REVIEW ARTICLE
Year : 2017  |  Volume : 11  |  Issue : 3  |  Page : 319-326

Anesthesia for minimally invasive chest wall reconstructive surgeries: Our experience and review of literature


1 Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
2 Department of Anaesthesia and Intensive Care, Dr. Ram Manohar Lohia Hospital and PGIMER, CHS, New Delhi, India

Correspondence Address:
Shagun Bhatia Shah
H. No. 174, 175 Ground Floor, Pocket-17, Sector-24, Rohini, New Delhi - 110 085
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sja.SJA_13_17

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Minimal access procedures have revolutionized the field of surgery and opened newer challenges for the anesthesiologists. Pectus carinatum or pigeon chest is an uncommon chest wall deformity characterized by a protruding breast bone (sternum) and ribs caused by an overgrowth of the costal cartilages. It can cause a multitude of problems, including severe pain from an intercostal neuropathy, respiratory dysfunction, and psychologic issues from the cosmetic disfigurement. Pulmonary function indices, namely, forced expiratory volume over 1 s, forced vital capacity, vital capacity, and total lung capacity are markedly compromised in pectus excavatum. Earlier, open surgical correction in the form of the Ravitch procedure was followed. Currently, in the era of minimally invasive surgery, Nuss technique (pectus bar procedure) is a promising step in chest wall reconstructive surgery for pectus excavatum. Reverse Nuss is a corrective, minimally invasive surgery for pectus carinatum chest deformity. A tailor-made anesthetic technique for this new procedure has been described here based on the authors' personal experience and thorough review of literature based on Medline, Embase, and Scopus databases search.


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