Top Five Hospitals for Adolescent Pectus Excavatum Correction Technology in New York City

Introduction

Pectus excavatum, often referred to as “sunken chest syndrome,” is a congenital condition where the breastbone is sunken into the chest. This condition can be both a functional and aesthetic concern for adolescents, potentially affecting their breathing, exercise capacity, and self - confidence. In New York City, several hospitals stand out for their advanced correction technologies and experienced medical teams. In this article, we will reveal the top five hospitals for adolescent pectus excavatum correction technology in the city.

What is Pectus Excavatum?

Pectus excavatum is a fairly common congenital malformation, occurring in about 1 in 300 to 1 in 500 people, with males being affected three to four times more frequently than females. It is caused by an overgrowth of the rib cartilages before and after birth, which pushes the breastbone inward. This overgrowth commonly accelerates during puberty.

The condition can lead to various symptoms. Young children usually show no symptoms, but as they enter puberty, the malformation becomes more pronounced. Teenagers may experience shortness of breath with exertion, pain at the front of the chest, and early fatigue. In severe cases, it can shift the heart to the left side of the chest and compress the lungs, limiting the child's ability to take deep breaths.

How is Pectus Excavatum Diagnosed?

Doctors typically measure the malformation by employing CT scanning to calculate the Haller index. The Haller index compares the depth of the chest cavity beneath the sternum to the width of the chest cavity (from right to left). A normal ratio of width - to - depth is about 2.5 to 1. Any calculation greater than 3.25 is considered a moderate to severe defect.

Top Five Hospitals for Adolescent Pectus Excavatum Correction Technology in New York City

1. NewYork - Presbyterian/Morgan Stanley Children's Hospital (ColumbiaDoctors)

Columbia’s pediatric surgeons at NewYork - Presbyterian/Morgan Stanley Children's Hospital launched the first video - assisted surgical program in the tri - state area dedicated exclusively to children. The hospital offers minimal access surgery for pectus excavatum correction.

Minimal access surgery involves using several small incisions, each 1/4 - to 1/2 inch in length, instead of one larger incision. During the procedure, a tiny video camera is placed through one incision, and working instruments are passed through others. The surgeon can then perform an operation by watching a video screen while manipulating the instruments. In some cases, only a single incision — one - port laparoscopy — is necessary.

Benefits for adolescents include less discomfort during the recovery period due to the small incisions and a shorter healing time. The surgeons use minimal access techniques for both diagnostic and therapeutic procedures related to pectus excavatum.

2. Johns Hopkins Children's Center (Although not in NY but widely recognized for expertise)

The pectus program at Johns Hopkins Children Center comprises one of the most experienced pediatric surgical teams in the country specializing in treatment for chest wall deformities. They support young children and adolescents suffering from these disorders before, during, and after correction. The team includes pediatric surgeons, pediatric anesthesiologists, pediatric nurse practitioners, pediatric radiologists, and a dedicated post - surgery nursing team.

Johns Hopkins has a rich history in pectus excavatum treatment. Mark Ravitch perfected the original open repair of pectus excavatum that bears his name at Johns Hopkins. Alex Haller introduced a radiographically defined pectus excavatum severity score using CT scans, known as the Haller index, which is now used worldwide to evaluate pectus patients.

Paul Colombani continued the long - standing tradition of chest wall reconstruction expertise and modified the minimally invasive repair of pectus excavatum known as the Nuss procedure. The modified Nuss procedure at Johns Hopkins Children’s Center has led to decreased complications and excellent clinical results.

The Nuss procedure at Johns Hopkins involves placing one or more stabilizing metal bars just inside the rib cage to move the sternum forward. The bars are shaped to the patient during the operation and remain in place for two to three years to allow the ribs to adjust to the new shape of the chest. Cryoablation is used to dramatically reduce pain after surgery by freezing the nerves above and below the bar on each side of the chest, temporarily decreasing pain transmission for three months following surgery. The bars are removed in a separate outpatient procedure.

3. Golisano Children's Hospital (University of Rochester Medical Center)

The Center for Chest Wall Reconstruction at Golisano Children's Hospital specializes in the evaluation and treatment of pectus excavatum and pectus carinatum, as well as other chest wall abnormalities. They take a multidisciplinary approach to the care of adolescents.

The journey for patients begins with an office consultation. The medical team will assess the adolescent’s chest wall to determine the best course of treatment. They will also decide if testing is needed to assess for a physiologic effect of the chest wall condition and ask the family to realistically address their desired outcomes. Testing may be ordered, and photographs will be taken and placed in the electronic chart.

If surgery is determined to be the best course of action, the process from meeting the team to operative correction may take several visits. After the surgery, the adolescent will be seen regularly in follow - up to evaluate the treatment plan. The hospital combines surgical expertise with colleagues in pediatric anesthesiology, pediatric cardiology, pediatric pulmonology, pediatric radiology, pediatric plastic surgery, and specialists in physical and occupational therapy, depending on the needs of the patient.

