Pectus Excavatum surgical treatment

SURGICAL TREATMENT
STEP-BY-STEP SURGICAL PROCEDURE
PLATE REMOVAL

Ventura Medical Technologies has developed Pectus Up, a new minimally invasive surgical technique for the reconstructive treatment of Pectus Excavatum.

Pectus Up consists of implantable material and a set of tools used in a very minimally invasive, very low-pain method, which involves a short recovery period and no serious complications.

The procedure is as follows: the Pectus Up implant is placed on top of the sternum, at a subpectoral level, in the area of greatest depression of the chest. Then, through a lifting system, the sternum is raised to the desired position and fixed with the implant.

Pectus Up components

Implantable components
a) Elevator Plate
b) Sternal Plate
c) Interplate fixing screws
d) Fixing screw

Pectus Excavatum step by step surgical procedure

Below we describe, step by step, the surgical technique for the treatment of Pectus Excavatum with the Pectus Up Surgery Kit.

1. Make the incision in the skin: A horizontal incision is made in the area of maximum depth of the Pectus Excavatum. The measurement of the incision would be between 3 and 4 cm.

2. Implant verification: Creation of a subpectoral space big enough to place the implant under it. Verify that the implant fits correctly in the pocket and make a mark is with an electrosurgery unit at the center point of the plate hole to establish the elevation point. The implant is then removed.

3. Insertion of the sternal plate: The plate is placed on the sternum so that its central hole coincides with the mark and it is fixed with fixation screws to the sternum.

4. Insertion of a patella screw: A patella screw is threaded in the central part of the sternal plate that will enable its adjustment to the elevator system. This screw manages to correct the asymmetry as the sternum is pulled.

5. Implant placement: The implant is placed in the subpectoral space, so that its central hole coincides with the point marked with the electrosurgery unit.

6. Insertion of the elevator system: The two components of the elevator system (power screw and power thread) are assembled to allow rotation between them and thus enable the elevation of the sternum. Once assembled, the ball at the bottom of the power screw is inserted into the ball screw.

7. Elevation of the sternum: The power thread is rotated around the power screw until it touches the plate. Here on, gentle rotation is continued using a flat key, allowing a progressive and controlled elevation of the sternum. Each full turn of the thread is the equivalent to 2mm elevation. From the CT measurements, the rotations are already planned.

Plate removal

The implant will be removed between 3 and 5 years after the intervention, although it can remain for longer. If the patient has any discomfort or any type of skin perception at an aesthetic level, he/she can agree with the surgeon to remove it before this period.

If possible, the implant should not be removed before two and a half years.

Plate removal procedure

Supine position, balanced general anesthesia, orotracheal intubation or laryngeal mask.

Incision over old scar; dissection by layers until the Pectus Up is identified; extension of the dissection towards the wings of the implant; removal of screws and other fixing elements; release of the Pectus Up from scar tissue and removal of all the implanted material; layer closure with absorbable material and skin closure with non-absorbable intradermal suture, which will be removed after ten days.

On rare occasions, a chest tube may be considered if the surgeon deems it necessary.

Postoperative care for plate removal

Oral analgesia prescribed with conventional drugs (Ibuprofen or Paracetamol).
Once the implant is removed, the patient can lead a normal social, academic and professional life.

All these recommendations are general and will always depend on the evolution of each patient, being always subject to the criteria of the surgeon who performed the surgical intervention.