Rultract system parts needed for sternal elevation for a modified Nuss procedure.
Minimally invasive repair of pectus excavatum (MIRPE) is performed by placement of substernal metal bars. Visualization across the mediastinum is compromised in severe defects, and cardiac puncture and aortic injury have been
reported. In adults with less chest wall flexibility, the bars require more force to rotate and intercostal muscle stripping may result, leading to bar malpositioning. The Rultract Skyhook Retractor can be helpful to elevate the sternum and facilitate
adult MIRPE.