# Chest Pain — GCMD Library living collection

Everything in the library about chest pain — built automatically from dossiers that name it.

Updated: n/a · 4 episodes · 99 cited statements

## Episodes
### Surgical Management
- [Tricks - Thoracoscopic-Assisted Partial Rib Resection - Jack Langer](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637) — video · 9:18 · [machine version](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637.md)

### Case-Based Learning
- [Thoracoscopic-Assisted Partial Rib Resection: Pediatric Surgery Difficult...](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431) — video · 8:28 · [machine version](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431.md)

### Patient & Family Education
- [Patient Testimonial and Experience: Pectus Innovations](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014) — video · 13:55 · [machine version](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014.md)
- [Pectus-Patient Testimonial and Experience](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241) — video · 14:33 · [machine version](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=0) Case presentation: thoracoscopic-assisted partial rib resection for chest wall lesion (Ep 1)
- [4:28](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=268) Discussion: reconstruction techniques and alternative approaches for chest wall lesions (Ep 1)
- [0:00](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=0) Case Presentation: Thoracoscopic-Assisted Rib Resection for Chest Wall Lesion (Ep 2)
- [4:28](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=268) Discussion: Chest Wall Reconstruction and Management of Osteochondromas (Ep 2)
- [0:00](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=0) Patient testimonial: Rebecca Garcia's pectus repair experience and recovery (Ep 3)
- [4:47](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=287) Pain management protocol and patient experience discussion (Ep 3)
- [6:51](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=411) Preoperative screening protocols and vacuum belt acquisition (Ep 3)
- [8:29](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=509) Post-operative activity restrictions and return to exercise protocols (Ep 3)
- [10:30](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=630) Management of rib flaring and sleeping positions post-operatively (Ep 3)
- [0:00](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=0) Patient testimonial: recovery experience and pain management (Ep 4)
- [4:47](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=287) Pain team effectiveness and patient support (Ep 4)
- [6:51](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=411) Clinical protocols: screening, activity restrictions, and post-operative care (Ep 4)
- [10:30](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=630) Management of rib flaring, sleeping positions, and session wrap-up (Ep 4)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- "Rebecca Garcia underwent pectus repair surgery on August 1st of the previous year at age 21" — Rebecca Garcia (clinical) [Ep 3 · 0:15](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=15)
- "Rebecca had previously undergone the Ravitch procedure in Atlanta, Georgia at age 3 or 4 years old" — Rebecca Garcia (clinical) [Ep 3 · 0:22](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=22)
- "Despite prior Ravitch procedure, Rebecca continued to experience chest pains and trouble breathing" — Rebecca Garcia (clinical) [Ep 3 · 0:22](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=22)
- "Meditation, specifically Jack Kornfield videos recommended by Dr. Garcia, helped with mental recovery from pectus surgery" — Rebecca Garcia (opinion) [Ep 3 · 1:39](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=99)
- "Post-operative pectus patients experience significant physical restrictions including inability to turn, twist, or lift more than 5 pounds" — Rebecca Garcia (clinical) [Ep 3 · 2:19](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=139)
- "The mental and emotional burden of post-operative dependency is as significant as the physical recovery challenges" — Rebecca Garcia (opinion) [Ep 3 · 2:19](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=139)
- "Robaxin (methocarbamol) helps relieve chest tightness and pressure sensations in post-operative pectus patients" — Rebecca Garcia (clinical) [Ep 3 · 3:36](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=216)
- "Dr. Garcia required Rebecca to wait 3 months before returning to weight training after pectus repair" — Rebecca Garcia (clinical) [Ep 3 · 4:15](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=255)
- "After 3 months and gradual return to exercise, Rebecca achieved strength levels exceeding her pre-operative baseline" — Rebecca Garcia (clinical) [Ep 3 · 4:32](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=272)
- "Having a dedicated pain team with established protocols reduces delays in pain medication administration" — Todd Ponsky (opinion) [Ep 3 · 5:41](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=341)
- "Pain team protocols eliminate the need to wait for individual physician orders for pain medication" — Todd Ponsky (clinical) [Ep 3 · 5:41](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=341)
- "Patients are systematically screened for resistant staph (MRSA/URSA) prior to pectus surgery" — Garcia (clinical) [Ep 3 · 7:23](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=443)
- "Patients who screen positive for resistant staph receive nasal and underarm swabs and are prepared according to protocol" — Garcia (clinical) [Ep 3 · 7:29](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=449)
- "Bactroban is given intranasally twice per day for 7 days prior to surgery for patients with resistant staph colonization" (clinical) [Ep 3 · 7:40](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=460)
