Journal of laparoendoscopic & advanced surgical techniques. Part A · 2012
Minimally invasive repair of symmetric pectus carinatum: bilateral thoracoscopic chondrotomies and suprasternal compression bar placement.
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Bell Robert, Idowu Olajire, Kim Sunghoon
Аннотация
PURPOSE: We previously reported a novel minimally invasive repair for unilateral pectus carinatum. We have now modified this approach for the repair of symmetric bilateral pectus carinatum.
MATERIALS AND METHODS: Using thoracoscopy, parasternal chondrotomies were performed at multiple rib levels at points of maximal sternal protrusion. The sternum was depressed to an appropriate position and maintained using a suprasternal metal compression bar. The bar was applied in a submuscular plane and anchored to the lateral ribs with sutures. Bars were removed after 6 months.
RESULTS: Three patients with severe symmetric pectus carinatum underwent the repair. The first patient returned to the operating room after 1 month for repeat fixation of the bar after suture breakage. No other complications occurred. Operative times were comparable to published series. Patient satisfaction after the repair was good.
CONCLUSIONS: Minimally invasive thoracoscopic repair of symmetric pectus carinatum using chondrotomies and suprasternal bar compression is a feasible alternative to open repair.
MATERIALS AND METHODS: Using thoracoscopy, parasternal chondrotomies were performed at multiple rib levels at points of maximal sternal protrusion. The sternum was depressed to an appropriate position and maintained using a suprasternal metal compression bar. The bar was applied in a submuscular plane and anchored to the lateral ribs with sutures. Bars were removed after 6 months.
RESULTS: Three patients with severe symmetric pectus carinatum underwent the repair. The first patient returned to the operating room after 1 month for repeat fixation of the bar after suture breakage. No other complications occurred. Operative times were comparable to published series. Patient satisfaction after the repair was good.
CONCLUSIONS: Minimally invasive thoracoscopic repair of symmetric pectus carinatum using chondrotomies and suprasternal bar compression is a feasible alternative to open repair.