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TitleAutomatic prebent customized prosthesis for pectus excavatum minimally invasive surgery correction
Author(s)Vilaça, João L.
Rodrigues, Pedro L.
Soares, Tony Ramos
Fonseca, Jaime C.
Pinho, António C. M.
Coelho, Tiago Henriques
Correia-Pinto, Jorge
Cohort Studies
Funnel Chest
Minimally Invasive Surgical Procedures
Prostheses and Implants
Prosthesis Design
Prosthesis Implantation
Radiography, Thoracic
Surveys and Questionnaires
Young Adult
Pectus excavatum
Biomedical engineering
Pediatric surgery
Personalized prosthesis
Issue dateJun-2014
PublisherSAGE Publications
JournalSurgical Innovation
Abstract(s)Pectus excavatum is the most common deformity of the thorax. A minimally invasive surgical correction is commonly carried out to remodel the anterior chest wall by using an intrathoracic convex prosthesis in the substernal position. The process of prosthesis modeling and bending still remains an area of improvement. The authors developed a new system, i3DExcavatum, which can automatically model and bend the bar preoperatively based on a thoracic CT scan. This article presents a comparison between automatic and manual bending. The i3DExcavatum was used to personalize prostheses for 41 patients who underwent pectus excavatum surgical correction between 2007 and 2012. Regarding the anatomical variations, the soft-tissue thicknesses external to the ribs show that both symmetric and asymmetric patients always have asymmetric variations, by comparing the patients' sides. It highlighted that the prosthesis bar should be modeled according to each patient's rib positions and dimensions. The average differences between the skin and costal line curvature lengths were 84 ± 4 mm and 96 ± 11 mm, for male and female patients, respectively. On the other hand, the i3DExcavatum ensured a smooth curvature of the surgical prosthesis and was capable of predicting and simulating a virtual shape and size of the bar for asymmetric and symmetric patients. In conclusion, the i3DExcavatum allows preoperative personalization according to the thoracic morphology of each patient. It reduces surgery time and minimizes the margin error introduced by the manually bent bar, which only uses a template that copies the chest wall curvature.
AccessRestricted access (Author)
Appears in Collections:ICVS - Artigos em Revistas Internacionais com Referee

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