Nuss Procedure for Pectus Excavatum – An early Experience

Puri, Bipin; Kaul, SK; Harjai, MM

doi:10.1016/s0377-1237(03)80144-2

Cited by 4 publications

(3 citation statements)

References 3 publications

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“…Then the centerline is projected to the costal surface fitted by the ribs and cartilages using thin plate spline [15]. The correction device is estimated based on the projected centerline with the typical pectus bar size of 1.5cm width and 2 mm thickness [16]. The estimated correction device is personalized to PE patient's costal curvature instead of their skin profile, which is more precise and accurate especially for female patients.…”

Section: Correction and Estimation Of Correction Device Del Buildingmentioning

confidence: 99%

Chest Modeling and Personalized Surgical Planning for Pectus Excavatum

Zhao

Safdar

Duan

et al. 2014

Medical Image Computing and Computer-Assisted Intervention – MICCAI 2014

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Abstract. Pectus excavatum is among the most common major congenital anomalies of the chest wall whose correction can be performed via minimally invasive Nuss technique that places a pectus bar to elevate the sternum anteriorly. However, the size and bending of the pectus bar are manually modeled intraoperatively by trial-and-error. The procedure requires intense pain management in the months following surgery. In response, we are developing a novel distraction device for incremental and personalized PE correction with minimal risk and pain, akin to orthodontic treatment using dental braces. To design the device, we propose in this study a personalized surgical planning framework for PE correction from clinical noncontrast CT. First, we segment the ribs and sternum via kernel graph cuts. Then costal cartilages, which have very low contrast in noncontrast CT, are modeled as 3D anatomical curves using the cosine series representation and estimated using a statistical shape model. The size and shape of the correction device are estimated through model fitting. Finally, the corrected/post-surgical chest is simulated in relation to the estimated shape of correction device. The root mean square mesh distance between the estimated cartilages and ground truth on 30 noncontrast CT scans was 1.28±0.81 mm. Our method found that the average deformation of the sterna and cartilages with the simulation of PE correction was 49.71±10.11 mm.

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Section: Correction and Estimation Of Correction Device Del Buildingmentioning

confidence: 99%

Chest Modeling and Personalized Surgical Planning for Pectus Excavatum

Zhao

Safdar

Duan

et al. 2014

Medical Image Computing and Computer-Assisted Intervention – MICCAI 2014

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“…We have been performing a rather modified version of the Nuss procedure for pectus excavatum in India since 2012 using video-endoscope, pectus tunneloscopy along with various fixation devices and our described sutureless moon bridge system for a stable bar [2,3]. A few reports on Nuss procedure for pectus excavatum from India can be traced back to Puri et al who reported 2 cases in pediatric age group in 2003 [4]. In view of the relatively normal cardio-respiratory function, the main concern in people with this deformity is about a good cosmetic correction, which will enable them to do outdoor activities, as well as alleviate their psychological problems and thus improve the quality of their life.…”

Section: Introductionmentioning

confidence: 99%

Single-centre Indian case series using X or cross bar for Nuss procedure in pectus excavatum

Darlong

2020

Indian J Thorac Cardiovasc Surg

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The modified Nuss procedure using two bars lying parallel or non-intersecting is use to correct pectus excavatum with varying degrees of patient satisfaction. This bar placement has its limitation for certain pectus excavatum morphology where the deformity is deep and focal or located below the subxiphoid. We have altered our bar placement so that bars intersects in an X or cross manner for such pectus morphology. We describe the X or cross bar placement and its specific indications based on morphology in a series of five patients from February 2019 until December 2019 with symmetrical focal deformity along the xiphisternum and asymmetric deformity below the xiphoid. The operating time varied from 90 to 120 min. There was no significant postoperative morbidity. They are on follow-up with period ranging from 4 to 15 months from the day of surgery. Early results show the X or cross bar Nuss procedure can be safely performed to achieve a desired long-term morphological correction of symmetric deep focal xiphisternal defects or asymmetric deformity below the xiphoid. Keywords X bar . Cross bar . Nuss procedure . Pectus excavatum * Laleng Mawia Darlong

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“…Prevalence and etiology of chest wall deformities, among the Indian population still remain unexplained and only scanty literature was retrieved on extensive search from [7] the journal web , probably pointing towards the lack of objective documentation about the deformity. Pectus that correction is necessary .…”

Section: Introductionmentioning

confidence: 99%

New Radiological Index for Evaluation of Pectus Deformities in Indian Population

Joshua¹,

Shetty

Pare

et al. 2016

Journal of Health and Allied Sciences NU

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Aim: To evaluate the effectiveness of new radiological index for the diagnosis of pectus deformities in Indian population using computed tomography (CT) imaging. Materials and methods: 60 subjects with mild to moderate pectus deformities and 100 controls with age group from 1 to 40 years were evaluated for the study. Non contrast CT images with sagittal, axial sections and 3D reconstructed images were utilized for the measurement of manubriosternal joint (MSJT) angulation as well as sterno-vertebral (SV) distance and transverse diameter (A) of chest. Results: In controls manubriosternal joint showed mean value of 166.6±5.27, in pectus carinatum (PC) MSJT measured about 170±5.2 and in pectus excavatum (PE) MSJT had a value of 157.6±14.57and internal thoracic dimensions like sterno-vertebral distance measured about mean of 91.3±18.12 in controls, 80.24±14.57 in PE and 99.13±15.6 in PC and transverse diameter with a mean of 208.72±33.9in controls, 223.14±28.92 in PE and 192.2±40.96 in PC. Conclusion: Inclusion of MSJT angulation as radiological index alongside of internationally accepted indices like sterno-vertebral distance and transverse diameter of chest would ensure comprehensive assessment of chest wall deformation and help in better understanding of sternal displacement during pectus deformities.

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Nuss Procedure for Pectus Excavatum – An early Experience

Cited by 4 publications

References 3 publications

Chest Modeling and Personalized Surgical Planning for Pectus Excavatum

Chest Modeling and Personalized Surgical Planning for Pectus Excavatum

Single-centre Indian case series using X or cross bar for Nuss procedure in pectus excavatum

New Radiological Index for Evaluation of Pectus Deformities in Indian Population

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