Funnel chest surgery principle

Written by Zhang Zhi Gong
Cardiothoracic Surgery
Updated on October 26, 2024
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The Wang procedure, named after Director Wang Wenlin from the Second People's Hospital of Guangdong Province, is a surgical method for correcting pectus excavatum. Traditional minimally invasive techniques for correcting pectus excavatum, such as the Nuss procedure or its modifications, involve placing a metal bar under or behind the sternum, forming an arch to lift the depressed area, similar to a traditional arch bridge. In contrast, the Wang procedure positions the metal bar on top and in front of the sunken sternum, and then uses stainless steel wires to suspend the deformed sternum forward and upward, transforming the traditional arch into a modern cable-stayed bridge, thus suspending the depressed chest area.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
48sec home-news-image

Funnel chest surgery principle

The Wang procedure, named after Director Wang Wenlin from the Second People's Hospital of Guangdong Province, is a surgical method for correcting pectus excavatum. Traditional minimally invasive techniques for correcting pectus excavatum, such as the Nuss procedure or its modifications, involve placing a metal bar under or behind the sternum, forming an arch to lift the depressed area, similar to a traditional arch bridge. In contrast, the Wang procedure positions the metal bar on top and in front of the sunken sternum, and then uses stainless steel wires to suspend the deformed sternum forward and upward, transforming the traditional arch into a modern cable-stayed bridge, thus suspending the depressed chest area.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
1min 28sec home-news-image

Causes of Pectus Excavatum

Although current medicine has developed to the molecular and genetic levels, the true causes of many modern diseases are still not completely clear, which includes pectus excavatum. There have been medical cases indicating that scientists have never ceased to explore the causes of pectus excavatum. It was once believed by early medical scientists that pectus excavatum might be caused by the inward and backward pulling of the sternum by the diaphragm. Therefore, for a period, the treatment for pectus excavatum involved releasing adhesions of the diaphragm, but this method was later found to be ineffective for children and was abandoned. Subsequently, it was discovered that pectus excavatum is somewhat related to the genetics of many families, such as those with Marfan syndrome (an autosomal dominant hereditary connective tissue disorder) and Noonan syndrome (a genetic disorder caused by mutations). However, no definitive pathogenic genes have been identified in families with sporadic cases of pectus excavatum. In summary, pectus excavatum is currently believed to be possibly caused by factors such as the development of rib cartilage on both sides, genetics, and other acquired conditions, like underdeveloped laryngeal cartilage or post-surgical factors from congenital diaphragmatic hernia repair. Overall, the causes of pectus excavatum are still actively being explored by medical scientists.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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How to exercise to correct pectus excavatum

Pectus excavatum refers to the inward and backward indentation of the sternum, a deformity that can compress the patient's heart and lungs. To exercise for pectus excavatum, patients are advised to practice deep breathing exercises to enhance lung function, as well as engage in appropriate running and routine physical activities to strengthen heart function. However, in cases of severe pectus excavatum which severely compresses the heart, even pushing it entirely to the left side, patients may not be able to tolerate running and other intense activities. Therefore, it is quite difficult to completely correct pectus excavatum through exercise alone. Some parents might think that doing push-ups can correct pectus excavatum, but push-ups make the pectoral muscles on both sides stronger, and since these muscles pull outward, the force is not directed in the same way as the inward and backward indentation of pectus excavatum. Furthermore, continuously training the pectoral muscles causes them to develop, and the resultant thickening of the muscles on both sides can exacerbate the inward and backward indentation of the sternum in the middle. Thus, after appropriate cardiovascular and pulmonary exercises, those with severe pectus excavatum should still consult a doctor for active advice and consider surgical treatment options.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Is the funnel chest suction cup effective?

If the patient is young and the chest wall still retains some elasticity, or there is a possibility of secondary development, then it might be worth trying a pectus excavatum suction cup. If during the development of the chest wall, the patient's family can actively encourage or supervise the use of the suction cup for over two hours a day, continuing for six months, preferably up to about two years, the suction cup can be somewhat effective. However, if the patient's chest wall is hard and lacks elasticity, or if there is little possibility of further development, then the suction cup might not be suitable for such patients. For patients whose chest wall has fully developed, the best or most definitive treatment for pectus excavatum is surgery. Therefore, while the pectus excavatum suction cup can be useful for some patients, it is not suitable for all patients.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
1min home-news-image

Is pectus excavatum hereditary?

In current medical technology, although no genes exclusively associated with pectus excavatum have been identified, there is evidence suggesting genetic predisposition when pectus excavatum coincides with other conditions. For instance, the incidence of pectus excavatum is significantly higher in patients with congenital connective tissue disorders, such as Marfan Syndrome, and is linked to certain genes within this syndrome. Additionally, patients with congenital diaphragmatic hernia also show an increased incidence of pectus excavatum. Moreover, the condition is more prevalent in patients, or children, who have subglottic airway stenosis or congenital bronchopulmonary dysplasia. Thus, these evidences confirm that pectus excavatum, as a disease in itself, is directly or indirectly related to congenital genetic factors, indicating a certain hereditary nature.