The Vacuum Bell device as a sternal lifter: An immediate effect even with a short time use

Togoro, Silvia Yukari; Tedde, Miguel Lia; Eisinger, Robert S.; Okumura, Erica Mie; Campos, José Ribas Milanez de; Pêgo-Fernandes, Paulo Manuel

doi:10.1016/j.jpedsurg.2017.04.016

Cited by 23 publications

(14 citation statements)

References 23 publications

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“…39 Latest reports confirmed the efficacy of VB therapy in carefully selected patients. [40][41][42][43][44][45] In our largest series including more than 500 patients, 80% of PE patients applied for conservative treatment using the VB, whereas 20% underwent surgical repair. 43 This is in concordance with other larger PE patients series.…”

Section: Treatment Of Pectus Excavatummentioning

confidence: 90%

Nonsurgical Treatment of Chest Wall Deformities: Contradiction or Complement?

Häcker

2018

Eur J Pediatr Surg

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For decades, open surgical repair was the only available method to treat congenital and acquired chest wall deformities (CWDs). In 1998, D. Nuss described a minimally invasive procedure for surgical repair of pectus excavatum (PE), and a few years later H. Abramson reported on his experience with the "reversed Nuss technique" for surgical repair of pectus carinatum (PC). Both procedures are performed with increasing frequency worldwide.However, nonsurgical measures such as vacuum bell (VB) therapy for conservative treatment of PE and more differentiated bracing systems for conservative treatment of PC were established 15 to 20 years ago. Nowadays, information on new therapeutic modalities circulates not only among surgeons and pediatricians, but also rapidly among patients. In particular, patients who refused operative treatment by previously available procedures now appear at the outpatient clinic and request to be considered for the new methods.Analyzing the increasing number of studies reporting on conservative treatment of CWDs as well as our own group of patients who visited a busy outpatient clinic in a small country within the last 15 to 20 years, we have to realize that the majority of patients asked for nonsurgical treatment of their CWD. Based on these experiences and results, we have to realize that nonsurgical treatment of CWD is no contradiction but a helpful complement to treat congenital and acquired CWDs and may be applied for the majority of patients suffering from a CWD.

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Section: Treatment Of Pectus Excavatummentioning

confidence: 90%

Nonsurgical Treatment of Chest Wall Deformities: Contradiction or Complement?

Häcker

2018

Eur J Pediatr Surg

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“…Using vacuum suction to lift the sternum was first described more than a century ago, and its usefulness has been confirmed in the treatment of PE over the last 20 years [1][2][3][4][5][6]. Obviously, one advantage brought by VB therapy compared to surgery is fewer associated risks and less discomfort.…”

Section: Discussionmentioning

confidence: 99%

“…The vacuum bell (VB) has established its role in the treatment of pectus excavatum (PE) in the last 20 years [ 1 – 6 ] as an alternative to surgery it has been extensively reported by Haecker, et al [ 1 – 3 ]. And then its usefulness has been confirmed by other authors [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

A novel three-dimensional printed vacuum bell for pectus excavatum treatment: a preliminary study

Deng

Huang

Luo

et al. 2020

J Cardiothorac Surg

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Objective Conservative treatment with a vacuum bell (VB) for pectus excavatum (PE) has now been gradually popularized as an alternative to surgery. We describe our initial experience with a novel three dimensional (3D) printed VB device. Methods Prospectively collected data of all patients who started using a 3D printed VB in 2018 at our institution were analyzed. Linear and logistic regressions were used to identify factors associated with effectiveness of device usage. Results In total, forty-two patients with a median age of 3.6 years were treated with the device. The median follow-up duration was 11.1 months and the mean initial Depth Ratio (DR) was 0.129. There were no permanent sequelae from side effects. Thirty patients with at least one follow-up body scan data showed varying improvement (z = − 4.569, p = 0.0000). Linear regression suggested that longer usage improved outcomes (R2 = 0.235, p = 0.014). By logistic regression there was a trend of younger ages and less initial DR for better improvement though neither was statistically significant (p = 0.086, 0.078, respectively). Conclusion Our initial experience has shown the 3D printed VB may be as effective as other conventional VBs and could be used as an alternative to surgical treatment for selected patients with PE. More experience and studies with this type of VB are needed to demonstrate its superiority with regard to the 3D printing design and optimal timing and indication for use.

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“…Several techniques have been used to avoid cardiac injury during the Nuss procedure [4][5][6]. Lifting the sternum is the key to releasing the substernal space in which the pectus bar will be inserted and placed.…”

Section: Correspondencementioning

confidence: 99%

Sudden cardiac arrest during Nuss procedure for pectus excavatum

Kim

Jeong

2020

J Cardiothorac Surg

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Cardiac arrest during the Nuss procedure is the most serious complication and is related to cardiac injury by the surgical instruments and pectus bars. To avoid the cardiac injury, there are several techniques with various devices, including crane and wire suture, lifting hook, the Kent or Langenbeck retractor, and the Vacuum Bell device. However, a case of cardiac arrest without direct cardiac injury during the Nuss procedure has been reported in the pectus excavatum patient with coronary-to-pulmonary arterial shunts. Recently, we encountered a case of cardiac arrest without cardiac abnormalities in preoperative studies and cardiac injury during the Nuss procedure.

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The Vacuum Bell device as a sternal lifter: An immediate effect even with a short time use

Cited by 23 publications

References 23 publications

Nonsurgical Treatment of Chest Wall Deformities: Contradiction or Complement?

Nonsurgical Treatment of Chest Wall Deformities: Contradiction or Complement?

A novel three-dimensional printed vacuum bell for pectus excavatum treatment: a preliminary study

Sudden cardiac arrest during Nuss procedure for pectus excavatum

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