Stay Current in Pediatric Surgery: Recent Episodes

GlobalCastMD

Through GlobalCastMD’s world-class network of physicians and technology, any health system can provide their doctors access to ongoing mentoring and education. Companies can leverage this same network to more effectively train physicians on products and use it to help train their own sales force. Our educational materials aim to provide entertaining, interactive education for anyone, regardless of geography. We truly are: Dedicated to the rapid advancement of care. Everywhere.

This video, featuring Dr. Douglas von Allmen from Cincinnati Children's Hospital, explores the differential diagnosis and management of cystic neck masses in pediatric patients, specifically ranulas and lymphatic malformations. It presents a clinical case that highlights diagnostic challenges and discusses various treatment approaches, including surgical excision, sclerotherapy, and emerging medical therapies. The role of genetic testing in guiding treatment for lymphatic malformations is also covered.

Narrated by Lizzy Lee, PA-C & Maggie Koenig, FNP-BC, this podcast, a rewind from the 2025 Pediatric Surgery Update Course, delves into crucial updates in Necrotizing Enterocolitis (NEC) management. Leading pediatric surgeons Drs. Augusto Zani, Simon Eaton, & Dan Ostlie discuss diagnostic challenges, highlighting the superior sensitivity of ultrasound over X-rays for early detection of surgical NEC indicators. The panel also debates various surgical interventions, including primary anastomosis versus ostomy, and examines emerging evidence on optimizing recovery outcomes for neonates with NEC.

This video, featuring experts from Cincinnati Children's, discusses the challenging management of recurrent tracheoesophageal fistula (TEF) years after initial repair. Dr. Douglas von Allmen presents a clinical scenario and highlights the risk of recurrent laryngeal nerve (RLN) injury during re-repair. The episode emphasizes a transtracheal approach to improve surgical exposure and minimize potential harm to the RLN, thereby reducing long-term voice and aspiration issues.

This video, featuring Dr. P. Ben Ham III, discusses sacral nerve stimulation (SNS) as a treatment option for children with severe fecal incontinence and constipation refractory to conventional medical therapies. It presents a clinical scenario of a 13-year-old male and reviews the technique, efficacy, and potential complications of SNS in pediatric patients. The discussion highlights improved continence rates and important considerations regarding its current FDA approval status for children.

This video, featuring Dr. Douglas von Allmen from Cincinnati Children's Hospital, explores the management of branchial cleft cysts. It discusses a clinical scenario of a child with a painless neck swelling and delves into the congenital nature of these cysts. The video highlights the comparison between endoscopic cauterization and open surgical excision, emphasizing the benefits of the endoscopic approach in reducing morbidity and avoiding recurrent laryngeal nerve injury for specific cyst types.

This video recaps key highlights from the 13th Annual Pediatric Surgery Update Course, focusing on nerve monitoring in pediatric thyroid surgery. Dr. Ben Ham discuss clinical scenarios, the utility of TI-RADS in children, and the role of intraoperative nerve monitoring (IONM) in preventing recurrent laryngeal nerve injury. The discussion covers current guidelines, surgeon expertise, and advancements in monitoring devices for pediatric patients.

This video, presented by Dr. Beth Rymeski of Cincinnati Children's Hospital, details the procedural aspects of Fetal Endoluminal Tracheal Occlusion (FETO). It explains how a fetoscope is used to insert a balloon into the fetal trachea to temporarily block fluid, facilitating lung expansion and preventing pulmonary hypoplasia in CDH babies. The presentation includes real-life video footage, demonstrating critical navigation techniques through fetal anatomy and careful balloon placement.

This video explores innovative technologies for central line management, focusing on solutions for blocked superior vena cava (SVC). Dr. Nathan Fagan discusses the MeritMedical Surfacer system for image-guided SVC recanalization via a femoral approach. The presentation also delves into the potential of 4D intracardiac echo catheters for radiation-free recanalization and reviews transhepatic and translumbar access as last-resort options when traditional venous access is lost.

Dr. Nathan Fagan, a Pediatric Interventional Radiologist from Akron Children's Hospital, presents a clinical scenario on central line management from the 13th Annual Pediatric Surgery Update Course. He discusses diagnosing and managing a malfunctioning subclavian dual-lumen port, highlighting how proper access assessment can prevent unnecessary port removal. The video also covers interventional radiology techniques like sharp recanalization of the Superior Vena Cava (SVC) to restore vascular access for complex patients.

This video series recaps highlights from the 13th Annual Pediatric Surgery Update Course. Dr. Juan Gurria discusses the pros and cons of robotic surgery in pediatric patients, comparing it to laparoscopic surgery, and exploring its future. The discussion covers surgical proficiency, cost-effectiveness, and various indications for robotic interventions in children.

For more information on Dr. Juan Gurria at Cincinnati Children's, click here: https://www.cincinnatichildrens.org/bio/g/juan-pablo-gurria

This video, featuring experts from Cincinnati Children's and Akron Children's, provides an in-depth look at Vertebral Body Tethering (VBT) for pediatric scoliosis. It covers clinical scenarios, highlighting VBT's advantages as a minimally invasive, non-fusion alternative to standard spinal fusion. The discussion includes precise timing for the procedure, current indications for patient selection, detailed surgical techniques for thoracic and lumbar approaches, and post-operative outcomes, emphasizing improved recovery times for young athletes.

Vertebral Body Tethering (VBT) is an FDA-approved, minimally invasive, non-fusion surgical treatment for growing patients with idiopathic scoliosis. It aims to correct spinal curvature and modulate growth while preserving disc motion, offering benefits like earlier return to sports compared to spinal fusion. Optimal timing for VBT is critical, performed on skeletally immature patients near their peak growth velocity (typically ages 8-15) to avoid overcorrection or tether failure. Indications include moderately severe (40-60 degree) and flexible curves. The surgical approach varies by spinal segment, utilizing thoracoscopic techniques for upper vertebrae and open approaches for lumbar segments, with careful neuro-monitoring. While early outcomes data showed a learning curve with some revision rates, improved patient selection and increased experience are now yielding more successful results. VBT represents a significant shift towards guided growth modulation in pediatric scoliosis.

Discover how Cincinnati Children's Hospital implemented protocol changes to significantly improve outcomes for babies with Congenital Diaphragmatic Hernia (CDH). This video details updates in ventilator management, ECMO utilization, blood pressure support, nutrition, and sedation protocols, leading to increased survival rates and reduced mechanical ventilation time. Learn about the evidence-based adjustments that have enhanced care for these complex pediatric patients.

For more information on the Fetal Care Center, click here: https://www.cincinnatichildrens.org/service/f/fetal-care

This video provides a comprehensive overview of Congenital Diaphragmatic Hernias (CDH), a significant birth defect. Dr. Paul Kingma from Cincinnati Children's discusses the incidence, prenatal assessment, and key factors influencing prognosis. The presentation highlights novel research using postnatal MRI, including Ultrashort Echo Time (UTE) MRI, to evaluate lung growth and vascular development, underscoring the critical role of nutrition and weight gain in improving respiratory outcomes for affected infants.

For more information on the Fetal Care Center at CCHMC, click here: https://www.cincinnatichildrens.org/service/f/fetal-care

This video, part of the GlobalCastMD series featuring Cincinnati Children's, recaps key highlights from the 13th Annual Pediatric Surgery Update Course. Dr. Jill Knepprath and Dr. Aaron Garrison discuss important updates in colorectal surgery, focusing on Hirschsprung's Disease (HD) and Anorectal Malformation (ARM). The presentation highlights the incidence of these combined conditions, particularly in patients with Trisomy 21, and provides diagnostic considerations for complex cases.

For more information on the Colorectal team at CCHMC, visit here: https://cincinnatichildrens.pulse.ly/264pcddqqh

This video from GlobalCast MD, featuring Cincinnati Children's, recaps key insights from the 13th Annual Pediatric Surgery Update Course on the use of Botox in Hirschsprung's Disease. It discusses current practices, poll results among pediatric surgeons regarding intrasphincteric botox injection during pull-through procedures, and findings from studies on its efficacy in reducing enterocolitis risk. Experts also delve into the challenges of dosing and the role of ultrasound guidance in these injections.

For more information on the Colorectal team at CCHMC, visit here: https://cincinnatichildrens.pulse.ly/264pcddqqh

In this Update Course Rewind from the 13th Annual Update Course in Pediatric Surgery, Drs. Annie Le-Nguyen, Jamie Harris, and Elizabeth Speck discuss one of the most debated questions in Hirschsprung disease management: when is the best time to perform a pull-through procedure?

Key Highlights:

Neonatal vs Delayed Pull-Through: Audience opinions were widely split, reflecting the lack of consensus in the field. Some surgeons favor neonatal repair before NICU discharge, while others prefer waiting several months.

What the Literature Shows: A 2021 PCPLC retrospective study comparing neonatal versus delayed primary pull-through procedures found no significant difference in enterocolitis rates, postoperative complications, or long-term fecal continence outcomes.

Timing Isn’t the Only Factor: The neonatal cohort underwent surgery at a median age of 11 days, while delayed repairs occurred closer to 98 days—yet outcomes remained comparable.

The Importance of Home Irrigations: Panelists emphasized that a family’s ability to safely perform rectal irrigations at home may be more important than patient age when deciding surgical timing.

Preventing Serious Complications: Inadequate decompression at home can increase the risk of enterocolitis or perforation, making caregiver education and confidence a critical component of successful Hirschsprung management.

Individualized Decision-Making: Surgeons should consider family readiness, follow-up access, and irrigation competency when determining the timing of pull-through surgery.

This session highlights that while surgical timing remains flexible, empowering families with proper bowel management skills is essential to achieving safe outcomes in Hirschsprung disease.

For more information on the Colorectal team at CCHMC, visit here: https://cincinnatichildrens.pulse.ly/264pcddqqh

In this Update Course Rewind from the 13th Annual Update Course in Pediatric Surgery, Drs. Jamie Harris, Elizabeth Speck, Aaron Garrison, and Annie Le-Nguyen revisit a long-standing postoperative practice in colorectal surgery: are routine anal dilations after PSARP truly necessary?

Key Highlights:

Questioning a Surgical Tradition: For decades, postoperative anal dilations have been considered standard after PSARP—but emerging studies and clinician experience are challenging whether they should be universally required.

Emotional Impact on Families: Panelists discussed the significant anxiety and stress dilations can create for caregivers, including concerns about harming the repair and reports of PTSD-like experiences for both families and patients.

What the Data Shows: Recent institutional reviews comparing dilation protocols versus no dilations found similar rates of neoanal stricture and reoperation, suggesting mandatory dilations may not always improve outcomes.

Alternative Approaches: Heineke-Mikulicz anoplasty (HMA) was highlighted as a safe, minimally invasive outpatient option for managing strictures instead of prolonged dilation regimens.

Why Some Surgeons Still Dilate: Many surgeons continue postoperative dilations in neonates, particularly in healthcare systems where rapid access to elective revision procedures may be limited.

Individualized Decision-Making: Patient age, anatomy, caregiver comfort, access to follow-up care, and institutional resources all play a role in deciding whether postoperative dilations are appropriate.

This session emphasizes that postoperative care after PSARP may not need a one-size-fits-all approach—and that family-centered decision-making is becoming increasingly important in colorectal surgery.

For more information on the Colorectal team at CCHMC, visit here: https://cincinnatichildrens.pulse.ly/264pcddqqh

In this Update Course Rewind from the 13th Annual Update Course in Pediatric Surgery, Drs. Nelson Rosen, Elizabeth Speck, Aaron Garrison, and Jamie Harris explore a key surgical debate: classic PSARP vs. the perineal body–preserving approach for anorectal malformations.

Key Highlights:

Technique Comparison: The perineal body–preserving PSARP is gaining traction, with many surgeons adopting it as an alternative to the traditional approach, while classic PSARP remains widely used.

Early Outcomes Data: Recent studies (2023) show promising results for the perineal body–preserving technique, including no dehiscence, no prolapse, and relatively low rates of anal stricture requiring revision.

Postoperative Recovery: Patients undergoing the perineal body–preserving approach may benefit from shorter hospital stays, with many discharged as early as postoperative day one.

Technical Considerations: While effective, the approach can be technically more challenging, particularly when identifying anterior anatomy and protecting the posterior vaginal wall.

Flexibility in Approach: Surgeons emphasized that conversion to a standard PSARP is always appropriate if there is any uncertainty about anatomy or safety during the procedure.

This session highlights that while newer techniques show promise, surgeon judgment and adaptability remain critical to achieving safe and effective outcomes.

For more information on the Colorectal team at CCHMC, visit here: https://cincinnatichildrens.pulse.ly/264pcddqqh

In this Update Course Rewind from the 13th Annual Update Course in Pediatric Surgery, Dr. Jamie Harris—joined by Drs. Nelson Rosen, Annie Le-Nguyen, Aaron Garrison, and Elizabeth Speck—explores one of the most debated questions in colorectal surgery: when is the optimal timing for PSARP in patients with rectovestibular fistula?

Key Highlights:

Early vs. Delayed PSARP: Both early repair (during the newborn admission) and delayed repair (1–3 months of age) are shown to be equally safe, with no significant differences in complications, reoperations, or readmissions.

What the Data Shows: Recent multi-institutional studies (NSQIP and PCPLC) found no difference in 30-day outcomes between early and delayed repairs, reinforcing that timing alone does not determine success.

Role of Dilations: Initial dilations can help decompress the bowel, but should be limited (e.g., up to 7 Hegar) to avoid fibrosis and preserve optimal conditions for future repair.

Clinical Tradeoffs:

Delayed repair: May increase technical difficulty due to fibrosis or rectal distention if not well managed
Early repair: Avoids additional hospitalizations and reduces burden on families, especially those facing access or financial barriers

What Really Matters: Decision-making should be individualized—taking into account patient size, comorbidities, surgeon experience, and family logistics, rather than a strict timeline.

This session highlights that while timing remains flexible, thoughtful, patient-centered decision-making is key to achieving the best outcomes.

For more information on the Colorectal team at CCHMC, visit here: https://cincinnatichildrens.pulse.ly/264pcddqqh

In this segment from Lurie Children’s Hospital, Dr. Justin Ryder breaks down the evolving science and treatment paradigm of pediatric obesity—highlighting why it must be approached as a chronic, biologically driven disease rather than a lifestyle issue.

