What Is Pectus Excavatum?

Pectus excavatum is a condition in which the breastbone (sternum) and several ribs are caved in. This happens because these ribs and the breastbone grow abnormally in an inward direction.

Health care providers sometimes suggest that kids use a vacuum bell to help correct pectus excavatum without surgery.

What Is a Vacuum Bell?

A vacuum bell is a rubber bell- or cup-shaped device that connects to a pump. You place the device on the front of the chest and use the pump to suck the air out of the device. This creates suction, or a vacuum, that pulls the chest and breastbone forward. Over time, the chest wall and breastbone stay forward on their own and hold a new shape.

Illustration: Vacuum Bell Device

Your child's health care provider will go over the instructions with you about how to use the vacuum bell at home.

How Do We Use the Vacuum Bell at Home?

To use the vacuum bell:

  • Place the device on the chest. The center of it should be on top of the deepest part of your child's pectus excavatum.
  • Push the device onto the chest to form a seal.
  • Use the hand pump to suck the air out of the device. If your health care provider told you to pump to a certain pressure, follow those instructions. Otherwise, pump until you see your child's chest wall rise.
  • Remove the hand pump and plug the end of the tubing so your child can move around and the air does not leak out of the device.
  • Leave the device on your child's chest for the amount of time recommended by your health care provider.
  • Lift the device off of the chest when the time is up.

If your child is under 10 years old, you should help him or use the vacuum bell. Most older kids can use the vacuum bell on their own.

How Long Do Kids Need to Wear the Vacuum Bell?

At first, the vacuum bell should be worn about 30 minutes, twice a day. Over the following 4–6 weeks, you can slowly increase the amount of time your child wears it, up to about 2 hours twice a day (or as recommended by your health care provider).

Most kids need to use the vacuum bell for a year or more.

Follow your health care provider's recommendations for how long and how often your child should wear the vacuum bell. This way your child can get the best results.

Are There Any Problems With Using a Vacuum Bell?

Usually, the vacuum bell causes no problems except a little redness or bruising where it attaches to the chest. This usually goes away on its own after a few hours. If your health care provider recommends it, you can reduce the amount of suction to lessen the chance of redness or bruising.

Less commonly, someone can have back pain or a burning or prickly feeling in the arms while wearing the vacuum bell. If this happens, take off the vacuum bell and try a lower pressure in a few hours. Call your health care provider if this continues with the lower pressure.

Is the Vacuum Bell Painful?

It can take some time to get used to the vacuum bell. Some kids might feel a bit of discomfort when the device is put on, but most get used to it pretty quickly.

What If My Child Won't Wear It?

Most kids do well with the vacuum bell. But if your child struggles, try to be understanding. Work together to come up with solutions and incentives to get your child to wear the vacuum bell. They can wear the vacuum bell under a shirt or even while they sleep.

Your care team is a resource — for you and your child. They are there to answer any questions and help you and your child get the best results from the vacuum bell.

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