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The Robicsek Procedure for Closure of a Dehiscence of the Sternum

Friday, April 17, 2020

Freystaetter K, Dunning J. The Robicsek Procedure for Closure of a Dehiscence of the Sternum. April 2020. doi:10.25373/ctsnet.12126438

This is a video of the Robicsek procedure for repair of a dehiscence of the sternum. Francis Robicsek, who died on April 3, 2020, created this technique among many other novel operations in his career, which spanned over 60 years. He began in 1949 in Budapest, Hungary, and spent his later years in Charlotte, North Carolina, where he built by hand his own heart-lung machine. He was also responsible for the creation of the Sanger Institute in North Carolina and the development of one of the busiest heart transplant programs in the world.

This video demonstrates the operation that bears his name. If the patient has a sternal dehiscence, this video shows how to debride the sternum, take off the pectoralis muscle from each sternal edge, and then weave a sternal wire from inferiorly to superiorly and back again on either side. This allows the surgeon to place either horizontal sternal wires or, as the authors did in this operation, a combination of wires and zipfix ties. This is an inexpensive and easy technique and is very successful as long as the treatment is for a mechanical dehiscence without chronic infection in the sternum.


Robicsek F, Daugherty HK, Cook JW. The prevention and treatment of sternum separation following open-heart surgery. J Thorac Cardiovasc Surg. 1977;73:267-268.


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Nice video, thank you. Having trained under Dr. Robicsek in North Carolina, we used to do lot of sternal reconstruction cases. I routinelt used robicsek weave +/- KLS sternalock fixaters +/- sternal wires. In many occasions now, I use longitudinal titanium bars/screws + wires ( and in almost all cases I utilize the pectoralis flap to cover the reconstruction).
We have used a similar technique in our patients, but putting titanium miniplates in front and behind the sternum in both sides (Sandwich-like). The pectorals weren't detached, and went well; but we take this excellent idea for the next cases. Great technique from a big master. Our deepest condolences to the family and colleagues.

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