NT = distance between nasion and top of steering wheel; NC = distance between nasion and Center of steering wheel; SC = distance between sternum and center of steering wheel; XB = distance between xiphisternum
and base of steering wheel.
Type IIB--Subtotal Sternectomy sparing Xiphisternum
On further examination, her abdomen distended up-to xiphisternum
Penetrating wound was present about 2 cm below the xiphisternum
Transverse incision from xiphisternum
to midaxillary line.
On abdominal examination a tense cystic lump was palpable extending upto the xiphisternum
whose lower pole could not be reached suggesting the lump to be arising from the pelvis.
On abdominal examination, ill-defined pelvi-abdominal mass was noticed, extended up to xiphisternum
, with evident dermal striae.
A lead marker was placed on the xiphisternum
, this site was approximately midway between the dome of diaphragm and upper part of the 'C' of duodenum.
Open cholecystectomy: The patient is placed in the supine position with a sandbag placed under the upper abdomen, after cleaning and draping, a 5 cm transverse incision is made in the right subcostal region midway between the xiphisternum
and the umbilicus just short of the midline.
9 cm (ML x AP) sized defect in the anterior diaphragmatic aspect in midline below the xiphisternum
through which a approximately 9 cm long loop of transverse colon and mesocolon was herniating in to the anterior mediastinum, causing widening of retrosternal space and compression effect and displacement of heart towards the left with atelectasis of Right Middle Lobe of the lung.
Another 10 mm trocar was inserted 3 cm below the xiphisternum
and finally a 5 mm trocar at the right hypochondrium anterior axillary line 3 cm below the costal margin (Image no.
Sacrificing of animals was followed by dissection a mid-line incision through the skin extending from xiphisternum
to pubic symphysis was given with a knife and was extended laterally at its lower end to achieve maximum exposure of abdominal cavity and the kidneys were exposed by displacing intestines.