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About Nuss Procedure

What is Nuss Procedure?

What is Nuss procedure?

Nuss procedure is a minimally invasive surgical procedure that is performed to correct pectus excavatum or funnel chest. Pectus excavatum is a congenital deformity in which the ribs and sternum grow abnormally, giving a sunken or funnel shaped appearance to the chest. This condition affects about one in one thousand children and is four times more common in boys than in girls.


Nuss procedure was developed by American surgeon, Dr. Donald Nuss and is therefore named after him. It is also known as Nuss technique or pectus bar procedure.

The procedure is carried out by a thoracic surgeon or a doctor specialising in operations on the chest. The child is given local anaesthesia and the operation lasts for about one to two hours. During the procedure, two small incisions are made on each side of the chest to insert the stabilising bar. A third incision is made for the purpose of inserting a small camera that helps the surgeon to see inside the chest wall. The stabilising bar is then placed under the breastbone to correct the depression in the chest. The bar is removed two to four years after the procedure and is usually performed on an outpatient basis.

Once the bar is in place, the surgeon checks its position with the help of endoscope and then carefully turns it so that the curved section is pressing against your child’s sternum or breastbone. Once the surgeon is satisfied that the bar is in the right place, it is secured with stabilisers and wires and the incisions are closed. The bar, stabilisers and wires are not visible as they are contained by the ribcage. The endoscope is taken out of the chest cavity and this smaller incision is also closed.

After the procedure to relieve pain and discomfort, the child is given pain relief or epidural. When the child starts eating and drinking, it is when the epidural is removed.

To ensure that your child heals quickly and safely after the nuss operation, you would need to ensure that he doesn’t exert himself for the first few days after the surgery, should not indulge in contact sports, and should avoid lifting anything heavy.

Nuss procedure has many benefits over conventional methods for treating pectus excavatum. Patients have a shorter stay in the hospital, less scarring compared to open chest operation, and quick recovery. Medical professionals around the world consider nuss procedure to be one the best and the most effective treatments for pectus excavatum.

Who is the best candidate?

The best candidate for nuss procedure is a child who has been diagnosed with pectus excavatum. However, since each person is different, the medical professionals conduct complete physical evaluation of the chest deformity to ensure whether the child is a safe candidate for pectus excavatum or not and whether or not he can benefit from the particular treatment. The medical health professionals also provide detailed explanation regarding pectus excavatum, evaluation process, and surgery to the parents of the concerned child to help them make an informed decision.

Side effects:

Every surgery has some risks and side effects. Some of the complications that are associated with this procedure are

  • Headache, soar throat, sick feeling after the anaesthetic
  • Infection at the site of incision
  • Blood clotting in the area around the legs
  • The bar may become lose or may slip out of position
The above risks are very rare and when the surgery is performed by a qualified, trained, and experienced surgeon specialising in performing the nuss procedure, there are hardly any risks and side effects involved.

What is the Cost?

The cost of noss procedure is usually between $7500 and $8500.

Possible Alternatives: