Implantation of a nuss bar under thoracoscopic guidance

Abstract

In 1998 Nuss et al. described a new procedure for the correction of pectus excavatum. The procedure basically consists of implantation of an anteriorly prebent metal bar in such a way that the median one third of the bar lies underneath the sternum and pushes it up, while the lateral thirds lie subcutaneously on the lateral chest wall. For inserting this bar a minimal access technique is used. Originally the passage of the bar between the sternum and the pericardium was made in a blind way but accidental puncture of the heart has occurred (Hebra et al. 2000). It is now common practice to make the passage between the sternum and the pericardium under thoracoscopic control. This chapter concentrates on the thoracoscopic part of the procedure. © Springer-Verlag Berlin Heidelberg 2008.