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PECTUS UP SURGERY KIT

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Pectus Excavatum Most frequent deformation of the chest wall in childhood and adolescence, adopting a funnel chest shape (1 in 400-500 births, more common in males). Due the complexity of the intervention*, currently only 25% of cases are operated on, which carry health problems,) Disorder caused by a deficiency in the growth of the costal cartilages. As age advances and the chest grows, the cartilages pull the sternum inside and the sinking of the chest is more pronounced. Breathing problems (severe restriction of pulmonary ventilation), heart (shortfall in the filling

• f blood into the right chambers of the heart), spine (scoliosis), psychological disorders.

The treatment is surgical correction. Haller Index Index to measure the severity of the malformation. It is calculated by dividing the distance between the sternum and the spine. With current surgical techniques only cases with a rate >3.5 Haller are operated on because it involves a serious functional disorder. There are extremes cases in which the rate is above 10.

*Due to the complexity, risk and type of surgery, neither mild cases nor for esthetic reasons are

• perated on.

INTRODUCTION Pectus Excavatum

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THECNIQUE DESCRIPTION ADVANTAGES DISADVANTAGES RAVITCH

• Invasive technique.
• This procedure is to remove cartilage,

connecting the ribs to the sternum and introducing a bar in the rear of the sternum.

• Correction of the malformation
• Tested method
• Documented Results
• Surgery at any age
• Very Invasive
• Rigid chest
• Significant surgical trauma: blood loss
• Painful procedure
• Leaves considerable scars on the patient's chest
• Many hours of surgery
• Long-term hospital stays
• Requires long stays in intensive care

NUSS

• Less invasive technique than Ravich.
• This

procedure involves an introduction of a steel concave bar under the breastbone and during the surgery proceeds to rotate the bar. It can be removed after several years.

• Correction of the malformation
• Less invasive
• Minimal blood loss
• Much shorter recovery time
• Small lateral incisions
• Risk of perforation of the heart or other internal
• rgans with the introduction and removal of the bar.
• Risk of Pneumo-hemothorax.
• Requires intensive care
• Long hospital stays
• Medication and postoperative analgesia

COMPARATIVE Current techniques

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TECHNIQUE DESCRIPTION ADVANTAGES DISADVANTAGES TAULINOPLASTIA Minimally invasive technique. Involves raising the sternum applying a pulling force on it, but without going into the ribcage, avoiding possible complications

• Minimally invasive.
• New innovative device: extrathoracic procedure.
• Minimal blood loss.
• Very short recovery.
• No risk of damaging intrathoracic organs.
• Shorter duration of surgery.
• Shorter average length of stay.
• Minimal incisions.
• Postoperative period in intermediate care.
• The device could be maintained in perpetuity.
• New innovative device: few cases made yet.

COMPARATIVE Taulinoplastia

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BENEFITS Pectus Up

INTERVENTION Less anesthesia Shorter time operating room Shorter hospital stays Minor pain medication Less blood loss No UCI is required No use of the thoracoscope No serious surgical or postoperative complications No mortality PROFESSIONAL / THE HOSPITAL Easy of implementation Less risk Minimally invasive Less anesthesia Lower costs PATIENT Less dangerous Fewer hospital stays Less medication Less pain

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DESCRIPTION Surgical technique of Pectus Up

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THORAX MODEL Sternum Cartilage Ribs

• 1. Intervention area
• 2. Incisions to perform during the intervention
• 3. Drilling of the sternum
• 4. Subcutaneous introduction of the plate
• 5. Placement of the lifting system
• 6. Extraction of the screw
• 7. Fixing of the plate
• 8. Final result of the operation