A new technique for removing the pectus bar used in the Nuss procedure.

BACKGROUND/PURPOSE: The Nuss procedure involves elevation of the sternum using a pectus bar, which is subsequently removed after approximately 3 years. When removing the bar, the tip of 1 end of the bar is exposed, and then the body is changed to the lateral recumbent position to remove the bar along the body surface. However, changing body positions in a sterile manner is often difficult. In this report, the authors present a new technique using their original bender design with which pectus bars can be smoothly removed.

METHODS

After exposing the pectus bar by placing a skin incision in the same location as had been used for bar insertion, benders were inserted subcutaneously into the thoracic wall at both ends of the bar. The bar was then immobilized, straightened, and removed. No change of body position was required.

CONCLUSIONS

Between 2002 and 2003, this technique was used on 10 patients, and the bars were removed easily from all patients. The new procedure uses benders at both ends of the pectus bar as supporting points. This reduces the force required to straighten the bar and stabilizes the bar during removal. Most importantly, our procedure eliminates the need for change of body position.