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Nuss procedure in Jordan: Surgical Treatment of Pectus Excavatum
The Nuss procedure is a minimally invasive surgery used to correct pectus excavatum. The Nuss procedure in Jordan, at our clinic, is performed by experienced thoracic surgeons using advanced techniques
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 reduce 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)
Nuss Procedure in Jordan-Amman
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.
FAQs about Nuss Procedure
Frequently Asked Questions About Pectus Excavatum Surgery (Nuss Procedure)
What is pectus excavatum surgery (the Nuss procedure)?
It is a minimally invasive surgical procedure in which a metal bar is inserted beneath the sternum to lift it into a normal position, effectively and permanently correcting the sunken chest without the need for a large surgical incision.
When is surgery necessary for pectus excavatum?
Surgery is considered the best option in the following cases:
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Moderate to severe pectus excavatum
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Shortness of breath or easy fatigue
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Compression or effect on the heart or lungs
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No improvement with conservative treatment
👉 In these cases, the Nuss procedure provides real and lasting correction.
What is the success rate of the Nuss procedure?
The success rate is very high, reaching more than 95–99% in appropriate cases, with clear improvement in chest shape and breathing function.
Is the Nuss procedure safe?
Yes, it is considered a safe operation when performed by an experienced thoracic surgeon, with low complication rates.
How long does the Nuss procedure take?
It usually takes between one and two hours, depending on the severity of the case and the number of bars used.
How long is the hospital stay after surgery?
Usually 4 to 5 days, during which pain is controlled and the patient is monitored.
Is the pain after surgery severe?
There may be pain during the first few days, but it is controlled using modern techniques such as advanced pain medications or continuous local anesthesia, making it manageable and acceptable.
When can the patient return to normal life?
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Light movement: within days
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Daily activities: within weeks
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Light exercise: after 6 weeks
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Most activities: after 2–3 months
How long does the bar stay inside the body?
The bar is usually left in place for 2 to 3 years, then removed with a simple procedure.
Is bar removal a complicated operation?
No, bar removal is considered a simple procedure compared with the first operation, and it is often done as a day-case or within one day.
Does the result disappear after bar removal?
In most cases, the result remains stable and lasting, because the chest wall has adapted to the new position.
Can the deformity come back after surgery?
The recurrence rate is very low, especially when postoperative instructions are followed carefully.
What is the difference between the Nuss procedure and the Ravitch procedure?
Nuss procedure:
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Minimally invasive
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Small incisions
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Faster recovery
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Preferred option in most cases
Ravitch procedure:
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Open surgery
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Removal of the deformed cartilage
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Used in selected or more complex cases
Does the operation affect the heart or lungs?
On the contrary, in moderate to severe cases, the operation helps reduce pressure on the heart and lungs and may improve their function.
Does the surgery leave obvious scars?
The incisions are small (about 2–3 cm) and usually become less noticeable over time.
What are the risks of the Nuss procedure?
Complications are uncommon, but they may include:
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Bleeding
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Infection
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Bar displacement
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Pain lasting for a longer period
👉 With surgical experience, these complications are very uncommon.
Can the operation be performed at all ages?
It can be performed in adolescents and adults, but results are generally better at younger ages because the chest wall is more flexible.
Can surgery be avoided with conservative treatment?
In mild cases, exercises or the Vacuum Bell may help.
However, in moderate to severe cases, surgery is usually the most effective solution.
How do I know if I am a candidate for surgery?
This is determined through:
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Clinical examination
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Imaging such as CT scan
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Assessment of the severity of the deformity and its effects
Can I send my case for evaluation before coming?
Yes, you can send a chest photo or imaging report via WhatsApp for a quick initial assessment.