The Vacuum Bell (VB) is a non-surgical medical device designed to treat Pectus Excavatum (PE), a common congenital chest wall deformity characterized by an inward depression of the sternum and rib cage. The VB device offers a less invasive alternative to surgical procedures, utilizing mechanical force to gradually reshape the anterior chest wall over an extended period.
The Physical Mechanism of Correction
The Vacuum Bell device consists of a silicone or rubber cup connected to a hand pump, positioned directly over the deepest part of the sternal depression. Its function relies on applying negative pressure; activating the pump extracts air, creating a vacuum effect. This mechanical force immediately lifts the depressed sternum and attached costal cartilage outward. Correction depends on the inherent elasticity and flexibility of the patient’s rib cage structures. Sustained application of this negative pressure stretches the shortened cartilage, prompting permanent remodeling of the chest wall tissue.
Clinical Efficacy and Success Rates
Clinical data shows that the success of the Vacuum Bell is highly dependent on patient characteristics and commitment. A successful outcome is defined as a lasting structural correction of the chest wall deformity, not just the temporary lift seen while the device is in use. Published studies report that between 35% and 43.6% of patients achieve a good or excellent outcome, often meaning significant improvement or a fully corrected sternum. Younger patients (aged 11 years or less) consistently demonstrate better results due to the greater pliability of their costal cartilage. The initial severity is also a major factor; patients with a pre-treatment depth of 1.8 centimeters or less are more likely to achieve a positive outcome, and these results can be stable for over two years after treatment cessation.
Patient Selection and Treatment Protocol
Identifying appropriate candidates is necessary, as the treatment is most effective for patients with a flexible chest wall and mild to moderate Pectus Excavatum. The degree of cartilage flexibility is often assessed by a clinician and is a stronger predictor of success than age alone. The treatment protocol requires substantial patient compliance and consistency to be effective. Patients typically begin with a brief daily wear time, such as 30 minutes twice a day, gradually increasing the duration as they tolerate the pressure; optimal results are often linked to wearing the device for more than two hours per day. The overall duration of therapy is lengthy, with a recommended course of 12 to 15 months, though many patients require 24 months or more of continuous use to stabilize the correction.
Potential Side Effects and Contraindications
The Vacuum Bell is generally considered safe, but it can produce several localized and temporary physical side effects. The most common issues are related to the intense suction on the skin, including redness (erythema) and bruising at the application site. Patients may also experience mild chest pain, swollen skin, or petechiae (small red spots caused by minor bleeding under the skin). These minor side effects usually resolve quickly after removal and can be managed by reducing the suction pressure or application duration. The device is contraindicated for patients with severe cardiac disorders, underlying connective tissue disorders, certain musculoskeletal disorders, vasculopathies, or bleeding disorders (coagulopathies).