{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:44:50Z","timestamp":1793295890988,"version":"4.5.0"},"reference-count":67,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T00:00:00Z","timestamp":1648684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>For decades, open surgical repair was the only available method to treat congenital and acquired chest wall deformities (CWDs). In 1998, D. Nuss described a minimally invasive procedure for surgical repair of Pectus excavatum (PE). Today, the Nuss procedure is performed with increasing frequency worldwide and considered as the \u201cgold standard\u201d. After its introduction, the method experienced numerous modifications such as routine thoracoscopy and\/or sternal elevation, increasing safety of the procedure. Placement of multiple bars and\/or the so called cross-bar technique were introduced to correct complex CWDs. Standardized pain management, the introduction of cryo-analgesia and a standardized postoperative physiotherapy program including deep breathing exercises facilitate the establishment of an enhanced recovery after surgery (ERAS) process. However, the widespread use of the minimally invasive repair of pectus excavatum (MIRPE) procedure has been associated with a significant number of serious complications. Furthermore, several studies report near-fatal complications, not only during bar placement, but also during bar removal. This review focuses upon the most relevant modifications, including recent published surgical techniques of MIRPE, in order to describe current developments in the field.<\/jats:p>","DOI":"10.3390\/children9040478","type":"journal-article","created":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T21:33:03Z","timestamp":1648762383000},"page":"478","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Current Development of Minimally Invasive Repair of Pectus Excavatum (MIRPE)"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8426-5011","authenticated-orcid":false,"given":"Frank-Martin","family":"Haecker","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Children\u2019s Hospital of Eastern Switzerland, CH-9006 St. Gallen, Switzerland"},{"name":"Faculty of Medicine, University of Basel, CH-4056 Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3102-7268","authenticated-orcid":false,"given":"Thomas Franz","family":"Krebs","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Children\u2019s Hospital of Eastern Switzerland, CH-9006 St. Gallen, Switzerland"},{"name":"Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, UKSH University Hospital of Schleswig-Holstein Kiel Campus, Arnold-Heller-Strasse 3, 24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai-Uwe","family":"Kleitsch","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Children\u2019s Hospital of Eastern Switzerland, CH-9006 St. Gallen, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1053\/j.sempedsurg.2008.03.002","article-title":"Pectus excavatum: Historical background, clinical picture, preoperative evaluation and criteria for operation","volume":"17","author":"Kelly","year":"2008","journal-title":"Semin. 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