Next generation Nuss Procedure: Computed-aided bar design

By | January 12, 2019

A recent study published in Applied Sciences outlines and tests a next-generation approach for the design of Nuss bars for patients with Petus excavatum (PE) undergoing the Nuss Procedure.

The current standard of care for the Nuss procedure involves manually shaping the Nuss bars in the operating room to fit the patient’s chest. This is an inexact process and requires estimation and thus, leads to imperfection.

The authors in this new study have proposed a computer-aided design and computed-aided manufacturing approach for Nuss bars that takes the uncertainty and estimation out of the equation. Under this new model, a three-dimensional chest wall model can be generated using computed tomography (CT) scans taken before the time of surgery. The computer then assists with designing the appropriate shape and dimensions of the Nuss bar(s) for each individual patient. This design model can then go directly to the manufacturing plant to obtain a patient-specific Nuss bar.

Under this model, the authors demonstrated feasibility of the approach by validating and confirming the accuracy of the entire process. Specifically, the error in the manufacturing process was no more than 5%.

In the future, it will be important to compare clinical outcomes after surgery between people undergoing conventional Nuss procedure and undergoing Nuss procedure using bars that were developed through this process.

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