PurePectus bars: Initial surgical experience and early outcomes in 111 patients

Area of Science:

• Thoracic surgery
• Minimally invasive surgery
• Pediatric surgery

Background:

• Pectus excavatum repair using traditional Nuss bars faces challenges with bar rotation and migration.
• The PurePectus system is a titanium construct designed to improve bar stability with bilateral connector plates.
• This study reports early outcomes of the PurePectus system implementation.

Purpose of the Study:

• To evaluate the early outcomes of the PurePectus system in pectus excavatum repair.
• To assess the system's effectiveness in mitigating bar migration and rotation.
• To report on complications and integration into surgical workflows.

Main Methods:

• Retrospective review of 111 patients undergoing pectus excavatum repair with the PurePectus system (September 2023 - January 2025).
• Data collected included demographics, operative details, radiographic findings, hospitalization, and postoperative outcomes.
• Surgical procedures involved sternal elevation, thoracoscopic mediastinal dissection, and cryoablation.

Main Results:

• 111 patients (mean age 15 years) underwent repair, with 84 receiving two bars and 27 receiving three bars.
• Mean operative times were 112.8 minutes for two bars and 135.5 minutes for three bars.
• No postoperative complications (bar migration, rotation, infection, reoperation) were observed during 16-month follow-up; median hospital stay was 1 night.

Conclusions:

• The PurePectus system requires specific technical considerations for connector measurement and bar alignment.
• Early outcomes in this series were favorable, with no increased complications.
• The system integrated smoothly into existing surgical workflows, suggesting potential for improved pectus excavatum repair.