An anterior mediastinotomy dividing the sternum in the midline is a standard approach for cardiac surgery but is also useful in thoracic surgery for lesions in the anterior mediastinum or where both lungs need to be approached at the same time such as when there are multiple metastases. The sternum is reconstituted with wire sutures either passing through the sternum itself or around the sternum taking care not to injure the internal mammary vessels. This incision is usually better tolerated by patients than a lateral thoracotomy.

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