Surgical treatment of pectus excavatum is intended to reduce pressure on vital organs and create a more normal chest shape by repositioning the chest including the ribs, sternum or “breastbone”, and the cartilage that connects the ribs to the breastbone.

Until the widespread adoption of the minimally-invasive Nuss Procedure during the 1990s, a surgery that is commonly referred to as the Ravitch Procedure was the most common surgical option for correction of pectus excavatum.

This surgery corrects the shape of the chest by making a long cut, or incision, below the breast line across the chest. After the surgeon raises the chest muscles off the breastbone and ribs, he or she removes the abnormal cartilage, moves the breastbone into a normal position and places a short steel bar behind the breastbone to keep it in place. Surgery is performed while the patient is asleep under general anesthesia.  Following the 4 to 6 hour surgery, the cartilage will typically regrow and reconnect the breastbone to the ribs.

A Ravitch Procedure generally follows these steps:

• An incision is made across the front of the patient’s chest.
• Deformed cartilage is removed (resected) and the lining that covers the ribs and cartilage is left in place to help the cartilage grow back correctly.
• A cut (osteotomy) is made in the breastbone so it can be raised to a flat position. The surgeon may use a metal bar or strut to support the breastbone in this position as it heals.
• To help drain fluids out of the body, a tube is sometimes placed at the area of the repair.
• The incision is closed at the end of the surgery.
• After approximately 6 to 12 months, the metal support struts (if used), are removed through a smaller incision. 

This 1- to 2-hour long surgery corrects the shape of the chest by using a curved metal bar that is placed under the breastbone. With the help of a small camera, the surgeon will create a pathway across the chest under the breastbone and insert a Pectus Support Bar. The bar is shaped to fit the patient’s anatomy and lifts the chest into a normal shape. As the bar pushes the breastbone forward, it lifts the cartilage that holds the breastbone to the ribs, reshaping the cartilage and creating a more normal shape. Surgery is performed while the patient is asleep under general anesthesia.