Key Highlights:

Obesity Is a Disease: Pediatric obesity is multifactorial, shaped by genetics, epigenetics, hormones, environment, stress, and socioeconomic factors. The newest AAP guidelines formally recognize obesity as a disease and recommend active treatment—not watchful waiting.

Shift in Clinical Practice: Treatment should be offered to children above the 85th percentile BMI. The model has shifted from prevention-only efforts to a proactive, continuum-based care strategy.

Continuum of Care: Management includes Intensive Health Behavior and Lifestyle Treatment (26+ contact hours), FDA-approved pharmacotherapy for adolescents, and bariatric surgery for select patients—each playing a role depending on severity and response.

Efficacy & Challenges: GLP-1 medications demonstrate meaningful weight loss, and bariatric surgery shows durable BMI reduction and improvement in comorbidities. However, weight regain remains a significant biological challenge.

MASLD & Long-Term Risk: Obesity is strongly linked to metabolic dysfunction–associated steatotic liver disease (MASLD), affecting millions of youth and placing many at risk for cirrhosis, transplant, or hepatocellular carcinoma.

Equity & Advocacy: Obesity disproportionately impacts children of color and those in under-resourced communities. Access to effective treatment—including medications—is a health equity issue that demands advocacy.

This session reinforces that pediatric obesity requires early, evidence-based intervention, multidisciplinary care, and systemic advocacy to improve lifelong health outcomes.

In this educational video from Ann & Robert H. Lurie Children’s Hospital of Chicago, Dr. Monica Laronda explores the rapidly evolving field of pediatric oncofertility—highlighting how fertility preservation is becoming an essential part of care for children at risk of treatment-related infertility.

Key Highlights:

Why Fertility Preservation Matters: Cancer therapies and certain genetic conditions can lead to premature gonadal failure, significantly impacting future reproductive potential and long-term quality of life.

Who Should Be Considered: Fertility preservation extends beyond oncology to include patients with conditions like Turner syndrome and gonadal dysgenesis—emphasizing early counseling regardless of risk level or prognosis.

Current Clinical Options: Post-pubertal patients may undergo oocyte or sperm banking, while ovarian and testicular tissue cryopreservation offer options for younger patients who are not yet producing mature gametes.

Risk Stratification: Fertility risk is assessed using treatment exposure (e.g., alkylating agents, radiation) and cumulative dosing, helping guide decision-making and timing of intervention.

Program Growth & Outcomes: Lurie Children’s has performed hundreds of tissue cryopreservation procedures, demonstrating both feasibility and increasing national awareness of these options.

Advances in Fertility Restoration: Ovarian tissue transplantation can restore hormone function and fertility, though risks—such as reintroducing malignant cells—remain a key limitation.

Future Innovation: Cutting-edge research in ovarian tissue engineering, including 3D-printed bioprosthetic scaffolds, is paving the way for safer and more effective fertility restoration.

This session highlights how multidisciplinary care, research innovation, and early intervention are reshaping the future of fertility preservation for pediatric patients.

In this special 50th episode of the Colorectal Quiz Podcast, Dr. Marc Levitt and an international panel review key takeaways from the 16th European Pediatric Colorectal Reconstruction Meeting in Stockholm, highlighting emerging ideas, evolving surgical techniques, and global perspectives in the care of children with colorectal conditions.

Key Highlights:

Early Irrigation Training in Hirschsprung’s Disease: Some centers are beginning irrigation competency even before ostomy takedown, helping families and patients adapt earlier and potentially reducing post-operative enterocolitis risk.

Advances in Surgical Technology: Innovations such as robotic-assisted surgery and ICG fluorescence imaging are improving visualization of blood supply during pull-through procedures, helping surgeons reduce complications like leaks and ischemia.

New Diagnostic Concepts: High-frequency ultrasound may help measure bowel wall muscle thickness to identify aganglionic segments, potentially supporting or supplementing traditional biopsy-based diagnosis.

Understanding Enterocolitis Risk: Emerging research suggests that reduced mucus protection in proximal bowel segments and mechanical stress on the bowel wall may contribute to microbial imbalance and breakdown of the intestinal barrier.

The Power of Nursing and Multidisciplinary Care: Dedicated colorectal nursing programs and global case discussions highlighted how long-term outcomes depend not only on surgical technique but also on ongoing bowel management, education, and coordinated care.

Evolving Techniques for Anorectal Malformations: New procedures such as perineal-preserving PSARP and posterior rectal advancement anoplasty (PRAA) aim to reduce complications while improving functional outcomes.

Transition to Adult Care: Experts emphasized the need for stronger transition programs and multidisciplinary teams—including gynecology, urology, and sexual health specialists—to support patients with congenital colorectal conditions into adulthood.

This episode offers a global snapshot of how pediatric colorectal care continues to evolve through collaboration, innovation, and shared clinical experience.

We’re back with 27th episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Gootee

NCBI - WWW Error Blocked Diagnostic

van Hal ARL, Aanen IP, Wijnen RMH, Pullens B, Vlot J. The Value of Preoperative Rigid Tracheobronchoscopy for the Diagnosis of Tracheomalacia in Oesophageal Atresia Patients. J Pediatr Surg. 2024 Nov;59(11):161620. doi: 10.1016/j.jpedsurg.2024.07.005. Epub 2024 Jul 14. PMID: 39089893.

NCBI - WWW Error Blocked Diagnostic

Mena R, Guillén G, Lopez-Fernandez S, Martos Rodríguez M, Ruiz CW, Montaner-Ramon A, López M, Molino JA. Conservative Management of Necrotizing Enterocolitis in Newborns: Incidence and Management of Intestinal Strictures. Eur J Pediatr Surg. 2025 Jun;35(3):224-231. doi: 10.1055/a-2426-9723. Epub 2024 Sep 30. PMID: 39348873.

NCBI - WWW Error Blocked Diagnostic

Hundscheid T, Onland W, Kooi EMW, Vijlbrief DC, de Vries WB, Dijkman KP, van Kaam AH, Villamor E, Kroon AA, Visser R, Mulder-de Tollenaer SM, De Bisschop B, Dijk PH, Avino D, Hocq C, Zecic A, Meeus M, de Baat T, Derriks F, Henriksen TB, Kyng KJ, Donders R, Nuytemans DHGM, Van Overmeire B, Mulder AL, de Boode WP; BeNeDuctus Trial Investigators. Expectant Management or Early Ibuprofen for Patent Ductus Arteriosus. N Engl J Med. 2023 Mar 16;388(11):980-990. doi: 10.1056/NEJMoa2207418. Epub 2022 Dec 6. PMID: 36477458.

We’re back with 26th episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Gootee

https://pubmed.ncbi.nlm.nih.gov/39826968/

St Peter SD, Noel-MacDonnell JR, Hall NJ, Eaton S, Suominen JS, Wester T, Svensson JF, Almström M, Muenks EP, Beaudin M, Piché N, Brindle M, MacRobie A, Keijzer R, Engstrand Lilja H, Kassa AM, Jancelewicz T, Butter A, Davidson J, Skarsgard E, Te-Lu Y, Nah S, Willan AR, Pierro A. Appendicectomy versus antibiotics for acute uncomplicated appendicitis in children: an open-label, international, multicentre, randomised, non-inferiority trial. Lancet. 2025 Jan 18;405(10474):233-240. doi: 10.1016/S0140-6736(24)02420-6. Erratum in: Lancet. 2025 Feb 8;405(10477):468. doi: 10.1016/S0140-6736(25)00206-5. PMID: 39826968.

https://pubmed.ncbi.nlm.nih.gov/40032536/

Xu TO, Hanke RE, Das K, Bowser M, Hisam B, Samuk I, Wissanji H, Teeple E, Mayhew A, Myseros JS, Badillo A, Levitt MA, Varda BK, Feng C. VACTERL Screening in Newborns With Anorectal Malformations - An Opportunity to Optimize Screening Practices, add Gynecologic and Spinal Conditions, and Utilize a New Acronym: VACTE(G)RLS. J Pediatr Surg. 2025 Jun;60(6):162252. doi: 10.1016/j.jpedsurg.2025.162252. Epub 2025 Feb 20. PMID: 40032536.

https://pubmed.ncbi.nlm.nih.gov/38245889/

Schlapbach LJ, Watson RS, Sorce LR, Argent AC, Menon K, Hall MW, Akech S, Albers DJ, Alpern ER, Balamuth F, Bembea M, Biban P, Carrol ED, Chiotos K, Chisti MJ, DeWitt PE, Evans I, Flauzino de Oliveira C, Horvat CM, Inwald D, Ishimine P, Jaramillo-Bustamante JC, Levin M, Lodha R, Martin B, Nadel S, Nakagawa S, Peters MJ, Randolph AG, Ranjit S, Rebull MN, Russell S, Scott HF, de Souza DC, Tissieres P, Weiss SL, Wiens MO, Wynn JL, Kissoon N, Zimmerman JJ, Sanchez-Pinto LN, Bennett TD; Society of Critical Care Medicine Pediatric Sepsis Definition Task Force. International Consensus Criteria for Pediatric Sepsis and Septic Shock. JAMA. 2024 Feb 27;331(8):665-674. doi: 10.1001/jama.2024.0179. PMID: 38245889; PMCID: PMC10900966.

We’re back with 25th episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Gootee

https://pubmed.ncbi.nlm.nih.gov/38914511/

Huerta CT, Beres AL, Englum BR, Gonzalez K, Levene T, Wakeman D, Yousef Y, Gulack BC, Chang HL, Christison-Lagay ER, Ham PB 3rd, Mansfield SA, Kulaylat AN, Lucas DJ, Rentea RM, Pennell CP, Sulkowski JP, Russell KW, Ricca RL, Kelley-Quon LI, Tashiro J, Rialon KL; American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee. Management and Outcomes of Pediatric Lymphatic Malformations: A Systematic Review From the APSA Outcomes and Evidence-Based Practice Committee. J Pediatr Surg. 2024 Oct;59(10):161589. doi: 10.1016/j.jpedsurg.2024.05.019. Epub 2024 Jun 6. PMID: 38914511.

https://pubmed.ncbi.nlm.nih.gov/39743432/

Moturu A, Coleman M, Mets C, Thompson V, Grant C, Ko CY, Saito JM, Berman L, Wakeman D. Identifying Quality Improvement Targets After Pediatric Gastrostomy Tube Insertion: A NSQIP-Pediatric Pilot Study. J Pediatr Surg. 2025 Jun;60(6):162107. doi: 10.1016/j.jpedsurg.2024.162107. Epub 2024 Dec 17. PMID: 39743432.

https://pubmed.ncbi.nlm.nih.gov/38733138/

Kollin C, Nordenskjöld A, Ritzén M. Testicular volume at puberty in boys with congenital cryptorchidism randomised to treatment at different ages. Acta Paediatr. 2024 Aug;113(8):1949-1956. doi: 10.1111/apa.17270. Epub 2024 May 11. PMID: 38733138.

We’re back with 24th episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Gootee

https://pubmed.ncbi.nlm.nih.gov/38914509/

Donati F, Cipriani MS, Pistorio A, Guerriero V, Mattioli G, Torre M. Pectus Bar Dislocation: Comparison Between Three Different Stabilization Techniques Adopted in a Single Centre. J Pediatr Surg. 2024 Oct;59(10):161591. doi: 10.1016/j.jpedsurg.2024.05.021. Epub 2024 Jun 4. PMID: 38914509.

https://pubmed.ncbi.nlm.nih.gov/38834671/

Males I, Boban Z, Kumric M, Vrdoljak J, Berkovic K, Pogorelic Z, Bozic J. Applying an explainable machine learning model might reduce the number of negative appendectomies in pediatric patients with a high probability of acute appendicitis. Sci Rep. 2024 Jun 4;14(1):12772. doi: 10.1038/s41598-024-63513-x. PMID: 38834671; PMCID: PMC11150468.

https://pubmed.ncbi.nlm.nih.gov/37957103/

Rauh J, Dantes G, Wallace M, Collings A, Sanin GD, Cambronero GE, Bosley ME, Ganapathy AS, Patterson JW, Ignacio R, Knod JL, Slater B, Callier K, Livingston MH, Alemayehu H, Dukleska K, Scholz S, Santore MT, Zamora IJ, Neff LP. Transcystic Laparoscopic Common Bile Duct Exploration for Pediatric Patients with Choledocholithiasis: A Multi-Center Study. J Pediatr Surg. 2024 Mar;59(3):389-392. doi: 10.1016/j.jpedsurg.2023.10.046. Epub 2023 Oct 21. PMID: 37957103.

We’re back with 23rd episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Gootee

0:00 Introduction

0:39 Locum Tenens and Pediatric Surgery: A Position Statement and Practice Guidelines From the American Pediatric Surgical Association (APSA)

1:40 Validation of the Clavien-Madadi Classification for Unexpected Events in Pediatric Surgery: A Collaborative ERNICA Project

2:50 Transitional Care in Anorectal Malformation and Hirschsprung's Disease: A Systematic Review of Challenges and Solutions

4:03 Outro

https://pubmed.ncbi.nlm.nih.gov/38806318/

Fahy AS, Klima DA, Gillam MM, Aprahamian CJ, Kim SS, Kokoska ER, Teeple EA, Weiss RG, Escobar MA Jr. Locum Tenens and Pediatric Surgery: A Position Statement and Practice Guidelines From the American Pediatric Surgical Association (APSA). J Pediatr Surg. 2024 Oct;59(10):161567. doi: 10.1016/j.jpedsurg.2024.04.021. Epub 2024 May 8. PMID: 38806318.

https://pubmed.ncbi.nlm.nih.gov/38582705/

Madadi-Sanjani O, Kuebler JF, Brendel J, Costanzo S, Granström AL, Aydin E, Loukogeorgakis S, Lacher M, Wiesner S, Domenghino A, Clavien PA, Mutanen A, Eaton S, Ure BM. Validation of the Clavien-Madadi Classification for Unexpected Events in Pediatric Surgery: A Collaborative ERNICA Project. J Pediatr Surg. 2024 Sep;59(9):1672-1679. doi: 10.1016/j.jpedsurg.2024.03.022. Epub 2024 Mar 16. PMID: 38582705.

https://pubmed.ncbi.nlm.nih.gov/37996349/

Plascevic J, Shah S, Tan YW. Transitional Care in Anorectal Malformation and Hirschsprung's Disease: A Systematic Review of Challenges and Solutions. J Pediatr Surg. 2024 Jun;59(6):1019-1027. doi: 10.1016/j.jpedsurg.2023.10.066. Epub 2023 Nov 2. PMID: 37996349.

