Introduction to Adult Pectus Excavatum Surgery

Pectus excavatum is a relatively common congenital deformity where the chest wall is sunken in, creating a caved - in appearance. In severe cases, it can affect lung capacity, cause fatigue, shortness of breath, chest pain, and a fast heartbeat. For adults, surgical intervention might be required to improve both physical and psychological well - being. In New York City, there are several top - notch hospitals offering high - quality treatment for adult pectus excavatum surgery.

Understanding Pectus Excavatum

Pectus excavatum occurs when several ribs and the sternum (breastbone) grow abnormally, resulting in a sunken chest. It often occurs more frequently in males and approximately 40% of people with this condition have one or more family members with the defect. Although it can be present at birth, it may also develop during puberty. The symptoms of pectus excavatum can vary from mild to severe. In mild cases, individuals may have no symptoms during ordinary daily activities. However, during rigorous exercise, symptoms such as fatigue, shortness of breath, and chest pain may appear. Severe cases can lead to heart murmurs due to the proximity of the sternum and the pulmonary artery. Psychosocial effects are also common, especially in children and teenagers, but can also impact adults, causing self - consciousness and avoidance of activities that expose the chest. Diagnosis of pectus excavatum involves multiple tools, including visual examination of the chest, auscultation, electrocardiogram (ECG), echocardiogram, pulmonary function testing, chest x - ray, CT - scan, and calculating the Haller index. A Haller index greater than 3.25 is generally considered severe.

Common Surgical Procedures for Pectus Excavatum

There are two main surgical procedures for correcting pectus excavatum: the Nuss procedure and the modified Ravitch repair.

The Nuss Procedure

The Nuss procedure is a minimally invasive technique. It is performed under general anesthesia using video - assisted thoracoscopic surgery (VATS). The surgeon creates a horizontal passage underneath the sternum through two small incisions in the side of the chest. A convex bar, known as the Lorenz pectus bar, is inserted through the passage and turned to push the sternum outward. The bar must remain in place for a minimum of three years while the chest contour re - forms. It is then removed as an outpatient procedure. Many adults have undergone this minimally invasive pectus repair with results comparable to the traditional approach.

The Modified Ravitch Repair

This procedure is also done under general anesthesia. It involves making a horizontal incision and removing small pieces of deformed chest cartilage and repositioning the protruding ribs and sternum. Titanium bars are secured to the ribs and sternum to support the repaired chest architecture. Unlike in the past, the current bars can remain permanently in place, avoiding the need for a second operation.

Top Five Hospitals for Adult Pectus Excavatum Surgery in New York City

New York - Presbyterian Hospital - Columbia and Cornell

Overview

New York - Presbyterian Hospital - Columbia and Cornell is a world - renowned medical institution. It is nationally ranked in 14 adult specialties and 10 pediatric specialties. It is also ranked #5 in orthopedics hospitals in New York City according to U.S. News.

Expertise in Pectus Excavatum Surgery

The hospital's surgical teams are highly experienced in performing both the Nuss procedure and the modified Ravitch repair. They have a deep understanding of the complex anatomy involved in pectus excavatum and can provide personalized treatment plans for adult patients. Their cardiothoracic surgeons work closely with other specialists such as pulmonologists, cardiologists, and anesthesiologists to ensure the best possible outcomes. The hospital is associated with Columbia University Irving Medical Center. This academic affiliation allows for access to the latest research and advancements in the field of thoracic surgery. For example, the institution has been at the forefront of developing new techniques to minimize the invasiveness of pectus excavatum surgery and improve recovery times.

Patient - Centered Care

New York - Presbyterian Hospital takes a patient - centered approach. They provide comprehensive pre - operative evaluations, which include detailed medical histories, physical examinations, and diagnostic tests. This helps in accurately assessing the severity of the pectus excavatum and planning the most appropriate surgical approach. Post - operative care is also a priority. The hospital has a team of dedicated nurses and rehabilitation specialists who assist patients in their recovery process. They provide pain management, respiratory therapy, and guidance on physical activities to help patients regain their strength and return to normal life as quickly as possible.

NYU Langone Hospitals

Overview

NYU Langone Hospitals are nationally ranked in 13 adult specialties and 3 pediatric specialties. The NYU Langone orthopedic hospital is also well - known, being ranked #4 in orthopedics hospitals in New York City by U.S. News.

Specialized Treatment for Pectus Excavatum

NYU Langone's team of doctors is dedicated to providing the most advanced, personalized care for pectus excavatum. Their surgeons are experts in minimally invasive techniques, such as the Nuss procedure. They have extensive experience in handling adult cases and are able to address the unique challenges that adults may face during surgery and recovery. The hospital also offers a comprehensive range of pre - operative and post - operative services. Their multidisciplinary approach involves collaborating with various specialists, including plastic surgeons, to improve the aesthetic outcomes of the surgery in addition to the functional improvements.

Research and Innovation

As an academic medical center, NYU Langone is actively involved in research related to pectus excavatum. They are constantly exploring new surgical techniques and treatment modalities to enhance the quality of care for patients. For instance, they may be researching ways to further reduce the recovery time and potential complications associated with pectus excavatum surgery.

Mount Sinai Hospital

Overview

Mount Sinai Hospital is nationally ranked in 12 adult specialties and 4 pediatric specialties. It is also ranked #11 in orthopedics hospitals in New York City according to U.S. News.

