Vacuum Bell wear and care instructions

Types of Klobe Vacuum Bell: the pectus clinic works with Eckart Klobe, the inventor and manufacturer of the Klobe Vacuum bell, the first device developed specifically to offer a non-surgical treatment for pectus excavatum. Photo provided by Eckart Klobe

How it works

The Vacuum Bell applies negative pressure to raise the depression of the chest wall. You may view the chest wall through the polycarbonate window. Consistent application of the vacuum bell is effective in remodelling the bones, cartilage and ligaments of the chest wall over time.

Wearing schedule
Week 1-4 5 6 7 8 9 10
Minutes
/day
30 45 60 75 90 105 120
Typical results
Weeks 2-4 Funnel chest is lifted close to the viewing window
Week 8 Funnel remains in a lifted position for hours before partially falling back to its sunken position
Week 12 Funnel may remain lifted by about 1cm between sessions. Improved body posture and appearance may be observed
Week 16 Continued improvement of approximately 1mm per month
End of treatment

According to Obermeyer et al., excellent correction of a funnel depth of <0.51cm can be achieved. Patient characteristics predictive of an excellent outcome including initial age ≤11 years, initial chest wall depth ≤1.5cm, chest wall flexibility and diligent wearing over 12 consecutive months.

How to apply
  1. The Vacuum Bell is best applied at rest: before/during sleep, after a meal, or, during recovery after activities.
  2. To avoid dizziness, ensure that you are in a sitting or supine position at the beginning and end of a treatment session. Slowly evacuate and repressurize the Vacuum Bell.
  3. Place the Vacuum Bell over the centre of the funnel chest with the tubing nozzle above the upper part of the sternum.
  4. Spread the outer flanks of the elastic silicone body and push them lightly against the body. This will seal the inner flanks against the skin. Once the negative pressure is established, the Vacuum Bell will adhere to the body by itself. If chest hair interferes with the seal, remove the hair.
  5. Squeeze the suction ball completely 1 to 2 times until you feel suction; not pain. To maintain negative pressure for the duration of the treatment unit, fold the end of the silicone tube, remove the suction bulb and insert the plug. Once the negative pressure is secure with the plug, you may stand up carefully and walk about.
  6. Slowly depresurize the Vacuum Bell at the end of treatment by turning the rotary knob on the T-valve.
How to clean

Wipe with a soft cloth that may be moistened with soap and water, ethyl alcohol, propyl alcohol (i.e., propanol) or isopropyl alcohol (i.e., isopropanol). DO NOT USE DISINFECTANTS.

DO NOT WEAR
  • Travel involving flights or high altitude mountain railroads
  • Following scuba diving
  • During thoracic surgery
  • With subcutaneious silicone or autologous fat implants in breast or funnel chest augmentation
  • With Poland Syndrome unless skeletal thorax is complete
SIDE EFFECTS SOLUTIONS
Darkening of the skin (i.e., brown) May occur and resolve after end of treatment. If buising is dark (i.e., black), seek medical attention.
Enlarged nipples (males) May be induced by repeated touch stimulus of the Vacuum Bell. Consult your Physician.
Irritated nipples Offset the Vacuum bell slightly to one side to completely cover one nipple while completely exposing the other nipple.
Chest tenderness Reduce the duration of the treatment sessions and/or reduce the pressure.
Back pain Reduce the duration of the treatment sessions and/or reduce the pressure and/or reduce level of activity during session.
Chafed skin Reduce the duration of the treatment sessions and/or reduce the pressure and/or reduce level of activity during session.
Watery skin vesicles Reduce the duration of the treatment sessions and/or reduce the pressure and/or reduce level of activity during session.
Flabby skin Reduce the duration of the treatment sessions and/or reduce the pressure.
Red coloration of the skin under the Vacuum Bell Reduce the duration of the treatment sessions and/or reduce the pressure.
Blood droplets on the skin Reduce the duration of the treatment sessions and/or reduce the pressure and/or reduce level of activity during session.
Petechiae (pinpoint bleeding in the skin) Typically resolves within a few weeks following end of treatment.
Acne May develop in the suction zone under the Vacuum Bell.
Tingling arms Reduce the duration of the treatment sessions and/or reduce the pressure.
Febrile bronchitis Avoid chilling, reduce the duration of the treatment sessions and/or reduce the amount of negative pressure.
  References

Nonoperative management of pectus excavatum with vacuum bell therapy: A single center study, Obermeyer RJ, Cohen NS, Kelly RE Jr, Ann Kuhn M, Frantz FW, McGuire MM, Paulson JF. J Pediatr Surg. 2018 Jun;53(6):1221-1225. doi: 10.1016/j.jpedsurg.2018.02.088. Epub 2018 Mar 8.

Incorporating vacuum bell therapy into pectus excavatum treatment, Obermeyer RJ. J Vis Surg. 2016 May 18;2:99. doi: 10.21037/jovs.2016.05.01. Full text, PDF

  Further reading

Determinants of success associated with vacuum bell treatment of pectus excavatum, Toselli L, Chinni E, Nazar-Peirano M, Vallee M, Sanjurjo D, Martinez J, Bellia-Munzon G. J Pediatr Surg. 2022 Apr 22:S0022-3468(22)00283-4. doi: 10.1016/j.jpedsurg.2022.04.010. Epub ahead of print.

Vacuum Bell: Is It a Useful Innovative Device for Pectus Excavatum Correction? Loufopoulos I, Karagiannidis IG, Lampridis S, Mitsos S, Panagiotopoulos N. Turk Thorac J. 2021 May;22(3):251-256. doi: 10.5152/TurkThoracJ.2021.20035. Full text

Physiotherapy in addition to vacuum bell therapy in patients with pectus excavatum, Alaca N, Alaca I, Yüksel M. Interact Cardiovasc Thorac Surg. 2020 Nov 1;31(5):650-656. doi: 10.1093/icvts/ivaa161. Full text

Noninvasive treatment of pectus excavatum with a vacuum bell combined with a three-dimensional scanner, Gao Y, Li JH, Yu JG, Tan Z, Liang L, Huang T, Han X, Shi Z, Shu Q. Pediatr Surg Int. 2020 Oct;36(10):1205-1211. doi: 10.1007/s00383-020-04726-9. Epub 2020 Aug 12.

Sternal elevation techniques during the minimally invasive repair of pectus excavatum, Haecker FM, Krebs T, Kocher GJ, Schmid RA, Sesia SB. Interact Cardiovasc Thorac Surg. 2019 Oct 1;29(4):497-502. doi: 10.1093/icvts/ivz142. Full text, PDF

Monitoring the effectiveness of the vacuum bell during pectus excavatum treatment: Technical innovation, Sesia SB, Hradetzky D, Haecker FM. J Pediatr Surg. 2018 Mar;53(3):411-417. doi: 10.1016/j.jpedsurg.2017.05.023. Epub 2017 May 31.

Non-surgical treatment of pectus excavatum, Haecker FM, Sesia S. J Vis Surg. 2016 Mar 23;2:63. doi: 10.21037/jovs.2016.03.14. Full text, PDF

The vacuum bell for treatment of pectus excavatum: an alternative to surgical correction? Haecker FM, Mayr J. Eur J Cardiothorac Surg. 2006 Apr;29(4):557-61. doi: 10.1016/j.ejcts.2006.01.025. Epub 2006 Feb 13. Full text, PDF

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