Is your child's chest sagging? Let's learn about the 'Nuss Procedure'

When we look at the chest of some children, we see that it looks sunken in, or like a hole? In medicine, this condition is called 'Pectus Excavatum'. This is a congenital condition. Because of this, some children may experience breathing difficulties, chest pain, and fatigue quickly during exercise. So, one of the most successful, modern treatments for this is the 'Nuss Procedure'. Today, we will talk about this very simply, so that you can understand.

Simply put, what is the Nuss Procedure?

'Nas' surgery is a special surgery performed to correct a sunken chest (Pectus Excavatum). Instead of making a large incision and opening the chest, this surgery is performed through two small holes on either side of the chest . That is why it is called 'minimally invasive' or minimally invasive surgery.

In this surgery, a curved rod or rods, typically made of titanium, are inserted into the chest to push the sunken breastbone forward and straighten it. These rods are left in the chest for about three years. During that time, the chest bones develop and form properly.

What is the best age to have this surgery?

This surgery is usually performed on young children , especially after the age of 14. This is because at that age, the body is still growing, and it is easier to shape the chest to the correct shape. However, there is no upper age limit for this. Adults can also have this surgery if necessary. You should talk to your doctor and decide if this surgery is right for your child or you.

Why is this surgery performed? What are the benefits?

The first thing is that immediately after the surgery, the sunken appearance of the chest disappears and the appearance becomes normal . This is very important for the child's mental health and self -confidence.

In addition, after this surgery, the pressure on the heart and lungs is reduced, and their function may improve. Many people experience a decrease in symptoms such as:

• Chest pain
• Shortness of breath
• Heart palpitations
• Getting tired quickly even after a little exercise

What should you do before surgery?

A few days before the surgery, the doctor will order several tests. These are to accurately measure the condition of the child's chest and to see if the body is ready for the surgery.

• Lung function test: See how well the child can breathe.
• CT (Computed Tomography) or MRI (Magnetic Resonance Imaging) scans:These take clear pictures of the inside of the chest and accurately measure things like how much is sunken in and how close it is to the heart.

How is the surgery done?

The entire surgery can take about four hours. The child is under general anesthesia throughout the procedure, so he or she will not feel anything.

The surgeon follows these steps:

1. First, two small incisions are made on either side of the chest.

2. A small camera is inserted through one incision to look inside.

3. In some cases, the nerves in the chest are frozen to reduce pain after surgery. This is called 'cryoablation' .

4. Then, a curved metal bar, custom-made to fit the child's chest, is inserted through an incision, placed under the sunken breastbone, and pushed up. This bar is sutured to the chest wall.

5. If you can't straighten your chest properly with just one stick, you can add a second or even a third stick.

6. Finally, the camera is removed and the incisions are closed and sewn shut.

What happens after the surgery?

The child usually has to stay in the hospital for about a day. From the day after the surgery, they are encouraged to sit up straight in bed, breathe deeply, and walk a short distance. These help the healing process a lot. They are also given medication ( laxatives ) to prevent constipation that may occur due to the painkillers.

How painful is the surgery?

These pain control methods are used while in the hospital and for about two weeks after you go home.

What are the risks of this surgery?

Like any surgery, there are some risks involved, but the likelihood of these occurring is low.

• Bleeding
• Infection
• Pain
• Bar moving

The most important thing to be careful of is the stick moving around . To prevent this, you need to specifically tell your child about these things in the first four weeks:

• Sit up straight.
• When bending, bend only at the waist.
• Don't sleep with your back turned.
• Do not do any twisting work.

How long does it take to fully recover?

It can take up to six months to fully recover, but most children are able to resume normal activities much sooner. They can go to school within about a month .

However, you will need to avoid activities such as weight lifting and contact sports for a few months. Your surgeon will give you detailed instructions on what activities you can resume and when.

When should you see a doctor?

After surgery, if your child has any of the following symptoms, call your doctor immediately.

• Fever
• Redness or swelling around the incision
• Bleeding or pus from cuts
• Severe chest pain
• Difficulty breathing
• If you feel like you're being stabbed in the chest

In addition, it is essential to follow-up with the doctor at regular intervals until the splint is removed.

Nuss Procedure, Pectus Excavatum, Sunken Chest, Chest Surgery, Pediatric Surgery, Sunken Chest Surgery