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Abramson Procedure

Abramson Procedure

The successful application of the minimally invasive Nuss procedure for the repair of pectus escavatum chest deformity by Dr. Donald Nuss prompted a search for a similar procedure for the repair of  pectus carinatum. Dr. Horacio Abramson an argentine thoracic surgeon modified the Nuss technique for the repair of pectus carinatum and was the first to report the successful results. Our department was one of the first centers to start the implementation of the technique after Dr. Abramson.

The technique is similar to the Nuss technique. It involves the application of pressure through a curved steel bar that is placed subcutaneously anterior to the sternum, via lateral thoracic incisions. The bar is inserted through a polyvinyl chloride tube with the convexity facing posteriorly. The polyvinyl chloride tube is positioned presternally by trocar.  Subperiosteal wires attach small fixation plates to the ribs laterally, and the convex bar is secured to the small fixation plates with screws applying manual pressure to the anterior chest wall until the desired configuration is achieved. After 2 -4 years, the bar, wires stitches, screws, and fixation plates are removed under general anesthesia. The operation which is similar to the Nuss procedure in general aspect has successful results in the repair of pectus carinatum.

So far we have 100% satisfactory results from the patients we have treated with this technique. After the operation patients are admitted for 5 days in the hospital. During this period analgesia is maintained. After discharge from the hospital at the end of the fifth day, the patient would require the support of the family for 2-3 weeks at home. Patients planning for this procedure would have to seek 3-4 weeks of permission from work or school.