Customized Two-Dimensional Computed Tomography-Guided Preoperative Pectus Bar Shaping

Area of Science:

• Thoracic surgery
• Medical imaging
• Biomechanical engineering

Background:

• Minimally invasive repair of pectus excavatum requires precise pectus bar shaping for optimal sternal elevation.
• Current intraoperative bar shaping is time-consuming and risks iatrogenic injury.

Purpose of the Study:

• To present a novel technique for preoperative pectus bar shaping using life-sized computed tomography (CT) printouts.
• To evaluate the efficacy and patient satisfaction with this CT-guided approach for pectus excavatum repair.

Main Methods:

• A life-sized CT printout of the patient's chest wall was used as a template for preoperative pectus bar bending.
• The technique involved using a polymethylmethacrylate block as a scaling marker during CT acquisition.
• Thirty patients underwent minimally invasive repair using the pre-shaped pectus bar.

Main Results:

• All 30 patients achieved satisfactory sternal elevation with a single bar insertion.
• No intraoperative bar revisions were needed.
• Patients reported high satisfaction with aesthetic (4.6/5) and functional (4.4/5) improvements, with an overall satisfaction score of 4.7/5.

Conclusions:

• CT-guided preoperative pectus bar shaping is a straightforward and effective method for correcting pectus excavatum.
• This technique minimizes intraoperative manipulation and improves patient outcomes.
• High levels of aesthetic and functional satisfaction were achieved in all patients.