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Sternal Lifting Force Is Reduced After Using Crane Technique During the Nuss Procedure

Sadashige Uemura, Atsushi Yoshida, Mayumi Yamamoto,Hisako Kuyama

Department of Pediatric Surgery, Kawasaki Medical School, Okayama, Japan


Objective: Crane technique has been introduced in many centers to avoid cardiac injury during the Nuss procedure. In addition to the safety of this operation, crane technique has advantageous for relaxing the stiff chest wall. We measured the force of the chest wall lifting before and after this technique and analyzed how much the chest becomes loose with this technique.

Materials and Methods: In 40 patients with pectus excavatum (median age; 17 years old, Male; 32, Female; 8), sternal lifting force is measured before and after the crane technique from Sep. 2014 to July 2015. We used sternal lifting hook and measured the force using digital weight scale at the desired level of the sternal correction.

Results: Average time of the crane technique was 22.2 minutes. During this time, skin incision and mediastinal dissection were completed, and guiding tapes were introduced. Before this technique, average lifting power was 11.0±4.2Kg, and after it was 6.8±2.4Kg.  The lifting force is reduced by 38%. There was no complication regarding this procedure.

Discussion: To achieve safe operation of the Nuss procedure, mediastinal dissection using a thoracoscope and crane technique is very important. In addition, we found in this study that depressed sternum became loose after continuous sternal lifting with crane technique. This result suggests that post-operative pain may be lower due to decreased stiffness of the depressed chest.

Keywords: pectus excavatum, Nuss procedure