Initial experience with a 3D printed model for preoperative simulation of the Nuss procedure for pectus excavatum

Abstract

The incidence of pectus excavatum has been estimated to be between 0.1% and 0.8% though a large autopsy series reports. After publication of the Nuss procedure for pectus excavatum, it became widely accepted. However, there are still some complications, such as over-correction and recurrence. To reduce differences in the procedure due to surgeons' experience level, preoperative simulation may be useful. Thus, we performed simulated surgery using a specific patient's three-dimensional (3D) chest wall model made by a 3D printer before operation. A 13-year-old male patient with a severe deformity of the chest underwent the Nuss procedure. As in the simulation, bars were inserted into the 5 and 7 intercostal spaces (ICS), leading to improvement of the chest wall. This simulation can increase surgeons' confidence to improve the deformity by determination of the number and insertion sites of bars.

Assessment and treatment of pectus deformities: a review of reverse engineering and 3D printing techniques

“…The short time, low cost, and extreme accuracy of replicas AM technologies offer are the main advantages that explain the introduction of simulation and planning as a standard for the preparation of some surgeries. Wei et al (2010), Zhao et al (2014), Zhong et al (2014), Matsuo et al (2018), Tse et al (2018), Wang et al (2020), Martinez et al (2021) exploited preoperative simulation to plan the PE correction surgery. In Wei et al (2010), Zhong et al (2014), Tse et al (2018), digital 3D models of the patient-specific anatomies were used to study the optimal geometry of the bar and the aesthetic outcome of the surgery, exploiting also finite element method tools.…”

“…Wei et al (2010) (2018), digital 3D models of the patient-specific anatomies were used to study the optimal geometry of the bar and the aesthetic outcome of the surgery, exploiting also finite element method tools. Matsuo et al (2018), instead, uses 3D printed physical replicas to identify, simulate and evaluate the ideal geometries of the corrective devices. (Carfagni et al, 2019) used a 3D printed model of the sternum to simulate and test a custom surgical guide for PA correction.…”

Modified Nuss operation using introducer-bar complex for pectus excavatum in adults: a retrospective study

“…First attempt to correct PE was performed in 1911 by Ludwig Meyer and Ravitch procedure was subsequent reported since 1949 [ 2 , 3 ]. After that, Nuss procedure (NP) and several technical modifications by the placement of metal bars to lift the depressed chest wall was introduced and considered as popular minimally invasive technique to repair PE [ 2 , 4 , 5 ]. However, some disadvantages with the Nuss procedure was gradually found.…”

Orientation in Perpetuity: An Online Clinical Decision Support System for Surgical Residents

“…Previous investigators have focused on simulation as a means to augment technical skills and enhance operative performance in pediatric surgery. [9][10][11][12][13][14] Parallel technological innovation has been proposed as a tool to combat errors in medical decision-making, 15 with significant advances already made. These include use of computerized order entry to decrease medication errors [16][17][18][19] and standardized "order sets" to reduce mistakes of omission.…”