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Editorial

When four plus four is less than eight: the Nuss operation

Carolinas Medical Center, 1001 Blythe Boulevard, Suite 300, Charlotte, NC 28203, United States

Received 1 December 2008; ^_* Corresponding author. Tel.: +1 704 444 3911; fax: +1 704 373 0781. (Email: FRobicsek@carolinashealthcare.org).

Key Words: Nuss procedure • Stabilizer plates

The first 20% of the full text of this article appears below.

In the course of the operation one or more (up to three) 2 x 12'' metal bars are driven through both pleural cavities and the mediastinum in front of the heart and may be left there for years.

It is labeled as a ‘Minimally invasive technique for the correction of pectus excavatum’ [1].

The article, ‘Can absorbable stabilizers be used routinely in the Nuss procedure?’, by Pilegaard and Licht published in this issue of the Journal examines [2] the feasibility of whether such devices may reliably keep the Nuss bar, used for the correction of pectus excavatum deformity, safely in place and then fulfill their purpose to dissolve and disappear.

The idea of using plates which gradually disintegrate seems to defy their purpose. As one may expect, in the series presented bar-dislodgement was frequent and the authors wisely discontinued their use. One, however, may question why they even tried to use degradable stabilizers in the first place, when removal of the steel-bars they are attached to makes reoperation inevitable anyhow?

Considering the issues, such as the one above, one may be inclined to address the entire subject of the new and undoubtedly controversial procedure of the Nuss operation itself.

Since Donald Nuss first introduced his operation entitled, ‘Minimally invasive technique for the correction of pectus excavatum’ [1] in 1997, at the . . . [Full Text of this Article]