VEPTR Rib Surgery

The Children’s Hospital is one of a few national pediatric institutions that perform VEPTR rib surgery. The unique procedure treats children with Thoracic Insufficiency Syndrome (TIS), a disease marked by severe deformities of the chest, spine, and ribs that prevent normal pulmonary development. Although TIS is relatively rare, nearly a dozen patients with the syndrome are seen at The Children's Hospital each year. Many of these children have a congenital fusion of the ribcage and almost 100 percent of kids with this disease have scoliosis or spine issues. In some children, several ribs on one side fuse together. In others, all the ribs fuse together. The ribs cannot move, and the child’s lungs are trapped in a fixed space. This can cause the children with this disease to become oxygen-dependent.

The implanted VEPTR device expands the ribs to help the lungs grow. Six to nine months later, the orthopedic surgeon will perform another outpatient surgery to expand the 3- to 8-inch device – which is curved like a rib – even more. The device is then expanded every six months to continue to allow the thorax to grow until the child reaches skeletal maturity. Although there is no set age for the procedure, the best candidates are younger than 5 years old but at least 16 to 18 months old. This treatment plan requires a long term commitment for the patient and their family. 

After operation, patients typically stay in the hospital for up to10 days – the first few days in the Pediatric Intensive Care Unit (PICU), then three to five days on the inpatient unit. Children who have this procedure often need the care of a variety of specialists, including pediatric pulmonologists, pediatric anesthesiologists, pediatric surgeons and child-life specialists. Following the procedure, patients are back to normal in a month or so and can participate in nearly all activities except contact sports.