Review article
https://doi.org/10.26800/LV-145-supl1-24
Minimally invasive Nuss procedure for repair of pectus excavantum
Tomislav Šušnjar
; Klinika za dječju kirurgiju, Klinički bolnički centar Split
Miro Jukić
Zenon Pogorelić
Klaudio-Pjer Milunović
Jakov Todorić
Tin Čohadžić
Abstract
Introduction: Pectus excavatum, an acquired or congenital malformation of the anterior chest wall, is the most common deformity of the chest wall. Pectus excavatum together with pectus carinatum are the most common chest deformities (about 90%) with a frequency of 1:400 in the newborns. These patients experience significant psychosocial difficulties and possible physiological disturbances like cardiopulmonary malfunctions. The treatment of pectus excavatum can be carried out in two ways: surgical and non-surgical. The traditional procedure of funnel chest repair is performed by large open surgery according to Ravitch and his modifications. Since 1998, Dr. Donald Nuss has published a minimally invasive funnel chest surgery technique that uses thoracoscopic visualization with small side incisions in the axillary line and early placement of a modeled metal rod behind the sternum. This technique was quickly adopted by many surgeons, resulting in a significant increase in the number of operations. The minimally invasive approach for funnel chest repair is accepted in many centers as the method of choice, primarily due to increased patient awareness and good long-term outcome. Initially, this procedure showed possible risks and complications, so important technical modifications were made that reduced the risk and improved the overall result. The aim of this paper is to present the treatment method of minimally invasive surgical correction of
pectus excavatum in pediatric patients according to the Nuss method. In the non-surgical treatment of funnelshaped chest, a vacuum bell is used, which is placed on the front wall of the chest and with the help of a pump creates a vacuum that pulls the front wall of the chest forward. Conclusions: The Nuss procedure is a successful method of surgical treatment for pectus excavatum in children and adults. Operative treatment of funnel-shaped chest according to the Nuss method gives mainly excellent aesthetic results and subjective satisfaction of the patient.
Keywords
PECTUS EXCAVATUM; NUSS PROCEDURE; CHILDREN; MINIMALLY INVASIVE SURGERY
Hrčak ID:
300848
URI
Publication date:
17.4.2023.
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