Robotic Takedown of Internal Mammary Artery to Prevent Occlusion From Bars During Nuss Pectus Repair

The Nuss procedure for repair of pectus excavatum involves the placement of substernal support bars that remain in place for 2 to 3 years. There are concerns about occlusion of the internal mammary artery due to the intrathoracic bars. It would be optimal to preserve one or more internal mammary arteries with the pectus repair. This report describes a 28-year-old man with severe symptomatic pectus excavatum who underwent Nuss repair. Robotic left internal mammary artery takedown was performed at the intercostal spaces planned for Nuss bars to prevent occlusion or damage from the bars.