FACTS ABOUT PECTUS DEFORMITIES

Does it return after successful vacuum treatment?

When vacuum treatment is successful, the risk of the deformity returning is low. However, it is important that patients adhere to the treatment program by following the doctor's advice and going for regular check-ups.

PECTUS WORKSHOP IN SEOUL

2012 Pectus Symposium & Live Surgery Workshop was held in Seoul, Korea on April 9, 2012. The Meeting was a great success with the participation of more than 50 Korean surgeons and 4 international guests (1 Japanese and 3 Chinese surgeons). The participants agreed on the foundation of the Chinese Pectus Group, and finally, the "Korea-Japan-China Pectus Surgeons Association.These efforts can be considered as the preliminary preperations of the next year's CWIG-Asia meeting in Seoul.

EACTS WINDSOR NOVEMBER 2012 REPORT

EACTS ACADEMY

SPECIALIST COURSES

CHEST WALL DISEASES

28 – 30 November 2012 – Windsor, United Kingdom

Dear Colleagues,

The Chest Wall Diseases Course of the EACTS Academy was held successfully on November the 28-30th, 2012 at the EACTS House in Windsor, United Kingdom.

Fifteen invited faculty from 10 countries, all experts in the field of chest wall diseases, presented their work and shared their experience with the 17 participants from 8 countries. Nine sessions were held in 3 days, including 5 sessions for congenital chest wall deformities, 1 session for thoracic outlet syndrome, 1 session for chest wall resection – reconstruction and trauma, 1 session for sternal dehiscence, and 1 session for various challencing case (video) presentations.

The first day of the course that was spared for the treatment of pectus excavatum (PE), started with the introduction speech of Professor Mustafa Yuksel, who was also the coordinator of the course. The first session was chaired by Professor Jean-Marie Whilm and Dr. Yuksel. As the first speaker of the session, Dr. Whilm presented the historical aspects on the surgery of PE, followed by Professor Hans Pilegaard presenting the thoracic surgeon’s aspect on minimally invasive repair of PE (MIRPE). Following him, Asc. Professor Michael Goretsky gave his speech on the pediatric surgeon’s aspect on MIRPE. Afterwards, Doctor Vladimir Kuzmichev spoke about the math-modelling of MIRPE, as the last speaker of the session.

Following the coffee break, the second session which was chaired by Professor Jose Ribas Milanez de Campos and Professor Pilegaard, started with the speech of Dr. Kuzmichev on the alternative techniques of MIRPE (without stabilizers). Dr. Goretsky gave the next two speeches, first one on the surgical treatment in asymmetrical PE, then on the pain control in MIRPE (epidural or intravenous?). The last speaker of the session was Dr. Milanez de Campos, and he gave a lecture on when and how to remove the bars in MIRPE.

After the lunch, the last session of the day, chaired by Dr. Goretsky and Dr. Pilegaard, started. Dr. Pilegaard gave a speech on the unexpected situations in MIRPE, followed by Dr. Wihlm, presenting his surgical technique for the patients with flaring ribs. As the third speaker of the session Dr. Goretsky shared his experience on Vacuum Bell assisted MIRPE. He was followed by Dr. Milanez de Campos who shared his experience with a cardiac perforation during MIRPE. The last speaker of the day was Dr. Kuzmichev who presented a case who had had a cardiac arrest during MIRPE.

In the evening, a dinner for the invited faculty and the participants was held at The Green Olive Restaurant. Everyone enjoyed the Greek Cypriot Mezes in a cosy atmosphere.

The second day of the course started with the session on treatment of pectus carinatum (PC) which was chaired by Dr. Goretsky and Ass. Professor Korkut Bostanci. The first speaker of the session was Dr. Yuksel presenting his own technique on the minimally invasive repair of PC (MIRPC). Following him Dr. Wihlm shared his experience on the surgical treatment in pectus arcuatum (PA) using Stratos. The next speaker was Dr. Bostanci giving a speech on the surgical treatment in PA (using resorbable co-polymer). Dr. Pilegaard then gave a lecture on various techniques in the correction of PC. The last speaker of the session was Dr. Goretsky, sharing his experience on the brace therapy in PC.

Following the coffee break, the second session which was chaired by Dr. Pilegaard and Dr. Wihlm started with the speech of Dr. Goretsky on the scoliosis and pectus deformities (which one to treat first?). Dr. Pilegaard then gave a lecture on the combined surgical interventions with MIRPE. The next speaker was Dr. Wihlm and he shared his experience with the Poland syndrome management, followed by Dr. Yüksel sharing his experience with the Jeune syndrome management. The last speaker of the session was Dr. Milanez de Campos, and he gave a speech on the sternal cleft and Cantrell pentalogy management. Following him Dr. Yuksel also shared his experience on a sternal cleft case.

The lunch break was followed by the last session of the second day on the treatment of thoracic outlet syndrome (TOS), chaired by Dr. Milanez de Campos. The first speaker was Doctor Gregor Kocher giving a speech on the supraclavicular approach in TOS. He was followed by Professor Mario Claudio Ghefter, giving two lectures in a row, the first one on the Brazilian experience in TOS and the second one on his personal experience in the minimally invasive surgery in TOS. Following him Dr. Yuksel presented two videos on the bar removal in MIRPE as the last speaker of the day.

