PurePectus bars: Initial surgical experience and early outcomes in 111 patients

Khang T Dao; Kristin M Rassam; Benjamin E Padilla; Jae-O Bae; Patrick E McGovern; Lisa E McMahon

doi:10.1016/j.jpedsurg.2026.163129

PurePectus bars: Initial surgical experience and early outcomes in 111 patients

J Pediatr Surg. 2026 Apr 4;61(7):163129. doi: 10.1016/j.jpedsurg.2026.163129. Online ahead of print.

Authors

Khang T Dao¹, Kristin M Rassam², Benjamin E Padilla², Jae-O Bae², Patrick E McGovern², Lisa E McMahon³

Affiliations

¹ The University of Arizona College of Medicine - Phoenix USA, Phoenix, AZ, USA.
² Division of Pediatric Surgery, Department of Surgery, Phoenix Children's, Phoenix, AZ, USA.
³ Division of Pediatric Surgery, Department of Surgery, Phoenix Children's, 1919 East Thomas Road, Phoenix, AZ 85016, USA. Electronic address: lmcmahon@phoenixchildrens.com.

PMID: 41942000
DOI: 10.1016/j.jpedsurg.2026.163129

Abstract

Background: Bar rotation and migration remain common challenges in pectus excavatum repair using traditional Nuss bars. The PurePectus system (KLS Martin), a titanium-based construct, is designed to mitigate these issues by enhancing bar stability with bilateral connector plates. We report early outcomes following its implementation.

Methods: We conducted a retrospective review of patients who underwent pectus excavatum repair using the PurePectus system between September 2023 and January 2025. Demographic, operative, radiographic, hospitalization, and postoperative data were collected and analyzed.

Results: A total of 111 patients underwent repair using the PurePectus system. Mean age was 15 ± 2.0 years (range 12-22). All patients underwent sternal elevation, thoracoscopic mediastinal dissection, and cryoablation. Across the cohort, 84 patients (76.6%) received two bars, 27 patients (24.3%) received three bars. For patients receiving two bars, the mean operative time was 112.8 ± 24 min (range 61-193); for three bars, 135.5 ± 27 min (range 93-216). Connector use ranged from 3 to 8 per case. The median hospital stay was 1 night (range 1-7). No postoperative complications, including bar migration, rotation, infection, or reoperation, were observed during a 16-month follow-up period.

Conclusion: The PurePectus system introduces new technical considerations, such as precise connector measurement and intraoperative bar alignment. In this first series, early outcomes were favorable, with no added complications and smooth integration into existing workflows.

Keywords: Chest wall deformity; Connector plates; Minimally invasive repair of pectus excavatum; Nuss procedure; Pectus excavatum; Thoracic surgery; Titanium implants.