Learn What to Expect from Pectus Excavatum for Sunken Chest

  • Talk to your doctor about any medications/vitamins/herbs your child is taking as he/she may need to stop certain ones before surgery.
  • Discuss any possible bleeding disorders or other medical conditions that your child may have.
  • Do not let your child eat or drink anything after midnight the night before the surgery.
  • Your child will have blood samples taken in case he/she needs a blood transfusion.

On the Day of the Surgery

  • Give your child any medications that the doctor has approved him/her to take with a small sip of water.
  • The doctor or nurse will tell you when to arrive at the hospital.

After Surgery
Your child will stay in the hospital for four to five days following surgery. During the hospital stay, he/she will:

  • Receive several different medicines to relieve pain. These will be delivered primarily through what is called a PCA - patient controlled analgesia. This PCA pump is a special machine that allows a child to safely self-administer a carefully measured amount of pain medication. The pump can also be set to deliver a steady amount of medicine. This pump helps reduce stomach upset from oral medications.
  • Begin eating ice chips or sipping clear liquids immediately after the operation. Solid foods will be added gradually to decrease the chance of nausea or vomiting. Once his/her appetite returns, he/she will return to a normal diet.
  • Have X-rays taken to ensure that the bar is in place and that the lungs are fully functional.
  • Sit up in bed once he/she feels strong enough to do so.
  • Have a bladder catheter for a day.
  • Walk with the assistance of a physical therapist or nurse who will teach him/her how to move with the bar in place. Walking will help increase strength and encourage deep breathing.
  • Be discharged once he/she can walk without problems and does not require IV pain medications.

Recovery: What to Expect in the Next Few Weeks

  • Most children feel better after a week at home; however, caution must be taken when advancing movement, etc. Activities will be restricted for several weeks to ensure that the bar is secure.
  • Your child will be able to return to school in two to three weeks and resume some exercise/sports in six to eight weeks. Your pediatric surgeon will advise which activities are safe and when your child can participate in sports again.

Alternative Names: Sunken chest

 Question & Answer

Q:

What does the procedure involve?

A:

Under general anesthesia (completely asleep), three incisions are made in the chest. The first two incisions are used for insertion of the supportive bar. The third incision is used to insert a thoracoscope (small camera) into the chest. This instrument gives a clear field to visualize placement of the bar. Once the bar is in place, the surgeon affixes it to the ribs on either side and closes the incisions. This bar will remain in place to help support chest development for about two years and will be removed in an outpatient procedure.

Q:

How long is the operation?

A:

While it may vary based on each case, most surgeries are completed in two hours.

Q:

How long will my child stay in the hospital?

A:

Normally, four to five days.

Q:

What is the recovery time?

A:

Most children recover in six weeks, but precautions must be taken during exercise/sports. The bar will be removed in an outpatient procedure in about two years.

Q:

What age is best for performing pectus corrective surgery?

A:

We advise that patients are about 6 years of age or older. By this age, they can typically follow critical post-operative instructions. However, if the case is extremely restrictive or the child is mature enough, the surgery can be performed at an earlier age.

Q:

Is there a danger in waiting a couple of years before letting my child have the surgery?

A:

Pectus excavatum is not normally a life-threatening condition. Your child’s symptoms may get worse over time, which should be taken into consideration. This is not an emergency surgery, so parents and children have time to prepare for the procedure.

Q:

My child is very active and participates in many sports. Will he/she be able to continue playing soccer and similar sports after surgery?

A:

We encourage patients to be active. Patients can return to some sports after three months, but heavy contact sports like football, boxing and wrestling are not recommended. Remember that the bar is in place for about two years. While this is a short period of time, it may seem like an eternity to your child. Please encourage them to engage in sports that are approved by the pediatric surgeon.