Pectus excavatum is a congenital chest wall deformity that affects a significant number of people. This article aims to provide a comprehensive guide to pectus excavatum correction surgery hospitals in New York City, including the hospital ranking list and price table. Understanding the available options and costs can help patients and their families make informed decisions about treatment.
Understanding Pectus Excavatum
Pectus excavatum is a condition where the breastbone (sternum) appears sunken and the chest concave. It is sometimes called funnel chest. Most cases are not associated with other conditions, but some genetic conditions can include pectus excavatum. The deformity is often present at birth and may worsen during the teen years.
The exact cause of pectus excavatum is not fully understood, but it is believed to be due to an overgrowth of the rib cartilage attached to the sternum, which pushes the sternum back towards the spine. The condition can have physical and psychological impacts on patients. Physically, in moderate to severe cases, the rib cage may press against the heart and lungs, causing chest pain, breathing difficulties, fatigue, and reduced exercise tolerance. Psychologically, it can affect a patient's self - esteem and body image.
Diagnosis and Evaluation
To evaluate pectus excavatum, doctors commonly use chest x - rays (both front and side views) or a chest CT scan. To reduce radiation exposure, the severity of the deformity can often be assessed with just x - rays, using measurements like the pectus severity index or Haller index. Additional tests may include pulmonary function tests to check how well the lungs are working and an echocardiogram, which is an ultrasound of the heart to assess its function and structure.
Surgery is typically recommended for moderate to severe pectus excavatum, especially if the Haller index (a measurement of the chest’s shape) is greater than 3.2. A normal Haller index is around 2.5. Surgery may also be considered if the patient has symptoms related to their condition, such as breathing difficulties or chest pain. If there are signs of connective tissue disorders, patients may be referred to specialized clinics for additional evaluation and care.
Surgical Procedures for Pectus Excavatum
The Ravitch Procedure
The Ravitch procedure is a well - established surgical method for correcting chest wall deformities. In this procedure, an incision is made across the chest, just below the nipples. The deformed cartilage is removed, and the sternum is gently adjusted and repositioned. A supportive bar is placed to help hold everything in the correct position as it heals. The recovery period includes a hospital stay of 3 to 5 days. The stabilizing bar is usually removed after about 6 months, by which time new cartilage will have formed to help support the sternum and ribs. According to research, Dr. Eric W. Fon Kalsrud at UCLA improved this method to reduce the amount of cartilage removed, make it easier to reshape the chest wall, and achieve better results.
The Nuss Procedure
The Nuss procedure is a newer and minimally invasive method for correcting pectus excavatum. Developed by Dr. Donald Nuss in 1998, it has become the most commonly chosen treatment for this condition. In this procedure, two small cuts, each about 1 inch long, are made on either side of the rib cage. A curved, titanium bar is carefully placed through these cuts and positioned under the sternum. A small camera is used to allow the surgeons to see and protect the organs inside the chest. Cryoablation of the nerves is performed to relax the chest so it remodels and heals with minimal pain. The bar is rotated to press against the chest wall, pushing the ribs and sternum outward, similar to how braces help realign teeth. Cartilage or bone is usually not removed during this procedure. The bar is secured with stitches and stays in place for 2 to 3 years to help reshape the chest. The chest deformity is corrected right away, and it usually leads to less blood loss, smaller incisions, and minimal scarring. The recovery time is faster than traditional methods, with a usual hospital stay of 1 to 2 days. The bar is removed in a brief outpatient procedure once the chest has fully healed.
Hospital Ranking for Pectus Excavatum Correction Surgery in New York City
Here are some of the top - ranked hospitals in New York City for orthopedics and related surgeries, which may also perform pectus excavatum correction surgery:
| Hospital Name | Orthopedics Score | Specialties and National Rankings | Contact Information |
|---|---|---|---|
| Hospital for Special Surgery | 100.0 / 100 | Nationally ranked in 2 adult specialties and 1 pediatric specialty | 1 - 332 - 263 - 3980, New York, NY 10021 - 4898 |
| NYU Langone Orthopedic Hospital | 75.8 / 100 | Nationally ranked in 14 adult specialties and 3 pediatric specialties | 1 - 573 - 273 - 4443, New York, NY 10016 - 6402 |
| Mount Sinai Hospital | 67.6 / 100 | Nationally ranked in 11 adult specialties and 3 pediatric specialties | 1 - 332 - 239 - 6252, New York, NY 10029 - 0310 |
| New York - Presbyterian Hospital - Columbia and Cornell | 66.6 / 100 | Nationally ranked in 14 adult specialties and 10 pediatric specialties | 1 - 445 - 545 - 2492, New York, NY 10065 - 4870 |
| Lenox Hill Hospital at Northwell Health | 60.8 / 100 | Nationally ranked in 9 adult specialties | New York, NY 10075 - 1850 |
Factors Affecting Hospital Ranking
Hospital rankings are determined by several factors. Patient outcomes are a crucial factor, which includes the success rate of surgeries, post - operative complications, and long - term recovery. Nurse staffing is also important as it affects the level of patient care and attention during the hospital stay. Services offered, such as advanced diagnostic tools, innovative surgical techniques, and comprehensive post - operative rehabilitation programs, can also influence the ranking. Additionally, public transparency regarding patient satisfaction, safety records, and quality measures is considered in the ranking process.
