Children's Hospital Colorado

Pediatric Surgery Medical Education Videos

At the Department of Pediatric Surgery at Children's Hospital Colorado, we constantly strive to advance our treatments and innovate surgical techniques to improve outcomes and raise standards of care. We are happy to share that knowledge so children that live in different areas of the country and around the world can also benefit from our continuing research and innovation.

We hope that the shared knowledge in these medical education videos help other pediatric surgeons and providers advance their surgical practices and improve their level of care to children everywhere.

Pectus excavatum in Children

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.

Laparoscopic inguinal hernia repair in children

During normal pre-birth development, the testis descends though the groin into the scrotum, bringing with it part of the lining of the abdomen. This tube-like communication between the abdomen and the scrotum usually closes off by the time a child is born. If the communication does not close off, fluid is free to move back and forth from the abdomen into the scrotum. This is called a communicating inguinal hernia or hydrocele.

In this video, Jose Diaz-Miron, MD, Pediatric Surgeon, and Thomas Inge MD, Director of the Division of Pediatric Surgery, explain the natural history and presentation of pediatric inguinal hernias. This discussion focuses around the laparoscopic approach for inguinal hernia repairs and the outcomes of the procedure. They also cover the most common questions we get from our patients and families in the pediatric surgery clinic including origin, incident rates and possible recurrence.