We’re back with 22nd episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Gootee

0:00 Introduction

0:39 The use of postoperative calibrations in Hirschsprung disease: a practice to reconsider?

1:47 Management of Gastroschisis: Timing of Delivery, Antibiotic Usage, and Closure Considerations

2:57 Treatment Facility Case Volume and Disparities in Outcomes of Congenital Diaphragmatic Hernia Cases

4:06 Outro

NCBI - WWW Error Blocked Diagnostic

Beati F, D'Angelo T, Iacusso C, Iacobelli BD, Scorletti F, Valfré L, Pellegrino C, Bagolan P, Conforti A, Fusaro F. The use of postoperative calibrations in Hirschsprung disease: a practice to reconsider? Pediatr Surg Int. 2024 Jul 5;40(1):176. doi: 10.1007/s00383-024-05761-6. PMID: 38967682.

NCBI - WWW Error Blocked Diagnostic

Slidell MB, McAteer J, Miniati D, Sømme S, Wakeman D, Rialon K, Lucas D, Beres A, Chang H, Englum B, Kawaguchi A, Gonzalez K, Speck E, Villalona G, Kulaylat A, Rentea R, Yousef Y, Darderian S, Acker S, St Peter S, Kelley-Quon L, Baird R, Baerg J. Management of Gastroschisis: Timing of Delivery, Antibiotic Usage, and Closure Considerations (A Systematic Review From the American Pediatric Surgical Association Outcomes & Evidence Based Practice Committee). J Pediatr Surg. 2024 Aug;59(8):1408-1417. doi: 10.1016/j.jpedsurg.2024.03.044. Epub 2024 Apr 30. PMID: 38796391.

NCBI - WWW Error Blocked Diagnostic

Peiffer SE, Mehl SC, Powell P, Lee TC, Keswani SG, King A. Treatment Facility Case Volume and Disparities in Outcomes of Congenital Diaphragmatic Hernia Cases. J Pediatr Surg. 2024 May;59(5):825-831. doi: 10.1016/j.jpedsurg.2024.01.042. Epub 2024 Feb 4. PMID: 38413264.

We’re back with 21st episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Gootee

NCBI - WWW Error Blocked Diagnostic

Li S, Wang J, Li M, Zhang Z, Mi T, Wu X, Wang Z, Jin L, He D. Efficacy and late kidney effects of nephron-sparing surgery in the management of unilateral Wilms tumor: a systematic review and meta-analysis. Pediatr Surg Int. 2023 Dec 27;40(1):29. doi: 10.1007/s00383-023-05611-x. PMID: 38150145.

NCBI - WWW Error Blocked Diagnostic

Gillipelli SR, Pio L, Losty PD, Abdelhafeez AH. Female Fertility Cryopreservation Outcomes in Childhood Cancer: A Systematic Review. J Pediatr Surg. 2024 Aug;59(8):1564-1568. doi: 10.1016/j.jpedsurg.2024.02.015. Epub 2024 Mar 1. PMID: 38519388.

NCBI - WWW Error Blocked Diagnostic

Witte AB, Van Arendonk K, Bergner C, Bantchev M, Falcone RA Jr, Moody S, Hartman HA, Evans E, Thakkar R, Patterson KN, Minneci PC, Mak GZ, Slidell MB, Johnson M, Landman MP, Markel TA, Leys CM, Cherney Stafford L, Draper J, Foley DS, Downard C, Skaggs TM, Lal DR, Gourlay D, Ehrlich PF. Venous Thromboembolism Prophylaxis in High-Risk Pediatric Trauma Patients. JAMA Surg. 2024 Oct 1;159(10):1149-1156. doi: 10.1001/jamasurg.2024.2487. PMID: 39083300; PMCID: PMC11292570.

In this session from the 12th Annual Update Course in Pediatric Surgery, Dr. Jill Larson from Ann & Robert H. Lurie Children’s Hospital outlines key strategies for preventing and managing the most common pediatric fractures—just in time for the seasonal surge.

Key Highlights:

• Timing of fractures: Fracture season peaks in spring, summer, and surprisingly, October—timing your prevention efforts matters

• Top five fracture types: Wrist, ankle, elbow, forearm, and tibia fractures are the most common injuries treated in pediatric orthopedics.

• What to treat—and how: Dr. Larson explains which fractures can be managed conservatively (e.g., buckle or greenstick) and which may need surgery (e.g., displaced triplane fractures).

• Casting and immobilization tips: Includes guidance on when to splint, when to cast, and how long to monitor growth plate–involved injuries.

• Injury prevention insights: From trampoline accidents to lawnmower-related trauma, this session covers key safety risks and how to address them proactively.

• Nutrition and bone health: Vitamin D deficiency and obesity are contributing factors—highlighting the need for a holistic approach to fracture prevention.

This session provides practical, seasonal insights for pediatric providers—and equips teams with the knowledge to protect growing bones before peak fracture months arrive.

In this session from the 12th Annual Update Course in Pediatric Surgery, Dr. Bhargava Mullapudi (Children’s Mercy Kansas City) presents updated strategies in Wilms tumor management, exploring how tumor biology and global guidelines are shaping decisions on surgery vs chemotherapy first.

Key Highlights:

COG vs SIOP Guidelines: North American centers (COG) typically favor primary surgery, while European protocols (SIOP) begin with chemotherapy—highlighting major global practice differences.
Impact of Tumor Genetics: Loss of heterozygosity (LOH) at chromosomes 1p and 16q, as well as gain of 1q, influence chemotherapy decisions even in lower-stage disease.
Staging and Size Aren’t Enough: While age and tumor weight are considered, biological markers ultimately guide treatment, challenging simplified “under 2 years / under 550g” rules.
Shifting Practice Patterns: Even for Stage I tumors, presence of LOH may justify adding chemotherapy, depending on evolving Children’s Oncology Group recommendations.
Pathology-Informed Protocols: Surgeons must often pause for biological profiling before placing ports or initiating adjuvant therapy.

This presentation underscores the importance of precision medicine in Wilms tumor care—and how treatment pathways increasingly rely on molecular markers, not just stage and weight.

In this session from the 12th Annual Update Course in Pediatric Surgery, Drs. Rebecca Stark and Steven Lee from Seattle Children’s Hospital walk through the timing, technique, and evolving protocols for performing ECMO and surgical repair in cases of severe congenital diaphragmatic hernia (CDH).

Key Highlights:

VA ECMO with bivalirudin: The presenters advocate for bivalirudin as a preferred anticoagulant over heparin due to its short half-life, predictable response, and ease of control—making it ideal for ECMO patients requiring surgery.
Dilute thrombin time for monitoring: They highlight a lab-friendly technique for monitoring bivalirudin using dilute thrombin time—5x more specific and sensitive than PTT and easily implementable in any lab.
Safe and timely surgical repair on ECMO: Early CDH repair (within 8–24 hours of ECMO initiation) can be performed with minimal bleeding and less tissue edema when using bivalirudin and meticulous technique.
Institutional buy-in for early repair: The team underscores the importance of cross-disciplinary collaboration—including neonatologists, anesthesiologists, and weekend OR availability—to enable early ECMO repair protocols.
Risk-stratified vs early repair strategy: Some centers risk-stratify ECMO patients, but Stark and Lee favor universal early repair to avoid complications associated with delayed surgery in non-weanable patients.
Evolving national practices: As of this year, over 80% of CDH Study Group centers are now performing early repair on ECMO—showing how rapidly clinical protocols can shift with strong supporting data.

This session emphasizes the role of proactive planning, team-based decision-making, and flexible protocol development in improving outcomes for neonates with severe CDH requiring ECMO.

In this session from the 12th Annual Update Course in Pediatric Surgery, Dr. Margaret Mutch from Australia walks through the complexities of chest wall reconstruction following thoracic osteosarcoma resection in a pediatric patient.

Key Highlights:

Massive resection and reconstruction: A 14-year-old patient underwent an aggressive en bloc resection involving ribs 4–7 and vertebral bodies T4–T7. The team used a combination of resorbable molded plates, Permacol mesh, and Gore-Tex patches to stabilize and recreate the chest wall structure.
Soft tissue closure with latissimus flap: A latissimus dorsi flap was mobilized for robust coverage, reducing dead space and supporting tissue healing over the reconstructed area.
Use of ROLL technique for lymph node excision: The team employed radio-guided occult lesion localization (ROLL) using Technetium-99 to precisely identify and remove targeted lymph nodes.
Managing early complications: Postoperative challenges included sterile seromas, a wound infection, and mild scoliosis—all managed conservatively with good outcomes.
Addressing recurrence and reoperation: When local recurrence occurred 18 months later, a second reconstruction involving the sternum and cement mesh was required, illustrating the long-term complexity of these cases.
Future outlook for pediatric reconstructions: Dr. Mutch emphasized the lack of standardization in pediatric materials and techniques, pointing toward a future where custom 3D-printed implants and biologics may offer better long-term solutions.

This session highlights the surgical precision, interdisciplinary coordination, and resilience required to manage large-scale reconstructions in growing children—where both oncologic control and functional outcomes must be balanced.

We are back with another episode of our Journal of Pediatric Surgery article review podcast. This time we have three publications from the second quarter of 2025, April, May and June issues. This time we're talking to editors Drs. George Holcomb III, Alana Beres and Shaun Kunisaki joined by authors Drs. Eric Skarsgard, Amanpreet Brar, Anoosha Moturu and Derek Wakeman.

Host: Em Gootee, MD

Articles:

https://pubmed.ncbi.nlm.nih.gov/39826297/

Shieh HF, Jennings RW, Hamilton TE, Izadi S, Zendejas B, Smithers CJ. Tracheobronchopexy to Avoid Tracheostomy in Esophageal Atresia Patients With Severe Life-Threatening Tracheobronchomalacia. J Pediatr Surg. 2025 Apr;60(4):162152. doi: 10.1016/j.jpedsurg.2024.162152. Epub 2025 Jan 3. PMID: 39826297.

https://pubmed.ncbi.nlm.nih.gov/39865003/

Brar A, Gow KW, Skarsgard ED. Pediatric Surgical Outreach: An Underutilized Resource for Increasing Children's Surgical Capacity in Canada. J Pediatr Surg. 2025 May;60(5):162174. doi: 10.1016/j.jpedsurg.2025.162174. Epub 2025 Jan 19. PMID: 39865003.

https://pubmed.ncbi.nlm.nih.gov/39743432/

Moturu A, Coleman M, Mets C, Thompson V, Grant C, Ko CY, Saito JM, Berman L, Wakeman D. Identifying Quality Improvement Targets After Pediatric Gastrostomy Tube Insertion: A NSQIP-Pediatric Pilot Study. J Pediatr Surg. 2025 Jun;60(6):162107. doi: 10.1016/j.jpedsurg.2024.162107. Epub 2024 Dec 17. PMID: 39743432.

In this session from the 12th Annual Update Course in Pediatric Surgery, Drs. Rebecca Stark and Steven Lee from Seattle Children’s Hospital walk through the timing, technique, and controversies surrounding ECMO in severe congenital diaphragmatic hernia (CDH) cases.

Key Highlights:

VV vs VA ECMO: While venovenous (VV) ECMO is gaining traction with improved cannulas, venoarterial (VA) ECMO remains the predominant choice for most centers treating CDH.
When to initiate ECMO: Early intervention is often favored in high-risk CDH cases, especially when prenatal imaging suggests severe compromise.
SPHERE protocol in decision-making: A structured approach from Michigan offers criteria for ECMO vs comfort care, but outcome prediction remains unreliable—50% of decisions based on early data may be incorrect.
Controversy in selection: Dr. Stark advocates for offering ECMO to all infants with isolated unilateral CDH, emphasizing the importance of treating every case as a potential survivor.
Role of prenatal counseling: Early, transparent discussions with families are critical for navigating high-stakes decisions and aligning on care pathways.

This session underscores both the technical and ethical complexity in managing severe CDH—and the need for thoughtful protocols paired with clinical flexibility.

In this session from the 12th Annual Update Course in Pediatric Surgery, Drs. David Vitale, Luke Neff, and Jeffrey Ponsky explore strategies for preventing gallstone pancreatitis in pediatric patients with biliary stones. This session is classified as a Green Circle (established practice).

Key Highlights:

Managing complex cases: When to use conservative management with antibiotics for neutropenic, thrombocytopenic patients.
Gallstone pancreatitis: How to differentiate management from typical choledocholithiasis cases.
Timing of cholecystectomy: Why surgery should be based on clinical improvement rather than complete biochemical normalization.
ERCP and IOC coordination: Determining when early ERCP is necessary and incorporating intraoperative cholangiograms for safe stone clearance.
Clinical judgment matters: How local resources and patient-specific factors shape decision-making.

This session emphasizes balancing early intervention with patient safety and tailoring care to individual circumstances.

Welcome to the 12th Annual Update Course in Pediatric Surgery recap series, hosted by Dr. Em Gootee from Cincinnati Children’s Hospital. In this Green Circle (established practice) session, Drs. David Vitale, Luke Neff, and Jeff Ponsky explore the “surgery-first” approach to pediatric biliary stone disease, highlighting the growing prevalence of choledocholithiasis in children and the evolving strategies to manage it effectively.

Key Highlights:

Surgery-First vs. ERCP-First: The panel compares the two main management strategies: ERCP followed by laparoscopic cholecystectomy versus laparoscopic cholecystectomy with intraoperative cholangiogram (IOC) and stone removal.
Practice-Based Decision Making: Experts emphasize that choice depends on surgeon skill, institutional resources, and the ability to perform IOC effectively.
Clinical Evidence: Studies show an 86–90% success rate for ductal clearance using a surgery-first approach with IOC and flushing—offering a safe, resource-efficient option that minimizes ERCP-associated risks like pancreatitis.
Learning Curve & Equipment: Surgeons are encouraged to become more comfortable with intraoperative stone removal techniques. Having a prepared kit and standardized workflow is key to success.
ERCP Complications: While ERCP is effective, it carries a ~10% risk of complications including cholangitis and pancreatitis—making intraoperative solutions appealing when feasible.

This session underscores a shift toward empowering surgeons with tools and confidence to manage choledocholithiasis directly in the OR, improving outcomes and optimizing resource utilization across institutions.