Price Table for Pectus Excavatum Correction Surgery
The cost of pectus excavatum surgery can vary widely depending on multiple factors. Here is a breakdown of the general cost range and potential additional expenses:
Base Surgery Cost
The average cost of pectus excavatum surgery alone costs around $15,000 to $45,000+ without health insurance. Longer hospital stays could get close to the six - figure mark. According to patient quotes on online forums, the cost can range from as little as $30,000 to more than $90,000+ without insurance. For example, one patient paid $28,300 for the insertion and another $14,200 for the removal. Another was quoted $50,000 from Milwaukee Children’s Hospital but was able to negotiate it down to $36,000. A breakdown of the Nuss procedure on pectusknowledge.com showed a grand total of $56,449, which included pharmacy, supplies, EKG, room and board, anesthesia, lab work, radiologist fees, physical therapy, and pulmonary function.
Extra Costs
- Medical Personnel Fees: Patients can expect to receive multiple bills outside of the base surgery fee, including anesthesiologist fees, radiologist fees, and surgeon fees. It is important to talk with the hospital ahead of time to know which bills you will be responsible for.
- Pre - operative Tests: A number of tests will be required before the surgery, including CT/MRI scans, consultations, a pulmonary function test, metal allergy test, heart sonogram, etc. These tests, outside of the estimates mentioned prior, could reach well into the thousands of dollars.
- Prescription Medication: Prescription medication will be prescribed after the surgery. Without insurance, this could cost more than $1,000.
- Physical Therapy: Physical therapy after the surgery is necessary. Without insurance, sessions can cost more than $100 each.
- Transportation and Accommodation: In some cases, patients may have to travel long distances to find a specialist. This can lead to additional transportation and hotel costs.
- Bar Removal: After the surgery, the metal struts will be removed one year after the insertion. This is an outpatient procedure and can be done in less than an hour. Depending on the billing policy, this can be an additional cost to consider.
Tips for Managing Costs
As always, it is advisable to check if your health insurance provider can cover your pectus excavatum surgery. Some insurance companies may not cover it as they deem it unnecessary, while others may cover it if they consider it medically necessary. If you don’t have health insurance or a policy that won’t cover the procedure, talk with the finance department of the hospital to see if they can either offer a cash discount or a low - interest finance plan.
Recovery and Aftercare
Recovery after pectus excavatum correction surgery varies depending on the type of procedure. After the Ravitch procedure, patients usually stay in the hospital for 3 to 5 days and the stabilizing bar is removed after about 6 months. After the Nuss procedure, the hospital stay is typically 1 to 2 days, and the bar is removed in a brief outpatient procedure after 2 to 3 years once the chest has fully healed.
During the recovery period, pain management is important. In the case of the Nuss procedure, most children, on average, will stay up to five days in the hospital, and an epidural catheter may be placed in the back to administer continuous pain medication for several days after the surgery. Physical therapy is also an essential part of the recovery process to help patients regain strength and mobility.
Conclusion
Pectus excavatum correction surgery can significantly improve the physical and psychological well - being of patients. New York City has several top - ranked hospitals with experienced surgeons and advanced treatment options for this condition. However, the cost of the surgery can be a concern for many patients and their families. By understanding the hospital rankings, price factors, and available cost - management strategies, patients can make more informed decisions about their treatment.
If you or a loved one is considering pectus excavatum correction surgery, it is recommended to research different hospitals, consult with multiple doctors, and thoroughly understand the costs and insurance coverage. Don't hesitate to reach out to the hospitals directly to get detailed information about their services, expertise, and pricing. Share this article with others who may benefit from this information and explore related topics on our website for more in - depth knowledge about pectus excavatum and other medical conditions.
