Minimally invasive repair of symmetric pectus carinatum: bilateral thoracoscopic chondrotomies and suprasternal compression bar placement.

Purpose: We previously reported a novel minimally invasive repair for unilateral pectus carinatum. We have now modified this approach for the repair of symmetric bilateral pectus carinatum.

Materials And Methods: Using thoracoscopy, parasternal chondrotomies were performed at multiple rib levels at points of maximal sternal protrusion. The sternum was depressed to an appropriate position and maintained using a suprasternal metal compression bar. The bar was applied in a submuscular plane and anchored to the lateral ribs with sutures. Bars were removed after 6 months.

Results: Three patients with severe symmetric pectus carinatum underwent the repair. The first patient returned to the operating room after 1 month for repeat fixation of the bar after suture breakage. No other complications occurred. Operative times were comparable to published series. Patient satisfaction after the repair was good.

Conclusions: Minimally invasive thoracoscopic repair of symmetric pectus carinatum using chondrotomies and suprasternal bar compression is a feasible alternative to open repair.