Current Thoracic Surgery
2019 , Vol 4 , Issue 3
Novel surgical integration technique in Ravitch procedure using an atraumatic O-ring wound retractor: case report
1Department of Thoracic Surgery, Organismo público descentralizado de hospitales civiles de Guadalajara, Hospital Civil Fray Antonio Alcalde, Guadalajara, Jalisco, México
DOI :
10.26663/cts.2019.00130
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Modified Ravitch procedure is the hallmark surgical procedure to repair pectus deformities, manual and
auto self-retaining metal retractors are very helpful because they grant and maintain the surgical site
exposure. However, these metal retractors often have sharp tips that are capable of causing soft tissue
flaps damage. In abdominal surgery, using an atraumatic O-ring wound retractor has been associated
with diminution of superficial surgical site complications and post-operative pain reduction due, these
suggested benefits can be reproducible in modified Ravitch procedure. A 20-year-old male patient is
referred to our service for presenting chest discomfort and body image issues. Subsequent work up
revealed a pectus carinatum without associated congenital heart disease. A transverse infra-mammary
skin 8 cm incision was made. We used an atraumatic O-ring wound retractor to expose surgical site
and performed bilateral subperichondrial abnormal costal cartilages resection with sternum wedge
osteotomy. Drains was removed in 24 hours, and the post-surgical hospital stay was 72 hours. In this
case, using an atraumatic O-ring wound retractor improved exposure with shorter incision, facilitated
stable access to the costal cartilage, protecting the skin from injury, and reduced the administration of
intravenous analgesics.
Keywords :
modified Ravitch procedure, pectus, auto self-retractor, atraumatic O-ring wound retractor, surgical retractor