The surgical repair of pectus excavatum, like other major surgeries, presents risks. What are the risks of surgical repair of pectus excavatum? The recurrence (happens again) rate for both procedures is less than 1%. Complete resolution of clinical depression, including the ability to discontinue medications that had been required for depression, has been seen in patients.īoth the Ravitch and Nuss procedures have excellent results, and patients are almost always satisfied with the way they feel and look following recovery. In patients whose main issue is the abnormal appearance of the chest, there have been dramatic, positive changes in their self-esteem and self-confidence.

It is not uncommon for patients with pectus excavatum to feel as if their breathing and stamina are normal before surgery and then realize they feel much improved following correction. This typically leads to improvements in breathing, exercise intolerance and chest pain. The goal of pectus excavatum repair is to relieve pressure on the heart and lungs that may impair function. What are the benefits of pectus excavatum surgical repair? Now, the reduced length of hospital stay and recovery time give patients greater flexibility in scheduling their PE procedure, which can often be done during winter or spring breaks. Before cryoablation-assisted Nuss procedures, the month or more needed for recovery meant that school-age patients had to undergo surgery during summer to avoid missing classes. Those who do require oral opioids typically discontinue their use in one to two days. Some patients do not need any intravenous or oral opioids in the hospital.

With cryoablation, most patients are now able to go home the day after surgery.

The latter is a concern, considering that opioid therapy may increase the risk of addiction.

Traditionally, pain management in patients undergoing the Nuss procedure required a one-week postoperative hospital stay with epidural anesthesia, followed by several weeks of opioid medication after discharge.

Coupled with injection of local anesthetics (numbing medicine) of those same nerves, and a pre- and postsurgical regimen of oral painkillers, cryoablation has transformed pectus patients’ pain experience. The new technique – cryoablation – is being used to “freeze” the intercostal nerves that provide pain sensation to the chest wall.

A new approach to minimizing severe pain after the Nuss procedure is significantly shortening hospital stays and reducing the need for opioid analgesics.

This bar is smaller than the bar used in the Nuss procedure. The bar is later removed with a short, outpatient procedure. Alternatively, a small metal bar can be placed behind the sternum to hold it in place for 6 to 12 months. A small plate and tiny screws are often used to stabilize the sternum in its new position.

This allows the sternum to be pulled forward, away from the heart and lungs and into the normal plane of the chest wall. The Ravitch procedure: Also known as the “traditional” or “open” surgical repair of pectus excavatum, the Ravitch procedure involves an incision on the front of the chest with removal of the cartilaginous part of the ribs which have overgrown and caused the sternum to be pushed backwards.The bar is left in place for 3 years and later removed as an outpatient procedure. Individually curved for each patient, the steel bar is used to correct the depression and is secured to the chest wall on each side. The Nuss procedure: After a tiny camera is inserted into the chest to guide the procedure, two small incisions are made on either side of the chest, and a curved steel bar is inserted under the sternum.Your surgeon will discuss which procedure is the most appropriate based on several variables.

Pectus excavatum can be corrected with the minimally invasive surgical technique called the Nuss procedure or with traditional surgery, known as the Ravitch procedure. The appearance of the chest is also dramatically improved, addressing any psychological symptoms that may also be present. Repositioning the sternum to a more normal, outward position lessens pressure on the heart and lungs, allowing them to function more normally. The primary goal of surgery for pectus excavatum is to correct the chest deformity to improve a patient’s breathing and cardiac function. Pectus excavatum can be treated surgically.

Misshapen ribs