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Surgical History
 After the definition of the pectus deformities in the 19th century, the primary treatment used to include respiratory exercises, pressure manipulation and aerobic exercises.
 
The first surgical treatment had been performed by Sauerbruch in 1913. However differing  a great extend from the recent method, in his operation ,a part of the chest wall had been resected and consequently the patient relived from the severe dsypnea and  tachycardia.
 
Later the surgeons Dr.Oschner, Dr.De Bakey and Dr.Brown  respectively, published their  previous experiences. However the milestone and threshold for pectus surgery was the procedure  that Dr.Ravitch introduced. In this procedure Dr.Ravitch used to disintegrate all the joints between the sternum and the ribs, which was used to be followed and completed  by the sternal osteotomy. However he couldn't prevent  the collapse of the sternum inwards totally. In 1961 Adkins and Blades modified the Ravitch procedure by inserting a steel bar and succeeded to prevent the collapse of the sternum.
 
On the other hand, after the recognisition of condrodistrophy in  children who were performed cartilage resection, this procedure was opposed  and disapproved 
In 1987, Dr.Donald Nuss innovated the Nuss operation depending on the flexibility and the expansion of the chest wall. The Nuss operations, which were initiated by the principle that it should have  been possible to change the shape of the chest wall  by pressing it inside through  under the sternum, if we were able to change the shape easily by pressing it from outside inwards. He published his experiences in 1997 at the tenth year since the beginning. Subsequently the Nuss Procedure have been developed and performed in all over the world.In the beginning of this century Dr.Horacio Abramson modified the Nuss Procedure  and innovated a new Minimal Invazive Procedure for pectus carinatum repair by stabilizing the subcutaneous pectus bar laterally to the ribs.
 
 
 

Donald Nuss  

Ravitch