- "Vacuum belts for pectus patients are obtained directly from suppliers in Germany at a cost of approximately $400-500" (clinical) [Ep 3 · 8:11](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=491)
- "For routine procedures like umbilical hernia repair, one surgeon places no activity restrictions, relying on children's self-limitation based on pain" (clinical) [Ep 3 · 8:40](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=520)
- "For pectus patients, full activity is permitted after 3 months (12 weeks) post-operatively" (clinical) [Ep 3 · 9:16](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=556)
- "Adolescent pectus patients do not always adhere to the 3-month activity restriction, with some observed doing prohibited activities" (clinical) [Ep 3 · 9:43](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=583)
- "After 3 months, pectus patients are recommended to perform stretching and core strengthening exercises using instructional YouTube videos" (clinical) [Ep 3 · 9:54](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=594)
- "A good percentage of lower anterior rib flaring after Nuss procedure resolves spontaneously" (clinical) [Ep 3 · 10:45](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=645)
- "For older patients with rib flaring, ribs below the repair site can be broken and pushed down, a technique observed at Mayo Clinic" (clinical) [Ep 3 · 10:50](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=650)
- "Rib osteotomy for flaring is less effective in pediatric patients due to their greater flexibility" (clinical) [Ep 3 · 11:04](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=664)
- "Rib flaring tends to improve over time in many pediatric pectus patients" — Garcia (clinical) [Ep 3 · 11:13](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=673)
- "Sleeping position after pectus repair is patient-guided; if side-sleeping is comfortable, it is permitted" (clinical) [Ep 3 · 11:33](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=693)
- "Patients naturally move during sleep regardless of prescribed sleeping positions" (clinical) [Ep 3 · 11:54](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=714)
- "MRI is preferred over CT scan for pectus evaluation based on discussion during this session" — Todd Ponsky (host_summary) [Ep 3 · 12:40](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=760)
- "Cardiac effects of pectus excavatum are clinically significant, not merely cosmetic" — Todd Ponsky (host_summary) [Ep 3 · 12:35](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=755)
- "A planned study will examine post-operative cardiac findings in pectus patients, led by cardiologist Michael Taylor" (clinical) [Ep 3 · 13:19](https://library.globalcastmd.com/watch/patient-testimonial-and-experience-pectus-innovations-1014?t=799)
- "The patient underwent pectus repair surgery on August 1st of the previous year at age 21" — Rebecca Garcia (clinical) [Ep 4 · 0:15](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=15)
- "The patient had previously undergone the Ravitch procedure in Atlanta, Georgia at age 3 or 4 years old" — Rebecca Garcia (clinical) [Ep 4 · 0:22](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=22)
- "Prior to revision surgery, the patient was experiencing chest pains and trouble breathing despite the previous Ravitch procedure" — Rebecca Garcia (clinical) [Ep 4 · 0:22](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=22)
- "Meditation, specifically Jack Kornfield's videos recommended by the surgeon, helped the patient mentally during recovery" — Rebecca Garcia (opinion) [Ep 4 · 1:39](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=99)
- "Post-operative restrictions included inability to turn, twist, or lift more than 5 pounds" — Rebecca Garcia (clinical) [Ep 4 · 2:19](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=139)
- "Walking and staying active were beneficial post-operative activities for this patient" — Rebecca Garcia (opinion) [Ep 4 · 3:14](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=194)
- "Stretching became important for the patient post-operatively, whereas she had not stretched before surgery" — Rebecca Garcia (opinion) [Ep 4 · 3:24](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=204)
- "Robaxin (methocarbamol) helped relieve chest tightness and pressure during home recovery" — Rebecca Garcia (clinical) [Ep 4 · 3:36](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=216)
- "The patient was required to wait 3 months before returning to weight lifting" — Rebecca Garcia (clinical) [Ep 4 · 4:00](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=240)
- "After the 3-month waiting period and gradual return, the patient reported being stronger than ever in the weight room and running" — Rebecca Garcia (clinical) [Ep 4 · 4:32](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=272)
- "Having a pain team and protocol helps patients receive pain medicine faster because they don't have to wait for a doctor to write the order" — Todd Ponsky (clinical) [Ep 4 · 5:41](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=341)
- "The institution screens for resistant staph (MRSA/VRSA) preoperatively" (clinical) [Ep 4 · 7:23](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=443)
- "If patients screen positive for resistant staph, they are swabbed from the nose and underarms and prepared per protocol" (clinical) [Ep 4 · 7:29](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=449)
- "Bactroban is given intranasally twice per day for 7 days prior to surgery for MRSA-positive patients" (clinical) [Ep 4 · 7:40](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=460)
- "Vacuum belts are obtained by communicating directly with suppliers in Germany, providing measurements, and cost approximately $400-500" (clinical) [Ep 4 · 8:11](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=491)
