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Pectus Excavatum India

Considering nuss procedure for sunken chest disease? Pectus excavatum in India could be an affordable option. The treatment in Indian hospitals is it at par with the west, and is also significantly low-priced as compared to most other countries. Listen to the surgeon in the video who talks about symmetrical and asymmetrical sunken chest deformity surgery in India.

Following is the video narration.

Symmetrical Vs Asymmetrical Pectus Excavatum

“One is symmetrical defect, where you know, defect is simple to repair comparatively. The Defect is located in the centre, so it is called symmetrical defect. Whereas in the other type we have asymmetrical defect, the defect is located not in the centre but away from the breast bone, may be towards the right side or towards the left side. It is not symmetrical as the defect is not in the centre. These are the defects which are more difficult to repair. And …Using the technique which I am…have learnt …it’s more simpler to do asymmetrical techniques of the defect. It involves minimally invasive nuss procedure or modified nuss procedure.”

Nuss Pectus Excavatum India

“We place a steel bar just behind the breast bone- from one side of the chest to the other side. This bar has been bend or controlled before inserting it to the desired shape. Once we pass this bar from one end to the other, it is rotated and what happens to this bar, it straightens out like this.________.and then it pushes the chest wall to the desired control. Within the period of two years to three years, there is remodelling of this one, along with the configuration of the bar which we have designed according to our desired shape. So, this technique is basically …there is a re-modelling of the bone.

It is not excising the bone and letting the bone again grow into shape which you never know in the open technique. But here we have atleast got a control along which the bone is re- modelled.

Same way…in this asymmetrical defect, the bars are inserted according to the desired control…like, this is the usual shape of the bar in case of symmetrical defect. In asymmetrical defect, you might have to design the bar like this also. Because you have to basically elevate those areas of depression and depress your bar into those areas of elevation.

Regarding complications of this surgery, as you can see here, this is the breast bone, behind it is a very important structure- that is the heart. It is very very important that whenever we are into this procedure, we do not injure the heart. Because it is something that will be pumping around about 5 litres of blood and immediately the patient will crush.  That is why there is no second chance regarding this. That is why, the technique we use…we use endoscope.

It is an endoscope through which we put this bar, under vision that we are putting this bar. And since this depression is there, we have a technique where we lift the breast bone up. So that we increase the distance between the heart and breast bone. Because we can see the defect can be so serious that there is hardly any space behind the breast bone, under heart, in between this.
Using this technique of pectoscope and the lifting of sternum bone, we call it sternum lift.

Using the sternum lift and pectoscope, we have almost what I called …avoided and not seen any injuries just like rupturing the heart _like that. It is all basically done under endoscopic vision…because all in the procedure that as we know, is called nuss procedure is a blind procedure.

Though people using thoracoscope, but even in using a thoracoscope, you are basically putting the scope in one side only, but you cannot see what is happening beyond that. You are seeing limited up to here only, but your heart starts basically from beyond the center. So there is always chance of injuring it. But using the pectoscope, we are basically going straight seeing it till the other end.”

In the video, a Delhi surgeon speaks about sunken chest and the difference between symmetrical and asymmetrical nuss procedure. The pectus excavatum surgeons in India are well experienced and the procedure here is safe.
Thousands of sunken chest patients can benefit from low cost pectus excavatum surgery in India.

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