A new technique for harvesting costal cartilage with minimum sacrifice at the donor site

With conventional procedures for harvesting costal cartilage, several large, full-thickness cartilage blocks are harvested from the chest wall and are cut, shaped, and joined to create the desired form. Many pieces of unused cartilage are discarded excluding those preserved for future use. Conventional procedures for costal cartilage harvesting are also associated with severe problems such as pain, deformity of the chest wall, and a long scar. We developed a new technique that permits only the necessary size and shape of cartilage to be directly harvested with the use of a chisel. With this technique, both sides and the bottom of the cartilage remain intact at the donor site. The anterior perichondrium can be harvested simultaneously. This technique was performed in 28 patients. The required quantities could be harvested in all patients without severe complications such as perforation of the pleura and excessive bleeding. The procedure required 30 min or less in all patients. The length of the skin incision was less than 3 cm in 25 patients and greater than 3 cm in two obese patients and a young man who had hard subcutaneous connective tissue. Pain intensity was markedly lower than that after conventional techniques. Twenty-six patients could walk 1 day after the operation. There were virtually no deformities of the thorax, even in children younger than 10 years. The structure of the reconstructed site was maintained during at least 2 years follow-up in all patients. Our technique for harvesting costal cartilage is associated with smaller scars, less pain, and less deformity of the chest wall than conventional procedures. In addition, it is minimally invasive and can be performed in a short time.