Ravitch Technique

The Ravitch procedure is a highly invasive surgical procedure, invented in 1949, for the treatment of Pectus Excavatum. The procedure involves an incision along the chest which is used to cut away rib cartilage on each side of the breastbone and the sternum is then flattened so that it will lie correctly. Next, one or more small metal bars (or ?struts?) are then inserted to ensure the sternum keeps it shape an position. Drains are inserted at each side of the chest to remove any fluid from the surgical site and the wound is closed using dissolvable stitches. The bar is left implanted until the cartilage fully grows back, which typically takes about 6 months. The bar is later removed by a simple out-patient procedure. The Ravitch technique is not widely practiced because it is so invasive, and as a result, high risk. It is often used in older patients, where the sternum has calcified substantially, or when the less invasive Nuss procedure has proven unsuccessful.

A substantial draw back associated with the Ravitch technique is that it requires a significant amount of recovery. Since the procedure involves the severing of costal cartilage and the complete separation of the sternum, a great deal of recovery time is required for the cartilage to grow back. Patients are advised to avoid physical activities, including work, for a period of up to 6 months. A further drawback associated with the condition is the large scar which will be present on the chest.

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