Dr. L . M Darlong
Sr. Consultant Thoracic Surgeon
• It is a chest wall deformity resulting in a sunken breastbone (sternum) or rib cage.
• It occurs in about one in 1,000 people and is more common in males than females.
• The deformity may be seen at birth or show up later during childhood or puberty.
• It may affect the heart and lungs depending on severity of deformity.
• May be associated with other syndromes.
Alternative names of Pectus Excavatum
• Funnel breast
• Funnel chest
• Sunken chest
Medical Help for Funnel Chest
You should see the doctor if you experience the following
• Chest pain [compressed heart and lung]
• Breathing difficulties [compressed heart and lung]
• Decreased exercise tolerance compared to peers [compressed heart and lung]
Evaluation before surgical repair
• A complete medical history and physical exam
• Chest measurements and photos of the chest
• Routine blood investigation
• CT scan of chest / Chest X-ray
• Pulmonary (lung) function tests (PFT)
• Cardiac (heart) echocardiography / ECHO / ECG
• To evaluate for effect on the heart, lung and any associated conditions.
Minimally Invasive Repair of Pectus Excavatum [MIRPE]
• Use of stainless steel bar
• Bone remodels along the bar
• No cutting of ribs
• Small skin incision
• Morphology / Defect based pectus repair
Repair based on morphology and CT images of chest using
• TERCOM/ Terrain contour mapping
• CT measurement for bar contouring
• Park's Morphological classification criteria [symmetrical and asymmetrical defects]
The above techniques help achieve a perfect morphological and heart lung function
Repair of Sunken Chest
The procedure is done under general anesthesia.
• Sternal lift technique/Crane technique – Prevent heart, lungs injury.
• Pectoscopy – Entire procedure in chest done under endoscopic vision [In thoracoscopy only one side chest under vision]
• Specially designed stainless steel bar/ bar stabilizers/ bar fixators / No wire fixation of bars
Complications of MIRPE
If they arise, complications are associated to:
• General Anesthesia which is used.
• Surgery related
1. Injury to heart/lung
3. Bar displacement/dislodgement
4. Wound infection
5. Care after Pectus/MIRPE Surgery
• Postoperation, patient will be shifted to the ICU for monitoring.
• Pain control will be our top priority during recovery
• Eating will be allowed once patient is awake and able to swallow
• Correction of defect will be monitored with Chest x ray / CT thorax.
• Chest physiotherapy and postural monitoring during stay which will be continued at discharge
• Discharge from hospital usually on the 5th to 7th postoperative day.
A detailed Dos and Don'ts will be advised according to the age and patient characteristics.
• Maintain a good posture
• Avoid lifting weight
• Avoid contact sports
Bar removal is done under general anesthesia At the end of 2 years to 3 years depending on age group. It can be done as a day care procedure or overnight admission.
Care after bar removal
• Wound care is most important
• Keep site clean and dry
Benefits of The Procedure
• PHYSIOLOGICAL – Improved heart and lung function
• Psychosocial – Improved self esteem
• If you are planning for surgery, we can connect you with closed group of patients, who have undergone surgery in past.
• For international patients travel, stay and visa assistance provided.