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Modification of the Nuss Procedure: The Single-incision Technique.

Aizawa T, Togashi S, Domoto T, Sasaki K, Kiyosawa T, Sekido M - Plast Reconstr Surg Glob Open (2014)

Bottom Line: To facilitate passing of the bar, a traction guide was created according to our unique method.There was no need for a bar stabilizer, and no severe intraoperative complications occurred.All patients exhibited satisfactory short-term results; however, 1 patient suffered from bar rotation and required repeat surgery for fixation.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, National Defense Medical College, Saitama, Japan; Department of Plastic and Reconstructive Surgery, Shonai Amarume Hospital, Yamagata, Japan; and Department of Plastic and Reconstructive Surgery, Tsukuba University, Ibaraki, Japan.

ABSTRACT

Summary: The Nuss procedure is a prevalent minimally invasive surgery for pectus excavatum. Although the Nuss procedure has the advantage of leaving less obtrusive scars, the standard technique requires at least 3 skin incisions to insert several instruments. We experienced 7 cases of the modified Nuss procedure using a single incision during a 7-year period. To facilitate passing of the bar, a traction guide was created according to our unique method. There was no need for a bar stabilizer, and no severe intraoperative complications occurred. All patients exhibited satisfactory short-term results; however, 1 patient suffered from bar rotation and required repeat surgery for fixation. Two patients underwent bar removal via the same single incision without any difficulties.

No MeSH data available.


Related in: MedlinePlus

The bar is bent into a stepwise convex shape (A). The bar is firmly locked by the fulcrum effect at 3 points: the posterior sternum (*) and the 2 bilateral highest points (arrow) (B).
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Figure 2: The bar is bent into a stepwise convex shape (A). The bar is firmly locked by the fulcrum effect at 3 points: the posterior sternum (*) and the 2 bilateral highest points (arrow) (B).

Mentions: The pectus bar is prebent into a convex shape. Step-shaped bending7 allows the pectus bar to elevate the sternum directly due to its flat convexity while fitting the ribs with its hinge points. When the bar is flipped, it is firmly locked by the fulcrum effect at 3 points: the posterior sternum and 2 bilateral highest points (Fig. 2). The right tip of the bar is fastened to the costal bone with polyester tape. No other devices, such as a bar stabilizer or sternal wire, are used.


Modification of the Nuss Procedure: The Single-incision Technique.

Aizawa T, Togashi S, Domoto T, Sasaki K, Kiyosawa T, Sekido M - Plast Reconstr Surg Glob Open (2014)

The bar is bent into a stepwise convex shape (A). The bar is firmly locked by the fulcrum effect at 3 points: the posterior sternum (*) and the 2 bilateral highest points (arrow) (B).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4255899&req=5

Figure 2: The bar is bent into a stepwise convex shape (A). The bar is firmly locked by the fulcrum effect at 3 points: the posterior sternum (*) and the 2 bilateral highest points (arrow) (B).
Mentions: The pectus bar is prebent into a convex shape. Step-shaped bending7 allows the pectus bar to elevate the sternum directly due to its flat convexity while fitting the ribs with its hinge points. When the bar is flipped, it is firmly locked by the fulcrum effect at 3 points: the posterior sternum and 2 bilateral highest points (Fig. 2). The right tip of the bar is fastened to the costal bone with polyester tape. No other devices, such as a bar stabilizer or sternal wire, are used.

Bottom Line: To facilitate passing of the bar, a traction guide was created according to our unique method.There was no need for a bar stabilizer, and no severe intraoperative complications occurred.All patients exhibited satisfactory short-term results; however, 1 patient suffered from bar rotation and required repeat surgery for fixation.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, National Defense Medical College, Saitama, Japan; Department of Plastic and Reconstructive Surgery, Shonai Amarume Hospital, Yamagata, Japan; and Department of Plastic and Reconstructive Surgery, Tsukuba University, Ibaraki, Japan.

ABSTRACT

Summary: The Nuss procedure is a prevalent minimally invasive surgery for pectus excavatum. Although the Nuss procedure has the advantage of leaving less obtrusive scars, the standard technique requires at least 3 skin incisions to insert several instruments. We experienced 7 cases of the modified Nuss procedure using a single incision during a 7-year period. To facilitate passing of the bar, a traction guide was created according to our unique method. There was no need for a bar stabilizer, and no severe intraoperative complications occurred. All patients exhibited satisfactory short-term results; however, 1 patient suffered from bar rotation and required repeat surgery for fixation. Two patients underwent bar removal via the same single incision without any difficulties.

No MeSH data available.


Related in: MedlinePlus