Magnetic Mini Mover Procedure to Repair Pectus Excavatum

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3mp

Magnetic Mini Mover Procedure

The Magnetic Mini Mover Procedure (3MP) is classified as a minimally invasive procedure that can fix pectus excavatum. It is invented at UCSF Pediatric Surgery, as an alternative to the Nuss and Ravitch procedures.

Even though these procedures are proven to be effective, they can be harsh on the patient’s well being. They frequently result in intolerable postoperative aches which are demanding not only to the patients but also their parents and surgeons.

The pain is so severe, that it typically requires opioid painkiller medications, which can create an addiction. The 3MP applies progressive pull on the sunken sternum.

After some time, it will reshape the deformed costal cartilages which will result in a corrected pectus excavatum. This procedure is inspired by the orthodontic and orthopedic braces which work with similar principles. Furthermore, the Magnetic Mini Mover Procedure is similar to the Eckart Klobe vacuum bell therapy.

What ​Consists the 3MP?

The Magnetic Mini Mover device is made of two separate parts.

  • Magnimplant – This is an inner magnet that is inserted on the concave breastbone.
  • Magnatract – An outer custom-fitted anterior chest wall brace that holds a secondary magnet.

The purpose of the internal and external magnets is to create an outward force on the concave breastbone. This force also secures the Magnatract brace to the patient’s chest wall.

Does the Magnetic Mini Mover Procedure Work?

A recent 2017 study investigated 15 patients that had severe cases of pectus excavatum with Haller Index greater, or equal to 3.5.

The patients were aged 8 to 14. The average patient age was 12.4, and the average Haller Index was 4.7, which causes respiratory and cardiac problems.

The treatment lasted approximately two years (24 months). The investigation concluded that the Magnetic Mini Mover Procedure is both safe and successful in fixing pectus excavatum.

8 out of 13 patients were satisfied with how their chest looked like after the 24-month procedure. There was a reduction of the Haller Index in most patients.

However, the titanium wires of the Magnimplant were prone to breakage. The wires broke in seven out of 15 patients. This led to unfavorable situations in two patients.

KEY POINT:

Scientific studies proved the Magnetic Mini Mover Procedure can be effective in correcting pectus excavatum.

Benefits of 3MP

  • The patient isn’t required to stay in the hospital for pain management after the surgery, as it is with the Nuss and Ravitch procedures. This will greatly lessen the expenses.
  • You can return to normal daily activities after the procedure. Playing sports and doing strenuous physical activities will be allowed without any restrictions.
  • The pain, while the magnets are repairing your inverted chest deformity, will be minimal, and even non-existant.
  • The chest wall structure will improve constantly until it is completely repaired.
  • Depending on how you feel and how fast you want to repair the deformity, you can modify the amount of magnetic pull on the Magnatract device.
  • There is a built-in pressure recorder in the Magnatract device.

How is the Magnimplant Inserted?

The Magnimplant surgery is done in a clinic, and the patient is under general anesthesia. It is inserted through a two-inch cut, starting from the sternal angle, down to the bottom of the breastbone.

The backplate of the Maginmplant with added titanium wires is implanted on the lower part of the breastbone. The magnet is placed on the upper section of the sternum.

The cables of the backplate are attached through tiny openings in the magnet and tightened with set fasteners. The backplate with attached titanium cables was inserted on the lower sternum, and the magnet placed directly on top of the sternum.

Where Can You Get the Procedure?

A lot of people have been asking me where they could get the Magnetic Mini Mover Procedure. As of February 2020, the procedure is offered only at the University of California San Francisco (UCSF), and the two other research places in Northern California and Kansas.

However, only patients who are aged 8-14 can apply for this clinical trial. Sadly, this is bad news for grownup pectus excavatum sufferers. If you want to directly communicate with the Pectus Trial Coordinator at UCSF, you should check the university’s website.

Who Is Eligible for 3MP?

As listed by the ClinicalTrials website, there are 5 rules the patients need to satisfy, to be eligible for the 3MP.

  • The male or female patients need to be completely healthy, with a pectus excavatum deformity.
  • They must be between the ages of 8 and 14, including the limits specified.
  • The Haller Index, which mathematically measures the severity of the sunken chest, needs to be greater than 3.5. The base HI of the people without the malformation is 2.56.
  • The patients must be able to fully understand, read, and speak English.
  • At the start of accelerated growth of puberty, backed up by hand/wrist X-ray in early to mid-adolescence. This is described as bone age in girls aged 7-13, and boys aged 9-14 years.

