Questions and answers about surgical treatment of pectus excavatum (by Dr. German Nikolaev, Head of Thoracic Surgery Research Laboratory)

• What surgical method is used to correct pectus excavatum?

Today, there are two main methods in world practice. With Ravitch technique, the deformity is corrected by transverse sternotomy and resection of malformed costal cartilages (from the costal arch to the third ribs). This procedure is associated with a massive tissue trauma. The second technique is a minimally invasive Nuss procedure. It involves insertion of a metal bar behind the breastbone through 2 small bilateral incisions.

• What method is used at Almazov Centre to correct pectus excavatum and why it was chosen? What are the main stages?

We use the Nuss technique at Almazov Centre. This technique was chosen primarily due to its reduced surgical trauma and high efficiency as can be seen in the photos of our patients before and after the surgery (read more). The main stages of treatment are as follows. In order to select a metal bar at the initial examination of the patient, measurements of the deformed chest are taken. Before the surgery, the patient undergoes examinations, including a general clinical examination, chest CT, echocardiography, spirography. The patient has surgery under general anesthesia. At the first stage, the introducer is inserted into the chest, and by using the introducer a prebent metal bar is placed under the deformed area. At the second stage, the bar will be rotated and fixed to the ribs. The duration of stay after this procedure as a rule does not exceed 4-6 days. The implanted metal bar is removed two years after the surgery.

• How much time will it take to recover after the Nuss surgery? How soon can I exercise or play sports after surgery?

Most patients will fully recover within one month after surgery. During this time, patients can return to normal life activities but it is important to avoid physical exertion. After a full recovery, you can play sports but you should avoid exercises that load the shoulder girdle.

• Can I get the Nuss surgery free of charge?

For Russians, the surgical treatment of pectus excavatum is free of charge under a quota allocated by the Russian Ministry of Health. For foreign patients, this surgery is a paid service. In any case, before the surgery you should have a consult with Dr. German Nikolaev, Head of Thoracic Surgery Research Laboratory, in person or remotely.

• Can I take a certified sick leave for the Nuss surgery?

Yes, Russian citizens will get a medical certificate for the whole period of treatment.

• How will I feel after the bar removal surgery and how long will it take to recover from it?

The second surgery is much easier. Normally, the patient is discharged 3-4 days after the removal of the bar and full recovery usually takes 2 weeks.