Introduction to Pectus Excavatum
Pectus excavatum is a congenital deformity of the front of the chest wall. It causes the breastbone (sternum) and ribs to form a sunken or funnel - shaped appearance. This condition may worsen during the teen years. Although the majority of cases are isolated findings, some genetic conditions can be associated with pectus excavatum.
Most people with pectus excavatum experience chest pain or discomfort, shortness of breath, and fatigue. It can also have a significant impact on a person's self - confidence, especially when it comes to activities like swimming or wearing revealing clothing. The severity of pectus excavatum is often measured using the Haller index, with a normal index ranging from 2.0 - 2.5, and a higher index indicating a more severe condition.
When it comes to treating pectus excavatum, surgery is often the most effective option, especially for severe cases. There are two main types of surgical procedures: open surgery and closed (minimally invasive) surgery. Open surgery involves making a large incision across the front of the chest, removing deformed cartilage, and moving the breastbone to its correct position. Closed surgery, on the other hand, typically uses a small video camera and a curved steel bar inserted through small incisions to lift the breastbone without removing cartilage or bone.
Top Five Hospitals for Pectus Excavatum Correction in New York City
Morgan Stanley Children's Hospital of New York - Presbyterian
Morgan Stanley Children's Hospital of New York - Presbyterian is renowned for its comprehensive pediatric care. It is ranked by U.S. News & World Report as one of the top five children's hospitals in the country. The hospital offers the best available care in every area of pediatrics, including the most complex neonatal and critical care, and all areas of pediatric subspecialties.
One of its key features is the new operating room, the OR - 1, dedicated to pediatric minimal access surgery (MAS). The OR - 1 is a computer system that allows the surgeon to control every aspect of the operating room, from accessing a patient's x - ray images or lab results to controlling the lighting and temperature levels. It can also display live video from the surgery and other relevant patient information on four separate monitors, making it an ideal teaching tool.
For pectus excavatum correction, the hospital has been a leader in MAS for children for more than a decade. The minimally invasive Nuss procedure, or video - assisted pectus excavatum repair, is available. This procedure allows for a complete repair without the need for a highly invasive procedure involving rib resections and fracture of the sternum. A team of specialized surgeons and operating room staff trained in the latest minimal access techniques uses the latest specialized equipment in a child - and parent - friendly environment.
According to the hospital, benefits of MAS include reduced pain and less need for pain medication, better cosmetic results (minimal scars), less blood loss, and shorter hospital stays. In many cases, the recovery time is half that of traditional open surgery. As of 2004, the hospital performed a total of 260 minimal access surgical cases, and this number has more than tripled since 2000.
Pediatric minimal access surgery at Morgan Stanley Children's Hospital is available to newborns and children of all ages. It encompasses a wide range of procedures performed through small "keyhole" incisions rather than large incisions through the chest, abdomen, or other part of the body.
Columbia University Irving Medical Center
As part of Columbia University Irving Medical Center and New York - Presbyterian, the surgical lung & chest care program is one of the top options for pectus excavatum correction in New York City. It is consistently named one of New York's top hospitals and one of the top ten medical centers in the nation.
The hospital has a team of highly experienced and high - quality specialists. They are leaders in the field, having developed the largest lung transplant program in the North Atlantic, established a special program addressing lung disease in women, and created the world's only comprehensive center for diaphragm disorders.
For pectus excavatum patients, the hospital offers the latest surgical treatment options. While the traditional open and closed surgeries are available, they stay updated on innovative treatment methods. For example, although they are not part of the trial of the new treatment using magnets and an external brace developed by a pediatric surgeon at the University of California, San Francisco's Benioff Children's Hospital, they find the concept interesting and are eager to see the study results.
Patients at Columbia University Irving Medical Center can expect personalized care. The medical team focuses not only on treating the condition but also on the individual needs of the patients. Clear communication is a priority, ensuring that patients and their families understand the treatment process and are actively involved in their care.
The hospital has multiple locations in New York and New Jersey, including the Herbert Irving Pavilion in New York City and the Columbia Lung and Esophageal Center of New Jersey. This allows patients to access care conveniently based on their location.