In this 2024 Update Course Rewind, pediatric surgeon Dr. John DiFiore shares new insights into the growing use of cryoanalgesia for pectus excavatum repairs. Classified as a “Blue Square” practice—indicating a promising newer technique—this approach provides targeted nerve pain relief with less opioid use, better precision, and shorter hospital stays.

Key Highlights:

What is Cryoanalgesia? A minimally invasive nerve freezing technique used to reduce chest wall pain during pectus repair.
Technique Deep Dive: From double-lumen tubes to improved cryoprobes, learn how to perform blocks from T3–T8 with precision.
Time-Saving Tools: New cryoprobes offer faster freeze cycles and better insulation, cutting procedure time nearly in half.
Clinical Outcomes: Lower pain scores, next-day discharges, and potential to further improve outcomes with dual freeze points.
Barriers & Workarounds: Addressing the main challenges of cost, equipment access, and proper training.

Whether you're currently using cryo or just considering it, this session is packed with pearls for improving postoperative pain control in pediatric patients.

In this special episode of the Colorectal Quiz, Drs. Marc Levitt and Jason Frischer are joined by Dr. Todd Ponsky and Em Gootee for a behind-the-scenes look at how AI is supporting medical education. The topic of this quiz: Collaborating for Kids: Colorectal & Pelvic Solutions. What’s unique about this episode? Everything after the intro was generated using NotebookLM, an AI tool that helped synthesize notes, transcripts, and case studies into an engaging, educational format. Key Highlights:

Case-Based Learning: A multidisciplinary team approach to treating children with complex colorectal and pelvic conditions.
Building the Right Team: The importance of urologists, gynecologists, psychologists, and colorectal surgeons working together to improve outcomes.
International Collaboration: How programs like the Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) are advancing global standards of care.
Family-Centered Care: Strategies for improving communication with families and providing continuity as patients transition into adulthood.
Innovative Communication: A glimpse into the future of podcasting and education in pediatric surgery.

This episode blends expert insight with cutting-edge technology to show what’s possible when collaboration meets innovation.

Alejandra Vilanova-Sánchez, Julie Choueiki, Caitlin A. Smith, Susan Callicot, Jason S. Frischer, Marc A. Levitt. Creating a collaborative program for the care of children with colorectal and pelvic problems. Seminars in Pediatric Surgery 29 (202) 150985.

In this insightful recap from the 12th Annual Update Course in Pediatric Surgery, Dr. Thomas Inge of Lurie Children’s Hospital explores emerging uses of cryoanalgesia beyond pectus repair. The video delves into novel applications of cryotherapy for conditions like slipping rib syndrome and rib fractures—highlighting how interventional radiology tools, including percutaneous needle probes, can offer powerful pain relief and reduce narcotic use and hospital stay.

Key Highlights:

Slipping Rib Syndrome: Often overlooked in teens, this condition can be addressed with intercostal blocks and cryoablation.
Percutaneous Cryoablation: A new frontier in treating rib fractures and chronic pain using ultrasound-guided techniques.
Multidisciplinary Approach: Collaboration between surgery and IR expands treatment options for hard-to-diagnose chest wall pain.

This session emphasizes the evolving role of cryoanalgesia as a versatile, minimally invasive tool in pediatric surgical care.

In this engaging session from the 12th Annual Update Course in Pediatric Surgery, Dr. Timothy Lautz explores the expanding role of cryoanalgesia in pediatric thoracotomy beyond pectus repair. As more institutions embrace this technique, Dr. Lautz breaks down its use, safety, and clinical advantages for thoracotomy pain control.

Key Highlights:

Beyond Pectus Repair: While commonly used for pectus excavatum, cryoanalgesia is now being applied in thoracotomy cases to improve postoperative recovery.
How It Works: Temporary nerve blockade is achieved by freezing the intercostal nerves, reducing or eliminating the need for epidurals and long-term opioids.
Safety & Recovery: The procedure is safe, repeatable, and allows even small children to benefit from reduced pain and faster recovery timelines.
Clinical Implementation: Dr. Lautz offers insight into when and how his team applies cryo, including tips for technique, timing, and avoiding complications.

This talk underscores the value of multidisciplinary collaboration and highlights how surgical innovation can reduce patient discomfort and streamline recovery.

In this insightful session from the 12th Annual Update Course in Pediatric Surgery, Drs. David Vitale, Luke Neff, and Jeff Ponsky break down the essentials of intraoperative cholangiography (IOC)—a technique that plays a key role in identifying biliary anatomy and managing stones.

Key Highlights:

Technique Tips: From contrast flushes to balloon dilation, the team shares practical advice on improving success rates during IOC.
Clinical Decision-Making: When and how to incorporate glucagon, and when to call in GI for support.
Avoiding Pitfalls: Recognizing common challenges, including misinterpretation of images and catheter misplacement.
Collaborative Care: How surgical teams can streamline intraoperative strategy and reduce post-op complications through consistent IOC use.

This session emphasizes IOC as a powerful tool when performed correctly—and reminds us that thoughtful execution and teamwork can make all the difference in surgical outcomes.

We’re back with 20th episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Gootee

0:00 Introduction

0:41 Comprehensive meta-analysis of surgical procedure for congenital diaphragmatic hernia: thoracoscopic versus open repair

1:35 Use of a new vertical traction device for early traction-assisted staged closure of congenital abdominal wall defects: a prospective series of 16 patients

2:39 Indocyanine green (ICG) fluorescent cholangiography during laparoscopic cholecystectomy using RUBINA™ technology: preliminary experience in two pediatric surgery centers

3:47 Outro

https://pmc.ncbi.nlm.nih.gov/articles/PMC11233350/ Shibuya S, Paraboschi I, Giuliani S, Tsukui T, Matei A, Olivos M, Inoue M, Clarke SA, Yamataka A, Zani A, Eaton S, De Coppi P. Comprehensive meta-analysis of surgical procedure for congenital diaphragmatic hernia: thoracoscopic versus open repair. Pediatr Surg Int. 2024 Jul 9;40(1):182. doi: 10.1007/s00383-024-05760-7. Erratum in: Pediatr Surg Int. 2024 Aug 31;40(1):247. doi: 10.1007/s00383-024-05832-8. PMID: 38980431; PMCID: PMC11233350.

https://pubmed.ncbi.nlm.nih.gov/38960901/ Ziegler AM, Svoboda D, Lüken-Darius B, Heydweiller A, Kahl F, Falk SC, Rolle U, Theilen TM. Use of a new vertical traction device for early traction-assisted staged closure of congenital abdominal wall defects: a prospective series of 16 patients. Pediatr Surg Int. 2024 Jul 3;40(1):172. doi: 10.1007/s00383-024-05745-6. PMID: 38960901; PMCID: PMC11222185.

https://pubmed.ncbi.nlm.nih.gov/34231069/ Esposito C, Alberti D, Settimi A, Pecorelli S, Boroni G, Montanaro B, Escolino M. Indocyanine green (ICG) fluorescent cholangiography during laparoscopic cholecystectomy using RUBINA™ technology: preliminary experience in two pediatric surgery centers. Surg Endosc. 2021 Nov;35(11):6366-6373. doi: 10.1007/s00464-021-08596-7. Epub 2021 Jul 6. PMID: 34231069; PMCID: PMC8523512.

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

In this episode of the Colorectal Quiz, Drs. Marc Levitt, Jason Frischer, and special guest Dr. Julia Grabowski from Lurie Children’s dive deep into the diagnosis and management of anal stenosis in infants. They walk through the case of a 10-month-old presenting with constipation and distention, leading to a discussion on clinical exams, imaging, biopsy pitfalls, and surgical strategies.

Key Highlights:

Physical Exam Essentials: Why a thorough digital rectal exam is critical and when to use a Hegar dilator vs. relying on feel.
Distinguishing Anal Stenosis vs. Hirschsprung Disease: How misdiagnoses occur and why biopsies can be misleading if not done correctly.
Surgical Management: Principles of preserving the anterior anal canal to protect continence during posterior sagittal approaches.
Megarectosigmoid Management: Why most dilated rectums improve after addressing the obstruction and when a Malone procedure can prevent the need for resection.
Special Considerations: The importance of spinal and pelvic MRI to rule out associated presacral masses before surgery.

This episode underscores the importance of a meticulous clinical approach, interdisciplinary review, and cautious surgical planning in treating children with suspected anal stenosis.

Join us for a highlight reel of the Top 10 Key Takeaways from the 12th Annual Update Course in Pediatric Surgery. This session covers the latest advances, practical tools, and emerging trends that are shaping the future of pediatric surgical care.

Key Highlights:

10. Collaboration Between Surgery & Interventional Radiology: Drs. Dan von Allmen, John Racadio, and Timothy Lautz highlight how combining surgical and interventional radiology techniques enhances precision and patient outcomes.

9. Top AI Tools for Surgeons: Drs. Ramy Shaaban and Carlos Colunga introduce AI platforms improving research, education, and clinical workflow.

8. Cryoanalgesia in Pectus Surgery: Dr. John DiFiore explains how cryoanalgesia is transforming pain management in chest wall repairs.

7. ECMO in Severe CDH: Drs. Steven Lee and Rebecca Stark explore ECMO’s evolving role in managing severe congenital diaphragmatic hernia.

6. CO₂ Laser Applications: Dr. Carlos Colunga shares expanding applications of CO₂ lasers for minimally invasive pediatric procedures.

5. Autofluorescence & ICG in Thyroid Surgery: Drs. Justin Huntington and Ben Ham showcase imaging technologies that improve parathyroid identification and reduce hypocalcemia.

4. Surgery-First Approach for Pediatric Biliary Stones: Drs. David Vitale, Luke Neff, and Jeff Ponsky advocate for earlier surgical intervention to avoid unnecessary imaging.

3. MMP-7 for Early Biliary Atresia Diagnosis: Dr. Greg Tiao presents the impact of MMP-7 as a biomarker for faster diagnosis and better outcomes.

2. REBOA in Pediatric Trauma: Dr. Regan Williams discusses the role of resuscitative endovascular balloon aortic occlusion in critical pediatric trauma cases.

1. Patient Education in Pilonidal Disease: Dr. Nelsen Rosen outlines strategies to manage pilonidal disease non-surgically through hygiene and hair removal.

These takeaways represent the cutting edge of pediatric surgery, offering practical insights for surgeons, researchers, and trainees alike.

This year was the 12th Annual Pediatric Surgery Update Course, where top hospital experts from around the world discussed this year’s changes in practices and innovation. Rewatch the event to learn more about the future of pediatric surgery and be at the forefront of medical excellence.

In this clip, Drs. Em Gootee, Ramy Shaaban, Carlos Colunga, with Todd Ponsky as moderator, speaks on the top AI tools of 2024.

Topics to be discussed:

• AI: TOP 10 websites & tools for everyday usage

We are back with another episode of our Journal of Pediatric Surgery article review podcast. This time we have three publications from the first quarter of 2025, January, February and March issues. This time we're talking to editors Drs. Romeo Ignacio, Patrick Chung and Mark Davenport joined by authors Drs. Oluyinka Olutoye, Howard Jen, Jordan Rook and Liam McCarthy.

Host: Em Gootee, MD

Articles:

Gadde R, Xia J, Hameedi S, Saulsbery A, Schafer C, Sbragia L, Olutoye OO. Remote Ischemic Conditioning (RIC) Decreases the Incidence and Severity of Necrotizing Enterocolitis (NEC) - Validation in a Large Animal Model. J Pediatr Surg. 2025 Jan;60(1):161957. doi: 10.1016/j.jpedsurg.2024.161957. Epub 2024 Sep 24. PMID: 39368858.

https://pubmed.ncbi.nlm.nih.gov/39368858/

Rook JM, Lee LK, Wagner JP, Sullins VF, Lee SL, Shekherdimian S, DeUgarte DA, Dichter CE, Jen HC. Six Years of Quality Improvement in Pectus Excavatum Repair: Implementation of Intercostal Nerve Cryoablation and ERAS Protocols for Patients Undergoing Nuss Procedure. J Pediatr Surg. 2025 Feb;60(2):161634. doi: 10.1016/j.jpedsurg.2024.07.019. Epub 2024 Jul 20. PMID: 39117536.

https://pubmed.ncbi.nlm.nih.gov/39117536/

Parkinson E, Robb A, McCarthy L. Long-term Survival of Bladder Augmentation is Influenced by its Shape and Mucosal Lining. J Pediatr Surg. 2025 Mar;60(3):162051. doi: 10.1016/j.jpedsurg.2024.162051. Epub 2024 Nov 1. PMID: 39572279.

https://pubmed.ncbi.nlm.nih.gov/39572279/

We’re back with nineteenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Gootee

https://pubmed.ncbi.nlm.nih.gov/38272766/

Fall F, Hu YY, Walker S, Baertschiger R, Gaffar I, Saltzman D, Stylianos S, Shapiro J, Wieck M, Buchmiller T, Brandt ML, Tracy T, Heiss K, Berman L. Peer Support to Promote Surgeon Well-being: The APSA Program Experience. J Pediatr Surg. 2024 Sep;59(9):1665-1671. doi: 10.1016/j.jpedsurg.2023.12.022. Epub 2024 Jan 6. PMID: 38272766.

https://pubmed.ncbi.nlm.nih.gov/38914091/

Basurto D, Watananirun K, Cordier AG, Otaño J, Carriere D, Scuglia M, de Luna Freire Vargas AM, Prat J, Russo FM, Debeer A, Peralta CFA, De Coppi P, Gratacós E, Benachi A, Deprest J. Tracheomalacia and tracheomegaly in infants and children with congenital diaphragmatic hernia managed with and without fetoscopic endoluminal tracheal occlusion (FETO): a multicentre, retrospective cohort study. Lancet Child Adolesc Health. 2024 Aug;8(8):580-588. doi: 10.1016/S2352-4642(24)00109-3. Epub 2024 Jun 21. PMID: 38914091.

https://pubmed.ncbi.nlm.nih.gov/38015091/

Pio L, Brisse HJ, Alaggio R, Zambaiti E, Stenman J, Giuliani S, Montano V, Hinojosa AS, Hoel AT, Pevere A, Abu-Zaid A, Franchi-Abella S, Abdelhafeez AH, Davidoff AM, Losty PD. Image-guided core-needle or surgical biopsy for neuroblastoma diagnosis in children: A systematic review and meta-analysis from the International Society of Pediatric Surgical Oncology (IPSO). Pediatr Blood Cancer. 2024 Feb;71(2):e30789. doi: 10.1002/pbc.30789. Epub 2023 Nov 27. PMID: 38015091.

