00474 Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum)

Name of the Procedure:

Anesthesia for Partial Rib Resection; Radical Procedures (e.g., Pectus Excavatum Repair)

Summary

This procedure involves administering anesthesia for surgeries where a part of a rib is removed. It is often performed during complex or radical surgical corrections, such as in the repair of pectus excavatum, a condition where the breastbone is sunken into the chest.

Purpose

The procedure addresses severe deformities or abnormalities of the rib cage, such as pectus excavatum. The goal is to correct the chest wall deformity, improve respiratory function, and enhance the cosmetic appearance of the chest.

Indications

• Severe pectus excavatum affecting breathing or heart function
• Significant chest wall deformities causing physical discomfort or psychological distress
• Patients with poor response to conservative treatments

Preparation

• Patient must fast for at least 8 hours before the procedure.
• Medication adjustments as directed by the healthcare provider.
• Preoperative imaging (e.g., CT scan, MRI) and blood tests.

Procedure Description

1. The patient is positioned on the operating table, and vital signs are monitored.
2. An intravenous (IV) line is started, and general anesthesia is administered to ensure the patient is asleep and pain-free.
3. The surgical area is sterilized and prepared.
4. A surgical incision is made to expose the rib(s).
5. The necessary portion of the rib is resected (removed) carefully.
6. For pectus excavatum, additional procedures such as the placement of a metal bar may be performed to support the sternum.
7. Once the desired surgical correction is achieved, the incisions are closed, and the patient is taken off anesthesia.

Tools and equipment include surgical instruments for rib resection, anesthesia machines, monitoring devices, and possibly a metal support bar.

Duration

The procedure typically takes 2 to 4 hours, depending on the complexity.

Setting

The procedure is performed in a hospital operating room.

Personnel

• Surgeons specialized in thoracic surgery
• Anesthesiologists
• Surgical nurses and technologists
• Respiratory therapists (if needed)

Risks and Complications

• Common risks: Infection, bleeding, pain, anesthesia-related complications
• Rare risks: Pneumothorax (collapsed lung), damage to surrounding organs, chronic chest pain Complications are managed with medications, drainage of fluid/blood, or additional surgical interventions as necessary.

Benefits

• Improved chest wall appearance
• Enhanced respiratory function
• Alleviation of associated symptoms (e.g., shortness of breath, chest pain) Benefits are often realized within a few weeks post-surgery.

Recovery

• Initial hospital stay of 3-7 days for monitoring and pain management.
• Avoid strenuous activities for 4-6 weeks.
• Follow-up appointments to monitor healing and remove any temporary support structures.
• Pain management with prescribed medications.

Alternatives

• Non-surgical treatments like physical therapy or external bracing (less effective for severe cases).
• Other minimally invasive surgical options, depending on the severity and patient's condition. Pros include less invasive methods; cons may include lower effectiveness or longer treatment duration.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel any pain. Post-procedure, the patient may experience discomfort, managed with pain medication. The recovery period includes limited physical activity and regular follow-up appointments to ensure proper healing.