NYU Langone Health
NYU Langone's team of doctors is dedicated to providing the most advanced, personalized care for pectus excavatum patients. Their doctors who treat pectus excavatum are highly skilled and experienced in dealing with this condition.
The hospital offers a comprehensive approach to treatment. They begin with a thorough evaluation of the patient's condition, which may include physical examinations, imaging tests such as X - rays or CT scans, and an assessment of the patient's symptoms and overall health. Based on this evaluation, they develop a personalized treatment plan.
NYU Langone provides both surgical and non - surgical treatment options. For surgical treatments, they are well - versed in the latest surgical techniques, including the minimally invasive Nuss procedure. They ensure that patients receive pre - operative counseling to understand the risks, benefits, and expected outcomes of the surgery.
After the surgery, the hospital has a strong post - operative care program. This includes pain management, monitoring of the patient's recovery, and providing instructions on activities and follow - up appointments. The medical team at NYU Langone is also available to answer any questions or concerns that patients and their families may have during the recovery process.
Patients can easily schedule an appointment online, which adds to the convenience of accessing care at NYU Langone. The hospital's commitment to patient - centered care makes it a popular choice for pectus excavatum correction in New York City.
Mount Sinai - New York
Mount Sinai - New York has a detailed understanding of pectus excavatum repair. They offer comprehensive information about the condition, its causes, symptoms, and treatment options.
The hospital clearly explains the two types of surgeries for pectus excavatum repair: open surgery and closed (minimally invasive) surgery. In open surgery, the surgeon makes a cut across the front part of the chest, removes the deformed cartilage, and moves the breastbone to the correct location. A metal strut may be used to hold the breastbone in place until it heals. In closed surgery, which is mostly used for children, the surgeon makes two small incisions on each side of the chest, inserts a curved steel bar under the breastbone to lift it, and leaves the bar in place for at least 2 years.
Before the surgery, Mount Sinai - New York requires a complete medical exam and various medical tests. These include an electrocardiogram (ECG) and possibly an echocardiogram to assess heart function, pulmonary function tests to check for breathing problems, and a CT scan or MRI of the chest. Patients and their families are also required to inform the medical team about any medications the patient is taking and any allergies.
During the pre - operative period, specific instructions are given, such as stopping certain blood - thinning drugs about 7 days before surgery. On the day of surgery, patients are usually asked not to eat or drink anything after midnight. The medical team ensures that the patient is in good health before proceeding with the surgery, and if the patient is ill, the surgery may be postponed.
After the surgery, the hospital provides in - depth post - operative care. Patients typically stay in the hospital for 3 to 7 days, and pain management is a priority. They may receive strong pain medicine through an IV or an epidural in the first few days, followed by oral medications. Tubes are placed in the chest to drain extra fluid, and these tubes are removed when the drainage stops. Patients are encouraged to engage in activities like sitting up, taking deep breaths, and walking to aid in the recovery process.
Center of Excellence for Pectus
The Center of Excellence for Pectus, established in 2005, is the premier center for the Nuss procedure to treat pectus excavatum and evaluate all forms of pectus. With over 1,400 successful Nuss procedures completed, it has a high level of expertise in this area.
Dr. Barry Losasso, who leads the center, is a board - certified adult and pediatric general surgeon. He trained with Dr. Donald Nuss, the founder of the Nuss procedure, at the Children's Hospital of the King's Daughter in Norfolk, Virginia. Dr. Losasso has been treating pectus excavatum and pectus carinatum for teens and adults since 1999.
The center is also one of the only centers to perform chest wall reconstruction on children and adults ages 10 - 55 years old. They understand that the best age to get the Nuss procedure is between 13 – 16 years old when the chest's cartilage and bones are still malleable. However, Dr. Losasso has successfully completed many Nuss procedures in patients as old as 53 years old.
The center assesses the severity of the pectus deformity using the Haller index. They order imaging to measure the index and determine the appropriate treatment. For patients with a Haller index of 3.2 - 3.25 or higher, surgical intervention may be considered. Dr. Losasso has successfully treated patients with Haller indexes of over 20.
At the Center of Excellence for Pectus, pain management is well - taken care of. They have an excellent pain management team at the award - winning Valley Hospital. Multiple pain management modalities, both within the operating room and post - operatively, are utilized to ensure patients have a successful and uneventful recovery. Most patients feel very little pain following the surgery and are quite comfortable throughout their stay at the hospital.
