What Is Vacuum Bell Treatment and How Is It Applied?

Vacuum bell treatment is a non-invasive method used to treat pectus excavatum (cobbler's chest), one of the chest wall deformities. Pectus excavatum is a condition characterized by an inward depression of the sternum (breastbone). Vacuum bell treatment is a non-surgical option preferred especially for patients with mild to moderate deformities. The method aims to improve the appearance of the deformity by pulling the breastbone outward.

How Does the Vacuum Bell Work?

The vacuum bell is a suction cup, usually made of silicone or medical-grade plastic, available in different sizes. It is placed at the center of the chest over the sternum, and its rim is designed to fit tightly against the chest wall. The negative pressure created inside the cup gently pulls the sternum outward.

The Treatment Process

Vacuum bell treatment follows these steps:

1. Evaluation and Planning

• Diagnosis: The degree of the chest deformity is assessed with a clinical examination and imaging methods (for example, CT or MRI).
• Patient Selection: Patients with mild to moderate pectus excavatum are suitable for this treatment. Surgical methods may be recommended in severe cases.
• Size Selection: The vacuum bell is chosen to match the patient's anatomy.

2. Placing the Device

• The patient sits in a reclined or slightly tilted position.
• The vacuum bell is placed directly over the sternum.
• It is checked that the edges of the cup are airtight.

3. Applying Negative Pressure

• The air inside the cup is slowly drawn out using the device's vacuum mechanism (a hand pump or an electric pump).
• The negative pressure moves the sternum outward.
• At the first application the pressure is started at a low level and increased to a tolerable level.

4. Duration and Frequency

• During the first few weeks, the device is usually used for 30 minutes to 1 hour a day.
• As the patient tolerates the device, the duration of use is increased and can reach 2-3 hours a day.
• Depending on the degree of the deformity, treatment may last from a few months to a few years.

5. Follow-Up and Assessment

• Regular check-ups assess the position of the breastbone and the rate of correction of the deformity.
• The treatment protocol is adjusted if necessary.

Advantages of the Treatment

1. Non-invasive: No surgery is required, so there is no general anesthesia or large incisions.
2. Minimal risk: The complication rate is low.
3. Tailored to the patient: The device is selected and adjusted according to the patient's anatomy.
4. Can be used at home: The patient can use the device on their own at home.

Side Effects and Complications

Vacuum bell treatment is generally safe, but some side effects may occur:

• Redness or bruising of the skin where the device makes contact.
• Mild pain or a feeling of pressure during the first uses.
• Rarely, temporary mild dizziness.

These effects are usually mild and do not prevent treatment from continuing.

Who Is It Not Suitable For?

• Patients with a severe pectus excavatum deformity.
• Deformities that cause serious pressure on the heart or lungs.
• Areas with a skin infection or wound.