The Nuss procedure made safer: an effective and simple sternal elevation manoeuvre

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorTEDDE, Miguel L.
dc.contributor.authorCAMPOS, Jose Ribas Milanez de
dc.contributor.authorWIHLM, Jean-Marie
dc.contributor.authorJATENE, Fabio Biscegle
dc.date.accessioned2013-07-30T14:34:40Z
dc.date.available2013-07-30T14:34:40Z
dc.date.issued2012
dc.description.abstractThe Nuss procedure requires the creation of a substernal tunnel for bar positioning. This is a manoeuvre that can be dangerous, and cardiac perforation has occurred in a few cases. Our purpose was to describe two technical modifications that enable the prevention of these fatal complications. A series of 25 patients with pectus excavatum were treated with a modification of the Nuss procedure that included the entrance in the left haemithorax first, and the use of the retractor to lift the sternum, with the consequent lowering displacement of the heart. These modified techniques have certain advantages: (i) the narrow anterior mediastinum between the sternum and the pericardial sac is expanded by pulling up the sternum; (ii) the thoracoscopic visualization of the tip of the introducer during tunnel creation is improved; (iii) the rubbing of the introducer against the pericardium is minimized; (iv) the exit path of the introducer can be guided by the surgeon's finger and (v) haemostasis and integrity of the pericardial sac can be more easily confirmed. We observed that with these manoeuvres, the risk of pericardial sac and cardiac injury can be markedly reduced.
dc.description.indexMEDLINE
dc.identifier.citationEUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, v.42, n.5, p.890-891, 2012
dc.identifier.doi10.1093/ejcts/ezs442
dc.identifier.issn1010-7940
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/133
dc.language.isoeng
dc.publisherOXFORD UNIV PRESS INC
dc.relation.ispartofEuropean Journal of Cardio-Thoracic Surgery
dc.rightsrestrictedAccess
dc.rights.holderCopyright OXFORD UNIV PRESS INC
dc.subjectFunnel chest
dc.subjectHeart injuries
dc.subjectMinimally invasive surgical procedures
dc.subject.otherpectus-excavatum
dc.subject.othercardiac perforation
dc.subject.otherbar
dc.subject.wosCardiac & Cardiovascular Systems
dc.subject.wosRespiratory System
dc.subject.wosSurgery
dc.titleThe Nuss procedure made safer: an effective and simple sternal elevation manoeuvre
dc.typearticle
dc.type.categoryoriginal article
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.author.externalWIHLM, Jean-Marie:Univ Sao Paulo, Sch Med, Clin Hosp, Dept Thorac Surg,Heart Inst InCor, Sao Paulo, Brazil
hcfmusp.citation.scopus41
hcfmusp.contributor.author-fmusphcMIGUEL LIA TEDDE
hcfmusp.contributor.author-fmusphcJOSE RIBAS MILANEZ DE CAMPOS
hcfmusp.contributor.author-fmusphcFABIO BISCEGLI JATENE
hcfmusp.description.beginpage890
hcfmusp.description.endpage891
hcfmusp.description.issue5
hcfmusp.description.volume42
hcfmusp.lim.ref2012
hcfmusp.origemWOS
hcfmusp.origem.pubmed22833539
hcfmusp.origem.scopus2-s2.0-84873185382
hcfmusp.origem.wosWOS:000310152600045
hcfmusp.publisher.cityCARY
hcfmusp.publisher.countryUSA
hcfmusp.relation.referenceGips H, 2008, PEDIATR SURG INT, V24, P617, DOI 10.1007/s00383-007-2097-1
hcfmusp.relation.referenceOhno K, 2009, J PEDIATR SURG, V44, P2426, DOI 10.1016/j.jpedsurg.2009.09.006
hcfmusp.relation.referencePark HJ, 2010, J THORAC CARDIOV SUR, V139, P379, DOI 10.1016/j.jtcvs.2009.09.003
hcfmusp.relation.referenceSchier F, 2005, J PEDIATR SURG, V40, P496, DOI 10.1016/j.jpedsurg.2004.11.033
hcfmusp.relation.referenceTedde ML, 2011, CLINICS, V66, P1743, DOI 10.1590/S1807-59322011001000012
hcfmusp.scopus.lastupdate2024-05-10
relation.isAuthorOfPublication5c144846-6eca-491c-81ab-6bd75589e39f
relation.isAuthorOfPublicationeed46d4d-04c8-439f-993b-8daacba7c5cc
relation.isAuthorOfPublication8af24ebc-578b-4192-8ea4-643cb9cd2377
relation.isAuthorOfPublication.latestForDiscovery5c144846-6eca-491c-81ab-6bd75589e39f
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