Comparing the Hospitals
| Hospital Name | Specialization | Treatment Approach | Patient Age Range | Post - operative Care |
|---|---|---|---|---|
| Morgan Stanley Children's Hospital of New York - Presbyterian | Pediatric minimal access surgery for various pediatric surgical cases, including pectus excavatum | Minimally invasive Nuss procedure, multiple minimal access techniques | Newborns - Children | Reduced pain, shorter hospital stays, better cosmetic results, follow - up care for recovery |
| Columbia University Irving Medical Center | Comprehensive chest care, including pectus excavatum, lung transplants, diaphragm disorders | Latest surgical options, keeping an eye on innovative treatments | All ages | Personalized care, post - operative monitoring, patient - centered approach |
| NYU Langone Health | Advanced and personalized care for pectus excavatum | Both surgical and non - surgical options, latest surgical techniques | All ages | Thorough post - operative pain management, recovery monitoring, patient education |
| Mount Sinai - New York | Detailed pectus excavatum repair, understanding of all aspects of the surgery | Open and closed surgical options, pre - operative evaluation and preparation | Children (mostly 12 - 16 years old) and adults (early 20s) | In - depth post - operative care, including pain management, tube removal, and activity guidance |
| Center of Excellence for Pectus | Expertise in Nuss procedure for pectus excavatum and chest wall reconstruction | Nuss procedure, Haller index assessment for treatment decision | 10 - 55 years old | Effective pain management, follow - up for recovery, patient - specific approach |
Factors to Consider When Choosing a Hospital for Pectus Excavatum Correction
When choosing a hospital for pectus excavatum correction, several factors should be taken into account:
- Hospital Reputation: Look for hospitals with a good reputation in the field of pectus excavatum correction. Hospitals that are highly ranked or have a long - standing history of successful treatments are often a better choice. For example, Morgan Stanley Children's Hospital of New York - Presbyterian, which is ranked among the top five children's hospitals in the country, is likely to have a high - quality treatment program.
- Surgeon Experience: The experience of the surgeon performing the procedure is crucial. Surgeons who have performed a large number of pectus excavatum surgeries, like Dr. Barry Losasso at the Center of Excellence for Pectus, are more likely to have the skills and knowledge to handle any complications that may arise.
- Treatment Options: Consider the hospital's available treatment options. Some hospitals may offer only traditional surgical methods, while others may also provide innovative or minimally invasive techniques. Columbia University Irving Medical Center, for instance, stays updated on new treatment concepts and offers a range of surgical options.
- Patient - Centered Care: A hospital that focuses on patient - centered care will provide better communication, involve the patient and their family in the treatment decision - making process, and offer comprehensive pre - and post - operative care. NYU Langone Health is known for its personalized approach to patient care.
- Location and Accessibility: The location of the hospital can be an important factor, especially for patients who may need to make multiple visits for pre - operative evaluations, the surgery itself, and post - operative follow - up. Columbia University Irving Medical Center has multiple locations in New York and New Jersey, which provides convenience for patients.
Conclusion
Pectus excavatum is a congenital chest wall deformity that can have physical and psychological impacts on patients. Fortunately, there are several top - notch hospitals in New York City that offer excellent treatment options for this condition. Morgan Stanley Children's Hospital of New York - Presbyterian stands out for its pediatric minimal access surgery expertise. Columbia University Irving Medical Center is known for its comprehensive chest care and leadership in the field. NYU Langone Health provides advanced and personalized care, while Mount Sinai - New York offers detailed pre - and post - operative care. The Center of Excellence for Pectus has a high success rate with the Nuss procedure and chest wall reconstruction.
When choosing a hospital, patients and their families should carefully consider factors such as hospital reputation, surgeon experience, treatment options, patient - centered care, and location. By making an informed decision, patients can increase their chances of a successful pectus excavatum correction and a better quality of life.
If you or someone you know is dealing with pectus excavatum, we encourage you to explore these top hospitals in New York City. Contact the hospitals directly to learn more about their services, schedule consultations, and take the first step towards effective treatment. Share this article with others who may benefit from this information, and spread awareness about the available treatment options for pectus excavatum.