Also, the patients must be aware that they should wear the external brace at a minimum of 10 hours in a day. If they wear it for just a few hours in a day, the effects will be minimal and the patient’s chest won’t be visibly repaired.

This will also destroy the patient’s motivation and they won’t be consistent with wearing the brace. They must also do monthly chest X-rays, return to the UCSF for follow-up a month after surgery. For the full list of rejection guidelines, you can check this website.

KEY POINT:

Not everybody can be eligible for the 3MP. You or your chilld needs to satisfy all 5 factors mentioned above to undergo the procedure.

Can You Wear the Magnatract Under a Shirt?

The Magnatract magnetic brace is small enough to be worn underneath a t-shirt. Nobody will notice that you’re wearing a device that is gradually correcting your inherited chest wall deformity.

This allows you to wear it as much as possible, whether you’re at school, at work, or even at the gym. I recommend you adjust the outer magnet to the smallest amount of force applied on the sternum while you’re doing other activities outside your home. That is because a strong breastbone pull can take your attention away from these actions.

KEY POINT:

You can comfortably wear the external brace underneath a shirt.

How Long Should I Wear the Brace?

Patients are advised to start wearing the Magnatract brace two weeks after the Magnimplant inserting surgery. It is recommended to wear Magnatract as much as possible, for at least 10 hours a day, both during the daytime or while you’re sleeping.

Some patients complain that they can’t sleep at night when they’re using the Magnatract. Luckily, there is a simple solution to this. The power of the magnet is adaptable. You can lower the force of the magnetic pull by turning the magnet housing.

This allows the Magnetic Mini Mover Procedure to correct your pectus excavatum, while you’re sleeping. The discomfort will stop.

The innovators of this procedure did a lot of studies and investigations on proper fitting and adaptations, so the patients will be able to wear the Magnatract daily, without any discomfort.

Wearing the brace shouldn’t stop your kid from doing its daily activities. It is recommended to remove the brace while showering or taking a bath.

KEY POINT:

Make sure you wear the brace as much as possible. Aim for 10 hours in a day.

Magnetic Mini Mover Surgery Cost

As stated in a 2012 study, the average price of the Magnetic Mini Mover Procedure was $47.000 in 2012.  Even though it may seem like it costs too much, it is half the price of the Nuss and Ravitch procedures, which cost about $80.000. They include a more significant surgery and hospitalization time for pain control, which is not the case with the 3MP.

The ​Surgery Process

So, if your kid is a candidate for this new treatment of pectus excavatum, and you accept to allow your child to undergo the surgery, you should expect the following:

Computer Tomogram (CT scan)

The CT scan combines a series of X-ray images taken from different angles around your children’s body. It uses computer processing to create images of the bones, blood vessels, and soft-tissue.

They produce more accurate data than normal X-ray images. The CT scan will be done to determine the severity of the child’s deformity.

If a CT scan was already done to your kid, then there is no need to do another one. You can just bring a copy of that scan to the hospital.

Electrocardiogram (EKG)

An electrocardiogram is a test that measures how the heart of your child affected by pectus excavatum is working. Before starting the treatment, the doctors need to make sure your child’s heart is operating flawlessly.

Left Hand-Wrist X-ray

A left-hand wrist X-ray will help doctors evaluate the development of your child’s skeletal system. Estimating the bone age plays a big role in the inclusion guidelines for the clinical trial. This is a safe and painless procedure that is executed by taking a single X-ray of the patient’s left wrist, palm, and fingers.

Plastic Model of Your Child’s Deformation

A plastic, that is similar to cementing material is put on the patient’s sunken chest. When the material is hardened, it creates a precise copy of your child’s breast.

The custom model will be used to produce a brace that will fit your kid’s abnormal chest. This suitable brace will be equipped with a magnet that is called Magnatract.

When your kid is wearing the brace, the magnet will pull the concave sternum outwards. If you and your child like how comfortable the external brace is, then surgeons will insert an inner magnet on the kid’s hollow breastbone.

Oppositely, if your kid doesn’t like the feel of the external brace, then you can stop continuing with the Magnetic Mini Mover Procedure at this point.

KEY POINT:

Before inserting the Magnimplant, there are three scans that your child needs to undergo. Additionally, a plastic model needs to be created.