In the evening, a dinner for the invited faculty and the participants was held at La Taverna Restaurant. Everyone enjoyed the Italian food and wine.

The last day of the workshop started with a session on the chest wall resection and reconstruction, chaired by Professor Claude Deschamp and Dr. Wihlm. Dr. Deschamp presented his experience on which prosthesis to use and when for the chest wall reconstruction. Following him Dr. Wihlm gave his speech on the chest wall reconstruction using Stratos. As the last speaker of the session Professor Federico Rea presented his experience on the sternal reconstruction with cadaveric sternum.

Following the coffee break the second session of the day, on sternal dehiscence, started with the presentation of Doctor Maria Pia Tocco. She shared her experience on vacuum assisted closure (VAC) in sternal dehisecence with the participants. Following her Dr. Yuksel gave a speech on surgical treatment using Stratos. Professor Ralph Schmid then shared his experience on surgical treatment using MatrixRib, both for cancer and trauma patients. The last speaker of the session was Doctor Matthias Müller and he shared his own experience on surgical treatment using Talon.

After the lunch break the last session of the course, chaired by Doctor Kalliopi Athanassiadi and Dr. Deschamp, started. Dr. Deschamps gave a speech on MIRPE in adults. He was followed by Dr. Schmid, Dr. Tocco, Dr. Wihlm, Dr. Athanassiadi, Dr, Rea and Dr Yuksel presenting various challenging cases. These cases with chest wall diseases were discussed by all the invited faculty and the participants.

Following the last presentations, the three-day course which had been held in high academic level and included complex academic debates, had succeeded to an end. Dr. Yuksel, the coordinator, gave a closing speech, summarizing the course and thanking the invited faculty, the participants. He also thanked EACTS, and especially Louise McLeod and Kathy McGree for their flawless organisation.

EACTS WINDSOR JUNE 2012 REPORT

CWIG - EACTS

IV. INTERNATIONAL CHEST WALL INTEREST GROUP

WORKSHOP ON CHEST WALL DISEASES

22 – 23 June 2012 – ISTANBUL, TURKEY

Dear Colleagues,

The Fourth International Chest Wall Interest Group Workshop on Chest Wall Diseases was held successfully on June 22-23th, 2012 at the Marmara University Pendik Hospital, Istanbul, Turkey.

The workshop was organized by the cooperation of the Departments of Thoracic Surgery of Marmara University and Dokuz Eylül University Medical Faculties together with the EACTS, Turkish Society of Thoracic Surgery and Sociedade Brasileira de Cirurgia Toracica.

Congenital and acquired chest wall diseases such as pectus deformities, chest wall tumors and sternal dehiscense were discussed and debated on the basis diagnosis and treatment, by the registration and participation of 180 academicians. The fourty of 75 attended from the USA, Latin America, Africa, Far East and various countries in Europe.

In the first day of the workshop four cases with pectus excavatum deformity was operated and the operations were watched live from the conference hall simultaneously

The workshop started on Thursday morning on 24th June 2010, by MIRPE operations that the participants were able to watch the operation room live from the conference hall by the tele-conference system momentously at the session which was chaired by Dr. MustafaYuksel and Dr. Jose Ribas Milanez de Campos. Four patients with pectus excavatum deformity were operated on by Dr. Hans Pilegaard, assisted by Dr. Korkut Bostanci.

The operations were completed successfully which had been interactively contributed by the participants as well. The lunch was at the Rosemary Reastaurant where everyone enjoyed the Mediterranean tastes and the Aegean view.

In the second day Dr.Robiscek gave a speech on the history of pectus correction surgery

In the second day, in the first session that Dr. H.J. Park chaired, the pioneer of the thoracic surgery, Dr. Francis Robicsek gave a speech on the history of pectus correction surgery. Subsequently, a debate on open versus closed repair of pectus deformities was carried on by Dr. Robicsek and Dr. Hans Pilegaard, who had the largest MIRPE series in Europe. As expected Dr. Robicsek defended the open surgery while Dr. Pilegaard defended MIRPE, both gaining support from the floor.

Dr. Robiscek, Dr. Wihlm, Dr. Pilegaard and Dr. Park

The next session, where the chairmen were Dr. Pilegaard and Dr. Kalliopi Athanassiadi, started with the speech of Dr. Vladimir Kuzmichev. He spoke about his experiece on correction of pectus excavatum without stabilizers. Following him Dr. Pilegaard presented his MIRPE experience on old adults. The last speaker of the session was Dr. Park and he gave a lecture on the morphology and age tailored approach which attracted great attention.

Dr. Athanassiadi and Dr. Pilegaard

In the afternoon the first session was chaired by Dr. Ralph Schmid and Dr. De Campos. Dr. W. Coosemans lectured on the evolution of pectus surgery from open to minimally invasive surgery, as the first speaker of the session. Following him Dr. Jean-Marie Wihlm gave an inspiring speech on failures and Nuss to Ravitch or Ravitch to Nuss conversions. The last speaker of the session was Dr. Athanassiadi and she answered on her speech, the question weather we always need a reconstruction after a chest wall trauma.

