Extrapleural, submuscular bars placed by bilateral thoracoscopy--a new improvement in modified Nuss funnel chest repair.

Background: Thoracoscopic Nuss funnel chest repair still has a significant complication rate. Bar dislocation, pneumothorax, pleural effusions, and pericarditis seem to be caused mechanical irritation by the bar. We intended to reduce these problems by further technical modification of the Nuss technique.

Thoracoscopic aortopericardiosternopexy for severe tracheomalacia in toddlers.

Background/purpose: Aortosternopexy from a left anterolateral thoracotomy is the procedure of choice in severe tracheomalacia. The authors report an alternative technique of modified thoracoscopic aortopericardiosternopexy.

Methods: Thoracoscopy under mild CO2 insufflation (insufflation pressures 4 to 6 mm Hg) provides excellent access without selective intubation.

Submuscular bar, multiple pericostal bar fixation, bilateral thoracoscopy: A modified Nuss repair in adolescents.

Background/purpose: Thoracoscopic Nuss repair of funnel chests is used increasingly, but has a high bar dislocation rate. The authors intended to reduce this by technical modifications of the original Nuss technique.

Methods: In 40 patients from 12.

Ultrasonic shear coagulation of main hilar vessels: A 4-year experience of 23 pediatric laparoscopic splenectomies without staples.

Background: Ultrasonic shears (LCS) are used increasingly for laparoscopic splenectomy. So far however, all investigators use vascular staplers or clips for section of the main splenic artery and vein.

Methods: After several trials the authors started to use the ultrasonic triple welding technique in open surgery to occlude major vessels of 5 to 8 mm by 10-mm LCS.