METHOD FOR THORACIC DEFECT REPLACEMENT BY INDIVIDUAL 3D IMPLANT Russian patent published in 2021 - IPC A61F2/28 A61B17/68 A61B17/80 A61B17/56 

FIELD: medicine.

SUBSTANCE: individual 3-D implant for replacing the tumor-affected area of the sternum in the size from the jugular notch to the interval between the second and third costal notches of the sternum body, made by layer-by-layer fusion of metal powder based on the results of computed tomography of the chest wall and using the obtained scans. The implant is made in the form of a perforated volumetric body in the form of a "crab" with interconnected internal cavities, having two costal processes on each side, equipped with "pincer" joints having a lower part fused with the body, and the upper part is movable, attached to the lower one by means of a connection Ear-plug. The upper and lower parts are made with through holes for conducting the wire. The body in the form of a "crab" has a rough surface on the inner and outer sides, and its costal processes have a rough surface only on the inner side. The method for replacing a defect in the chest wall with an individual 3-D implant is characterized by the fact that a plastic trial template is used to determine the border of resection of the ribs, sternum and sternotomy and the above implant. During the operation, the internal thoracic artery is isolated from both sides in the second intercostal space using a standard approach, transected and ligated, the aforementioned template is applied, and the boundaries of the resection of the ribs, sternum and sternotomy are determined. After marking, the said template is removed and the sternum is crossed along the marked boundaries at the point of attachment of the third ribs. The first and second ribs are resected along the boundaries indicated by the said template. Cartilaginous segments of 1 and 2 ribs are resected on both sides. Acute and blunt way, the tumor is separated from the mediastinum. The clavicles are dislocated from the joints. The preparation is removed, after which the above implant is fixed through the perforation of the body to the edges of the resection of the ribs, clavicle and sternum with wire. The pectoralis major muscles are sutured through the perforated body to the above implant. The lower part of the "pincer" connector is inserted from the inner side of the rib, and the movable upper part is folded back, closed and fixed with a wire through the through holes of the "pincer" connector.

EFFECT: inventions provide a reduction in trauma during the operation and an increase in the aesthetic effect.

2 cl, 7 dwg