Pectus Excavatum (PE) and Pectus Excavatum are the most common chest wall deformities in pediatric patients (see figure), with an incidence of 1/300 to 1000 births. It is named because the anterior chest wall (sternum, rib cartilage, etc.) is sunken or protruding, with the appearance of a funnel-shaped or chicken chest. The cause of chest wall deformity is unknown, and the onset is thought to be due to abnormal overgrowth of congenital rib cartilage rather than rickets, so calcium supplements are not effective. Most of them are present after birth and vary only in severity. The deformity gradually worsens with age and is most pronounced during adolescent development. The presentation of the child tends to be consistent with the degree of malformation. From asymptomatic in the early stages, it progresses to recurrent unexplained pulmonary infections, low exercise or poor endurance compared to children of the same age (mostly considered poor/weak constitution), and finally to a significant decrease in exercise endurance and organic changes in the heart and lungs (e.g., rightward deviation of the cardiac axis, conduction block, heart valve prolapse, restrictive or (and) obstructive lung disease) due to persistent severe compression of the mediastinum, heart, and lungs by the invaginated sternum and rib cartilage (e.g., Figure ). In girls, mammary gland development is severely affected and the diseased side is less developed (e.g., Figure ). The chest wall deformity, regardless of the severity, will affect the parents and the child’s work, life and study, the child is reluctant to participate in swimming (the affected area is exposed), contact sports (basketball, soccer, etc., fear of injury), long-term will affect the child’s psychological development and character formation, the child is lonely and introverted, less talkative, self-confidence is reduced. In order to reduce the deformity, the child habitually forms a “funnel chest posture” with anterior neck slant, forward shoulders, posterior spine protrusion, and forward abdomen, which not only affects the image and posture, but also aggravates the development of deformity (anterior/posterior spine protrusion or lateral curvature), and makes it more difficult to correct the habitual posture after surgery and prolongs the rehabilitation time. In order to relieve compression, improve the appearance of the thorax, and reduce or eliminate the psychological stress of parents and children, surgical correction has been used for more than 80 years in children with moderate to severe cases of this disease. The classic surgical procedures include sternal elevation, sternal reversal, and their respective modified surgical methods. These procedures are very traumatic, with an operation time of 2-3 hours, high bleeding (100-200 ml), and serious complications, such as rib dysplasia/deformity, thoracic deformity or reduced elasticity or even fixation of the thorax resulting in uncorrectable respiratory distress; sternal necrosis can occur with sternal reversal, etc. In 1998, Dr. Nuss in the United States developed a minimally invasive method for the correction of funnel chest by taking advantage of the good shaping characteristics of the pediatric thorax. Nuss surgery is only suitable for symmetrical type of funnel chest, and the complications related to Nuss support plate (displacement, rotation) occur about 10 The complications associated with the Nuss support plate (displacement, rotation) occur in about 10 % of cases, all of which can lead to surgical failure. Chronic effusion around the plate, thoracic and pericardial effusion, poor incision healing, and chronic ulceration have been reported and are thought to be closely related to the direct contact between the support plate and pericardium and the poor histocompatibility of the support plate. the emergence of the Nuss procedure has revolutionized the concept of orthopedic surgery for chest wall deformities, and its surgical design has inspired many scholars to develop minimally invasive treatment for PE. Non-surgical correction (2003); modified sternal elevation with small incision and short segment of rib cartilage resection (2005), etc. Vacuum suction PE non-surgical correction treatment is unstable, long course, and poorly tolerated by patients (skin congestion and ulceration). Most scholars use modified correction for reoperation in recurrent cases. Asymmetric PE accounts for about 50-60% of surgical cases. Special types such as Grand Canyon type, PE combined with pheasant chest, inferior rib exostosis (especially in older children), sternal rotation, sternal malformation or dysplasia, scoliosis, Marfan syndrome, Poland syndrome, etc. lack minimally invasive correction methods. We have developed our own surgical instruments suitable for national conditions. According to the principle and requirements of surgery, we have improved the indications, contraindications, surgical access (left/right side) and level, and surgical methods for minimally invasive funnel chest surgery correction. Preoperative chest CT scan and triple micro reconstruction, intraoperative sternal elevation, direct thoracoscopic guidance, ECG and heart sound co-monitoring, double “3” point fixation and other techniques were developed. After more than 10 years of clinical use, we have accumulated rich experience in minimally invasive treatment and formed a systematic and standardized treatment plan for preoperative examination, surgical operation, postoperative analgesia and rehabilitation training, which has been adopted by large medical centers around the world. No serious intra-operative or post-operative complications have occurred in our surgical cases, and no reoperation cases of support plate displacement or infection have occurred without the use of fixation plates; the surgical incision has been further shortened (1.5cm incision in each bilateral axilla) for better cosmetic results; more than 2/3 of the children have had their support plates removed, and 95% of the children have a full and proportional chest wall, so the treatment results have reached the international advanced level. For asymmetric funnel chest and complex cases lacking effective minimally invasive treatment methods, based on the accumulation of a large number of case data, we proposed a new classification method for the first time at home and abroad, and designed a surgical correction method that was first applied and reported in China. The surgical results show that the use of oblique support plate, double support plate, irregular support plate and other techniques are satisfactory for the treatment of asymmetrical type of patients in older children and adolescents. To further improve the treatment results in complex cases, we have developed a 3-D model of funnel chest as well as an internal support treatment model for funnel chest (shown on the right) in collaboration with relevant institutions. This technology allows for the shaping of the support plate prior to surgery, simulating the surgical approach and the position of the support plate in and out of the chest cavity, in order to achieve individualized and precise correction and reduce anesthesia and surgery time, truly allowing all patients with funnel chest to “lift their chests” with minimal invasion.