Repair of Pectus Excavatum with Sternal Plate

Repair of Pectus Excavatum with Sternal Plate

Repair of pectus excavatum with sternal plate is a surgical procedure to repair the pectus excavatum, which is a severe depression of the lower half of the breastbone.

Operation

We perform the operation by making an incision along the lower boarder of the breast tissue called the inframammary fold to expose the breastbone. We remove the cartilage between the breastbone and the ribs. We divide the breastbone at the height of the depression to allow straightening of the breastbone. We then fix the breastbone with a sternal plate. We place a chest tube and drains in the surgical site to drain any fluid.

Overall, the risks of the operation are very low. With any operation, there is a risk of injuring any structure that we operate around including the lung. Other risks include bleeding and infection at the surgical site.

Hospital Stay: 2-3 Days

After the operation, the patient goes to a recovery area called PACU or post-anesthesia care unit. Once the patient recovers from anesthesia, the patient is admitted to the floor. On average, patients are in the hospital for two to three nights. Patients start a regular diet during the night of the surgery along with pre-emptive pain control with around the clock pain medication. Every day, the chest tube and drains will be evaluated to determine if the tube can be safely removed. Once the patient’s chest tube and drains are removed with good pain control, they are ready to continue the recovery at home.

Pain Management

We advise our patients to stay ahead of pain with pre-emptive pain control. Instead of taking pain medication after having pain, we ask patients to take pain medication in regular intervals. The typical regimen for post-operative pain medication is:

3 days of Aleve (Naprosyn) 1 tab two times a day

5 days of Tylenol (Acetaminophen) 1 g three times a day

7 days of Neurontin (Gabapentin) 300 mg three times a day.

After 7 days, take Tylenol as needed. If this regimen is not adequate to control pain, we ask patients to call our office.

Activity

In order to further help with recovery from surgery, we advise patients to walk at least three times a day, work on the incentive spirometer, and sit in a chair for at least 6 hours a day for about a week after the surgery. We advise patients to avoid heavy lifting for 6 weeks. As long as the patient is not on narcotic pain medication, it is safe to drive.