TY - JOUR
T1 - A Simple technique for removing the nuss bar with one stabilizer
T2 - The lateral approach
AU - Varela, Patricio
AU - Romanini, Moria Victoria
AU - Asquasciati, Caterina
AU - Torre, Michele
PY - 2010/1/1
Y1 - 2010/1/1
N2 - The removal of the substernal bar after the Nuss operation is not always an easy and fast maneuver. Only a few different technical solutions have been described. In the original Nuss technique, the patient was lying on dorsal decubitus and rotated on the side during the procedure. The Noguchi technique avoids the rotation of the patient, but requires two incisions and straightening of the bar before pulling it out the thorax. Recently, another technique was proposed, avoiding the need of straightening the bar, but it is feasible only if two operative beds in a large operative room are available. We propose another approach for the removal of the bar: The patient is lying on the lateral decubitus, only one incision is performed, and the bar is pulled out along the thoracic wall. Twenty-one bars were removed by using the present approach without any complications. The advantages of our approach on the previous techniques are the single incision, no need of rotating the patient, straightening the bar, or having two operative beds. Our approach is not feasible when metallic stabilizers have been used on both sides, but in our experience, this was not necessary in order to stabilize the bar.
AB - The removal of the substernal bar after the Nuss operation is not always an easy and fast maneuver. Only a few different technical solutions have been described. In the original Nuss technique, the patient was lying on dorsal decubitus and rotated on the side during the procedure. The Noguchi technique avoids the rotation of the patient, but requires two incisions and straightening of the bar before pulling it out the thorax. Recently, another technique was proposed, avoiding the need of straightening the bar, but it is feasible only if two operative beds in a large operative room are available. We propose another approach for the removal of the bar: The patient is lying on the lateral decubitus, only one incision is performed, and the bar is pulled out along the thoracic wall. Twenty-one bars were removed by using the present approach without any complications. The advantages of our approach on the previous techniques are the single incision, no need of rotating the patient, straightening the bar, or having two operative beds. Our approach is not feasible when metallic stabilizers have been used on both sides, but in our experience, this was not necessary in order to stabilize the bar.
UR - http://www.scopus.com/inward/record.url?scp=76149134080&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=76149134080&partnerID=8YFLogxK
U2 - 10.1089/lap.2008.0351
DO - 10.1089/lap.2008.0351
M3 - Article
C2 - 19432531
AN - SCOPUS:76149134080
VL - 20
SP - 91
EP - 93
JO - Journal of Laparoendoscopic and Advanced Surgical Techniques - Part A
JF - Journal of Laparoendoscopic and Advanced Surgical Techniques - Part A
SN - 1092-6429
IS - 1
ER -