Minimally invasive repair of pectus excavatum

The minimally invasive approach for repair of pectus excavatum has become widely accepted by pediatric and thoracic surgeons primarily because of increased patient awareness and good long-term outcomes. Although the technique is considered fairly new, it was quickly embraced by many, resulting in a significant increase in the number of such procedures being performed in North America over the last decade. Early reports demonstrated the potential risks and complications of this procedure. Important technical modifications were implemented, and the operation as well as selection criteria for surgery were modified to minimize risks and improve overall outcomes. This article reviews the indications for treatment of patients with pectus excavatum, with emphasis on the evolution and outcomes of the procedure known as the minimally invasive repair or Nuss technique.