India offers affordable Pectus Excavatum surgery for patients suffering from the sunken chest disease. In the following video, leading sunken chest surgeon from Delhi explains the nuss procedure using pectoscope.
Following is the video narration.
“This video shows us …wherein stainless steel rod has been taken through the sternum bone and is fit to the crane. It is lifted off and speed is increased and….get adequate space for passing the bar. Again I like to emphasize it is very important because safety is very very important. In this surgery, it is most important. Since we are using minimally invasive technique we don’t want that we make a big sternotomy at the end of the surgery just because we have done complications and this is one potential area… where most of the complications can occur.
So using the crane technique, we avoid any _ injury and most important I would again say, is the heart, and additional… which I’ll be talking about soon is using the pectoscope, which involves additional safety by lessening the bar under direct endoscopic vision. This is a pectoscope which is basically an industrial borescope which is fit through bore, that’s a stainless steel bore at the end of which we place a plastic tubing through which we can see as it is transparent. As we can see this will be place from one end of the chest wall to the other end of the chest wall. And through the whole procedure, we have direct add on vision of where we are going till the time we come on the other side. So absolutely you always sure that you are not puncturing the pericardium.
Even when you are puncturing the pericardium, at least you don’t puncture the heart. This is one thing, so using this track the bars are again placed. This is an external view of that. __ the pectoscope from one end to the other end. This is an add on view, we can see here. This is the lung, that is diaphragm from outside, these are the pericardial fat. Not to rapture the inside of pericardium and cause grievous injury. You can see, we are just above the pericardium, we can see very clear.
Now we can see the other side of the pleura about to puncture the pleura on the other side. Everything is absolutely under vision. Now we have punctured the other side. Now we are seeing the chest bone on the other side, lung and under the illumination of ____. The tube has to come out on the other end and thats…
So once the tunnel is made, through that tunnel we are placing the bar from one end to the other end and this is absolutely a safe technique as the tunnel we made is absolutely under vision. Once it’s done, we rotate the bar and fix it. One more thing before we fix the bar, it is not that once we put the bar, it is the end of it. We can see the morphology, there might be some places where there are more elevations and depressions; the process is repeated not just one time.
Once we place the bar, we have to place it in a desired location or area and it should not be moving …flipping up and down just because you want bone re-modelling desired specification. And that is where we use the claw fixators, these are basically fixators like claw which fix bar to the desired position by hooking to the ribs up and below and we don’t use things like stainless steel wires, which st some places are used, but causes more pain…every thing that goes in, the bar has to come out definitely and at the end of two years and about three years of procedure or 4 years in __, the bar comes out. This is the technique where we remove a bar using the Hercules bar removal technique, getting removed…are using the hand help bar bender..from one end taking out the bar and you can see that the defect has been corrected”
In the video, a leading surgeon from India says he prefers to use pectoscope in pectus excavatum surgery to avoid any kind of heart injury. Patients, who cannot afford this surgery back home, can consider India as an alternative medical destination for affordable treatments.
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