Sunken Chest Surgery: Cryo Nerve Block Numbs the Pain


DENVER, Colo. (Ivanhoe Newswire) – One in 400 babies born today will have a deformity called pectus excavatum — or sunken chest. While most of the defects are improved before the baby turns one, some become worse as the child grows. To correct it as a teen, the surgery is invasive and extremely painful. Now, surgeons are using a breakthrough technique to freeze the pain away.

Pectus excavatum, or sunken chest, looks like a child’s breastbone literally sinking into their chest.

Some children are born with it, for others, it appears before puberty. It can cause kids to have trouble breathing, a rapid heartbeat, and chest pain. It can also cause a heart murmur, fatigue, and dizziness. It can also worsen with growth.

Pediatric surgeon Kristen Shipman, MD, at Rocky Mountain Hospital for Children, says the surgery to correct it can be painful. But now, a new groundbreaking procedure is changing that.

(Read Full Interview)

“We’re able to freeze each intercostal nerve that runs underneath the rib on both sides,” Dr. Shipman explains.

Cryo nerve block uses a probe that is cooled to minus 60 degrees Celsius to deaden the nerves that transmit the pain signals.

Dr. Shipman further explains, “We use two incisions along the lower ribs and we can put a camera into the chest on the left side and watch us freeze each one of those nerve bundles underneath the rib.”

This injures the nerves without permanently damaging them.

“That nerve will repair itself and regrow where it was frozen,” Dr. Shipman adds.

There’s less pain immediately following the surgery, the nerve block last for four to six months, eliminating the need for pain medication, and gives these kids a way to look and feel normal faster.

Cryo nerve block is not only being used in surgeries for sunken chests, but also to reduce pain for cancer patients and other forms of neuropathic pain.

Contributors to this news report include: Marsha Lewis, Producer; Roque Correa, Videographer & Editor.

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BACKGROUND: Pectus excavatum is a condition in which the person’s breastbone is sunken into the chest. In severe cases, pectus excavatum can look as if the center of the chest has been scooped out, leaving a deep dent. While the sunken breastbone is often noticeable shortly after birth, the severity of pectus excavatum typically worsens during the adolescent growth spurt. Also called funnel chest, pectus excavatum is more common in boys than in girls. Severe cases of pectus excavatum can eventually interfere with the function of the heart and lungs. But even mild cases of pectus excavatum can make children feel self-conscious about their appearance. Surgery can correct the deformity. Pectus excavatum occurs in an estimated 1 in 300-400 births, with male predominance (male-to-female ratio of 3:1). The condition is typically noticed at birth, and more than 90% of cases are diagnosed within the first year of life.


DIAGNOSING: For many people with pectus excavatum, the only sign or symptom is a slight indentation in their chests. In some people, the depth of the indentation worsens in early adolescence and can continue to worsen into adulthood. In severe cases of pectus excavatum, the breastbone may compress the lungs and heart. Signs and symptoms may include: decreased exercise tolerance, rapid heartbeat, recurrent respiratory infections, wheezing or coughing, heart murmur, and/or dizziness. Pectus excavatum can usually be diagnosed simply by examining the chest. Your doctor may suggest several different types of tests to check for associated problems with the heart and lungs. These tests may include: chest X-ray, CT scan or MRI, electrocardiogram, echocardiogram, lung function tests, exercise function test.


NEW TECHNOLOGY: Cryo Nerve Block Therapy (cryoNB) harnesses the power of cryotherapy to provide a new form of temporary pain relief for patients who undergo certain invasive cardiac or thoracic surgical procedures. This technology uses a unique freezing method to temporarily block pain signals from nerves in the affected area, providing an effect that’s similar to a local anesthetic. Cryotherapy was originally developed as a treatment for cardiac arrhythmias. AtriCure consulted with leading pain management experts to develop new techniques for applying cryoNB to nerves, specifically in order to block pain. AtriCure’s cryoICE cryoSPHERE cryoablation probes are sterile, single use devices intended for use in blocking pain by temporarily ablating peripheral nerves in adult patients. CryoNB is also indicated for ablation of peripheral intercostal nerves for patients of at least 12 years of age.



Stephanie Sullivan

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Doctor Q and A

Read the entire Doctor Q&A for Kristen Shipman, MD Pediatric Surgeon

Read the entire Q&A