for general education. Product details, blade fit, and prices should always be checked against the manufacturer’s current documents.
What Is a Sternal Saw?
A sternal saw is a specialized bone cutting instrument built for one job. It divides the sternum from top to bottom so the two halves can be spread apart. That opening gives the surgical team a clear view of the heart.
It differs from a general bone saw in a few ways. It is designed for the chest, so it has a guard that keeps the blade from reaching deeper than needed. The blade moves in a short, fast back and forth motion, which gives a controlled cut. The shape of the tool also lets the surgeon follow the midline of the chest with steady aim.
What Is a Sternal Saw Used For?
The machine follows a simple path. Blood leaves the body, passes through the machine, and returns to the body with fresh oxygen.
Open Heart Surgery
Most open heart operations begin with a sternotomy. The saw opens the chest so the team can work on the heart, the large vessels, and the area around them.
Coronary Artery Bypass Grafting (CABG)
CABG creates new paths for blood around blocked arteries. These blockages usually come from coronary artery disease. A sternotomy gives the surgeon room to harvest and sew grafts onto the heart.
Heart Valve Repair and Replacement
Valve surgery is another common use. Patients with valvular heart disease or severe leaking valves may need an open repair or replacement.
Other Cardiothoracic Procedures Requiring Sternotomy
Some aortic repairs, certain congenital heart operations, and some chest tumor removals also use this approach. Surgeons choose it when they need wide access to the middle of the chest.
How Does a Sternal Saw Work?
Reciprocating Blade Mechanism
The blade moves back and forth in a very short stroke. This is called a reciprocating or oscillating motion. The small stroke gives the surgeon good control and lowers the chance of the blade catching on tissue.
Cutting Through the Sternum
The surgeon places the tip of the blade at the top or bottom of the sternum and guides the saw along the midline. The saw cuts through the bone in one pass, with the surgeon keeping a steady line.
Protective Footplate and Safety Features
A flat guard, called a footplate, rides under the breastbone as the saw cuts. It lifts the bone slightly and shields the structures behind it. Anesthesia teams often pause the ventilator for a moment during the cut so the lungs move away from the blade. The machine used for breathing support is explained in more detail on the page about ventilators.
Surgical Access After Sternotomy
After the cut, a self retaining retractor spreads the two halves of the sternum apart. That gives the team a wide, stable opening to reach the heart. Once the operation is done, the surgeon closes the sternum with stainless steel wires and later closes the skin.
What Are the Different Types of Sternal Saws?
Electric and Battery Powered Sternal Saws
These saws run on electricity or on rechargeable batteries. Battery powered models are popular because there are no cords or air hoses in the way. Many have speed controls so the surgeon can adjust the cut.
Pneumatic Sternal Saws
Pneumatic saws run on compressed air or gas. They have been used in hospitals for many years. They need a supply line and hose connected to the tool.
Manual Sternal Saws
Manual saws use hand power. They are less common today. Some hospitals keep them as a backup if power tools fail.
Disposable and Reusable Surgical Saws
Some parts are reusable and others are made for one use. Handpieces are often reusable and go through cleaning and sterilization between cases. Blades are commonly made for single use. Always confirm which parts are reusable by reading the maker’s instructions for the exact model.
Stryker Sternal Saw: Features and Applications
Overview of Stryker Sternum Saw Systems
Stryker is one of several companies that make sternum saw systems. Other makers, such as deSoutter Medical, also supply saws for the same purpose. A system usually includes a handpiece, a power source, a blade, and a guard or footplate.
Battery Powered Design and Speed Controls
Many modern systems use battery power and offer control over blade speed. These features give the surgeon more freedom to move and adjust the cut. Hospitals should check current product documents to see what each model offers.
Blade Compatibility and Replacement Options
Blades must match the handpiece. Using a blade that is not approved for the saw can affect cutting and safety. Hospitals should buy blades and parts that the manufacturer lists as compatible.
Important Considerations When Selecting a Model
Teams often look at power type, weight and balance, blade availability, cleaning needs, and support from the maker. Training for staff also matters. These details change by model and year, so buyers should confirm them with the manufacturer.
What Is a Sternal Saw Blade?
A sternal saw blade is a thin, flat cutting piece made to move in the short back and forth motion of the saw. The blade is shaped to cut bone cleanly and to work with the footplate that guards the tissue behind it.
Blades differ in length, width, and material. They are usually made of stainless steel. The handpiece is the main body of the tool, while the blade is the part that wears out. Because the blade and handpiece must work together, surgical teams should use only parts the manufacturer approves.
Sternal Saw Safety and Sterilization
Safety starts before the first cut. Staff should inspect the saw, the blade, and the guard for damage. They should check that the blade is seated correctly and that the battery or air supply works.
After surgery, the tool goes through manufacturer approved cleaning, disinfection, and sterilization steps. Tiny gaps and hinges need careful attention because bone and tissue can hide there. Only trained surgical staff should use the saw, and they should follow the instructions for use at every step. Operating room equipment of this kind falls under major surgical equipment.
How Much Does a Sternal Saw Cost?
Price depends on the brand, the model, the power source, and what comes in the kit. A full system with a handpiece, battery, charger, and accessories costs more than a single blade. Blades are bought again and again, so hospitals plan for that ongoing cost too.
When comparing prices, ask whether the quote includes batteries, handpieces, blades, and service. Use current figures from the maker or an approved supplier rather than old numbers found online.
Final Thoughts
The sternal saw is a simple idea with a big role. It gives surgeons safe access to the heart so they can repair or replace damaged parts. Good training, careful cleaning, and the right blades keep it working well.
Surgery is often a last step after heart disease has already caused damage. The BaleDoneen Method focuses on finding the causes of artery disease early so patients can lower their risk of a heart attack or stroke. Anyone interested in that kind of prevention can find a provider trained in the method.