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3D Implant Technique Intervention for Pectus Excavatum at the Tenon Hospital (Paris, France)

Monday, September 27, 2021

Assouad J, Debrosse D, Chavoin J-P. 3D Implant Technique Intervention for Pectus Excavatum in the Tenon Hospital (Paris, France). September 2021. doi:10.25373/ctsnet.16688890

The 3D custom-made implant technique fills the chest hole but does not touch the ribs in the way that orthopedic techniques such as the Nuss technique or Ravitch technique do. The design of each implant is adapted to each patient's anatomy. The intervention is simple, painless, with a rapid recovery and the results are immediate.

The surgery for a funnel chest takes place under general anesthesia, lasts on average 1 hour, and presents minimal risks.

The following breaks down every surgical step in the video :

  • Set up - pre-operative drawing - prototype presentation
  • Pre-sternal vertical line
  • Distance measurement between the top of the sternum and implant apex
  • Outline of the perimeter of the prototype in good position
  • Emergence zone of the perforating vessels
  • Incision area
  • Rectus abdominis muscles
  • Abdominal muscles and fascia
  • Cutaneous and subcutaneous incision
  • Hemostasis of a perforating vascular pedicle
  • Pectoralis major medial section
  • Section of costal insertions and respect of the intercostal muscular plan
  • Horizontal right section of the rectus abdominis fascia
  • Left section
  • Dissection of the rectus abdominis inter-muscular septum
  • Median septum respect
  • Hot serum gauzes for hemostasis
  • Gauzes ablation
  • Hemostasis complement with Electric Knife
  • Hemostasis control throughout the cavity
  • Insertion of the folded soft silicone implant - center line is visible in a good position
  • Caudal pole externalization for median section
  • Insertion straddling the median wall
  • Pectoralis major suture
  • Deep fascia suture
  • Separate subcutaneous stitches
  • Intra-dermal continuous suture
  • Chest belt for thoracic compression with a soft pad
  • Puncture of the sero-hematic collection in the low area


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Is there a limit to the "severity" of the pectus before you use a procedure that actually correct the deformity? If the deformity is purely cosmetic, who pays and what is the implant cost?
Custom implants can fit any kind of Pectus, even very deep or asymmetric ones. But of course if there is an evidence of functional troubles, the implant is not indicated. Depends on the country, the implant can be paid by social security/ hospital/ private insurance or the patient himself.

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