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MIRPE (Minimally Invasive Repair of Pectus Excavatum) – (Modified) Nuss Procedure

Minimally invasive repair of Pectus Excavatum is a method used for the treatment of pectus excavatum. MIRPE is based on the principle of lifting the sternum by one or more metal rods that enter the rib cage from the points where the patient's right and left ribs begin to collapse and pass under the deepest point of the sternum bone.


A pediatric surgeon who first described MIRPE, Prof. Dr. Donald Nuss placed this bar with the help of his fingers in young children. Over time, the technique was developed and perfected, and it was named the "Modified Nuss Procedure". In general, all variations are grouped under the MIRPE heading.


As Dr. Pectus, we can perform this surgery in all spectra, including the Cross bar, which can be applied in only a few clinics in the world, and the 4 bar techniques, which we have described for the first time in the world and have been published in the literature in this way. We have the honor of being one of the clinics that performs this surgery the most in the world with our experience in many cases.

Would you like to see how the pectus deformity looks at the heart from the inside with surgical images?

Attention! The video may contain surgical footage. In this regard, we recommend that it not be watched next to sensitive individuals and children.

Nuss Procedure - Dr.Pectus
Youtube - Dr.Pectus
Youtube - Dr. Pectus
Dr Hasan Ersoz's Article - 4 Four Bar Technique - Oxford University Press

There is no age limit for this surgery. It can be performed at any age in the appropriate patient. You can reach the article that we published by bringing the largest case series reported in the world at the age of 40 and over to the literature.

Nuss Surgery Over 40 Years old - Nuss Procedure - MIRPE - Advanced Age
Check NUSS Procedure.webp
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Nuss Procedure Details

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Cross Bar vs Parallel Bar Nuss Procedure - Dr.Pectus Article - MIRPE
Dr. Pectus Article - MIRPE- Nuss Surgery - Minimally Invasive Repair of Pectus Excavatum - Cross Bar - XI Bar - Modification

When performing the MIRPE, or Nuss Procedure, it may sometimes be necessary to use more than one bar, depending on the patient's condition. In these cases, these bars are placed in parallel form in the classical approach in many centers around the world. However, placing bars in a diagonal design also has great advantages over parallel. There are very few centers in the world that use the cross bar technique. Together with my colleagues from 6 centers performing cross-bar surgeries from 5 countries, we published a multi-center international study in a reputable ISI-indexed (SCI-exp) journal (Updates in Surgery). By examining the data of a total of 418 patients, 213 with parallel bars and 205 with cross bars, we were honored to have clarified in the scientific literature the issue in which cases the cross bar and in which cases the parallel bar should be used. Dr. Pectus Clinic has shown its great experience in choosing which technique to use for which patient, by not adhering to a single technique fanatically, but by being able to apply both techniques and basing this on scientific evidence with a sufficient number of patients. With all this experience, you can have no doubt that he will choose the best treatment method for you. Don't let pectus be your destiny!