Nuss Procedure With Cryoanalgesia for Symptomatic Pectus Excavatum

Pectus excavatum is a common chest wall deformity that can cause significant symptoms. The minimally invasive Nuss procedure is a widely used surgical technique to correct this condition by placing a curved metal bar (Nuss bar) behind the sternum, repositioning it into a more normal anatomical shape. 
 
In this video, the authors present the case of a 17-year-old patient with symptomatic pectus excavatum who underwent correction using the Nuss procedure. At Catharina Hospital, Eindhoven, Netherlands, the surgeons performed this procedure using their specific technique, incorporating cryoanalgesia for prolonged postoperative pain relief, which led to early discharge and reduced postoperative pain. 

Disclosure 

Dr. Bart Koene is a proctor at AtriCure.

References

1. Janssen, N., Coorens, N. A., Franssen, A. J. P. M., Daemen, J. H. T., Michels, I. L., Hulsewé, K. W. E., Vissers, Y. L. J., & de Loos, E. R. (2024). Pectus excavatum and carinatum: a narrative review of epidemiology, etiopathogenesis, clinical features, and classification. Journal of thoracic disease, 16(2), 1687–1701. https://doi.org/10.21037/jtd-23-957
2. Jaroszewski DE, Farina JM, Gotway MB, Stearns JD, Peterson MA, Pulivarthi VSKK, Bostoros P, Abdelrazek AS, Gotimukul A, Majdalany DS, Wheatley-Guy CM, Arsanjani R. Cardiopulmonary Outcomes After the Nuss Procedure in Pectus Excavatum. J Am Heart Assoc. 2022 Apr 5;11(7):e022149. doi: 10.1161/JAHA.121.022149. Epub 2022 Apr 4. PMID: 35377159; PMCID: PMC9075480.
3. Ravitch M. M. (1949). The Operative Treatment of Pectus Excavatum. Annals of surgery, 129(4), 429–444. https://doi.org/10.1097/00000658-194904000-00002
4. Nuss, D., & Kelly, R. E., Jr (2010). Indications and technique of Nuss procedure for pectus excavatum. Thoracic surgery clinics, 20(4), 583–597. https://doi.org/10.1016/j.thorsurg.2010.07.002
5. Morikawa N, Laferriere N, Koo S, Johnson S, Woo R, Puapong D. Cryoanalgesia in Patients Undergoing Nuss Repair of Pectus Excavatum: Technique Modification and Early Results. J Laparoendosc Adv Surg Tech A. 2018 Sep;28(9):1148-1151. doi: 10.1089/lap.2017.0665. Epub 2018 Apr 19. PMID: 29672193.

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