Facts: Nuss Procedure
- New approach to repair pectus excavatum
- Simple technique with better cosmetic results; aiming to elevate the deepest part of the depression
- Done by placing a retrosternal metallic bar through small incisions in the intercostal space. The bar penetrates the pleural cavity at the hinge point at either side.
- Several types of bars available to choose depending on the morphology of pectus excavatum
- It is important for surgeon to elevate the deepest part of the depression, which is not necessarily the center of the sternum!
- Most common = pneumothorax
- Followed by: bar displacement, seroma, pleural effusion, pericardial effusion
- Bar displacement can be: 1) flipping (most common), 2) lateral sliding, 3) backward shift
Park et al. The Nuss procedure for pectus excavatum: evolution of techniques and early results on 322 patients. Ann Thorac Surg 2004;77:289-295.