[Minimally invasive funnel chest correction: initial experiences and critical evaluation of this fascinating...

The discussion about the surgical correction of funnel chest deformities enjoys a great renaissance since D. Nuss presented a new, minimal invasive technique. Although his method has gained wide acceptance among patients and pediatric surgeon the question arises, whether it can be considered as the Golden Standard' already. In 2000-2001 a total of 14 patients were corrected by transthoracic implantation of the pectus bar and subsequent elevation of the deformity. Results (mean data): age 14.3 years body weight 54 kg, height 170 cm, operative time 57 min, minimal blood loss, no intraoperative complications. The cosmetic result was considered as very good by all patients on the day of dismission. As a late complication one bar dislocated and had to be repositioned surgically. The minimal invasive approach for funnel chest corrections is a fascinating technique, which demonstrates striking advantages for the children: reduced operative trauma (no rib resections), shorter recovery, small incisions. However only few studies validate the long-term benefit of this procedure. Consequently, the minimal invasive method should not be advocated as the new Golden Standard', until these results meet the high quality of the conventional technique.