JOURNAL OF MEDICAL AND SURGICAL RESEARCH - Vol. IX, n 3, March 2023

Pages: 1184-1188
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The Contribution of 3D Printing in the Minimally Invasive Surgery of Pectus Excavatum:

A Report Case of The First Experience of A Moroccan Center

Author: N. El hajjami, M.Lakranbi, A. Aboutajjedine, M. Tachaouine, B. Alami, M. Maaroufi, Y.Ouadnouni , M. Smahi

Category: JMSR Surgery

Abstract:

Introduction: Pectus excavatum is a congenital deformity of the chest wall, seemingly related to abnormal cartilage growth in the costochondral region. Minimally invasive repair, as described by Donald Nuss, has become the gold standard therapeutic approach. This procedure relies on metallic bars of which the number, length and insertion site are adapted to each patient, following precise radiological data; the results depend heavily on the surgeon’s experience. The authors report a case of the minimally invasive repair of pectus excavatum using 3D printing. Report Case: A 16 years old child, with a 2-year funnel chest deformity and a history of exertional dyspnoea and symptoms of clinical depression presented with an asymmetrical pectus excavatum of the lower sternum and a right sternal rotatory deviation. Spirometry showed a restrictive ventilatory defect. Digital simulation, using images from a computed tomography segmentation of the chest wall, allowed a tailored printing of the bars prototype to the length and shape required to correct the defect. The patient underwent a Nuss procedure using a crossed-bar system, with excellent clinical and esthetical outcomes. Discussion: The use of 3D printing in the Nuss procedure ensures better planning, through an early adjustment of the bars and a preoperative detection of both bar insertion and exit bar sites. 3D printing allowed us to repair the deformity using only two-bars implant. Following the conventional procedure would have required three parallel bars, thus cutting costs in a low-revenue country. Conclusion: The pre-operative 3D conception of the chest wall’s deformity and the bar’s measurements helps simulate and adequately plan the surgical procedure. Therefore, reducing surgical time and creating pedagogical support for surgeons training.

Keywords: Pectus excavatum, chest wall, 3D printing, Morocco

DOI: https://doi.org/10.46327/msrjg.1.000000000000237

DOI URL: https://doi.org/10.46327/msrjg.1.000000000000237

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