We are devoted exclusively to the management of surgical problems in infants and children at Cleveland Clinic Children’s.
Our staff is specially certified by the American Board of Surgery to treat a variety of pediatric conditions occurring throughout infancy and childhood.
Our pediatric surgeons also work within the renowned Cleveland Clinic Fetal Care Center, a multidisciplinary clinic available for developmental issues, neurological and congenital anomalies found before birth.
We see children and adolescent patients at Cleveland Clinic’s main campus, Avon, Fairview, Hillcrest, and Twinsburg.
General Pediatric Surgery Details
- Center of Excellence for Pectus Excavatum and Carinatum.
- Newly constructed state of the art pediatric operating rooms will transform four of the five non-cardiac rooms to advanced minimally-invasive suites. These rooms will have advanced high-definition imaging technology, advanced image-capture and routing capabilities, and plumbed gases in an ergonomically efficient environment. For the first time, advanced surgical technology will be available for use by all surgeons at any time, accelerating the application of these tools to neonates, and stimulating innovative uses for complex surgical problems.
- Among the numerous diseases and conditions our pediatric team treats, Children's Hospital is a nationally renowned resource for the management of pediatric chest wall deformities.
- The hospital is a recognized Center of Excellence in the treatment of Pectus Excavatum.
- Our pediatric surgeons are leaders in employing the Nuss Procedure, the minimally invasive repair of Pectus Excavatum. This procedure uses principles of minimal-access surgery and thoracoscopy combined with the placement of a custom titanium support bar to achieve correction of Pectus Excavatum. Over 98% of the cases we see are treated in this fashion, with less pain and a shorter hospital stay.
What We Treat
Staff in the Pediatric General Surgery department treat conditions related to the anatomic area of the body (thorax and abdomen), as well as diseases unique to infants, children and adolescents or those that require special expertise.
- Abdominal masses and tumors including Wilm’s tumor and Neuroblastoma
- Biliary atresia
- Chest wall deformities
- Congenital anomalies of the intestine
- Congenital malformations
- Cystic hygromas
- Esophageal atresia
- Head and neck tumors
- Hepatobiliary cysts and tumors
- Inflammatory conditions
- Lung and mediastinum malformations and tumors
- Minimally invasive techniques
- Pediatric colorectal diseases including, imperforate anus, Hirschsprung’s disease and inflammatory bowel disease
- Pectus Excavatum and Carinatum
- Undecided testes
- Pediatric operating suites are designed and equipped specifically for children and adolescents.
- Pediatric patients have access to child-friendly, state-of-the-art imaging technologies available at Cleveland Clinic.
- A special parents' waiting area is immediately adjacent to the pediatric operating rooms, providing immediate accessibility to the child if needed.
Center for Pectus Excavatum
Details about Pectus Excavatum and Carinatum surgery, procedures and treatment at Cleveland Clinic.
Pectus excavatum is a congenital chest wall deformity, sometimes known as"funnel chest" or “sunken chest.” The pectus excavatum defect is characterized by a deep depression of the sternum, typically involving the lower half or two thirds of the sternum. The lower 4-6 rib cartilages dip backward abnormally to increase the deformity or depression and push the sternum backward toward the spine. Other problems, especially in the muscle, skeletal and respiratory system, also may accompany this pectus excavatum defect. Cleveland Clinic Children’s Hospital is currently one of only five centers in the country recognized for excellence in treating pectus excavatum. When you want qualified, certified treatment for pectus excavatum, look to us to deliver.
Among the procedures available to correct pectus excavatum is the Nuss Procedure and the Ravitch Procedure. The Nuss procedure starts with general anesthesia and the placement of an epidural catheter for the management of pain after the operation. Two incisions are made on either side of the chest for insertion of a curved steel bar under the sternum. A separate, small incision is made to allow for a thorascope (small camera) for direct visualization as the bar is passed under the sternum. The bar is individually curved for each patient. The bar is used to pop out the depression and is then fixed to the ribs on either side. The incisions are the closed and dressed. The second procedure available to correct pectus excavatum is called the Ravitch procedure. The Ravitch procedure involves placing stainless-steel struts across the anterior chest to support the breastbone and then wired to appropriate ribs, elevating the breastbone. In treating pectus excavatum, the Ravitch procedure is generally used in the event the child is not eligible for the Nuss procedure.
Pectus excavatum surgery options like the Nuss procedure or Ravitch procedure may involve placing a small steel, grooved plate at the end of the bar to help stabilize and fix the bar to the rib. The bar is not visible from the outside and stays in place for a minimum of two years. When it is time, the bar is removed as an outpatient procedure.
The Nuss Procedure, also known as the “Minimally Invasive Repair of Pectus Excavatum,” uses principles of minimal-access surgery and thoracoscopy combined with the proper placement of a Lorenz Pectus Bar to achieve correction of pectus excavatum.