The Nuss procedure is a procedure for the treatment of pectus excavatum.

A small incision is made on either side of the chest, and a small camera is inserted for observation as the surgeon passes a thin, curved metal bar through the chest cavity below the sternum. When the bar is flipped, the sunken chest is instantaneously repaired. A metal plate (called a stabilizer), sutures (stitches), or wire is placed to hold the bar in place. The post-operative stay for this operation is 3-4 days.

Your child will undergo a general anesthetic which will put him or her completely to sleep and prevents the sensation of pain.

The bar remains in place for two years, and is periodically monitored by a pediatric surgeon. After a period of two to four years, depending on the severity of the pectus excavatum, the surgical stainless steel bar will be removed, which will require a second operation and hospital stay.

Even though the Nuss procedure is minimally invasive with small incisions, your child will need pain medicine and rest after the surgery. He or she will need to stay home from school for about 3 weeks. It may take 6 months or more for your child to return to all activities he or she did before the surgery.

For about 3 months after the surgery, your child should:

  • Perform breathing exercises (this helps prevent infection).
  • Walk or do other gentle exercises as recommended by the surgeon.
  • Avoid strenuous activity, including running.
  • Not drive.
  • Ride in the back seat to avoid possible trauma from an air bag.

Your child should not play sports that could cause a chest injury (such as football, soccer, and baseball) until the surgeon says it’s OK.

Check with your surgeon if you have any questions about what activities are safe for your child.

Complications of Nuss procedure

  • damage to the heart and lungs
  • air in the chest (pneumothorax) is one of the more frequent complications. A chest tube may be required or aggressive breathing exercises and close monitoring may be adequate.
  • bar movement or displacement requiring re-positioning
  • blood in the chest (hemothorax
  • infection
  • prolonged post-operative pain
  • recurrent pectus excavatum

References:

CHOC children’s hospital