In this episode of the Colorectal Quiz, Drs. Marc Levitt, Jason Frischer, and special guests Dr. Chris Gayer and Dr. Sarah Ulrich tackle the complexities of managing megarectosigmoid in a 13-year-old patient with a history of cloaca. They explore the intricacies of diagnosis, anatomy, and long-term management for a child struggling with soiling despite a well-positioned rectum and no anatomical stricture.

Key Highlights:

Case Discussion: A deep dive into a patient with severe rectal dilation despite a perineal repair and normal bladder function.
Diagnostic Strategy: The role of MRI, EUA, contrast enema, and sacral assessment to understand anatomy and guide treatment.
Treatment Options: From Malone procedures to tapering and resection—what’s the right next step?
Surgical Pearls: When to preserve the rectum and when to consider redoing the entire repair.

This episode is packed with expert commentary, clinical pearls, and plenty of humor (including a colorectal-themed joke from a young patient).

In this 2024 Update Course Rewind session, pediatric surgeons Dr. Justin Huntington and Dr. Ben Ham explore the emerging use of autofluorescence and ICG angiography during thyroid surgery. These imaging technologies are helping identify and assess parathyroid gland perfusion, with the goal of reducing hypocalcemia and improving long-term outcomes—especially in pediatric patients.

Classified as a Black Diamond (early adopter practice), this approach is still gaining traction in pediatric centers, but adult trials are already showing promise.

Key Highlights:

What is Autofluorescence? A no-injection technique that uses natural gland fluorescence to locate parathyroids during surgery.
ICG Angiography: Assessing real-time perfusion of glands to determine viability and reimplantation need.
Clinical Impact: Reduced rates of post-op hypocalcemia, improved identification of glands in surgical specimens, and more targeted decision-making.
Challenges in Practice: Equipment bulkiness, variable image quality, and limited adoption in lower-volume pediatric centers.

While further pediatric data are needed, this episode shows how new technologies may shape the future of thyroid surgery—especially in safeguarding parathyroid function.

In this 2024 Update Course Rewind, pediatric surgeons Drs. Regan Williams and Katie Russell share new updates on the management of thoracic aortic injuries. Classified as a “Black Diamond” practice—indicating unproven approaches for early adopters—this session reviews how Thoracic Endovascular Aortic Repair (TEVAR) is emerging as a less invasive and effective treatment option in pediatric patients, especially adolescents.

Host: Lizzy Lee, PA-C

Key Takeaways:

Prioritize stabilization and life-threatening injuries before addressing thoracic aortic injury.
Thoracic aortic injuries in children are rare and can be easily missed—maintain a high index of suspicion.
A widened mediastinum on chest X-ray should prompt a CT chest to evaluate for vascular injury.
Decisions should be guided by patient age, injury severity, and available expertise at your institution.
Collaboration with vascular surgeons or interventional radiologists is essential for optimal care.

In this episode of the Colorectal Quiz, Drs. Marc Levitt, Jason Frischer, Kristy Rialon, and Lily Cheng explore the diagnostic and surgical challenges of Hirschsprung disease, featuring a neonatal patient with Trisomy 21. Through a step-by-step case discussion, they highlight how early recognition, biopsy strategy, and patient-specific surgical planning can dramatically improve outcomes.

Key Highlights:

Patient Case Study: A newborn with Trisomy 21, bilious emesis, and delayed meconium passage sparks a thorough workup for Hirschsprung disease.
Diagnosis: The team breaks down how rectal irrigations and full-thickness biopsies confirm aganglionosis and rule out other causes.
Surgical Strategy: A discussion on when to perform a pull-through, mapping biopsies, and choosing between colostomy and ileostomy.
Long-Term Management: Addressing the role of Botox for internal sphincter relaxation and educating families on home care and irrigations.

This episode emphasizes the value of thoughtful, team-based decision-making and patient-tailored care in managing Hirschsprung disease. Don’t forget to download the StayCurrentMD app to view supporting visuals and expert resources—and subscribe for more pediatric surgery insights!

In this special episode from the QUAD Conference hosted by Cincinnati Children’s, Lizzy Lee takes us inside one of the world’s largest and most advanced multidisciplinary programs for children with complex airway and digestive conditions: the Aerodigestive and Esophageal Center (ADEC).

You'll hear from a diverse team of specialists—including speech-language pathologists, ENTs, GI, pulmonologists, and pediatric surgeons—who collaborate to manage complex conditions like esophageal atresia, TEF, chronic aspiration, GERD, and swallowing disorders.

Key Highlights:

Speech Pathology: VFSS, FEES, manometry, and innovative approaches to swallowing therapy
Pulmonology: Airway clearance, aspiration management, bronchoscopy, and ventilator weaning
ENT Perspective: Stratifying airway risk and managing vocal fold and structural anomalies
Gastroenterology: Managing GERD, motility, EOE, and feeding disorders
Surgical Insight: Feeding access, tracheopexy, and complex lung or airway repairs

The episode is a masterclass in how cross-specialty teamwork leads to better diagnostics, better surgeries, and better long-term outcomes for children with aerodigestive disorders.

Dr. José Campos is back, this time helping us review some of the latest literature on the management of Inguinal Hernia in children. In this podcast, we're reviewing a hernia case with Dr. Todd Ponsky and incorporating literature from the last few years.

Host: Em Gootee

Articles in the order we mentioned if you want to follow along:

https://pubmed.ncbi.nlm.nih.gov/38530261/

HIP Trial Investigators; Blakely ML, Krzyzaniak A, Dassinger MS, Pedroza C, Weitkamp JH, Gosain A, Cotten M, Hintz SR, Rice H, Courtney SE, Lally KP, Ambalavanan N, Bendel CM, Bui KCT, Calkins C, Chandler NM, Dasgupta R, Davis JM, Deans K, DeUgarte DA, Gander J, Jackson CA, Keszler M, Kling K, Fenton SJ, Fisher KA, Hartman T, Huang EY, Islam S, Koch F, Lainwala S, Lesher A, Lopez M, Misra M, Overbey J, Poindexter B, Russell R, Stylianos S, Tamura DY, Yoder BA, Lucas D, Shaul D, Ham PB 3rd, Fitzpatrick C, Calkins K, Garrison A, de la Cruz D, Abdessalam S, Kvasnovsky C, Segura BJ, Shilyansky J, Smith LM, Tyson JE. Effect of Early vs Late Inguinal Hernia Repair on Serious Adverse Event Rates in Preterm Infants: A Randomized Clinical Trial. JAMA. 2024 Mar 26;331(12):1035-1044. doi: 10.1001/jama.2024.2302. PMID: 38530261; PMCID: PMC10966421.

https://pubmed.ncbi.nlm.nih.gov/34856625/

Dreuning KMA, Derikx JPM, Ouali A, Janssen LMJ, Tulder MWV, Twisk JWR, Haverman L, van Heurn LWE. One-Stop Surgery: An Innovation to Limit Hospital Visits in Children. Eur J Pediatr Surg. 2022 Oct;32(5):435-442. doi: 10.1055/s-0041-1740158. Epub 2021 Dec 2. PMID: 34856625; PMCID: PMC9481276.

https://pubmed.ncbi.nlm.nih.gov/36307301/

Fraser JD, Duran YK, Deans KJ, Downard CD, Fallat ME, Gadepalli SK, Hirschl RB, Lal DR, Landman MP, Leys CM, Mak GZ, Markel TA, Minneci PC, Sato TT, St Peter SD; Midwest Pediatric Surgery Consortium. Natural history and consequence of patent processus vaginalis: An interim analysis from a multi-institutional prospective observational study. J Pediatr Surg. 2023 Jan;58(1):142-145. doi: 10.1016/j.jpedsurg.2022.09.012. Epub 2022 Oct 3. PMID: 36307301.

https://pubmed.ncbi.nlm.nih.gov/21259030/

Zendejas B, Onkendi EO, Brahmbhatt RD, Greenlee SM, Lohse CM, Farley DR. Contralateral metachronous inguinal hernias in adults: role for prophylaxis during the TEP repair. Hernia. 2011 Aug;15(4):403-8. doi: 10.1007/s10029-011-0784-2. Epub 2011 Jan 23. PMID: 21259030.

In this Update Course Rewind, Drs. Dan von Allmen, John Racadio, and Timothy Lautz, alongside IR technologist Amanda Wallingford, discuss how strong collaboration between surgery and interventional radiology is transforming patient care at Cincinnati Children’s and beyond. From ultrasound-guided lymph node localization to cone beam CT in a hybrid OR, this session highlights the power of shared expertise and image-guided surgery.

Key Highlights:

Use of cone beam CT, ultrasound, and fluoroscopy to improve surgical precision
Hybrid OR vs. traditional OR: benefits and workarounds
Real-life examples: neuroblastoma surgery, vascular malformations, pulmonary nodule localization
Preview of emerging tech like augmented reality and holographic overlays for surgical planning

This session is marked as a “Blue Square”—a promising newer practice that’s showing significant results and potential. Watch to learn how breaking down silos between teams can elevate outcomes across specialties.

We’re back with eighteenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Gootee

https://pubmed.ncbi.nlm.nih.gov/39083294/

Pilkington M, Nelson G, Pentz B, Marchand T, Lloyd E, Chiu PPL, de Beer D, de Silva N, Else S, Fecteau A, Giuliani S, Hannam S, Howlett A, Lee KS, Levin D, O'Rourke L, Stephen L, Wilson L, Brindle ME. Enhanced Recovery After Surgery (ERAS) Society Recommendations for Neonatal Perioperative Care. JAMA Surg. 2024 Sep 1;159(9):1071-1078. doi: 10.1001/jamasurg.2024.2044. PMID: 39083294.

https://pubmed.ncbi.nlm.nih.gov/38493027/

Moore EJ, Sawyer SM, King SK, Tien MY, Trajanovska M. Transition From Pediatric to Adult Healthcare for Colorectal Conditions: A Systematic Review. J Pediatr Surg. 2024 Jun;59(6):1028-1036. doi: 10.1016/j.jpedsurg.2024.02.012. Epub 2024 Feb 23. PMID: 38493027.

https://pubmed.ncbi.nlm.nih.gov/36658074/

Zeng G, Zhang Q, Song B, Feng X, Sun J, Mo X, Wu KH. Clinical Symptoms Affect Treatment and Prognosis in Pediatric Patients with Congenital Pulmonary Airway Malformation: A Propensity Score Matching Retrospective Cohort Study. J Pediatr Surg. 2023 Oct;58(10):1963-1968. doi: 10.1016/j.jpedsurg.2022.11.013. Epub 2022 Nov 29. PMID: 36658074.

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

In this episode of the Pediatric Surgery Update Course Rewind, Dr. Nelson Rosen and Dr. Whit Holcomb discuss advancements in the surgical management of pilonidal disease, emphasizing minimally invasive techniques like the GIPS procedure. Learn how these methods offer faster recovery, fewer complications, and better outcomes for patients.

Key Highlights:

Minimally Invasive Techniques: The GIPS procedure and hybrid approaches that maximize skin preservation and minimize recovery time.
EPSIT Technique: A global perspective on endoscopic management, including its benefits and challenges.
Recurrence Prevention: The importance of ongoing hair removal strategies, including laser treatments, to prevent recurrence and improve long-term outcomes.
When to Escalate: For cases where minimally invasive approaches fail, off-midline closure options like the Bascom cleft lift offer effective solutions.

This video is essential for understanding the evolving management of pilonidal disease and the role of patient-centered care in achieving lasting results.

Host: Em Gootee, MD

In this engaging episode of the Colorectal Quiz, Drs. Marc Levitt, Jason Frischer, and Erin Teeple dive into the complexities of pelvic floor dyssynergia, an often under-recognized condition impacting bowel and urinary function. Dr. Teeple, the only U.S. surgeon dually trained in pediatric and adult colorectal surgery, shares invaluable insights on diagnosis, treatment, and management strategies.

Key Highlights:

Patient Case Study: A 17-year-old with unexplained urinary retention and testicular pain leads to a detailed exploration of pelvic floor dysfunction.
Diagnostic Tools: The role of SITZ marker studies, defecography, and manual assessments in identifying pelvic floor tightness.
Treatment Approaches: From pelvic floor physical therapy to Botox injections for puborectalis relaxation.
Collaboration Matters: How pediatric and adult colorectal care intersect for comprehensive management.

This episode underscores the importance of a multidisciplinary approach and innovative techniques for treating pelvic floor dysfunction. Don’t forget to download the Stay Current app to access related images and resources, and subscribe for more pediatric surgery content!

In this Update Course Rewind session, Dr. Greg Tiao, Surgical Director of the Liver Transplantation Program at Cincinnati Children’s, discusses the critical role of MMP-7 as a biomarker in the early diagnosis of biliary atresia. With data showing that every 10-day delay in treatment worsens outcomes by 20%, early detection is essential for improving native liver survival.

Key Highlights:

Importance of Early Diagnosis: Performing a Kasai procedure before 45 days significantly improves patient outcomes.
MMP-7 as a Biomarker: Validated in international studies, MMP-7 is proving to be a powerful diagnostic tool.
Challenges in Diagnosis: Distinguishing BA from other neonatal cholestasis conditions remains complex.
Global Impact: Lessons from high-incidence regions like China are helping shape best practices in North America.

With the integration of MMP-7 testing, pediatric surgery is moving towards earlier diagnosis and intervention, improving the chances of avoiding liver transplant in affected infants. Don’t forget to like, comment, and subscribe for more updates!

Pediatric empyema pneumonia is a lung infection that occurs when pus collects in the pleural space, the area between the lungs and chest wall. In this video, we cover the management of pediatric empyema, including diagnosis, treatment algorithms, imaging, and surgical versus non-surgical approaches with Dr. Aaron Garrison, a pediatric surgeon at Cincinnati Children’s.

Host: Brittany Levy

Key Takeaways:

• Pediatric empyema pneumonia requires a combination of medical and surgical management, but decision-making can be complex.

• Community-acquired pneumonia is a leading cause of hospitalization in children, yet bacterial pathogens are detected in only 15% of cases.

• Empyema progresses in three stages: exudative, fibrinopurulent, and organizing. The fibrinopurulent stage is when surgical intervention is often needed.

• Ultrasound is more sensitive than CT in detecting septations in pleural effusions and avoids radiation exposure.

• Chest tube drainage with fibrinolytics (such as TPA) has been shown to be a viable alternative to VATS, reducing hospital stays and costs.

