Pediatric Pectus Excavatum

In moderate and severe cases, pectus excavatum may require surgery, which has proven very effective at correcting the condition and its psychological and physical effects. The most common types of operations are the Nuss procedure and the Ravitch technique. Children’s National Hospital's team of experts in the Chest Wall Defects Program can help families determine the best treatment option for their child.

The Nuss procedure is more popular because it requires much smaller incisions and is minimally invasive. Surgeons make two incisions on either side of the chest, through which they insert a curved steel bar under the sternum. The surgeons flip the bar so it pushes outward on the sternum. The bar usually stays in the body for about two years. When the bones have solidified into place, the bar is removed during a same-day operation.

Using the Ravitch technique, surgeons create an incision along the chest, through which they remove cartilage and detach the sternum. They then implant a small bar beneath the sternum to raise and hold it up in the desired position. The bar is left in position until the cartilage grows back, and can support the chest in a normal position. That usually takes about one to two years. The bar is then removed during a same-day operation.