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This technique, which Ravitch developed in 1949, emerged as a method used in treating Pectus Excavatum, or shoemaker's chest.

So how is the Ravitch surgery performed, and is it risky?We tried to answer the frequently asked questions about the Ravitch surgery and the shoemaker's chest treated with this procedure.

What Is Pectus Excavatum?

Pectus Excavatum is a chest wall deformity popularly known as a shoemaker's chest. It occurs when the bone in the middle of the chest, called the sternum, and the cartilage structure that provides the connection with the ribs collapses inward to the chest wall.

Although patients visit the doctors due to aesthetic concerns in shoemakers' chests, discomfort may also occur. For example, pressure on the lungs and heart increases due to the inward collapse of the chest wall. Especially in severe cases, there is a situation such as displacement of the heart towards the left side.

On the other hand, pressure on the heart and lungs can cause respiratory problems and heart rhythm disturbances. The most common symptoms of shoemaker's chest are shortness of breath, chest pain, and fatigue.

Which methods are used in treating Pectus Excavatum (shoemaker's chest)?

There are three treatments for shoemaker's chest disease: non-surgical and two surgical methods. The first of these, the non-surgical Vacuum Bell method, aims to treat the condition with a hand pump and a bell placed outside the chest.

Another method is the Nuss procedure, a minimally invasive method performed surgically. In this treatment method, a metal bar called a pectus stick passes over the ribs and sternum, giving a new position to the sternum. This metal bar is placed on the sternum with incisions made under the two arms. The most commonly used method is the Nuss procedure.

The third method used in treating pectus excavatum is the Ravitch procedure or Ravitch surgery.

What is Ravitch Surgery?

The Ravitch procedure is the longest-lasting surgery used to treat pectus excavatum. It takes approximately 4 to 6 hours. The steps that surgeons follow during the operation are as follows:

  • The patient is under general anesthesia.
  • A horizontal incision is made in the middle of the chest.
  • Anormal costal cartilages are removed. During this process, we preserve the cartilage lining to allow the sternum to return to a more normal position.
  • In some patients, a fracture (osteotomy) may be necessary to allow the slab to move to a more advanced position.
  • After all, procedures, a metal bar is placed to hold and support the sternum in the desired position.

After the Ravitch surgery, the support bar placed on the chest should remain in place for approximately 2-3 years. Patients can start taking showers after five days. Because the stitches are absorbable, there is no need to remove their stitches. Since the patient may have pain after the operation, we may give painkillers.

Frequently Asked Questions About Ravitch Surgery

Although Ravitch surgery is risky for its long duration, it is done by specialist surgeons without any problems.

There are some restrictions after the operation. For example, avoiding sports requiring high effort, such as boxing or taekwondo, is necessary. On the other hand, pain is more severe in cold weather.

On average, the disease heals entirely within 3 to 6 months.

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