International Society For Minimally Invasive Cardiothoracic Surgery

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Combined Robot-assisted Mitral Valve Plasty And Nuss Procedure Via Small Ports

OBJECTIVE: Pectus excavatum (PE) can be associated with cardiac disorders that also require surgical repair. The present study reports the experience of combined totally endoscopic robot-assisted mitral valve plasty and Nuss procedure.
METHODS: Before treatment of mitral valve regurgitation, their sternum were elevated by our original electrical sternum lifting system to avoid cardiac compression during robotic surgery. Totally-endoscopic robot-assisted mitral valve plasty were performed via small ports. At the end of the cardiac procedure, the anterior mediastinum was opened from thoracic cavity to right thoracic cavity robotically to insert Nuss bar easily. Finally submuscular NUSS procedure was performed successfully via small incision.
RESULTS: Repair of PE was performed by modified Nuss technique after completion of the robot-assisted cardiac procedure, performed via small ports. No patients had bar removal so far, but no PE recurrence, bar displacement, or upper sternal depression was reported.
CONCLUSIONS: Simultaneous robot-assisted cardiac surgery and repair of PE is safe and effective. Sternal elevation during cardiac surgery is very important for safe procedure. The Nuss technique prevents Perioperative cardiac compression and allows for correction of the pectus deformity with good cosmetic and functional results.

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