Pectus excavatum, or shoemaker's chest, is a disease seen once every 400 live births. Although it creates a cosmetic defect, it can also cause serious health problems. The most common health problems are shortness of breath and chest pain.
Therefore, treating it before problems occur is the best way for management. The Nuss technique is one of the most commonly used treatment methods for shoemaker's chest disease. So what is the Nuss technique, and how is it performed? Let's take a look at this topic together.
What is Nuss Technique?
Nuss technique treats the disease, also known as pectus excavatum or shoemaker's chest. This method, which doctor Donald Nuss developed, a US surgeon in 1987, dramatically facilitates the treatment of the disease.
Before the Nuss method, treating pectus excavatum was very difficult, and patients had to stay in the hospital for a long time. However, Nuss's surgery enabled patients treated for pectus excavatum disease to return to their everyday lives concisely.
Nuss surgery takes significantly less time than Ravitch surgery to treat shoemakers' chest disease. While Ravitch surgery takes 4 to 6 hours on average, this time is approximately 15 to 20 minutes in Nuss surgery.
On the other hand, there is less scarring compared to Ravitch surgery, which prevents the patient from feeling bad aesthetically. It is because Nuss surgery is much more invasive and thoracoscopic than Ravitch surgery. Nuss operation is excellent in terms of patient comfort and the time to discharge from the hospital is just as short.
How is Nuss Technique Applied?
Surgeons follow the following steps during the Nuss technique, which is the most commonly used surgery in the treatment of pectus excavatum today:
- The patient receives general anesthesia in the operating room
- The uppermost points are marked on both sides of the chest, and 2-centimeter incisions are made at these points.
- The aluminum model of the metal bar serves for length determination.
- After the modeling, the metal bar placed on the chest is formed by looking at this model. A metal bar bender serves during this step.
- We make another incision from the lower right armpit line; the thoracoscope is sent through this incision and inserted into the chest cavity.
- The tunneler inserted into the chest cavity goes through the right incision.
- The tunneler inserted into the left chest cavity goes through the tunnel between the pericardium and the sternum.
- We remove the guide rope at the end of the tunneler.
- The previously made metal bar is attached to the guide rope and placed.
- The metal bar is rotated 180 degrees in the thoracic cavity with the help of a particular metal spinning tool in a way that pushes the sternum outward.
- The process is terminated by suturing the incisions.
Although it seems like a risky operation, high success rates are reported when performed by a specialist and experienced surgeon.
Post-Nuss Surgery Process
After the operation, the patient is hospitalized in the inpatient service. Oral feeding starts on the same day, and the patient can stand up. Patients may feel pain for the first three days after surgery. Therefore, we can apply pain relief treatment. We recommend that patients discharged in approximately 4 to 5 days should rest at home for an average of 2-3 weeks. Here are some tips about sports after surgery:
- Patients can start walking and light exercises without using weights one month after the surgery.
- Patients can start sports such as swimming or fitness three months after the operation.
- All sports can be performed six months after the operation, except for contact sports such as boxing, karate, or wrestling.