Pectus Excavatum – Surgery
There are two types of surgical correction, both done under general anaesthesia, open repair (Ravitch Procedure) and minimally invasive repair with a metal bar (Nuss Procedure), both associated with very good results.
The majority of the patients with pectus excavatum are candidates for the Nuss procedure. However, the decision for the patient to undergo a Ravitch or Nuss procedure will depend on the degree of the pectus deformity, the age and lifestyle of the patient and the risks of each procedure.
The Ravitch procedure is performed through a midline incision. During this repair, the abnormal costal cartilages are removed, preserving the lining of cartilage, and the sternum is moved forward in a normal position. In some patients, an osteotomy (a break) in the sternum is done to allow the sternum to be positioned forward and that can be supported with the use of a biosynthetic mesh behind the sternum.
The Nuss Procedure involves the insertion of a stainless-steel bar under the sternum, to push the sternum forward into the correct position. Two incisions are performed on the lateral side of the chest for the insertion of the bar. The bar will stay in for 2-3 years and then it will be removed.