Day of Surgery

If your kid wants to wear the external brace and fix pectus excavatum with the 3MP, then you’ll be given a document for operation and anesthesia to read and sign as a parent.

This is the last documentation step before your child is operated. The purpose of the surgery is to insert the Magnimplant, (titanium enclosed disc-shaped magnet with a diameter of 1 inch) on the patient’s hollow sternum.

The implantation lasts no more than two hours. The general anesthesia is of short duration. You and your child can go home a few hours after the operation.

The best part of this minimally invasive surgery is that your kid can continue regular everyday activities on the very next day. There is no need to stay in the hospital for a week and wait for months until it can start doing some physical actions.

Within the First Month

In the first month, your kid is required to have weekly meetings with the surgeons and nurses. They must ensure the 3MP is working properly, and there is no pain or discomfort in this crucial month.

After the First Month

One month after inserting the Magnimplant, a chest X-ray is required to see the condition of the magnet. Also, a second EKG is needed to monitor the cardiac functioning.

After that, you’ll be given a second survey to complete the child’s physical and mental well-being after starting the magnetic therapy. Your kid needs to do monthly check-ups until the pectus excavatum deformity is fully repaired.

The purpose of these check-ups is to track the chest reconstruction progress and see whether there are any skin problems, discomforts, allergic reactions or aches.

Also, the doctors will suggest your child to start a daily journal to write how many hours in a day it is wearing the Magnatract brace.

18 – 24 Months After First Surgery

After the deformity is corrected (usually in 18 to 24 months), your kid needs to do another CT scan of the chest to record the outcome. Then, the internal Magnimplant will be removed from your child’s breastbone in a surgical procedure.

The magnet removal operation is similar to the implantation surgery. It is minimally invasive, and your kid can go home the very same day.

After Magnet Removal

After the magnet is removed, your child will need to visit the surgeon’s office for a physical examination. Your kid needs to undergo another EKG and CT-scan, to re-measure the pectus excavatum Haller Index, one month after magnet extraction.

Again, your kid will be given a survey to complete about it’s physical and mental well-being.

Year After Magnet Removal

After undergoing the 3MP, your child will be asked to do continuing check-ups every six months.

Six months after magnet removal, you and your kid need to visit the clinic and complete a similar survey like the one given to you before.

Then, visits should be completed after 12, 18 and 24 months. This will help scientists and surgeons who invented the 3MP, ways to advance it and be more effective in improving both the cosmetic and psychological outcomes of the procedure.

KEY POINT:

The surgery is painless, because of the general anesthesia. Generally, it takes two years until the deformity is corrected. After that, the internal magnet is removed surgically.

3MP Side Effects

The Magnetic Mini Mover Procedure is considered very safe. Still, the magnet implantation and removal procedure require a surgery executed under general anesthesia.

There are a few side effects that you should be familiar with.

Radioactivity

The patient that undergoes a 3MP will suffer from a small amount of radiation, caused by the few X-rays. To be fully informed of the dangers of radiation to your kid, you should read this article in detail.

CT Scans

CT Scans include the risks of radiation that I mentioned before. There is an increased risk of an allergic reaction if iodine dye is used during the scans.

The reactions can be mild to severe, which can lead to shortness of breath, shock and even death. Your kid must be adequately hydrated before doing CT scans because it can cause kidney difficulties.

Also, doctors must be fully aware of whether your kid has allergies or other conditions that may put its health at risk.

The CT Scan can also be very uncomfortable for your kid. It may rise claustrophobic feelings while staying for a longer period in the enclosed structure of the CT Scanner.

The use of iodine dye can also cause a metallic flavor in the kid’s mouth after it kid exits the CT scanner, which can lead to sickness, vomiting or even agony.

Magnet Implantation Surgery Risks

There are a few dangers that may occur while the surgeons implant the inner magnet.

  • Risks associated with the general anesthesia. They include nausea, vomiting and trouble breathing which may need a supporting breathing tube to be inserted in your kid’s lungs.
  • 1% chance of damage to the surrounding tissues and organs.
  • Less than 1% risk of a collapsed lung.
  • Small chance of massive blood loss.
  • 1% chance of infection that must require a magnet removal.
  • 1% probability of seroma, which will be asked to be observed for infection risk.

Pectus Excavatum Correction Failure

Just like in any other type of treatment, there is a chance that the Magnetic procedure won’t fix the concave chest deformity. If this is the case, your kid can always choose another, more promising type of treatment.