4. Mount Sinai Hospital

Mount Sinai offers two types of surgery to repair pectus excavatum: open surgery and closed (minimally invasive) surgery. Both surgeries are performed while the adolescent is under general anesthesia.

Open surgery is more traditional. The surgeon makes a cut across the front part of the chest, removes the deformed cartilage while leaving the rib lining in place to allow the cartilage to grow back correctly. A cut is then made in the breastbone, which is moved to the correct location, and a metal strut may be used to hold the breastbone in the normal position until it heals, which takes 3 to 12 months. A tube may be placed to drain fluids that build up in the area of repair, and the metal struts are removed in 6 to 12 months through a small cut in the skin under the arm on an outpatient basis.

The closed (minimally invasive) method is mostly used for children. The surgeon makes two small incisions, one on each side of the chest. A small video camera called a thoracoscope is placed through one of the incisions to allow the surgeon to view inside the chest. A curved steel bar shaped to fit the adolescent is inserted through the incisions and placed under the breastbone to lift it. The bar is left in place for at least 2 years to help the breastbone grow properly.

The hospital also provides comprehensive pre - and post - operative care. Before the procedure, a complete medical exam and medical tests, including an electrocardiogram, possibly an echocardiogram, pulmonary function tests, and a CT scan or MRI of the chest, are required. The patient and family are also asked to provide information about the medications the adolescent is taking and any allergies. After the procedure, the adolescent usually stays in the hospital for 3 to 7 days, and pain management and proper wound care are closely monitored.

5. The Center of Excellence for Pectus

Established in 2005, the Center of Excellence for Pectus is the premier center for the Nuss procedure to treat pectus excavatum and evaluate all forms of pectus. Dr. Barry Losasso, a board - certified adult and pediatric general surgeon, has been treating pectus excavatum and pectus carinatum for teens and adults since 1999. He trained with Dr. Donald Nuss, the founder of the Nuss procedure.

The center is one of the only centers to perform chest wall reconstruction on children and adults ages 10 - 55 years old. The best age to get the Nuss procedure at this center is between 13 – 16 years old when the chest’s cartilage and bones are still malleable and easier to manipulate and bend into the correct shape. However, Dr. Losasso has successfully completed many Nuss procedures in patients as old as 53 years old.

Dr. Losasso has performed over 1,400 minimally invasive Nuss procedures to correct pectus excavatum. The center uses the Haller index to determine the severity of the pectus deformity. A Haller index of 3.2 - 3.25 is required to meet the criteria for surgical intervention, and Dr. Losasso has successfully treated Haller indexes of over 20. The center also has an excellent pain management team at the Valley Hospital, where the Nuss procedure is performed, to ensure patients have a successful and uneventful recovery.

Comparison of the Five Hospitals

Factors to Consider When Choosing a Hospital

• Experience of the Medical Team: Look for hospitals where the surgeons have extensive experience in treating pectus excavatum. For example, Johns Hopkins Children's Center and The Center of Excellence for Pectus have well - known surgeons with a long history of successful procedures.
• Treatment Approach: Decide whether you prefer a minimally invasive approach like the Nuss procedure or if open surgery is more suitable based on the severity of the condition. Hospitals like NewYork - Presbyterian/Morgan Stanley Children's Hospital offer minimal access surgery, while Mount Sinai offers both open and minimally invasive options.
• Recovery Support: Consider the hospital's post - operative care and pain management. Hospitals with dedicated pediatric pain services or excellent pain management teams, such as Johns Hopkins and The Center of Excellence for Pectus, can ensure a more comfortable recovery for adolescents.
• Multidisciplinary Care: A hospital that takes a multidisciplinary approach, like Golisano Children's Hospital, can provide comprehensive care by involving different specialists depending on the patient's needs.

Conclusion

Adolescent pectus excavatum correction is a specialized field, and choosing the right hospital is crucial for a successful outcome. The top five hospitals in New York City mentioned in this article - NewYork - Presbyterian/Morgan Stanley Children's Hospital, Johns Hopkins Children's Center, Golisano Children's Hospital, Mount Sinai Hospital, and The Center of Excellence for Pectus - each have their unique strengths in terms of treatment approach, experience, and recovery support.

Whether it's the advanced minimally invasive techniques, the long - standing history of expertise, the multidisciplinary approach, or the excellent pain management, these hospitals offer high - quality care for adolescents with pectus excavatum. Parents and adolescents should carefully consider their options and consult with medical professionals to make an informed decision.

If you or someone you know is dealing with adolescent pectus excavatum, we encourage you to reach out to these hospitals for more information. Share this article with others who may benefit from this valuable information, and explore further resources on pectus excavatum treatment to ensure the best possible care for adolescents.