A 10-Year Review of a Minimally Invasive Technique for the Correction of Pectus Excavatum
Donald L. Nuss, Robert E. Kelly, Daniel P. Croitoru, Michael Katz
Abstract
This chapter presents a report from the Children's Hospital of the King's Daughters, Norfolk, Virginia, on the tenth anniversary of the Nuss procedure, a minimally invasive approach in the management of pectus excavatum. This was a retrospective single-centre series of children < 15 years presenting between 1987 and 1996. Those with pectus excavatum underwent an initial physiotherapy and posture program, and correction was offered for those who failed this conservative approach. The Nuss technique involved creating a retrosternal tunnel between two thoracic incisions using a curved Kelly clamp and then placing a 1.5 cm wide and 2 mm thick steel bar to lift the sternum forward. Recurrence of excavatum anomaly requiring further corrective surgery was reported in three cases after the Nuss procedure. The Nuss procedure provides a minimally invasive alternative in pectus excavatum repair with very good cosmetic outcomes.