What kind of surgical procedure is Nuss? How does it compare to traditional surgery? What are the special considerations for patients in terms of hospital and patient selection? Zhu Yanjun, Department of Thoracic Surgery, Air Force General Hospital, is a congenital malformation in which the sternum, rib cartilage, and part of the rib cage are sunken into the spine to form a funnel-shaped deformity, with an incidence of 1 to 4 per 1,000. Due to the misunderstanding, funnel chest is often mistaken for “calcium deficiency” or “special body type”. Because the chest cavity is invaginated, the patient’s heart and lungs are severely compressed, so patients with funnel chest are generally short and thin. In addition to the significant impact on the patient’s body shape, it also brings a heavy burden to the patient’s psychology. They seldom go out, dare not swim, and some are even afraid to go to school or work for fear of strange looks around them. Their special body shape also causes them great problems when buying clothes. Due to the extreme inferiority complex, some patients wear thick clothes all year round to hide their body shape to the maximum. The pathogenesis of funnel chest is still unknown, and foreign statistics show that there is a 40% chance that the condition is genetic, so it may be present from the time of birth, but is often discovered by parents only after months or even years, when the physical features become more pronounced. In order to facilitate the postoperative development of patients with funnel chest, the best period of treatment for pediatric patients is recommended to be 5 years old – before puberty develops. However, the exact timing of surgery requires a detailed analysis by a specialized surgeon based on the patient’s specific situation. For adult patients with funnel chest, early treatment is best to relieve the tremendous pressure on the heart and lungs and to improve the quality of life and survival. Minimally invasive Nuss surgery is the first choice for treatment of funnel chest At this stage, surgery is still the only treatment for funnel chest. Traditional funnel chest surgery usually involves making an incision of about 20 cm in the chest, cutting off all the bent ribs, placing orthopedic plates, and then reattaching the bones and placing them in the chest cavity. The disadvantages of this surgery are the large incision, the 3-6 hours of operation time, the large amount of bleeding, and the slow post-operative recovery, which requires the patient to be bedridden for 2 weeks before he can walk around. In addition, the postoperative orthopedic results are not completely satisfactory to the patient, and the recurrence rate and complications are relatively high, especially due to the large trauma scars, which seriously affect the patient’s aesthetics and daily life in the future. The minimally invasive Nuss procedure, the latest treatment for funnel chest, was pioneered by Professor Donald Nuss in 1998 and is now widely performed worldwide. The procedure is minimally invasive, with a small incision of about 2 cm in each of the patient’s left and right armpits. The orthopedic plate is entered through the incision, fixed at both ends, and removed in about three years. The surgery takes only about 45 minutes, with minimal bleeding and a short recovery period, and the patient can get out of bed and walk around the next day. At the same time, with the maturing of thoracoscopic clinical applications, the Nuss procedure is safe and has few complications, and the patient has a short recovery period and can quickly return to school and work. Nuss surgery has now become the first choice for patients with funnel chest and has largely replaced traditional surgery. The Nuss procedure has been performed in China since 2002 and has been well received by patients because of its good characteristics. However, there are many irregularities in the operation of Nuss surgery due to various reasons. As the founder of Nuss surgery, Prof. Nuss especially pointed out that because Nuss is such a delicate surgery, it is very demanding for the operator, requiring both skilled surgery and rich clinical experience, and any weakness in the operation may bring great physical damage to the patient, and in serious cases, it will be life-threatening. In order to minimize the risk of surgery, Nuss emphasizes that minimally invasive Nuss surgery must be performed in a major hospital by an experienced surgeon.