- "For umbilical hernia repairs, one surgeon places no activity restrictions, reasoning that children will self-limit if they experience pain" (clinical) [Ep 4 · 8:40](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=520)
- "The surgeon qualifies the no-restriction approach by restricting organized sports or when the father is a football coach" (clinical) [Ep 4 · 8:58](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=538)
- "For pectus patients, full activity is permitted after 3 months (12 weeks)" (clinical) [Ep 4 · 9:16](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=556)
- "The surgeon acknowledges that adolescent patients do not always adhere to the 3-month activity restriction" (clinical) [Ep 4 · 9:33](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=573)
- "After the 3-month period, stretching and core strength exercises are recommended, with patients given two YouTube videos demonstrating these activities" (clinical) [Ep 4 · 9:54](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=594)
- "A good percentage of lower anterior rib flaring after the Nuss procedure resolves on its own" (clinical) [Ep 4 · 10:45](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=645)
- "At Mayo Clinic, for older patients with rib flaring, ribs below the repair are broken and pushed down, but this technique is less effective in flexible pediatric patients" (host_summary) [Ep 4 · 10:50](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=650)
- "Surgeons in Brazil use a brace for post-operative rib flaring" (host_summary) [Ep 4 · 11:04](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=664)
- "The surgeon's approach to rib flaring is watchful waiting, telling patients to be patient as it improves over time" (clinical) [Ep 4 · 11:10](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=670)
- "Patients are advised to avoid sleeping on their side initially, but if they are comfortable doing so and attempt it, they will self-limit based on discomfort" (clinical) [Ep 4 · 11:33](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=693)
- "Patients naturally sleep on recliners post-operatively because that position is most comfortable" (clinical) [Ep 4 · 11:33](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=693)
- "A future study is planned with cardiologist Michael Taylor to examine post-operative cardiac outcomes in pectus patients" (clinical) [Ep 4 · 13:19](https://library.globalcastmd.com/watch/pectus-patient-testimonial-and-experience-5241?t=799)
- "A 16-year-old male presented with a two-month history of left-sided chest pain." — Jack Langer (clinical) [Ep 2 · 0:00](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=0)
- "Chest X-ray showed an ill-defined 3×5×5 centimeter calcified lesion in the left lower lung zone." — Jack Langer (clinical) [Ep 2 · 0:20](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=20)
- "CT scan showed the lesion was pedunculated and exophytic, arising from the internal aspect of the left 6th rib." — Jack Langer (clinical) [Ep 2 · 0:40](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=40)
- "Resection was advised due to ongoing symptoms of pain and diagnostic uncertainty." — Jack Langer (clinical) [Ep 2 · 1:00](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=60)
- "Patient was positioned with left side elevated 30 degrees using a beanbag." — Jack Langer (clinical) [Ep 2 · 1:15](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=75)
- "A single 5 millimeter port was placed posteriorly in the fifth intercostal space." — Jack Langer (clinical) [Ep 2 · 1:30](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=90)
- "A 22 gauge needle was passed through the chest wall to map out the smallest incision possible and better define the margins." — Jack Langer (clinical) [Ep 2 · 2:30](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=150)
- "A 5 centimeter incision was made with electric cautery." — Jack Langer (clinical) [Ep 2 · 2:55](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=175)
- "The intercostal muscles and neurovascular bundles were separated from above and below the 6th rib." — Jack Langer (clinical) [Ep 2 · 3:20](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=200)
- "The rib was cut anterior and posterior to the stock of the lesion, and the rib segment and lesion were extracted." — Jack Langer (clinical) [Ep 2 · 3:40](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=220)
- "The specimen consisted of a 3.5 centimeter rib segment and a 5×3×5 centimeter lesion." — Jack Langer (clinical) [Ep 2 · 4:05](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=245)
- "Final pathology showed an atypical osteochondroma with normal underlying rib and negative margins." — Jack Langer (clinical) [Ep 2 · 4:18](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=258)
- "The operation duration was 67 minutes." — Jack Langer (clinical) [Ep 2 · 4:00](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=240)
- "The operation was complicated by a small postoperative pneumothorax which was managed with oxygen therapy." — Jack Langer (clinical) [Ep 2 · 4:05](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=245)
- "The patient was discharged on the 3rd postoperative day." — Jack Langer (clinical) [Ep 2 · 4:18](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=258)
- "At 8 months follow-up, the patient was pain-free and back to normal activities." — Jack Langer (clinical) [Ep 2 · 4:25](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=265)
- "For chest wall defects up to three ribs, a Surgisis patch can be used without struts." (clinical) [Ep 2 · 4:44](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=284)
- "For very large chest wall defects, struts or methylmethacrylate are required." (clinical) [Ep 2 · 4:44](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=284)
