Understanding the Nuss Procedure

Nuss Procedure Surgery

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Pediatric surgeons at CHKD are the pioneers of the Nuss Procedure and have trained extensively under Dr. Donald Nuss, the originator of the Nuss Procedure.

Understanding The Surgery

The Nuss Procedure, a minimally invasive approach to correcting pectus excavatum, involves surgeons inserting a metal bar (Lorenz pectus bar) under the ribs and sternum to reshape the chest wall. This technique does not require removal of any ribs and has significantly less blood loss and a shorter recovery time than the Ravitch procedure.

The surgeon bends the Lorenz pectus bar to the correct shape based on precise measurements of your child's chest. Two small incisions, one on each side of the chest, allow the bar to enter and be guided beneath the sternum to the other side. A small, separate incision is made for the thoracoscope, a tiny camera that monitors the procedure.

The bar is inserted through the right-side incision and advanced across the chest under the sternum to the left incision. Surgical tape and a tool called an "introducer" are used to guide the bar. A "bar flipper" is used to rotate the bar 180 degrees. This pushes the sternum out and corrects the deformity.

Once the bar is positioned and the chest has taken the correct shape, a stabilizer bar is attached to the bar and sutured to the ribs to prevent the bar from slipping. The opposite end of the bar is also sutured to the ribs. Finally, the incisions are dressed and X-rays are taken to confirm correct bar position.

Recovery Time

Most children return to school in a few weeks and resume normal activity after about a month. The Nuss Procedure was developed by pediatric surgeon Donald Nuss at CHKD in the late 1980s.

Through almost three decades of experience and research, Dr. Nuss and his colleagues have refined the procedure, improving outcomes and the lives of our patients.

Nuss Procedure Surgery Location

(757) 668-7703

The Nuss Procedure

Diving Dynamo

Drs. Donald Nuss and Ann Kuhn performed the Nuss Procedure on Emily Padgett, helping her get back to what she loves to do: competitive diving. Emily tells her story in her own words.

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