Excellence in Pectus Excavatum Repair

The hospital has a long - standing history of performing pectus excavatum repairs. Their surgical team is well - versed in both open and minimally invasive surgical procedures. They are able to carefully evaluate each patient's condition and determine the most suitable surgical approach based on factors such as the severity of the deformity, the patient's overall health, and their personal preferences. Mount Sinai's pre - operative assessment includes a thorough evaluation of the patient's cardiac and respiratory function. This helps in identifying any potential risks and formulating a comprehensive treatment plan.

Comprehensive Patient Support

In addition to surgical expertise, Mount Sinai provides comprehensive patient support throughout the treatment process. They offer psychological counseling services to address the potential emotional impacts of pectus excavatum and its treatment. Their rehabilitation programs are designed to help patients regain their strength and mobility after surgery.

New York - Presbyterian Queens

Overview

New York - Presbyterian Queens has earned a three - star rating from the Society of Thoracic Surgeons (STS) for patient care and outcomes in isolated coronary artery bypass grafting (CABG) procedures. This demonstrates the high - quality care and surgical expertise available at the hospital.

Advanced Thoracic Surgery for Pectus Excavatum

The hospital's thoracic surgery program is one of the most sophisticated minimally invasive thoracic surgery programs in the world. Their surgeons are trained in the latest cutting - edge techniques, including the minimally invasive Nuss procedure for pectus excavatum. The multidisciplinary team at New York - Presbyterian Queens, which includes thoracic surgeons, medical and radiation oncologists, pulmonologists, gastroenterologists, and others, collaborates to provide seamless, high - quality care to patients. This teamwork ensures that all aspects of a patient's health are considered during the treatment process.

Benefits of Minimally Invasive Approach

The majority of patients at New York - Presbyterian Queens are able to have their pectus excavatum surgery performed through a minimally invasive approach. This results in less blood loss, less postoperative pain, shorter hospital stays, and a quicker recovery and return to normal activities. It is also a viable option for many elderly and very ill patients who may not be able to tolerate conventional open surgery.

Lenox Hill Hospital at Northwell Health

Overview

Lenox Hill Hospital at Northwell Health is nationally ranked in 10 adult specialties and is ranked #32 in orthopedics hospitals in New York City according to U.S. News.

Experienced Surgical Team

The hospital has an experienced surgical team that is proficient in performing pectus excavatum surgeries. They have the necessary skills to handle complex cases and are committed to providing the best possible outcomes for patients. Their surgeons stay updated with the latest advancements in the field of thoracic surgery and incorporate new techniques into their practice. Lenox Hill Hospital also offers a range of pre - operative and post - operative services. Their pre - operative care includes detailed patient education, which helps patients understand the surgical procedure, its risks, and the expected recovery process.

Rehabilitation and Aftercare

After surgery, the hospital's rehabilitation program is designed to help patients regain their strength and function. They provide physical therapy, respiratory training, and follow - up care to ensure that patients recover well and are able to resume their normal activities.

Comparison of the Top Five Hospitals

Hospital Name	National Specialties Ranking	Orthopedics Ranking in NYC	Specialty in Pectus Excavatum Surgery	Unique Features
New York - Presbyterian Hospital - Columbia and Cornell	14 adult, 10 pediatric	#5	Experienced in both Nuss and modified Ravitch, comprehensive multi - specialty approach	Associated with Columbia University, access to latest research
NYU Langone Hospitals	13 adult, 3 pediatric	#4	Expertise in minimally invasive Nuss procedure, focus on aesthetic and functional outcomes	Active in research, multidisciplinary collaboration including plastic surgeons
Mount Sinai Hospital	12 adult, 4 pediatric	#11	Skilled in open and minimally invasive surgeries, thorough pre - operative cardiac and respiratory assessment	Offers psychological counseling and comprehensive rehabilitation
New York - Presbyterian Queens	Not specified in provided info, but high - rated in CABG by STS	Not specified in orthopedics ranking but known for advanced thoracic surgery	Minimally invasive Nuss procedure, multidisciplinary team approach	Minimally invasive approach suitable for elderly and ill patients, shorter recovery time
Lenox Hill Hospital at Northwell Health	10 adult	#32	Experienced surgical team, detailed pre - operative patient education	Well - designed rehabilitation and aftercare program

Conclusion

Adult pectus excavatum surgery is a complex procedure that requires the expertise of skilled surgeons and a comprehensive healthcare team. In New York City, the top five hospitals - New York - Presbyterian Hospital - Columbia and Cornell, NYU Langone Hospitals, Mount Sinai Hospital, New York - Presbyterian Queens, and Lenox Hill Hospital at Northwell Health - offer high - quality treatment for this condition. These hospitals have nationally recognized specialties, experienced surgical teams, and innovative approaches to treatment. They also provide comprehensive pre - operative, operative, and post - operative care, addressing both the physical and psychological aspects of the patient's well - being. If you or someone you know is considering adult pectus excavatum surgery, we encourage you to explore these hospitals further. You can contact their respective patient information desks to learn more about their services, schedule consultations, and make an informed decision about the best place for treatment. Don't let pectus excavatum limit your life - take the first step towards a healthier, more confident you.