- "Osteochondromas can be shaved off rather than requiring rib resection; one was removed by biting it off with a rongeur." (clinical) [Ep 2 · 5:09](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=309)
- "For large chest wall gaps from multi-rib resections, patches can leave significant cosmetic deformity with respiratory variation." (clinical) [Ep 2 · 5:49](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=349)
- "An autologous rib can be harvested from above or below the resection site and used to replace the resected rib, providing better chest wall contour without respiratory gaping." (clinical) [Ep 2 · 6:20](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=380)
- "Autologous rib grafts used for chest wall reconstruction are free grafts (without preserved blood supply) and remain visible on X-ray months after surgery." (clinical) [Ep 2 · 6:39](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=399)
- "In patients with multiple hereditary exostosis, symptomatic lesions can be shaved off rather than requiring rib resection, particularly in younger children where malignancy is unlikely." (clinical) [Ep 2 · 7:32](https://library.globalcastmd.com/watch/tricks-thoracoscopic-assisted-partial-rib-resection-jack-langer-637?t=452)
- "A 16-year-old male presented with a two-month history of left-sided chest pain" (clinical) [Ep 1 · 0:00](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=0)
- "Chest X-ray showed an ill-defined 3×5×5 centimeter calcified lesion in the left lower lung zone" (clinical) [Ep 1 · 0:20](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=20)
- "CT scan showed the lesion was pedunculated and exophytic, arising from the internal aspect of the left 6th rib" (clinical) [Ep 1 · 0:40](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=40)
- "Resection was advised due to ongoing symptoms of pain and diagnostic uncertainty" (clinical) [Ep 1 · 1:00](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=60)
- "A single 5 millimeter port was placed posteriorly in the fifth intercostal space for thoracoscopic visualization" (clinical) [Ep 1 · 1:15](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=75)
- "A 22 gauge needle was passed through the chest wall to map out the smallest incision possible and define margins" (clinical) [Ep 1 · 2:20](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=140)
- "A 5 centimeter incision was made with electric cautery" (clinical) [Ep 1 · 2:40](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=160)
- "The intercostal muscles and neurovascular bundles were separated from above and below the 6th rib" (clinical) [Ep 1 · 3:00](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=180)
- "The rib was cut anterior and posterior to the stalk of the lesion and the rib segment and lesion were extracted" (clinical) [Ep 1 · 3:15](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=195)
- "The specimen consisted of a 3.5 centimeter rib segment and a 5×3×5 centimeter lesion" (clinical) [Ep 1 · 3:40](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=220)
- "Final pathology showed an atypical osteochondroma with normal underlying rib and negative margins" (clinical) [Ep 1 · 3:55](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=235)
- "The operation duration was 67 minutes" (clinical) [Ep 1 · 4:10](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=250)
- "The operation was complicated by a small postoperative pneumothorax which was managed with oxygen therapy" (clinical) [Ep 1 · 4:15](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=255)
- "The patient was discharged on the 3rd postoperative day" (clinical) [Ep 1 · 4:25](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=265)
- "At 8 months follow-up, the patient was pain-free and back to normal activities" (clinical) [Ep 1 · 4:28](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=268)
- "For chest wall defects up to three ribs, a Surgisis patch can be used without struts" (clinical) [Ep 1 · 4:44](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=284)
- "For very large chest wall defects, struts or methylmethacrylate may be required" (clinical) [Ep 1 · 5:10](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=310)
- "Surgisis patches heal in well with scar tissue formation" (clinical) [Ep 1 · 5:20](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=320)
- "Osteochondromas can be shaved off rather than requiring rib resection" (clinical) [Ep 1 · 5:36](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=336)
- "For large chest wall gaps from resection, patches can leave significant cosmetic deformity with respiratory variation" (clinical) [Ep 1 · 5:51](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=351)
- "An intact rib above or below the resection can be harvested and used as a free graft to replace the resected rib, providing better chest wall contour" (clinical) [Ep 1 · 6:15](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=375)
- "Autologous rib grafts function similarly to rib grafts used by plastic surgeons and orthopedists for other reconstructions" (clinical) [Ep 1 · 6:53](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=413)
- "Metal struts that screw into the rib are used in trauma to close rib gaps" (clinical) [Ep 1 · 7:15](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=435)
- "In patients with multiple hereditary exostosis, symptomatic lesions can be shaved off rather than requiring rib resection, particularly in younger children where malignancy is unlikely" (clinical) [Ep 1 · 7:32](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=452)
- "Needle mapping through the chest wall is useful to determine the optimal incision location for chest wall lesion resection" (opinion) [Ep 1 · 8:15](https://library.globalcastmd.com/watch/thoracoscopic-assisted-partial-rib-resection-pediatric-surgery-difficult-431?t=495)

## Changelog
- Sep 15: 4 items added automatically

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