Bone, Joint and Muscle Conditions
Pectus Excavatum Treatment
Our surgery team has seen hundreds of children with pectus excavatum and can help you decide if your child’s condition needs treatment or tests. Treatment is not always necessary. Many children live normal, healthy lives without treatment. But some children have symptoms and might need surgery to move the breastbone and make more room for the heart and lungs, or to help them feel better about their body.
Surgery for Pectus Excavatum
The Ravitch repair and the Nuss procedure are the 2 main surgeries for pectus excavatum. Your child’s doctor will explain these to you and decide which one is best for your child. If your child has one of these surgeries, we will first give your child medicine (general anesthesia) to make them sleep without pain during the surgery. Our pediatric anesthesiologists have special training in giving anesthesia specifically for kids.
With the Ravitch repair, the surgeon makes a long cut, or incision, across the chest below the breast line, and raises the chest muscles off the breastbone and ribs. Then the surgeon removes the abnormal cartilage, moves the breastbone into a normal position and places a short steel bar behind it to keep it in place. Finally, the surgeon reattaches the muscles and sews up the incision.
The Ravitch repair takes about 4 to 6 hours. After surgery, your child will be in the recovery room for another hour. Your child will stay in the hospital for about 4 to 7 days.
As your child heals, their cartilage will regrow and reconnect the breastbone to the ribs. After about 6 months, surgeons remove the steel bar during an outpatient surgery, so your child can go home the same day.
The Nuss procedure is a newer procedure where the surgeon inserts a long, stainless-steel bar that is bent to the desired shape of the chest. It goes under your child’s breastbone and in front of the heart. As the bar pushes the breastbone forward, it bends the cartilage that holds the breastbone to the ribs. The goal is for the bone and cartilage to heal in this new, more normal shape.
The Nuss procedure takes about 2 to 3 hours. Then your child will be in the recovery room for another hour. Your child will stay in the hospital for about 4 to 7 days.
It takes most children about 2 to 3 months to heal. Then they can start playing sports again. Doctors usually leave the bar in place for 2 years. Surgeons remove it in an outpatient surgery, so your child can go home the same day.
Many surgeons prefer the Nuss procedure over the Ravitch repair because it requires smaller incisions, allowing faster healing. Seattle Children’s was the first hospital in the Pacific Northwest to offer the Nuss procedure and has been doing it since 2000. During that time, we have treated hundreds of children with the condition.
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After Surgery for Pectus Excavatum
Before you go home, we will teach you how to care for the incision — keeping it clean and dry — and how to give your child pain medicine. You should also limit your child’s activity while they recover. Your child should:
- Sit up straight for the first month after surgery
- Avoid lifting anything heavy for a few months
- Avoid playing sports for 2 to 3 months
The surgery team will explain these and other limits before your child goes home.
About 2 to 3 weeks after surgery, your child will need to see the surgeon for a follow-up visit. The surgeon will make sure the incision is healing and that your child is recovering well.
Our doctors and nurses are always available to help you and answer questions.
To learn more about pectus excavatum treatment at Seattle Children’s, call our General and Thoracic Surgery Department at 206-987-2794 x4.