The Nuss Procedure, represents a revolutionary approach in the surgical treatment of pectus excavatum, (a
condition characterised by a sunken or concave chest). This condition, affecting the sternum and rib cartilages, can
cause not only cosmetic concerns but also physical discomfort and potential impact on cardiac and respiratory
function. Before the introduction of the Nuss Procedure, the primary surgical intervention was the Ravitch technique,
a more invasive procedure involving the removal of cartilage and the repositioning of the sternum. In contrast, the
Nuss Procedure is minimally invasive and thus, represents a leap forward in terms of reduced recovery time and less
scarring.
The core of the Nuss Procedure involves the insertion of one or more curved metal (sterile stainless steel) bars into
the chest cavity. These bars are placed under the sternum, and their curvature is designed to mirror the desired
shape of the chest. By positioning these bars, the sunken sternum is effectively pushed outward, correcting the
concavity. The bars are usually left in place for about two to three years, allowing the chest to reform and stabilise in
its new shape. After this period, the bars are removed in a subsequent, relatively minor surgery.
This procedure is typically recommended for patients in their teenage years, as their bones and cartilages are still
malleable. One of the significant advantages of the Nuss Procedure is that it involves less blood loss and a shorter
hospital stay compared to traditional methods. Additionally, the cosmetic results are generally excellent, with a
natural chest appearance.
However, as with any surgical intervention, there are minor risks and potential complications, including pain, bar
displacement, and infection associated with it. The decision to undergo the Nuss Procedure should be made after
thorough consultation, considering the individual's specific condition and overall health.