title: Systematic traction techniques in minimal-access pediatric cardiac surgery.
abstract: Minimal-access pediatric cardiac surgery is now common in the treatment of simple congenital heart defects. However, methods of securing a good, unobstructed view for surgery and the difficulties of working in a deep, narrow field jeopardize safety in surgical procedures, especially for less experienced surgeons have been described. Our systematic, step-by-step traction techniques on the skin, the pericardium, the right atrial appendage, the aortic root, both venae cavae, and the free wall of the right ventricular outflow, using a mechanical retractor and traction sutures, facilitate surgical field exposure and the achievement of safety. As described below, our procedures are simple, allow direct inspection, and assist those working toward technical mastery.
authors.affiliation: Department of Cardiovascular Surgery, Kyorin University School of Medicine, Tokyo, Japan. hiroshioiwa@hotmail.com
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Oiwa
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Ishida
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sudo
mesh_terms: D000293:Adolescent; D006348:Cardiac Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D013536:Suture Techniques