Nuss Procedure

Also known as: Nuss procedure for pectus excavatum, pectus excavatum surgery.

What is pectus excavatum surgery?

Pectus excavatum surgery is a medical procedure used to treat pectus excavatum, also known as funnel chest or sunken chest. In our country, about two thirds of these deformities present during the adolescent growth spurt, while one third of patients have the problem from infancy.

What happens during the procedure?

Pectus excavatum surgery is performed under general anesthesia. Two incisions are made in the sides of the chest in line with the deepest part of the central deformity. A steel bar or two is inserted below the sternum, under the direct vision of an internal camera (a thoracoscope), in order to force the rib cage outward. The bar remains in place for several years, usually about 4, until the new chest contour is stable. The bar is then removed in a second surgery, after which about half of patients go home the same day.

Is any special preparation needed?

Most children need imaging studies, a cardiology evaluation and pulmonary function tests.  Just before the operation, the patients may need to avoid food, drink and certain medications.  . This is a major medical procedure that requires a stay of 4 to 5 days in the hospital.

What are the risk factors?

Infection, pain, swelling, difficulty walking or moving, pneumonia, cosmetic imperfection or damage to surrounding organs are potential risks of pectus excavatum surgery, along with other more unusual ones.  These complications are not common and most children have uneventful convalescence.

What about recovery?

A pain team is involved in managing the discomfort after this major reconstructive surgery.  Most children are out of bed the day after the operation and go home in two to five days. Breathing exercises and physical therapy are important.  Most patients will be back to most of their normal activities within a month, with full contact sports in about two months.


Reviewed by: Cathy Anne Burnweit, MD

This page was last updated on: 8/9/2018 9:12:18 AM

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When Layla was 5, she came to Nicklaus Children's Hospital with a severe case of scoliosis. To help straighten her spine, Layla spent time in halo gravity traction. While her mom returned home to Gainesville for work and school, the nurses at Nicklaus Children's took care of Layla, acting as substitute mothers and making sure she was well cared for.
January Patient of the Month: Layla
When Layla was 5, she came to Nicklaus Children's Hospital with a severe case of scoliosis. To help straighten her spine, Layla spent time in halo gravity traction. While her mom returned home to Gainesville for work and school, the nurses at Nicklaus Children's took care of Layla, acting as substitute mothers and making sure she was well cared for.