Minimally Invasive Procedure Can Correct Sunken Chest Syndrome

Jackson, Miss. - September 15, 2003 -- Baptist Medical Center in Jackson, Miss. offers a minimally invasive surgery to correct sunken chest syndrome in pediatric patients. Sunken chest syndrome, called pectus excavatum, affects about one out of every 1,000 children. It is a malformation in which the ribs and chest wall appear indented or sunken toward the spine.

The Nuss procedure, the newest technique for correcting sunken chest, is performed by thoracic surgeon Dr. Michael Koury at Baptist. In the procedure, a small incision is made on each side of the rib cage. Next, a curved, custom-shaped, stainless steel rod is woven through the rib cage beneath the sternum. Once in place, the rod is rotated, turning the curved portion against the chest wall, and pushing the ribs and chest out. The rod is secured to the chest wall with sutures and wire and left in place for about two years.

"The theory behind this procedure is similar to correcting misaligned teeth with braces," said Dr. Koury. " We know that even in adults, the chest wall will change shape. So when this bar is used in children whose chests are still forming, the effects are very good. The bar acts as an internal brace and the deformity is corrected over time."

Dr. Koury was trained by Dr. Donald Nuss, who introduced this procedure in 1987. The Nuss procedure shortens the surgical time significantly. The procedure takes one hour or less with blood loss averaging 10 to 30 ccs, and it uses smaller incisions and leaves only two small scars. Whereas, the traditional open procedure, in addition to the increased operative morbidity, has a significant incidence of recurrence and could also leave the patient with a more rigid than normal chest. Plus, the traditional procedure takes two to three hours with the possibility of significant blood loss.

Following surgery, most patients experience some discomfort that is managed with medication. The average hospital stay is three to five days, with return to normal activities - with some precautions - within a month.

Dr. Koury added that not every child with sunken chest will require surgical correction.

"Objective data can be obtained on those children who experience symptoms such as shortness of breath and chest pain during physical exertion to see if surgery is an option. Even when surgical intervention is not judged appropriate, children with pectus excavatum do bear watching in all cases," Dr. Koury said.

Click here to learn more or to request a referral to a surgeon at Baptist.

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