METHOD OF CHEST WALL DEFECT REPLACEMENT WITH INDIVIDUAL 3D-IMPLANT FOR STERNUM REPLACEMENT Russian patent published in 2025 - IPC A61B17/56 A61F2/28 A61B17/80 

FIELD: medicine.

SUBSTANCE: individual 3D-implant for sternum replacement is made by layer-by-layer fusion of metal powder based on results of chest wall computed tomography and obtained scans. 3D implant comprises a longitudinal perforated body of a sternum with four pairs of holes for screws and perforated ribs, each made with two holes for screws. Said body of sternum and ribs can be screwed together. On each side, the ribs-arches are made with "pincer" connectors, made with the lower part, fused with the body, and the upper part is movable, attached to the lower one by means of an ear-plug connection. Upper and lower parts are made with through holes for wire passage. Method of replacing a chest wall defect with individual 3D implant is characterized by the fact that a plastic fitting template is used to determine the border of the resection of the ribs, sternum and sternotomy and 3D implant. During the operation, an internal thoracic artery is separated from both sides by a standard approach, transected and ligated, the above template is applied, and the borders of the resection of the ribs, sternum and sternotomy are determined. After marking, the above template is removed and along the marked boundaries the sternum is crossed at the point of attachment of the ribs. Ribs are resected along the borders indicated by the above template; the cartilage segments of the ribs are resected on both sides. Tumour is separated from the mediastinum by the sharp and blunt way, the clavicles are dislocated from the joints, the preparation is removed, after which above 3D implant is fixed through the perforation of the body to the edges of the resection of the ribs, clavicles and sternum with wire. Greater pectoral muscles are sutured through the perforated body to above 3D-implant. Lower part of the "pincer" connector is brought 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. Affected ribs are resected from both sides; the ribs-arches are inserted and fixed by means of "pincer" connectors through the perforated holes to the edges of the resection of the ribs by means of braided titanium sutures and ligatures. Then a perforated body of a sternum is installed, and through four pairs of holes it is connected by means of screws with ribs-arches, which also have corresponding holes for screws. Thereafter, greater pectoral muscles are sutured through perforated holes of said 3D implant with the help of braided titanium sutures and ligatures.

EFFECT: reduced traumatism, increased aesthetic effect and convenience of implant installation during surgery.

3 cl, 9 dwg, 1 ex