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What is Pectus Excavatum?

Pectus Excavatum is the most common thoracic deformity (one in 500) characterized by a depression of the sternum in the anterior thoracic wall. The deformity worsens during onset of puberty until about age 18. Patients are usually asymptomatic but can have related cardiovascular dysfunction, thoracolumbar scoliosis, or psychological effects. In these conditions medical evaluation might be provided in order to assess the advantages of surgical repair (non surgical treatments in moderate to severe deformities are documented as ineffective). Although several techniques have been described, after description of the minimally invasive surgical correction in nineteen’s there has been an increase in the number of patients seeking for Nuss repair.


How is pectus excavatum diagnosed and its severity assessed?

Before pectus excavatum can be properly treated, it must first be properly diagnosed and its severity stratified. Your doctor and other specialists, including a pediatric surgeon or thoracic surgeon, will perform a complete physical exam and comprehensive blood tests to confirm the diagnosis. In addition other tests may be performed, including pulmonary function test, chest x-ray, electrocardiogram (EKG) and echocardiogram. Because the morphology of the deformity varies a lot among patients, preoperative CT-scan of the chest for documentation of morphology, dimensions and depression severity (Haller index, depression index) of the chest is also very important.

Correction by Nuss Procedure

Correction of Pectus Excavatum can be performed at any age, but commonly it is recommended during puberty. The Nuss procedure might be performed using a video-assisted thoracoscopic surgery (VATS) technique. Briefly, the procedure consists in the insertion of a curved steel  or titanium bar under the sternum that is used to ‘pop out’ the depression and is then fixed to the ribs on either side. The bar is not visible from the outside and stays in place for a minimum of two years. When it is time, the bar is removed as an outpatient procedure. The success rate of the procedure is over 95%.

What is the innovation of i3DExcavatum System?

Taking advantage of the preoperative CT-scan we can determine the best thoracic plan to insert the bar and more important we can now personalize the size and morphology of the bar more appropriately for each patient. The personalized bars printed by i3DExcavatum System fit perfectly in the patient deformity distributing uniformly the forces necessary to ‘pop up’ the sternum over the ribs. This is likely associated with less discomfort in the immediate post-operative period. The i3DExcavatum System was developed and it is patented by iSurgical3D.

The i3DExcavatum system:
  • Predicts the correct bar size;

  • Models perfectly the bar according to patient morfology (CT scan information);

  • Ensures a smooth bar surface.

The use of personalized prosthesis:
  • Allowed to reduce the surgical and hospitalization times (less postsurgical pain);


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