Pectus excavatum repair is surgery to correct pectus excavatum. This is a deformity of the front of the chest wall that causes a sunken breastbone (sternum) and ribs.

Pectus excavatum is often called a funnel or sunken chest. It occurs at birth, and often gets worse during adolescence.

Funnel chest repair; Chest deformity repair; Sunken chest repair; Cobbler's chest repair; Nuss repair

There are two types of surgery to repair this condition -- open surgery and closed (minimally invasive) surgery. Both of these are done while the child is in a deep sleep and pain-free from general anesthesia.

Open surgery is more traditional. In this method, the surgeon makes a cut across the front part of the chest.

• The surgeon removes the deformed cartilage and leaves the rib lining in place. This will allow the cartilage to grow back correctly.
• The surgeon makes a cut in the breastbone and moves it aside. The surgeon may use a rib or a metal strut (support piece) to hold the breastbone in this normal position until it heals. Healing will take 3 to 6 months.
• The surgeon may place a chest tube to drain fluids that build up in the area.
• Metal struts will be removed in 6 months through a small cut in the skin under the arm. This procedure is usually done on an outpatient basis.

The second type of surgery is a closed, less invasive method (Nuss repair). It is used mostly for children. No cartilage or bone is removed.

• The surgeon makes two small cuts, one on each side of the chest. A curved steel bar that has been shaped to fit the child is inserted through the cuts and placed under the sternum (breastbone).
• This bar is guided into position using a small video camera called a thoracoscope. This camera is placed inside the chest and removed after surgery.
• Then the surgeon uses a special instrument to rotate the bar and lift the sternum or breastbone. No bone or cartilage is removed. The bar is left in place for at least 2 years.

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Pectus excavatum

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Review Date: 01/24/2011
Reviewed By: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)