[en] Our strategy for repairing pectus excavatum is based on the Nuss procedure regarding the use of a bending pectus bar, and we have modified the procedure to create a bar tunnel extrapleurally using an endoscope. We use two methods for pectus repair. One is a modified Nuss procedure, designated the MN method, which we use for prepubescent patients if the force required to elevate the end of the sternum after detachment of the xiphoid process from the sternum through an incision at the deepest point of the depression is <4 kg and allows sufficient repair of the depression. The other is endoscope-assisted sternal elevation, designated the EA method, which we use for adolescents and adults requiring sternal elevation forces of >4 kg or having severe asymmetrical shapes. The EA method includes costal cartilage resection to reduce the resistance to sternal elevation and allow repair of asymmetrical depressions. We performed the MN method on 31 patients and the EA method on 26 patients. We experienced no infections, pericarditis, hemothorax, persistent pain, or cardiovascular complications. We performed long-term follow-up of ≥6 months (6-88.3 months) after bar removal for 25 MN cases and 10 EA cases using the CT index. The CT indexes for the early period after bar removal and the long-term period did not differ significantly for both methods. Although our methods for pectus repair require more time than the original Nuss procedure, we believe that they are safer and more flexible for various types and ages of pectus excavatum. (author)