article on less invasive repair of pectus carinatum

[Guest guest]

I found this article this morning...very interesting idea.

Surgeons demonstrate new minimally invasive technique to correct chest deformity

Technique replaces invasive technique used to correct pectus carinatum or

'pigeon chest'

NORFOLK, VA. –- A new minimally invasive surgery to correct a chest wall

deformity -- often known as pigeon chest -- was demonstrated Friday at an

international conference attended by surgeons from the U.S., Canada, Argentina,

Chile, Panama, Puerto Rico, Germany, Spain and Russia.

Technically known as pectus carinatum, the condition causes the chest wall to

protrude outward, giving the patient's chest the appearance of the breast of a

bird. In years past, the only surgery to correct severe cases was extremely

invasive and involved cutting open the chest to remove excess cartilage. Because

of the invasive nature of the surgery, the condition often went uncorrected.

" For many years, the medical community treated pectus carinatum as a merely

cosmetic issue, " said Dr. , a pediatric surgeon at CHKD. " Pectus

carinatum causes real physical and psychological problems for young people. We

want physicians to understand that this condition should be treated. No child

should have to suffer with it. "

The new surgical technique was developed in South America by surgeons trained in

a minimally invasive technique developed by CHKD pediatric surgeon Dr.

Nuss to correct pectus excavatum, a related condition that causes the chest to

protrude inward.

The " Nuss technique " involves passing a curved bar inside the chest cavity,

below the rib cage, to push out the indentation from underneath. After a period

of time, the bar is removed and the chest grows normally.

In South America, where the outward protrusion is more common, surgeons

developed what some doctors call a " reverse Nuss " in which the bar runs beneath

the musculature, but above the ribs, pushing down the protruding section of

cartilage. Again, the bar is removed after the condition is corrected.

During the conference, Dr. operated on a pectus carinatum patient,

demonstrating " reverse Nuss " procedure, while one of the technique's pioneers,

Dr. Patricio Varela of Santiago, Chile, offered narration.

At the same conference, CHKD's team of pediatric surgeons, physical medicine

physicians and physical therapists demonstrated another device that, in the

majority of the cases, can correct pectus carinatum before it becomes so rigid

that surgery is required.

The new dynamic compression brace, also developed in South America where pectus

carinatum is more common, can be calibrated to exert the exact pressure needed

to correct the condition in the same manner that braces straighten crooked

teeth.

Dr. Marcelo ez-Ferro of Argentina explained the history of the dynamic

compression device, including the role of Drs. Nuss and in its

development, and brought up four patients to the conference room to demonstrate

how to use the new dynamic compression brace.

" Both of these techniques are major advances in correction of pectus carinatum, "

said Dr. Nuss.

At present, CHKD -- home to the nation's top chest deformity research and

surgery program – is the only hospital in the nation where these techniques

are used.

The techniques were demonstrated at the 8th International Nuss Conference, part

of CHKD's mission to promulgate the newest and best techniques for correcting

chest wall deformities to surgeons around the world.

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Children's Hospital of The King's Daughters is the only freestanding children's

hospital in Virginia and serves the medical and surgical needs of children in

Virginia and northeastern North Carolina.

For more information on chest wall deformities, visit www.chkd.org/nuss.