Accounting for 90% of all congenital chest wall deformities, pectus excavatum occurs in one to eight per 1,000 live births. While this can be noted early in life, pediatric pectus excavatum often worsens during a growth spurt in adolescence.
The severity of this condition can range from mild to severe. In cases that are moderate to severe, children may become self-conscious and have a negative body image. A common operative procedure to repair a pectus deformity is the minimally invasive repair of pectus excavatum (MIRPE), also called a Nuss procedure. This involves the substernal placement of a contoured metal bar secured to the lateral aspect of the ribs. Although cosmetic results are excellent, patients do report significant pain from the constant pressure exerted on the chest wall from the metal bar.
In this video, Jose Diaz-Miron, MD, and David Partrick, MD, Director of Pediatric Surgical Endoscopy, explain our surgical approach and the common pain methodologies at Children’s Colorado as they are leading a randomized controlled trial studying the three most used methods. These methods include patient-controlled analgesia (PCA), erector spinae blocks (ESB) with continues infusion pumps and video-assisted intercostal nerve cryoablation (INC). Newly FDA approved, INC essentially freezes the pain receptors, and they are studying these patients may experience shorter length of stay, decreased narcotic use and improved quality of life. Learn more about this approach and how they plan to complete the study by 2023.