Surgical Technique


A Percutaneous Sternal Elevation Technique Using the Tian-Ping Sternal Lifter for Nuss Repair of Pectus Excavatum

Hao-Nan Lin, Jun-Min Zhu, Zhi-Qiang Deng, Xiao-Han Jin, Yong Xiao, Xing-Bao Zhang, Zhong-Yi Zeng, Hao-Tian Du, Dong Tian, Feng Lin

Abstract

The conventional Nuss procedure carries a risk of catastrophic injury during retrosternal tunnel creation. This study aimed to evaluate the feasibility, safety, and preliminary clinical outcomes of a novel percutaneous sternal elevation device, the Tian-Ping (Tian's) sternal lifter, in assisting the Nuss procedure for pectus excavatum. This study included patients undergoing chest wall correction via the Nuss procedure assisted by the Tian-Ping (Tian’s) sternal lifter from July 2025 to October 2025. Patient demographics, operative time, intraoperative blood loss, complications, and postoperative pain scores were recorded. A total of 15 consecutive patients were enrolled. All procedures were completed successfully without major intraoperative complications. Thoracoscopy revealed retrosternal space enlargement and sternal elevation up to 6–8 cm. The median operative time was 51 minutes with a median intraoperative blood loss of 2 mL. The median postoperative hospital stay was 9 days. The median postoperative visual analog scale (VAS) pain score was 2. Postoperative pneumothorax occurred in two patients; no other postoperative complications were observed. The Tian-Ping (Tian's) sternal lifter-assisted Nuss procedure is a safe and feasible technique for chest wall correction, with potential advantages in avoiding bone injury. We recommend this technique as an alternative for patients who value procedural safety and aesthetic satisfaction.

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