Thoracic Institute
Titanium Rib Program

History of the Titanium Rib Project

The Titanium Rib Project began in 1987 when Dr. Melvin D. Smith, pediatric general surgeon, consulted with Dr. Robert M. Campbell, Jr., pediatric orthopaedic surgeon, regarding a patient with severe congenital absence of ribs and scoliosis.  The infant, who was full-time ventilator dependent, was expected to die without intervention, so a chest wall prosthesis was designed of fracture pins.  Postoperatively, the child’s scoliosis had decreased and he was weaned from the ventilator. 

Faced with a child that was going to grow with a crude implant that could not grow, Dr. Campbell designed the first titanium rib implant as a custom prosthesis.  The fracture pin prosthesis was replaced with two titanium ribs at CHRISTUS Santa Rosa Children’s Hospital in San Antonio as a historical first in 1989.  

Worldwide publicity followed and referrals flocked to CHRISTUS Santa Rosa Children’s Hospital for evaluation by the multi-specialty team of a pediatric orthopedist, pediatric general surgeon and pediatric pulmonologist.  After a 14-year FDA study, the titanium rib, also known as “VEPTR” (Vertical Expandable Prosthetic Titanium Rib) was approved by the FDA in 2004 as a Humanitarian Device Exemption (HDE) and is now approved world wide.

VEPTR Expansion Thoracoplasty is the first new innovation in spine surgery for children in over 40 years, and represents a physiologic corrective approach to the complex diseases of the spine and chest wall in the child.
In 2002, the Titanium Rib Project evolved to become the Thoracic Institute whose mission is to deliver the most advanced and comprehensive care to patients with thoracic insufficiency syndrome, the inability of the thorax to support normal respiration or lung growth, and related diseases with compassion and dignity in a friendly environment while leading research and training in these areas.