Surgical Treatment of Pectus Excavatum
Rib cage excavation can be treated surgically. The primary goal of rib cage surgery is to correct chest deformity to improve the patient's respiratory and cardiac function. Repositioning the sternum outward reduces pressure on the heart and lungs, allowing them to function normally. The appearance of the chest is also greatly improved. Concavity of the rib cage can be corrected using a minimally invasive surgical technique called the Nuss procedure or traditional surgery known as the Ravitch procedure
Treating Pectus Excavatum using thoracoscopic surgery and metallic bars (so-called Nuss procedure)
First, a small camera is inserted into the chest from the right side to see the chest from the inside. Then two small incisions are made on both sides of the chest, each about 3 cm long. Then a curved metal rod (designed to be suitable for each individual case) is inserted under the sternum to correct the depression. It is attached to the chest wall with a special anchor on both sides. We then close the wound with absorbable suture. The process generally takes between one and two hours, depending on each case A small needle will be placed in the back to administer painkillers, so the patient will be comfortable after the operation The patient remains in the hospital for five days to take antibiotics and painkillers Light exercise such as jogging and swimming is allowed after 6 weeks
Most activities are allowed after 12 weeks, with the exception of vigorous sports The metallic bar is left in place for 3 years and is later removed through a simple daily procedure
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Ravitch Procedure
Also known as “conventional” or “open” surgical repair of rib cage excavation,
Ravitch’s procedure involves an incision in the front of the chest with the
removal of the enlarged cartilaginous portion of the ribs that has caused
the sternum to be pushed back. This procedure allows the sternum to be
pulled forward, away from the heart and lungs and to the normal level of
the chest wall. A small plate with screws is often used to hold the sternum
in its new position, or a permanent mesh may be used.