• Some children with effusions may not require TPA—clinical improvement within 24 hours of drainage can indicate that it’s unnecessary.

• Inhaled foreign bodies, particularly peanuts, can mimic pneumonia and require a high index of suspicion for proper diagnosis.

• CT scans are now being used to diagnose airway foreign bodies with high reliability, reducing unnecessary bronchoscopies.

Further reading:

https://api.semanticscholar.org/CorpusID:53467976

Module 2 . Hemodynamic Disorders, 2015

https://thoracickey.com/nonmalignant-pleural-effusions/

Nonmalignant Pleural Effusions by John E. Heffner

https://www.ctsnet.org/article/thoracoscopic-decortication

Thoracoscopic Decortication by Christopher Komanapalli

https://publications.aap.org/neoreviews/article-abstract/18/9/e564/91880/A-Newborn-with-a-Cyst-in-the-Lung?redirectedFrom=fulltext

A Newborn with a Cyst in the Lung by Shabih Manzar, MD; Liaqat H. Khan, MD

https://journals.lww.com/ascp/fulltext/2019/07020/management_of_parapneumonic_effusion_and_empyema.1.aspx

Singh, S et.al. Management of parapneumonic effusion and empyema. The Journal of Association of Chest Physicians

https://pubmed.ncbi.nlm.nih.gov/23164006/

Islam S et.al. The diagnosis and management of empyema in children: a comprehensive review from the APSA Outcomes and Clinical Trials Committee

https://pubmed.ncbi.nlm.nih.gov/31973927/

Derderian SC et.al. Pediatric empyemas - Has the pendulum swung too far?

https://pubmed.ncbi.nlm.nih.gov/26382287/

Long AM et.al. 'Less may be best'-Pediatric parapneumonic effusion and empyema management: Lessons from a UK center

In this QUAD Conference presentation, Dr. Doug von Allmen from Cincinnati Children’s shares groundbreaking research on using ultrashort echo-time MRI to evaluate tracheomalacia in neonates with esophageal atresia (EA). This innovative imaging technique offers a non-invasive, sedation-free, and radiation-free way to assess airway weakness and create detailed 3D models for better surgical planning.

Key Highlights:

New Diagnostic Tool: Ultrashort echo-time MRI offers high-resolution imaging without the need for sedation or radiation.
Study Findings: Patients with long gap esophageal atresia showed more severe tracheomalacia than those with short gap EA.
Pre- and Post-Surgical Analysis: Repair improves upper trachea eccentricity but may worsen the distal trachea postoperatively.
Clinical Implications: Long gap EA patients are at higher risk for respiratory complications and require close post-operative monitoring.

This research sheds light on how advanced imaging can lead to better diagnosis, treatment, and follow-up care for infants with esophageal atresia and tracheoesophageal fistula (TEF).

In this recap from the 12th Annual Pediatric Surgery Update Course, Dr. Carlos Colunga highlights the potential of CO2 lasers in pediatric surgery. From circumcisions to frenulectomies and pilonidal cyst ablations, CO2 lasers are gaining traction for their precision, reduced pain, and shorter operating times.

Key Highlights:

Clinical Applications: Successfully used for circumcision, frenulectomy, perianal fistulas, pilonidal cysts, and more.
Benefits of CO2 Lasers: Reduced bleeding, lower complication rates, shorter operative times, and improved cosmetic outcomes.
Evidence-Based Insights: Meta-analyses show CO2 laser-assisted surgeries have better results than traditional techniques in specific cases.
Challenges: High equipment cost, steep learning curve, and the need for specialized training remain barriers to adoption.

Join us to explore how CO2 lasers are transforming pediatric surgery and learn about the exciting possibilities for the future!

Host: Lizzy Lee, PA-C

We’re back with seventeenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Gootee

https://pubmed.ncbi.nlm.nih.gov/37983822/

Zhang M, Huang J, Jin Z, Zhang X, Zhou Y, Chi S, Rong L, Zhang Y, Cao G, Li S, Tang ST. Comparison of robotic versus thoracoscopic repair for congenital esophageal atresia: a propensity score matching analysis. Int J Surg. 2024 Feb 1;110(2):891-901. doi: 10.1097/JS9.0000000000000889. PMID: 37983822; PMCID: PMC10871573.

https://pubmed.ncbi.nlm.nih.gov/38677965/

Ullrich S, Austin K, Avansino JR, Badillo A, Calkins CM, Crady RC, Durham MM, Fuller MK, Rana A, Reeder RW, Rentea RM, Rollins MD, Saadai P, Speck KE, Wood RJ, van Leeuwen K, Frischer JS; Pediatric Colorectal and Pelvic Learning Consortium. Does Delayed Diagnosis of Hirschsprung Disease Impact Post-operative and Functional Outcomes? A Multi-Center Review From the Pediatric Colorectal and Pelvic Learning Consortium. J Pediatr Surg. 2024 Jul;59(7):1250-1255. doi: 10.1016/j.jpedsurg.2024.03.034. Epub 2024 Mar 18. PMID: 38677965.

https://pubmed.ncbi.nlm.nih.gov/37978002/

Ameer A, Mirza MB, Talat N. The Outcome of Purse-string Versus Conventional Wound Closure Techniques in Patients Undergoing Stoma Reversal: A Randomized Controlled Trial. J Pediatr Surg. 2024 Jun;59(6):1186-1189. doi: 10.1016/j.jpedsurg.2023.10.062. Epub 2023 Oct 30. PMID: 37978002.

In this episode of the Colorectal Quiz, Drs. Marc Levitt, Jason Frischer, and Martin Lacher dive into the intricacies of frozen sections and reoperative strategies in Hirschsprung disease. Using a fascinating case of a late-diagnosed Hirschsprung patient, they explore critical decision-making in staged repairs and reoperative pull-through surgeries.

Key Highlights:

Frozen Section Techniques: Best practices for biopsy marking and pathology review to confirm ganglion cells.
Staged Repairs: Why ileostomy followed by a laparoscopic-assisted Swenson pull-through was chosen for this case.
Reoperative Strategies: Managing transition zone pull-throughs, early reoperations, and avoiding long-term complications.
Surgical Pearls: Insights into laparoscopic port placement, anastomotic site preparation, and collaboration with pathologists for accurate diagnoses.

Whether you're a seasoned colorectal surgeon or new to the field, this episode is packed with practical tips and lessons learned. Download the Stay Current app to view related images, X-rays, and resources discussed in the episode.

In this episode, Dr. Greg Burg, a pulmonologist at Cincinnati Children’s, discusses the medical management of minor laryngeal clefts, highlighting a comprehensive approach that includes swallow assessments, pulmonary therapies, and long-term monitoring. Learn how a combination of safe swallowing strategies, dietary modifications, and reactive therapies can help manage aspiration risks in pediatric patients.

Key Takeaways:

Diagnostic Approach: Importance of bronchoscopy, swallow studies, and chest CT scans in identifying aspiration-related issues.
Medical Management: Use of inhaled steroids, macrolide therapy, and saline treatments to reduce inflammation and improve airway clearance.
Swallowing & Nutrition: Thickened feeds, pacing, and feeding tube strategies to prevent aspiration.
Long-Term Monitoring: Vaccination recommendations, environmental risk reduction, and periodic reassessments to guide further intervention.

This discussion provides valuable insights into how a multidisciplinary approach can improve outcomes for children with minor laryngeal clefts. Don’t forget to like, comment, and subscribe for more expert discussions!

We are back with another episode of our Journal of Pediatric Surgery article review podcast.

This time we have three publications from the fourth quarter of 2024, October, November and December issues. This time we're talking to editors Drs. Mauricio "Tony" Escobar, Mikko Pakarinen, and Pablo Laje joined by authors Drs. Aodhnait Fahy, Anne-Fleur van Hal, John M. Woodward and Ben Ham III.

Host: Em Gootee

Articles:

Fahy AS, Klima DA, Gillam MM, Aprahamian CJ, Kim SS, Kokoska ER, Teeple EA, Weiss RG, Escobar MA Jr. Locum Tenens and Pediatric Surgery: A Position Statement and Practice Guidelines From the American Pediatric Surgical Association (APSA). J Pediatr Surg. 2024 Oct;59(10):161567. doi: 10.1016/j.jpedsurg.2024.04.021. Epub 2024 May 8. PMID: 38806318.

https://pubmed.ncbi.nlm.nih.gov/38806318/

van Hal ARL, Aanen IP, Wijnen RMH, Pullens B, Vlot J. The Value of Preoperative Rigid Tracheobronchoscopy for the Diagnosis of Tracheomalacia in Oesophageal Atresia Patients. J Pediatr Surg. 2024 Nov;59(11):161620. doi: 10.1016/j.jpedsurg.2024.07.005. Epub 2024 Jul 14. PMID: 39089893.

https://pubmed.ncbi.nlm.nih.gov/39089893/

Woodward JM, Chunco C, Brierley SF, Bittner K, Osei H, Harmon CM, Ham PB 3rd. Same-Day Discharge for Elective Pediatric Laparoscopic Gastrostomy Tube Insertion is Safe and Increasing in Frequency; A NSQIP Pediatric Retrospective Review 2017 to 2021. J Pediatr Surg. 2024 Dec;59(12):161665. doi: 10.1016/j.jpedsurg.2024.08.005. Epub 2024 Aug 6. PMID: 39261186.

https://pubmed.ncbi.nlm.nih.gov/39261186/

We’re back with sixteenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Gootee

https://pubmed.ncbi.nlm.nih.gov/36805142/

Brandt K, Dukleska K, McKeown M, Brancato J, Grossi V, Schoem S, Sacco T, D'Amato J, Bourque MD, Campbell BT. Utilizing a critical airway response team expedites esophageal button battery removal. J Pediatr Surg. 2023 May;58(5):810-813. doi: 10.1016/j.jpedsurg.2023.01.037. Epub 2023 Jan 19. PMID: 36805142.

https://pubmed.ncbi.nlm.nih.gov/38413262/

Hodgson E, Briatico D, Klapman S, Skarsgard E, Beltempo M, Shah PS, Huisman E, Walton JM, Livingston MH; Canadian Association of Pediatric Surgeons Network (CAPSNet) and Canadian Neonatal Network (CNN) investigators. Association of Exclusive Breast Milk Intake and Outcomes in Infants With Uncomplicated Gastroschisis: A National Cohort Study. J Pediatr Surg. 2024 May;59(5):863-868. doi: 10.1016/j.jpedsurg.2024.01.045. Epub 2024 Feb 3. PMID: 38413262.

https://pubmed.ncbi.nlm.nih.gov/36494205/

Lai K, Notrica DM, McMahon LE, Kang P, Molitor MS, Egan JC, Bae JO, Hunteman ZM, Ostlie DJ, Lee JH, Padilla BE. Cryoablation in 350 Nuss Procedures: Evolution of Hospital Length of Stay and Opioid Use. J Pediatr Surg. 2023 Aug;58(8):1435-1439. doi: 10.1016/j.jpedsurg.2022.10.051. Epub 2022 Nov 7. PMID: 36494205.

In this episode from the 12th Annual Update Course in Pediatric Surgery, Dr. Nelson Rosen discusses non-surgical approaches to managing pilonidal disease, emphasizing the importance of patient education and hygiene. Learn how techniques like hair removal, meticulous hygiene, and lifestyle adjustments can significantly reduce the need for invasive procedures.

Key Highlights:

Non-Surgical Success Rates: Up to 60-70% of patients experience improvement with non-surgical interventions alone.
Hair Removal Techniques: Options include weekly clipping, waxing, Nair-type agents, and even laser removal for long-term maintenance.
Hygiene Best Practices: Showering regularly, using washlets, and debunking myths about bathing restrictions for faster healing.
Setting Expectations: How to guide patients and families through treatment while balancing realistic outcomes.

Join us to explore how non-surgical management can transform the care and recovery of patients with pilonidal disease. Don’t forget to like, comment, and subscribe for more pediatric surgery updates!

Host: Em Gootee, MD

In this episode, pulmonologist Dr. Cherie Torres-Silva from Cincinnati Children's shares insights on managing pulmonary challenges in patients with CHARGE syndrome. Through a detailed case study, she explores strategies to address chronic aspiration, airway clearance limitations, and recurrent infections.

Key Highlights:

Challenges in CHARGE Syndrome: Understanding how aspiration, obstructive sleep apnea (OSA), and recurrent infections intersect in CHARGE patients.
Management Strategies: Improving airway clearance with therapies like intrapulmonary percussion and thinning secretions using hypertonic saline.
Infection Prevention: The role of dental hygiene, prophylactic antibiotics (e.g., inhaled tobramycin), and balancing the risks of antibiotic resistance.
Individualized Care: Tailoring treatments based on respiratory cultures and underlying comorbidities such as hypotonia and restrictive lung disease.

Learn how a multidisciplinary approach can improve outcomes for CHARGE patients with complex pulmonary issues. Don’t forget to like, comment, and subscribe for more insights!

Host: Em Gootee, MD

In this educational video, Dr. Robin Bowman from Lurie Children’s Hospital in Chicago demonstrates the surgical release of a fatty filum terminale in a patient with tethered cord syndrome. Tethered cord syndrome is a stretch-induced condition that can cause progressive neurological deficits, including gait abnormalities, loss of bladder control, and chronic pain.

Key Highlights:

Understanding Tethered Cord Syndrome: How abnormal attachment of the filum terminale stretches the spinal cord and impacts function.
Preoperative Imaging: The use of spinal MRI to identify the location of the conus, tethering lesions, and spina bifida occulta.
Surgical Technique: A step-by-step overview of the untethering procedure, including laminotomy, nerve root stimulation, and filum transection.
Postoperative Closure: Ensuring a watertight dura closure and layered wound repair to optimize healing and outcomes.

Learn about this critical surgical procedure designed to relieve symptoms and prevent further neurological deterioration in children with tethered cord syndrome.

In this episode of the Colorectal Quiz, Drs. Marc Levitt and Jason Frischer are joined by Drs. Jeffrey Avansino and Hira Ahmad to discuss the nuances of the Malone procedure, used for managing fecal incontinence and constipation in pediatric patients. From patient selection to managing complications, this in-depth conversation highlights the importance of collaboration between urology and surgery for optimal outcomes.

