Surgical Techniques- Pectus Excavatum: The Modified Ravitch Procedure

Abstract

A modification of the established Ravitch procedure is described which may be applied to treat symmetric as well as asymmetric forms of Pectus Excavatum and Carinatum. The correction of the deformity is performed via vertical midline incision in males and females. If a monocortical osteotomy of the sternum is necessary depends on the severity of the deformity as well as on the stiffness of the thorax after performing the chondrotomies/rib resections of the deformed ribs. The main advantage of the modified procedure is the implantation of a bioresorbable allogenic lyophilized bone strut usually of tibial or femoral origin. Thus, a second procedure for implant removable is unnecessary. Generally, the surgical correction of pectus deformities with this operation is recommended in adolescence or young adulthood. It is also suitable for patients with relatively stiff chest walls. Good long-term results with a high rate of patient satisfaction can be achieved with this method with a low rate of morbidity.