Modifications and Further Development of the Original Nuss Procedure: Blessing or Curse?

The procedure introduced by Donald Nuss in 1997 for the treatment of pectus excavatum at the American Pediatric Surgical Association meeting has now been adopted by pediatric, thoracic, and plastic surgeons around the world. Rather than resection of the costal cartilages and sternal fracture, which had been standard practice for decades, he advocated using a metal bar to push the sternum into position. Reasoning that the chest wall of children is very flexible, he felt that resection was unnecessary.