Key Topics:

Understanding the Malone Procedure: Creating a channel to administer enemas for patients with continence challenges.
Technical Considerations: When to use a shared appendix, manage leakage, and troubleshoot complex cases.
Complication Management: Addressing stenosis, leakage, and rare issues like appendiceal prolapse.
Future Approaches: Exploring the importance of teamwork and innovative solutions in colorectal surgery.

Whether you're a pediatric surgeon or someone interested in advancing your understanding of colorectal care, this episode is packed with practical tips and insights. Don't forget to download the Stay Current app for related images and resources, and subscribe for more episodes of the Colorectal Quiz!

In this podcast, we explore the anatomy, conditions, and treatment strategies related to umbilical disorders in newborns and young children with Dr. Rebeccah Brown from Cincinnati Children's.

From umbilical cord anatomy and infections like omphalitis to congenital abnormalities like gastroschisis and umbilical hernias, this comprehensive discussion covers key diagnostic and management approaches. We also highlight treatment guidelines for umbilical granulomas and practical tips for avoiding complications with silver nitrate applications.

Host: Em Gootee, MD

0:00 Introduction

0:59 Omphalitis

2:00 Umbilical Hernia

6:55 Proboscoid Hernia

8:48 Umbilical Granuloma

10:18 Summary

Zens TJ, Rogers A, Cartmill R, Ostlie D, Muldowney BL, Nichol P, Kohler JE. Age-dependent outcomes in asymptomatic umbilical hernia repair. Pediatr Surg Int. 2019 Apr;35(4):463-468. doi: 10.1007/s00383-018-4413-3. Epub 2018 Nov 14. PMID: 30430281. https://pubmed.ncbi.nlm.nih.gov/30430281/

Zens T, Nichol PF, Cartmill R, Kohler JE. Management of asymptomatic pediatric umbilical hernias: a systematic review. J Pediatr Surg. 2017 Nov;52(11):1723-1731. doi: 10.1016/j.jpedsurg.2017.07.016. Epub 2017 Jul 24. PMID: 28778691. https://pubmed.ncbi.nlm.nih.gov/28778691/

Halleran DR, Minneci PC, Cooper JN. Association between Age and Umbilical Hernia Repair Outcomes in Children: A Multistate Population-Based Cohort Study. J Pediatr. 2020 Feb;217:125-130.e4. doi: 10.1016/j.jpeds.2019.10.035. Epub 2019 Nov 8. PMID: 31711762. https://pubmed.ncbi.nlm.nih.gov/31711762/

He K, Graham DA, Vernacchio L, Hatoun J, Patane L, Cramm SL, Rangel SJ. Age and Probability of Spontaneous Umbilical Hernia Closure. JAMA Pediatr. 2024 May 1;178(5):497-498. doi: 10.1001/jamapediatrics.2024.0087. PMID: 38466296; PMCID: PMC10928535. https://pubmed.ncbi.nlm.nih.gov/38466296/

In this video, Dr. Catherine Hart, ENT surgeon at Cincinnati Children’s, discusses the unique airway and aspiration challenges faced by children with CHARGE syndrome. From structural abnormalities like anteriorly positioned arytenoids to feeding difficulties due to cranial nerve impairments, Dr. Hart explores the multidisciplinary approaches required to provide optimal care.

Key Highlights:

CHARGE Larynx Features: Structural differences leading to upper airway obstruction, foreshortened vocal folds, and difficult intubation.
Feeding Challenges: Aspiration risks due to absent cough reflex, high rates of reflux, and swallowing dysfunction in over 60% of CHARGE patients.
Medical and Surgical Management: Options including Robinul, Botox, duct ligation, submandibular gland excision, and tympanic neurectomy to reduce aspiration risks.
Tracheotomy and Beyond: When tracheotomy or laryngotracheal separation becomes necessary for severe cases with chronic lung impact.

Learn how the team at Cincinnati Children’s combines innovative treatments and surgical expertise to improve the quality of life for children with CHARGE syndrome. Don’t forget to like, comment, and subscribe for more expert insights!

In this educational video, Dr. Catherine Hart, ENT surgeon at Cincinnati Children’s, provides an overview of CHARGE syndrome, a rare genetic disorder that affects multiple organ systems. Learn about its diagnosis, clinical features, and the comprehensive care required for patients with this condition.

Key Highlights:

What is CHARGE Syndrome? The acronym stands for coloboma, heart defects, atresia of the choanae, retardation of growth and development, genital/urinary anomalies, and ear malformations.
Causes and Diagnosis: CHARGE is typically caused by a CHD7 mutation on chromosome 8 but can also be diagnosed clinically with specific major and minor criteria.
Multisystem Impact: The syndrome’s highly variable expression means it can affect almost every organ system, requiring coordinated care.
Care through an Aerodigestive Center: The Aerodigestive Center at Cincinnati Children’s ensures comprehensive management of airway, feeding, and developmental challenges.

Learn how Cincinnati Children’s provides expert care for patients with CHARGE syndrome, helping them overcome complex challenges and improve quality of life. Don’t forget to like, comment, and subscribe for more pediatric insights!

In this video, we take you through a Total Pancreatectomy with Islet Autotransplantation (TPIAT)—one of the most complex abdominal surgeries performed in children. Learn about who qualifies for TPIAT, the surgical process, and the critical role of the lab team in isolating islet cells for infusion.

From patient evaluation to the OR, lab preparation, and postoperative care, you’ll see how multiple specialists—surgeons, lab physicians, GI experts, and critical care teams—work together to ensure successful outcomes.Join Dr. Juan Gurria for a behind-the-scenes look at TPIAT, brought to you by the Pancreas Care Center at Cincinnati Children’s Hospital.

Main Takeaways

TPIAT is a complex procedure for patients with chronic or acute recurrent pancreatitis who have failed all medical and endoscopic therapies. It involves pancreas removal, islet cell processing, and infusion into the liver.
A multidisciplinary approach is key to success, involving extensive preoperative planning, precision surgery, lab-based islet cell isolation, and meticulous postoperative care.

0:08 Introduction

0:49 What is Total Pancreatectomy with Islet Autotransplantation?

1:02 Who are the candidates for TPIAT?

1:23 Pre-op evaluation

2:13 Step-by-step overview of TPIAT surgery

7:42 Post-op Care

9:07 Summary

Host: Cecilia Gigena, MD

In this session from the 12th Annual Pediatric Surgery Update Course, Dr. Gloria Gonzalez discusses the innovative use of lipiodol to mark pulmonary nodules for minimally invasive resection in children. Adapted from adult procedures, lipiodol is a promising alternative to traditional localization methods, offering precise marking with minimal complications.

Key Points Covered:

Challenges in Nodule Localization: High conversion rates during thoracoscopy due to failure to locate small or calcified nodules using CT, ultrasound, or hook wires.
Lipiodol Technique: A CT-guided marking procedure where lipiodol dye remains stable for up to three months, allowing for flexible surgery scheduling.
Clinical Outcomes: Dr. Gonzalez’s team achieved 100% sensitivity in 33 patients, resecting over 50 nodules with improved accuracy and efficiency.

Learn how this novel approach is transforming lung metastasis management in pediatric surgery. Don’t forget to like, comment, and subscribe for more cutting-edge updates!

In this episode of the Colorectal Quiz, Drs. Mark Levitt, Jason Frischer, and Chris Gayer discuss a complex case of persistent constipation in a patient with a history of Hirschsprung’s disease. Despite a successful pull-through surgery in infancy, the patient continued to experience significant symptoms into adulthood, highlighting the importance of long-term management.

Key Points Covered:

Challenges Post-Surgery: Why constipation persists in some Hirschsprung’s patients despite anatomically successful surgeries.
Diagnostic Approach: The use of exams under anesthesia, rectal biopsies, contrast enemas, and motility testing to evaluate potential causes.
Segmental Dysmotility Management: How a Malone procedure can provide a minimally invasive solution for improved colon emptying.
Multidisciplinary Care: Collaboration between surgeons, gastroenterologists, and therapists to address motility disorders, pelvic floor dysfunction, and behavioral factors.

This case highlights the importance of moving beyond the initial diagnosis and surgery to focus on the patient’s current symptoms for better quality of life. Don’t forget to like, comment, and subscribe for more insights into colorectal surgery!

In this insightful session from the QUAD Conference, Dr. David Lehenbauer, a cardiothoracic surgeon at Cincinnati Children’s, discusses the management of concurrent cardiac pathology in patients undergoing slide tracheoplasty. Learn about the role of ECMO vs. cardiopulmonary bypass, timing of cardiac and tracheal repairs, and the challenges of addressing complex cases with multiple comorbidities.

Key Points Covered:

Slide Tracheoplasty: A transformative surgical technique for congenital tracheal stenosis.
ECMO vs. Cardiopulmonary Bypass: Benefits of ECMO, including reduced inflammation, lower heparin requirements, and better post-op outcomes.
Concurrent Cardiac Pathologies: Common conditions such as PA sling, ASDs, VSDs, and Tetralogy of Fallot, often repaired simultaneously with tracheoplasty.
Timing of Repairs: Exploring when to combine vs. stage cardiac and tracheal interventions, with insights from recent studies and case reviews.

Join us for an in-depth look at how a multidisciplinary approach is transforming care for children with complex cardiac and airway conditions. Don’t forget to like, comment, and subscribe for more expert insights!

In this recap from the 12th Annual Pediatric Surgery Update Course, Drs. Regan Williams and Katie Russell delve into the latest approaches to deep vein thrombosis (DVT) prophylaxis in pediatric trauma patients. Learn when to start chemical prophylaxis, how to balance bleeding risks, and the best options for discharge medication.

Key Points Covered:

Timing is Critical: Start chemical DVT prophylaxis within 24 hours of admission for stable trauma patients to reduce the risk of venous thromboembolism (VTE).
Guideline Recommendations: Follow EAST guidelines and assess factors like Injury Severity Score (ISS) to determine risk levels.
Discharge Medications: Recent studies show aspirin is as effective as Lovenox for DVT prevention and offers easier compliance for pediatric patients at home.

Join us as we explore how new evidence is shaping DVT prevention strategies in pediatric trauma care. Don’t forget to like, comment, and subscribe for more updates from the Pediatric Surgery Update Course!

In this episode of the Colorectal Quiz, research fellow Filipa Jalles from Children's National Hospital is joined by Dr. Marc Levitt, Dr. Jason Frisher, and Dr. Paola Midrio to discuss a challenging case involving perineal hypospadias and anorectal malformation. Together, they explore the intricacies of diagnosis, the emotional impact on families, and the detailed surgical approach required for successful outcomes.

Key Topics Covered:

Prenatal Diagnosis: How advancements in imaging are reshaping prenatal counseling for conditions like hypospadias.
Surgical Strategy: The decision-making process around colostomy, PSARP, and collaboration with pediatric urologists.
Anoplasty Techniques: Detailed discussion on the mobilization of the rectum and management of the fistula in these rare and complex cases.
Multidisciplinary Collaboration: The importance of teamwork between pediatric surgeons and urologists to ensure optimal care.

Join us for an in-depth look at this fascinating case and learn from the expertise of a world-class surgical team. Like, comment, and subscribe for more pediatric surgery insights!

In this video, Dr. Catherine Hart, ENT surgeon at Cincinnati Children’s, discusses the endoscopic repair of minor laryngeal clefts, highlighting key surgical techniques and considerations. She explains the importance of accurately diagnosing these subtle clefts using combined evaluations and the criteria for deciding when surgery is necessary.

Key Points Covered:

When to Operate: Indications include persistent respiratory symptoms, aspiration, or recurrent infections in children.
Surgical Technique: The procedure involves removing the interarytenoid mucosa, using precise suturing to prevent issues like inverted edges, and ensuring complete demucosalization at the apex.
Postoperative Care: Patients are monitored overnight and follow a preoperative diet until a follow-up evaluation 6-8 weeks later, which includes a video swallow study and endoscopy.
Outcomes and Complications: While endoscopic repair shows a high success rate, Dr. Hart discusses the potential risks, including scarring and supraglottic infections, and emphasizes the importance of technique to minimize these complications.

Learn how Cincinnati Children's ENT team ensures successful outcomes for kids with minor laryngeal clefts and why endoscopic repair is often preferred.

In this educational video, experts from Cincinnati Children’s Pancreas Care Center discuss the complexities of diagnosing and managing chronic pancreatitis. Dr. Maisam Abu-El-Haija and Dr. Andrew Trout cover the condition’s impact on pancreatic function, imaging techniques, genetic testing, and treatment options.

Key Topics:

What is Chronic Pancreatitis? A progressive inflammatory condition leading to fibrosis, loss of pancreatic function, and complications like diabetes and malnutrition.
Diagnosis: The role of imaging (MRI, CT) and genetic testing in identifying and understanding the disease.
Treatment Strategies: From nutritional management and pancreatic enzyme replacement to endoscopic therapy and a multidisciplinary approach to pain management.
Pain Management: A stepwise approach involving pain specialists, psychologists, and physical therapists to address both the physical and emotional aspects of chronic pain.

Learn how the team at Cincinnati Children’s is transforming care for patients with chronic pancreatitis through innovative techniques and a comprehensive, patient-centered approach.

In this insightful podcast, Drs. Marc Levitt, Jason Frischer, and Chris Westgarth-Taylor discuss the challenging anatomy and surgical strategies for complex female anorectal malformations. They walk us through a unique case involving a cloacal malformation with a high blind-ending rectum, highlighting the importance of detailed preoperative planning, multidisciplinary collaboration, and a tailored surgical approach.

Key Topics Covered:

Case Presentation: A young patient with a rare cloacal anomaly presenting with a single perineal orifice and absent Mullerian structures.
Surgical Strategy: Using laparoscopic-assisted PSARP, considerations for colostomy, and preserving future options for gynecological reconstruction.
Anatomy & Vascular Concerns: Managing unexpected vascular anomalies and protecting critical structures.
Future Planning: Long-term follow-up for continence, bladder function, and possible tissue engineering solutions for gynecologic needs.

Join us for a fascinating discussion on managing rare anorectal malformations and the careful planning that goes into achieving successful outcomes.

In this video, Dr. Charlie Myer IV from Cincinnati Children's Hospital explores the role of laryngeal sensory reinnervation in children with swallowing and aspiration issues, particularly those with nerve injuries impacting both motor and sensory functions. He reviews the significance of combining motor function restoration with sensory reinnervation to improve swallowing and reduce the risk of aspiration.