Still an Experimental Treatment

Because this is still considered an experimental technique, there may be certain risks that nobody is aware of. Nevertheless, the clinical trials are approved by the Food and Drug Administration (FDA) and the Institutional Review Board.

If you’re interested in this type of treatment, please contact UCSF about the latest adverse effects of the 3MP. Your kid’s wellbeing is the most important thing as a parent.

You don’t want to put your child’s health in jeopardy at any point in their life.

KEY POINT:

Even though the 3MP is effective, there are some side effects that you must be aware of. They are radiation, magnet implantation surgery risks and a failure to correct the deformity.

Is the Magnet in Your Kid’s Chest Harmful?

As of February 2020, there is no risk of having a magnet inserted on your kid’s sternum. The Magnimplant is inserted close to your child’s heart.

However, the innovators of the procedure at UCSF guarantee that it isn’t harmful to the patient’s health.

Airport Metal Detectors Will Beep

The fixed magnetic device in the patient’s chest can be detected by metal detector systems. It can be very awkward to hear the beeper every time you go inside a store in the mall.

Expect the store’s security to inspect your items. Don’t take it personally. That’s what they are supposed to do. First, let them browse through your bags and backpack, then kindly explain your situation.

Also, the magnetic device can cause obstacles while you’re going through airport security. People waiting in line behind you will usually get upset at you. Don’t worry.

The inventors of this procedure found a solution for this. They will give you and your parents a confirmation note that proves there is a magnetic device inserted in you to correct a chest deformity.

Remember to always carry it inside your wallet, just in case. You don’t want to spend hours explaining your situation to the mall security officers. Also, you may want to avoid the uncomfortable stares of everyone inside the shopping center.

Avoid Other Metals

Your kid should stay away from little metal objects and other magnets. They can stick to your child’s chest, which can be quite uncomfortable feeling.

Kids love magic tricks. Your kid can be a class clown and play a magician, trying to impress its schoolmates with taking metal objects and attaching them the chest, without them falling.

If you see your child doing this, please tell him/her to stop it. Kindly explain the dangers and harms it can cause.

Skin Damage

This is probably the biggest concern parents have for their children who undergo the 3MP. The external brace (Magnatract) can pull the internal magnet too hard, which will be painful and can even cause an injury.

Ask your kid if the brace is pulling too hard. You can easily modify the amount of pulling pressure. The Magnatract is capable of causing harm to the skin over the breastbone.

Redness and skin rashes are clear indications of this. The vacuum bell therapy for correcting a hollow chest can also be harsh on the patient’s skin.

To treat skin damage for 3MP, start using moisturizing milk on the chest area, at least once a day.

MRI Dangers

MRI or Magnetic Resonance Imaging is a medical procedure used in radiology to create pictures of the structure of the body.

Some of the most powerful MRI systems use up to 30,000 gauss. Comparatively, the Earth has a magnetic field of 0.5 gauss.

That shows you how powerful the magnets of the MRI are. All metal objects, including the inner magnet (Magnimplant), can become a deadly missile if they’re brought to the scanning room.

Your child who undergoes a Magnetic Mini Mover Procedure shouldn’t stand next to a powerful magnetic field like the MRI device.

After undergoing a 3MP, your kid will get to wear a wristband or a necklace that alerts it shouldn’t get an MRI scan.

​Risk to Others

Patients with Magnimplant and Magnatract shouldn’t come in close contact with people applying pacemakers and other nerve stimulation devices. As a general rule, a safe distance is six inches.

KEY POINT:

Sometimes the magnet will beep at the airport, or at the store. Also, patients should avoid other metals and MRI systems. The magnet can also cause skin damage.

​Conclusion

The Magnetic Mini Mover Procedure is a safe and effective way of correcting pectus excavatum. In the above-mentioned studies, surgeons are looking for additional ways to make this type of therapy more effective and safe.

This type of therapy isn’t popular worldwide, mainly because there are still some types of improvements that need to be done. In my honest opinion, I think kids will like this procedure far more than undergoing a Nuss procedure that will require a Pectus bar implant that needs to be carried for years.

If the Magnimplant is dislocated, it cannot puncture the nearby vital organs like the lungs or heart. If this sounds promising to you, feel free to contact UCSF to give you more details about the procedure. In the comment section below, you can ask anything that concerns you. I’ll do my best to answer it.

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