Article
Intraoperative Use of the Vacuum Bell for Elevating the Sternum during the Nuss Procedure
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Published: | April 26, 2013 |
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Intrioduction: To evaluate the routine use of the vacuum bell for elevating the sternum during minimally invasive repair of Pectus excavatum (MIRPE, the Nuss procedure).
Material and methods: Retrospective evaluation of a prospective database including all patients who underwent MIRPE at our institution between 2005 and 2010. Data included patient’s demographic characteristics, age at surgery, gender, Haller index, duration of surgery and intraoperative complications.
Results: 50 patients aged from 9 to 28 years (average 14.95 years) were observed, including 39 males and 11 females. The preoperative Haller index was between 3.25 and 7.4 (average 5.05). Mean duration of surgery was 58 minutes (range, 45 to 92 minutes). The use of the vacuum bell led to a clear elevation of the sternum as confirmed by thoracoscopy. Advancement of the Pectus introducer and placement of the pectus bar was safe, successful and uneventful in all patients. No cardial and/or pericardial lesion was noted as well as no lesion of the mammary vessels.
Conclusion: The intraoperative use of the vacuum bell during the MIRPE is safe and effective as it facilitates the retrosternal dissection and the insertion of the pectus bar. If available, we recommend the routine use of this device for MIRPE.