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Modification of the Nuss Procedure: The Single-incision Technique
Tetsushi Aizawa1, Shinji Togashi1, Takashi Domoto1
1Department of Plastic and Reconstructive Surgery, National Defense Medical College, Saitama, Japan; Department of Plastic and Reconstructive Surgery, Shonai Amarume Hospital, Yamagata, Japan; and Department of Plastic and Reconstructive Surgery, Tsukuba University, Ibaraki, Japan.
Summary:
The Nuss procedure is a prevalent minimally invasive surgery for pectus excavatum. Although the Nuss procedure has the advantage of leaving less obtrusive scars, the standard technique requires at least 3 skin incisions to insert several instruments. We experienced 7 cases of the modified Nuss procedure using a single incision during a 7-year period. To facilitate passing of the bar, a traction guide was created according to our unique method. There was no need for a bar stabilizer, and no severe intraoperative complications occurred. All patients exhibited satisfactory short-term results; however, 1 patient suffered from bar rotation and required repeat surgery for fixation. Two patients underwent bar removal via the same single incision without any difficulties.

