Pectus Excavatum is the most common thoracic deformity (one in 500) characterized by a depression of the sternum in the anterior thoracic wall. The deformity worsens during onset of puberty until about age 18. Patients are usually asymptomatic but can have related cardiovascular dysfunction, thoracolumbar scoliosis, or psychological effects. In these conditions medical evaluation might be provided in order to assess the advantages of surgical repair (non surgical treatments in moderate to severe deformities are documented as ineffective). Although several techniques have been described, after description of the minimally invasive surgical correction in nineteen’s there has been an increase in the number of patients seeking for Nuss repair.
Before pectus excavatum can be properly treated, it must first be properly diagnosed and its severity stratified. Your doctor and other specialists, including a pediatric surgeon or thoracic surgeon, will perform a complete physical exam and comprehensive blood tests to confirm the diagnosis. In addition other tests may be performed, including pulmonary function test, chest x-ray, electrocardiogram (EKG) and echocardiogram. Because the morphology of the deformity varies a lot among patients, preoperative CT-scan of the chest for documentation of morphology, dimensions and depression severity (Haller index, depression index) of the chest is also very important.
Correction of Pectus Excavatum can be performed at any age, but commonly it is recommended during puberty. The Nuss procedure might be performed using a video-assisted thoracoscopic surgery (VATS) technique. Briefly, the procedure consists in the insertion of a curved steel or titanium bar under the sternum that is used to ‘pop out’ the depression and is then fixed to the ribs on either side. The bar is not visible from the outside and stays in place for a minimum of two years. When it is time, the bar is removed as an outpatient procedure. The success rate of the procedure is over 95%.
The i3DExcavatum System offers a wide range og option for minimally invasive surgical correction of pectu excavatum, thus allowing the physician to choose the option that best suited to each patient's chest mophology.
The i3DExcavatum system also offers non-surgical options for correctiong the pathology.