Abstract
Introduction: Most hospitals that treat patients with Pectus Excavatum use the pectus bar designed by D. Nuss. In essence, chest elevation is achieved by using a previously moulded steel bar.
It is relatively safe since the introduction of thoracoscopy, although there is a risk of injury to the heart.
Our group has attempted to diminish this risk by means of sternal traction using a clamp specially designed for use with a thorascope anchored in the cancellous tissue of the sternum.
Materials and methods: We used a tailored clamp in three consecutive patients aged 8, 12 and 15 with Pectus Excavatum Haller index > 7.
Procedure: Thorascopy was performed for a good assessment of the rib cage. Under direct vision, we inserted one arm of the clamp underneath the sternum at the deepest point of the defect about 5 cm to the right of the midline. With the other arm of the clamp we grasped the anterior side of the sternum percutaneously. When the clamp was closed, we could raise the sternum to increase the mediastinal space.
Results: The sternal elevation was satisfactory. Using thorascopy during the procedure enhanced safety and the additional time was a few minutes.
Conclusions: Correction of pectus excavatum is indicated for aesthetic purposes in many patients and the absence of severe complications is a goal. The sternal elevation described here (although it is only a preliminary study) is fast, economical and appears to make the Nuss procedure safer.
The abstracts were prepared by Dr. E. Carlos Rodríguez-Merchán, Editor-in-Chief, Spanish Journal of Orthopaedics and Traumatology (Revista de Ortopedia y Traumatología). Correspondence should be addressed to him at: Sociedad Española de Cirugía Ortopédica y Traumatología (SECOT), Calle Fernández de los Ríos 108, 28015-Madrid, Spain
