Pectus Info

Pectus Excavatum

  • It is a chest wall deformity resulting in a sunken breastbone (sternum) or rib cage.
  • It occurs in about one in 1,000 people and is more common in males than females.
  • The deformity may be seen at birth or show up later during childhood or puberty.
  • It may affect the heart and lungs depending on severity of deformity.
  • May be associated with other syndromes.

Alternative names  of Pectus Excavatum

  • Funnel breast
  • Funnel chest
  • Sunken chest

Medical Help for Funnel Chest

You should see the doctor if you experience the following

  • Chest pain [compressed heart and lung]
  • Breathing difficulties [compressed heart and lung]
  • Decreased exercise tolerance compared to peers [compressed heart and lung]

Evaluation before surgical repair

  • A complete medical history and physical exam
  • Chest measurements and photos of the chest
  • Routine blood investigation
  • CT scan of chest / Chest X-ray
  • Pulmonary (lung) function tests (PFT)
  • Cardiac (heart) echocardiography / ECHO / ECG
  • To evaluate for effect on the heart, lung and any associated conditions.

Minimally Invasive Repair of Pectus Excavatum [MIRPE]

  • Use of stainless steel bar
  • Bone remodels along the bar
  • No cutting of ribs
  • Small skin incision
  • Morphology / Defect based pectus repair

Repair based on morphology and CT images of chest using

  • TERCOM/ Terrain contour mapping
  • CT measurement for bar contouring
  • Park’s Morphological classification criteria [symmetrical and asymmetrical defects]

The above techniques help achieve a perfect morphological and heart lung function

Repair of Sunken Chest

The procedure is done under general anesthesia.

  • Sternal lift technique/Crane technique – Prevent heart, lungs injury.
  • Pectoscopy – Entire procedure in chest done under endoscopic vision [In thoracoscopy only one side chest under vision]
  • Specially designed stainless steel bar/ bar stabilizers/ bar fixators / No wire fixation of bars
  • Only 1.5cm big incision on the right and left chest

Complications of MIRPE

If they arise, complications are associated to:

  • General Anesthesia which is used.
  • Surgery related
    • Injury to heart/lung
    • Pneumothorax/hemothorax
    • Bar displacement/dislodgement
    • Wound infection
    • Care after Pectus/MIRPE Surgery


  • Postoperation, patient will be shifted to the ICU for monitoring.
  • Pain control will be our top priority during recovery
  • Eating will be allowed once patient is awake and able to swallow
  • Correction of defect will be monitored with Chest x ray / CT thorax.
  • Chest physiotherapy and postural monitoring during stay which will be continued at discharge
  • Discharge from hospital usually on the 5th to 7th postoperative day.

Discharge advice

A detailed Dos and Don’ts will be advised according to the age and patient characteristics.

  • Maintain a good posture
  • Avoid lifting weight
  • Avoid contact sports

Bar Removal

Bar removal is done under general anesthesia At the end of 2 years to 3 years depending on age group. It can be done as a day care procedure or overnight admission.

Care after bar removal

  • Wound care is most important
  • Keep site clean and dry

Bnenefits of The Procedure

  • PHYSIOLOGICAL – Improved heart and lung function
  • Psychosocial – Improved self esteem
  • Cosmetic
  • External Pectus link



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