In 1830, orthopedic technician-turned-orthopedic surgeon Bernhard Heine shook up the medical and physical sciences with a new medical chainsaw invention. Heine had designed and built many of his own instruments and appliances through the years, but nothing was as renowned as his chain osteotome.
Similar to the modern chainsaw (which bears a slight resemblance to the chain osteotome), the instrument had little “teeth on the exterior, grooves on the inside corresponding to spurs on the motive wheel,” according to Tizzano’s circa 1889 copy of George Tiemann & Co.’s Surgical Instruments catalog. It also had a “thin, knife-like plate (deeply grooved longitudinally), over which, and the motive wheel, the saw is extended.”
Heine’s osteotome had a hand crank and could cut through bone comparatively quickly, saving the patient from blows of a hammer and chisel or the jarring of a regular amputation saw. (This was golden, considering anesthesia was rarely used at the time.)
Symphysiotomies were still being performed then, but the osteotome was never used for this surgical procedure, Tizanno assures, as the operation required an initial approach that was not possible with Heine’s version of the chainsaw.
However, the osteotome was adjustable, making it ideal for other delicate surgeries. Guards on the chainsaw could be configured to minimize the area of the patient that had to be cut. This prevented soft-tissue damage, which allowed surgeons to perform surgical procedures like craniotomies without splintering bones or damaging surrounding tissue, including the brain.
There were some drawbacks to the osteotome, though. It was a pricy surgical instrument, ringing in at $300 in Tiemann’s 1872 catalogue compared to just $5 for standard medical chainsaws. (These days, pristine, cased and complete examples of antique Heine osteotomes have sold for upward of $30,000, Tizzano says.) Furthermore, using it required a great deal of skill and, unfortunately, Heine was one of the few who mastered it.