Finite element-guided optimization of personalized vacuum bell devices for pectus excavatum: an exploratory retrospective clinical study.

BACKGROUND

Vacuum bell (VB) therapy is a noninvasive option for pectus excavatum (PE), but the clinical value of device optimization remains unclear. This study used finite element analysis (FEA) to guide VB design optimization and retrospectively evaluated the outcomes of the final customized devices in pediatric PE.

METHODS

Two finite element models (VB1 and VB2) were constructed from three-dimensional chest wall point-cloud data. Their deformation and stress distributions were compared to derive structural optimization principles. The final clinical devices were customized accordingly. We retrospectively analyzed 69 pediatric patients with PE treated at a single center between January 2024 and December 2025. Three-dimensional scanning was used to assess thoracic dimensions and sternal depression depth.

RESULTS

FEA showed that deformation was concentrated at the center of the polycarbonate observation window, whereas peak stress occurred at the junction between the window and the silicone ring, identifying this region as a key target for optimization. In the clinical cohort, 68/69 patients (98.55%) showed measurable correction of anterior chest wall depression, and 29/69 (42.03%) achieved excellent or good outcomes. Thoracic transverse diameter, longitudinal diameter, and sternal depression depth were all significantly reduced after treatment (all P < 0.05).

CONCLUSIONS

FEA-guided optimization may improve VB structural stability and negative-pressure regulation. The optimized customized devices showed favorable objective morphological outcomes in pediatric PE.