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Patient Leaves Hospital Pain-Free after Nuss Procedure, Thanks to New Advancement in Pain Control

David Miller, pectus excavatum patient, at the Berlin Wall

Pectus excavatum occurs when the chest wall doesn’t form properly. This causes the cartilage connecting the sternum to the ribcage to grow abnormally, causing a concave appearance or indentation in the chest.

Although Miller has been self-conscious about his chest since he was young, he wasn’t interested in having the surgery until recently.  

“When I was twelve, my mom told me there was surgery that would push out the dent in my chest,” said Miller. “I didn’t want to do it.”

Two years later, Miller was still worried about having the procedure done.

“I was terrified,” he said.

Although there are two ways to fix pectus excavatum, the Nuss procedure is far more common – both at University of Utah Health and at other institutions.

For the Nuss procedure, a metal bar is placed behind the ribcage in the chest. Two small incisions are made near each armpit, where the surgeon positions the bar to raise the sternum and correct the depression in the chest wall. Most patients have the bar removed two or three years after placement.

Earlier this year, Miller knew he was ready for the Nuss procedure. So, in August 2023 he had a Nuss bar placed to fix the growing indentation in his chest.

For Miller, the process couldn’t have gone better thanks to cryoablation, a new advancement in post operative pain control.

Cryoablation freezes all the nerves in the chest wall, leaving them numb for two months after surgery. This helps make the recovery process a lot less painful.

“We’ve been doing cryoablation at the U for about two years, and it’s revolutionary,” said Pediatric Surgeon Katie Russell, MD. “Patients used to stay in the hospital for four or five days after surgery, but now most patients are home the day after surgery.”
Katie Russell, MD, pediatric surgeon
David Miller, pectus excavatum patient, hiking in Southern Utah

Katie Russell, MD, is also the trauma medical director and the surgical director of the ECMO program. Repairing chest wall deformities is her specialty.

University of Utah Health providers have been performing the Nuss procedure since the mid-nineties. In 2019, the Nuss program was established at U of U Health. The program provides a collaborative, interdisciplinary care team for patients with chest deformities. This collaborative approach provides these patients with the best possible care and health outcomes. Just four years after its inception, the Nuss program providers who do multiple Nuss procedures a day.

“Creating a formal program and getting more in sync has really streamlined our process and allowed us to do more to help our patients,” said Russell. “Cryoablation is a good example of that.”

Although Miller had some pain after surgery, it was minimal compared to what it would have been without cryoablation.

It’s been nearly four months since Miller’s surgery, and he is doing better than ever.

“Before getting the surgery, I didn’t realize how difficult it was for me to breathe, since it had been that way my entire life,” said Miller. “My mom said one of the first things I said right after I came out of surgery, was that I could breathe a lot better.”
David Miller, patient

Miller no longer feels self-conscious about how his chest looks. He feels comfortable and confident and is looking forward to getting back to playing volleyball at school.

“I am glad I did the surgery,” he said. “I’m feeling a lot better now, and I’m really happy with how things turned out. If anyone else is thinking about getting the surgery, they should do it. It went so well for me and I’m so grateful.”