What is the Ravitch procedure

At The Children's Hospital of Philadelphia (CHOP), the Ravitch procedure is used to correct severe or complex cases of pectus carinatum. The procedure may also be used to treat pectus excavatum when your child is not a candidate for the Nuss procedure.

The Ravitch procedure involves an incision across the chest and the removal of the cartilage that causes the defect. The sternum is then placed in the normal position. If your child is being treated for pectus excavatum, a small bar is then inserted under the sternum to hold it in the desired position.

The extent of the operation depends upon the severity of your child’s pectus carinatum.

The cartilage will regenerate over the next 4-6 weeks, causing the sternum to be in a fixed position. A small drain may be placed at the site of the operation to prevent a fluid collection.

After surgery

Following the Ravitch procedure, your child will remain hospitalized for 3-5 days. The length of hospitalization is mainly determined by pain management. CHOP’s dedicated Pain Management Program team will work with the surgical team to make sure her pain is well managed so she can recover smoothly.

There are multiple ways we can control your child’s pain. Our pain management team will come up with a plan based on your child’s individual recovery. Initially, IV pain medications will be used to control your child’s pain. When your child begins to eat, oral pain medications will be used.

In the hospital, your child will have activity restrictions that will continue after discharge. The restrictions are in place to protect your child’s chest during cartilage regeneration. Your child’s surgeon or nurse practitioner will discuss these restrictions with you. Your child might need to avoid strenuous activity or sports for several months while the cartilage is growing back.

After being discharged from the hospital, your child will follow up in the general surgery clinic in 2-4 weeks. For children treated for pectus excavatum, the bar is removed approximately six months after the procedure.