Pectus excavatum is a common chest wall deformity characterized by an inward depression of the sternum and adjacent ribs, resulting in a sunken appearance of the anterior chest wall. Contrary to common misconceptions, this condition is not simply caused by calcium deficiency or malnutrition, and may instead be associated with multiple factors, including genetic influences, trauma, and surgery. Besides affecting aesthetics, severe pectus excavatum can affect cardiopulmonary function, and some patients may also experience symptoms of indigestion. When patients and their families have a desire for surgical intervention, or the deformity compresses internal organs, surgical correction may be considered. The Wang procedure, pioneered by Dr. Wenlin Wang, is one innovative surgical method.
Technical Mechanism and Safety
The Wang procedure operates on a “lifting” principle rather than the “flipping” or leverage force used in traditional methods. Unlike the Nuss procedure, which requires placing bars inside the thoracic cavity, the Wang procedure is entirely extra-thoracic. During the procedure, a shaping bar is positioned on the exterior of the chest wall. The depressed sternum and costal cartilages are then lifted toward the bar using medical-grade wires. Because the instrumentation remains outside the thoracic cavity, the risk of injury to the heart and lungs is effectively avoided.
Clinical Advantages and Patient Suitability
This technique is particularly suitable for pediatric patients, especially children under 5 years old and infants. Because it does not utilize additional short steel plates for fixation, it reduces the difficulty of the procedure, minimizes incision length, and results in better fixation, reducing the incidence of subsequent plate displacement or poor wound healing. Furthermore, this procedure is an ideal option for patients who have experienced failed Ravitch or Nuss procedures.
Conclusion
The Institute of Chest Wall Surgery (ICWS) offers the Wang procedure as a stable solution for correcting pectus excavatum. Beyond this technique, Dr Wang Wenlin’s work spans a broad spectrum of thoracic deformities, such as asphyxiating thoracic dystrophy and barrel chest. For patients, this broader clinical experience allows for clearer assessment and more personalized treatment pathways when dealing with complex or uncommon chest wall conditions.