ePlasty: Vol. 14
A Simple and Safe Technique for Manipulation of Retrosternal Dissection in the Nuss Procedure
Masahiko Noguchi, MD, PhD,a,b Shoji Kondoh, MD, PhD,c and Kenya Fujita, MD, PhDa

aDepartment of Plastic and Reconstructive Surgery, Nagano Children's Hospital, Toyoshina, Azumino, Japan; bDepartment of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Matsumoto, Japan; and cDepartment of Plastic Reconstructive Surgery, Ina Central Hospital, Ina, Japan

Correspondence: noguchi@naganoch.gr.jp
Keywords: Nuss procedure, pectus excavatum, prevent life-threatening complication, safe dissection, the layer of the dissection level

Objective: The Nuss procedure has become the first choice for repairing the pectus excavatum because of the advantages of the technique including minimal invasiveness and short operative duration. Although this technique appears simple and easy, life-threatening complications during dissection such as intraoperative cardiac perforation have been reported. We developed a new approach for safer dissection of retrosternal space. Methods: We use a dissector that is commonly used for laparoscopic operation, instead of the Nuss introducer. The dissector goes through the same skin incision where the Nuss bar will be inserted. .......