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Thoracoscopic Treatment of Pectus Excavatum: The Nuss Procedure

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The SAGES Manual of Pediatric Minimally Invasive Surgery

Abstract

Pectus excavatum is the most common chest wall deformity affecting up to 1 % of the population. Traditional management required an open procedure that included an anterior chest incision, resection of the affected cartilages, and sternal osteotomy. In 1997, Donald Nuss proposed a minimally invasive approach that utilized small, laterally oriented incisions and placement of a rigid bar to push the sternum up into the appropriate position. Over time this support allows the chest wall to remodel resulting in reversal of the defect, all without cartilage resection or osteotomy. Since its inception, it has experienced widespread application in many centers worldwide with good results. In this chapter we present the workup, selection of patients, and procedure for the minimally invasive repair of pectus excavatum. There is extensive literature on many aspects of this condition and procedure. The emphasis of this chapter is to present the technical logistics of the minimally invasive approach.

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Author information

Authors and Affiliations

  1. Department of General Surgery, Vidant Medical Center/East Carolina University, 600 Moye Blvd., Greenville, NC, 27834, USA

    Barrett P. Cromeens

  2. Department of Pediatric Surgery, Carolinas HealthCare System, 1025 Morehead Medical Dr., Suite 275, Charlotte, NC, 28203, USA

    Michael J. Goretsky

Authors
  1. Barrett P. Cromeens
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  2. Michael J. Goretsky
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Corresponding authors

Correspondence to Barrett P. Cromeens or Michael J. Goretsky .

Editor information

Editors and Affiliations

  1. Division of Pediatric Surgery, East Carolina University Brody School of Medicine, Greenville, North Carolina, USA

    Danielle S. Walsh

  2. Northeast Ohio Medical College Division of Pediatric Surgery, Akron Children’s Hospital, Akron, Ohio, USA

    Todd A. Ponsky

  3. Division of Pediatric Surgery, Akron Children’s Hospital, Akron, Ohio, USA

    Nicholas E. Bruns

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Cromeens, B.P., Goretsky, M.J. (2017). Thoracoscopic Treatment of Pectus Excavatum: The Nuss Procedure. In: Walsh, D., Ponsky, T., Bruns, N. (eds) The SAGES Manual of Pediatric Minimally Invasive Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-43642-5_10

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  • DOI: https://doi.org/10.1007/978-3-319-43642-5_10

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43640-1

  • Online ISBN: 978-3-319-43642-5

  • eBook Packages: MedicineMedicine (R0)

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