Invitied faculty of the workshop

The next session was chaired by Dr. Kuzmichev and Dr. Onur Genç. Dr. Ahmet Önen gave the first lecture on the evolution of MIRPE. Following him Dr. Yüksel shared his experience with the participants on how to reduce the morbidity in MIRPE. The last speaker of the session was Dr. Kamil Kaynak and he lectured on the pain management in MIRPE.

The last session where Dr. Nezih Özdemir and Dr. Robicsek were the chairmen, started with the speech of Dr. Mehmet Bilgin on the preoperative evaluation in MIRPE. Following him Dr. Kuzmichev answered on his speech, the question weather we still need the Haller index for decision making in MIRPE. The last speaker of the day was Dr. Genç and he gave a lecture on the postoperative complications after Ravitch operation.

The participants departed from the Dokuz Eylül University Conference Hall for the Gala Dinner that was going to be held the same evening. In the gala dinner which was conceived in the concept of ''A view of the Izmir Gulf from above” held at the Kosebasi Restaurant, the guests assessed the whole evening while having their drinks, and enjoyed themselves after the mezes and kebabs along with the classical Turkish music performed live.

The gala dinner was held at the Kosebasi Restaurant with the view of the gulf of Izmir

On Saturday, the workshop began at 09:00. The first session was chaired by Dr. Yüksel and Dr. Schmid. In this session Dr. J.M. Hendriks presented the Belgian experience on MIRPE and Dr. Gilson Sawaya followed him with the Brasilian experience on Nuss and Abramson procedures.

The second session, where Dr. Kaynak and Dr. Önen were the chairmen, started with the speech of Dr. Wihlm on the auto-correction test in preoperative assesment for MIRPE. Following him Dr. Park gave an inspiring lecture on the new devices and technologhy for pectus surgery. He introduced instruments such as pectoscope, claw fixator and hinge plate which were welcomed by the participants.

The third session chaired by Dr. Park and Dr. de Campos was on hard cases. Very interesting challenging cases were presented by Dr. Kaynak, Dr. Park, Dr. Kuzmichev and Dr. Coosemans. All the cases were debated by the participants interactively.

Dr. Yüksel and Dr. Schmid

The fourth session was about the rare chest wall deformities and was chaired by Dr. K.T. Kim and Dr. Bilgin. Dr. Mehmet Bayramiçli shared his personal experience on the reconstruction of Poland Synrome as the first speaker. Following him Dr. De Campos introduced his own “De Campos” technique fort he sternal cleft repair. The last speaker of the session was Dr. J. Amato, sharing his own experience with the participants on the surgical approach in ectopia cordis.

Dr. De Campos

Following the lunch the pectus carinatum session started where Dr. Wihlm and Dr. Horatio Abramson were the chairmen. Dr. Abramson, who had blazed a trail by the minimally invazive correction surgery on pectus carinatum deformity which is depicted as the the Abramson Procedure, shared his experience with the participants. Following him Dr. Yüksel presented the second largest series of Abramson procedure in the world, after Dr. Abramson’s own series.

The sixth session was chaired by Dr. Yüksel and Dr. Bostanci and the first lecture was given by Dr. Sydney Haje. Dr. Haje presented his experience on the orthosis treatment for pectus excavatum and carinatum. Following him Dr. F.M. Haecker lectured on his vacuum bell applications for pectus excavatum cases.

In the next session where Dr. Sawaya and Dr. Amato were the chairmen, cardiac functions in patients with pectus deformity were debated. Dr. Schmid lectured on the functional cardiac assesment with MRI in PE, followed by Dr. T. Krueger sharing his experience on cardiac function assesment by transesophageal echocardiography during PE repair.

Some of the invited faculty and the participants at the end of the workshop

The last session of the workshop was a mini symposium with oral presentations, chaired by Dr. J.M. Hendriks and Dr. T. Krueger. Four institutes from the various cities of Turkey presented their experience on the correction of pectus deformities.

Therefore, the three day workshop which had been held in high academic level and included complex academic debates had succeeded to an end. It was announced by Dr. Mustafa Yüksel at the closing speech of the workshop, that the Fourth International MIRPE Workshop was going to be held in Istanbul on 23-25th June 2012 and the participants were invited for this appointment.

The invited faculty having dinner at Su Restaurant in Kordon

At night a dinner at Su Restaurant in Kordon was organised for the invited faculty to enjoy the Turkish meze and fish by the Aegean Sea.

On Sunday an Ephesus tour was organised for all the participants. Ephesus, once the most important commercial center of Asia Minor, the second largest city of the Roman Empire after Rome and one of the highlights of Turkey was fascinating as always.

In addition, we sincerely thank to everyone who had taken part in any aspect of this workshop as well as the Topkon Company which undertook the responsibility of the organisation and to Turkmed, Tasarimmed and Seres Medikal companies for their financial and moral support.