Chest Wall Resection Prosthesis

Daniel Haberek, University of Rhode Island, BME 281 Sec 1

What is Chest Wall Resection?

A surgery that requires the removal of ribs and possibly the sternum

Depending on the amount of rib cage removed, reconstruction may be required

Prostheses are required in the most severe cases

Who needs Chest Wall Resection?

The most common reasons of resection correlate to cancerous tumors on the ribs/lungs

Other causes include breast cancer and trauma

http://www.sciencedirect.com.uri.idm.oclc.org/science/article/pii/S0003497502035270

Why Chest Wall Resection?

In most cases, the surgery is required in order to retain proper function of the lungs

The ribcage serves to protect the lungs

With trauma, the surgery is required to restore the lost ribs

The Tools

In the past, grafts were popular

Tissue from the body was re-purposed

Now, prostheses are used

These prostheses are designed by use of pre-operative CT scans http://icvts.oxfordjournals.org.uri.idm.oclc.org/content/18/1/145/F1.expansion.html

http://ejcts.oxfordjournals.org.uri.idm.oclc.org/content/48/4/e92/F1.expansion.html

The Surgery

After building the prosthetic, the resection is performed

The prosthetic is then inserted and anchored

Mesh is then used to secure the prosthetic and skin tissue is repositioned http://icvts.oxfordjournals.org.uri.idm.oclc.org/content/18/2/234/F2.expansion.html

Issues

While the procedure has advanced since its 18th century origins, there are still issues

Many patients still experience harmful post-operative side effects

http://www.sciencedirect.com.uri.idm.oclc.org/science/article/pii/S0003497502035270?np=y

The Future

Within three recent cases, patients underwent chest wall resection with good results

All three left the hospital within a week, and experienced no surgery-related postoperative issues

In the most recent case, a 3D printed prosthetic was used, paving the way for how the prostheses can be manufactured in the future

References Reconstruction with a patient-specific titanium implant after a wide anterior chest wall resection. 2013

Oxford Journal. <

http://icvts.oxfordjournals.org.uri.idm.oclc.org/content/18/2/234.full>

Tridimensional titanium-printed custom-made prosthesis for sternocostal reconstruction. 2015 Oxford Journal.

<http://ejcts.oxfordjournals.org.uri.idm.oclc.org/content/48/4/e92.long#ref-4>

Sternal replacement with a custom-made titanium plate after resection of a solitary breast cancer metastasis. 2013 Oxford Journal.

<http://icvts.oxfordjournals.org.uri.idm.oclc.org/content/18/1/145.full>

Chest wall resections and reconstruction: a 25-year experience. 2002 The Annals of Thoracic Surgery. <http://www.sciencedirect.com.uri.idm.oclc.org/science/article/pii/S0003497502035270?np=y>