Key Points Covered:

Sensory & Motor Balance in Swallowing: Understanding that swallowing involves both motor control and sensory input, and why both are essential for safe swallowing.
Innovative Reinnervation Technique: Connecting the great auricular nerve to the superior laryngeal nerve to enhance sensation and improve swallowing function.
Case Study: A 12-year-old patient with high vagal injury, severe aspiration, and lung complications who experienced remarkable improvement after laryngeal sensory reinnervation.
Results and Challenges: Promising outcomes seen in initial cases, though more research is needed to determine the best timing and long-term effects of this emerging technique.

Join us to learn more about this exciting approach to laryngeal sensory reinnervation and its potential to transform care for children with complex swallowing disorders.

In this recap from our 12th Annual Update Course in Pediatric Surgery, Lizzy Lee introduces a thought-provoking session on Resuscitative Endovascular Balloon Aortic Occlusion (REBOA) for pediatric trauma patients, featuring Drs. Regan Williams and Katie Russell. This emerging technique is categorized as both a Black Diamond (unproven) and Blue Square (newer) practice, sparking valuable discussion among trauma surgeons.

Key Points Discussed:

What is REBOA? A life-saving procedure used to control bleeding by inflating a balloon in the aorta, buying time for surgical intervention.
Pediatric Use Challenges: REBOA is rarely performed in pediatric hospitals, making rapid application difficult, and there is no clear survival advantage in pediatric cases.
Clinical Debate: A case study of a 16-year-old trauma patient illustrates the decision-making process, with most surgeons opting for laparotomy over REBOA.
Algorithm Comparison: When to use REBOA versus resuscitative thoracotomy, based on guidelines from the Western Trauma Association.

Learn more about this complex and evolving topic in pediatric trauma care. Don’t forget to like, comment, and subscribe for more updates from our 12th Annual Pediatric Surgery Update Course!

In this video, Dr. Carl Backer, renowned pediatric surgeon, shares insights on vascular rings and aortic uncrossing at Cincinnati Children's Hospital. Discover the history, diagnosis, and surgical approaches to these complex congenital anomalies that compress the trachea and esophagus, impacting respiratory and digestive health.

Key Points Covered:

History of Vascular Rings: From Dr. Robert Gross's first case in 1945 to the techniques established today.
Diagnostic Process: Importance of chest X-rays, bronchoscopy, CT scans, and echocardiograms in identifying vascular ring anomalies.
Surgical Techniques: How procedures like dividing double aortic arches or addressing Kommerell's diverticulum relieve pressure on vital structures.
Fetal Diagnosis Benefits: Early detection has reduced surgery age, hospital stay, and respiratory complications for newborns.

Tune in to learn how Cincinnati Children’s continues to lead in the treatment of vascular rings and congenital airway anomalies. Don’t forget to like, comment, and subscribe for more pediatric surgical content!

Join us for an insightful discussion with Dr. Jose Peiro, pediatric surgeon and director of endoscopic fetal surgery at Cincinnati Children’s Fetal Care Center, which is the highest-volume fetoscopic center in the nation. Dr. Peiro walks us through the importance of fetal surgery, the role of advanced prenatal diagnostics, and groundbreaking techniques like fetoscopy, open fetal surgery, and the EXIT procedure.

Key Topics Covered:

Prenatal Diagnosis: Utilizing ultrasounds, Doppler, and MRI to detect and evaluate fetal malformations early in gestation.
Fetal Surgery Techniques: The evolution from open fetal surgery to minimally invasive options like fetoscopy to treat conditions such as Twin to Twin Transfusion Syndrome (TTTS), spina bifida, and congenital diaphragmatic hernia (CDH).
EXIT Procedure: A life-saving technique performed at birth to ensure a safe airway for babies with obstructions.
Innovative Outcomes: How fetal surgery has significantly improved survival rates and postnatal outcomes for babies with severe conditions.

Discover how the team at Cincinnati Children’s is pushing the boundaries of fetal care and saving lives before birth. Don't forget to like, comment, and subscribe for more groundbreaking medical content!

We are back with another episode of our Journal of Pediatric Surgery article review podcast. This time we have three publications from the third quarter of 2024, July, August and September issues. This time we're talking to editors Drs. Colin Martin, Casey Calkins and Whit Holcomb joined by authors Drs. Sarah Ullrich, Jason Frischer, Joanne Baerg, Mark Slidell and Omid Madadi-Sanjani.

Host: Em Gootee

0:00 Introduction

0:57 Does Delayed Diagnosis of Hirschsprung Disease Impact Post-operative and Functional Outcomes? A Multi-Center Review From the Pediatric Colorectal and Pelvic Learning Consortium

6:47 Management of Gastroschisis: Timing of Delivery, Antibiotic Usage, and Closure Considerations

13:56 Validation of the Clavien-Madadi Classification for Unexpected Events in Pediatric Surgery: A Collaborative ERNICA Project

18:12 Summary

Articles:

Ullrich S, Austin K, Avansino JR, Badillo A, Calkins CM, Crady RC, Durham MM, Fuller MK, Rana A, Reeder RW, Rentea RM, Rollins MD, Saadai P, Speck KE, Wood RJ, van Leeuwen K, Frischer JS; Pediatric Colorectal and Pelvic Learning Consortium. Does Delayed Diagnosis of Hirschsprung Disease Impact Post-operative and Functional Outcomes? A Multi-Center Review From the Pediatric Colorectal and Pelvic Learning Consortium. J Pediatr Surg. 2024 Jul;59(7):1250-1255. doi: 10.1016/j.jpedsurg.2024.03.034. Epub 2024 Mar 18. PMID: 38677965.

https://pubmed.ncbi.nlm.nih.gov/38677965/

Slidell MB, McAteer J, Miniati D, Sømme S, Wakeman D, Rialon K, Lucas D, Beres A, Chang H, Englum B, Kawaguchi A, Gonzalez K, Speck E, Villalona G, Kulaylat A, Rentea R, Yousef Y, Darderian S, Acker S, St Peter S, Kelley-Quon L, Baird R, Baerg J. Management of Gastroschisis: Timing of Delivery, Antibiotic Usage, and Closure Considerations (A Systematic Review From the American Pediatric Surgical Association Outcomes & Evidence Based Practice Committee). J Pediatr Surg. 2024 Aug;59(8):1408-1417. doi: 10.1016/j.jpedsurg.2024.03.044. Epub 2024 Apr 30. PMID: 38796391.

https://pubmed.ncbi.nlm.nih.gov/38796391/

Madadi-Sanjani O, Kuebler JF, Brendel J, Costanzo S, Granström AL, Aydin E, Loukogeorgakis S, Lacher M, Wiesner S, Domenghino A, Clavien PA, Mutanen A, Eaton S, Ure BM. Validation of the Clavien-Madadi Classification for Unexpected Events in Pediatric Surgery: A Collaborative ERNICA Project. J Pediatr Surg. 2024 Sep;59(9):1672-1679. doi: 10.1016/j.jpedsurg.2024.03.022. Epub 2024 Mar 16. PMID: 38582705.

https://pubmed.ncbi.nlm.nih.gov/38582705/

In this video, Dr. Doug von Allmen from Cincinnati Children’s Hospital shares insights into managing innominate artery compression using a transcervical approach. Originally described in the 1940s, this condition is seen in about 30% of children under 2 years old and can lead to tracheomalacia and obstructive symptoms. Dr. von Allmen reviews the procedure, patient selection, and outcomes from his team’s experience with this approach.

Key Highlights:

Innominate Artery Compression: Causes tracheal compression leading to breathing difficulties, especially in syndromic patients.
Procedure Overview: A transcervical approach to innominate artery pexy, which includes removing the thymus and lifting the artery to relieve tracheal compression.
Patient Case: A 6-month-old with a history of esophageal atresia and tracheoesophageal fistula underwent the surgery with successful outcomes.
Postoperative Results: Improvements in the tracheal lumen, weaning off oxygen, and even decannulation for some patients.

This procedure offers a good alternative in appropriately selected patients, and the team at Cincinnati Children’s Hospital has shown positive results with this approach.

In this episode, we have a guest from the pediatric gynecology department here at Cincinnati Children’s, Dr. Lesley Breech. And she will talk about management of tubal torsion and when to consider salpingectomy.

Host: Em Gootee

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

In this video, Dr. Jose Peiro from Cincinnati Children’s discusses the groundbreaking role of fetoscopy in modern fetal surgery, offering hope for conditions like Twin to Twin Transfusion Syndrome (TTTS), amniotic band syndrome, and congenital diaphragmatic hernia (CDH). Fetoscopy, a minimally invasive technique, allows surgeons to intervene in utero and improve survival outcomes by targeting the root causes of these conditions.

Host: Em Gootee

Key Highlights:

Twin to Twin Transfusion Syndrome (TTTS): Using fetoscopy to photocoagulate blood vessel connections between twins, reducing the risks for both babies.
Amniotic Band Syndrome: Releasing amniotic bands in the womb to prevent potential amputations or complications for the developing fetus.
Congenital Diaphragmatic Hernia (CDH): Performing tracheal occlusion to promote lung development in fetuses with severe CDH, significantly improving survival rates.

In this video, Dr. Sara Zak from Cincinnati Children's Hospital discusses the essential role of flexible bronchoscopy in the management of patients undergoing slide tracheoplasty. She covers its application during the preoperative, intraoperative, and postoperative phases to ensure optimal outcomes.

Key Points:

Preoperative Use: Bronchoscopy helps assess airway anatomy, detect infections, and guide surgical planning for better outcomes.

Intraoperative Use: Ensures proper tube placement, visualizes the airway, and helps clear secretions to avoid complications.

Postoperative Care: Dr. Zak’s retrospective study highlights risk factors predicting the need for urgent bronchoscopy, especially in younger or sicker patients with congenital heart disease or prior airway surgeries.

Join us as we explore how flexible bronchoscopy supports patient care at every stage of slide tracheoplasty and helps reduce post-op complications.

In this podcast, we cover the basics of neuroblastoma including presentation, differentiation, diagnosis and management with Dr. Meera Kotagal.

Host: Em Gootee

0:00 Introduction

1:00 Case 1

8:31 Case 2

11:39 Case 3

13:02 Summary

In this video, we dive into the complexities of tracheal A-frame deformities, a common issue following airway surgeries like tracheostomies or reconstructions.

What Are A-Frame Deformities? A tracheal deformity that typically occurs at the site of a previous tracheostomy, affecting about a third of patients with prior airway surgery.
Challenges in Airway Sizing: Traditional endotracheal tube sizing is unreliable for A-frame deformities due to the oblong shape of the airway, making it crucial to assess both static and dynamic aspects of the deformity.
Symptoms and Progression: Symptoms may take 1-2 years to manifest post-decannulation, often presenting as exercise intolerance, dyspnea, or obstructive sleep apnea.
Surgical Interventions: Dr. Smith demonstrates two approaches for treating A-frame deformities—open repair with tracheoplasty or anterior graft placement, and endoscopic resection using a CO2 laser.
Case Studies: Real-life examples of successful interventions, including a 6-year-old with campomelic dysplasia and a 12-year-old with subglottic and tracheal stenosis, highlighting the effectiveness of both open and endoscopic procedures.

We are back with another episode of our Journal of Pediatric Surgery article review podcast. This time we have three publications from the second quarter of 2024, April, May, and June issues. This time we're talking to editors Drs. Mary Brindle, Alana Beres and Whit Holcomb joined by authors Dr. Michael Livingston, Emma Moore and Prof. Sebastian King.

Host: Em Gootee

0:00 Introduction

0:48 Clinical Characteristics and Prognosis of Biliary Atresia with Low Serum Matrix Metalloproteinase-7 Levels

5:09 Association of Exclusive Breast Milk Intake and Outcomes in Infants With Uncomplicated Gastroschisis

10:57 Transition From Pediatric to Adult Healthcare for Colorectal Conditions: A Systematic Review

15:50 Summary

16:42 Outro

Articles:

Jiang J, Yang Y, Ren X, Xu C, Ye C, Zhou J, Qian M, Wang S, Chen G, Dong R, Zheng S. Clinical Characteristics and Prognosis of Biliary Atresia with Low Serum Matrix Metalloproteinase-7 Levels. J Pediatr Surg. 2024 Apr;59(4):648-652. doi: 10.1016/j.jpedsurg.2023.11.019. Epub 2023 Dec 2. PMID: 38145921.

https://linkinghub.elsevier.com/retrieve/pii/S0022-3468(23)00727-3

Hodgson E, Briatico D, Klapman S, Skarsgard E, Beltempo M, Shah PS, Huisman E, Walton JM, Livingston MH; Canadian Association of Pediatric Surgeons Network (CAPSNet) and Canadian Neonatal Network (CNN) investigators. Association of Exclusive Breast Milk Intake and Outcomes in Infants With Uncomplicated Gastroschisis: A National Cohort Study. J Pediatr Surg. 2024 May;59(5):863-868. doi: 10.1016/j.jpedsurg.2024.01.045. Epub 2024 Feb 3. PMID: 38413262.

https://www.jpedsurg.org/article/S0022-3468(24)00077-0/fulltext

Moore EJ, Sawyer SM, King SK, Tien MY, Trajanovska M. Transition From Pediatric to Adult Healthcare for Colorectal Conditions: A Systematic Review. J Pediatr Surg. 2024 Jun;59(6):1028-1036. doi: 10.1016/j.jpedsurg.2024.02.012. Epub 2024 Feb 23. PMID: 38493027.

https://www.jpedsurg.org/article/S0022-3468(24)00094-0/abstract

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

In this episode of the Colorectal Quiz, hosted by Liza Bokova, a colorectal research fellow at Children's National, we explore a case of a 12-year-old female with a history of cloaca and Mullerian anomaly. Joined by leading experts Dr. Levitt from Children's National, Dr. Frischer from Cincinnati Children's Hospital, Dr. Lesley Breech, and Dr. Veronica Gomez-Lobo, we discuss the importance of gynecologic assessments in patients with anorectal malformations, the challenges of identifying Mullerian anomalies, and the significance of a multidisciplinary approach in patient care.

Key Topics:

Early assessment of Mullerian anomalies in patients with anorectal malformations.
Case discussion on a 12-year-old with a history of cloaca and twin sister advancing in puberty.
Techniques such as vaginoscopy, saline perturbation, hysteroscopy, and MRI for evaluating Mullerian structures.
Collaboration between colorectal, gynecology, and urology teams in patient management.

Tune in to learn from top experts in the field and deepen your understanding of managing these complex cases.

In February 2024, we held our 3rd Best of the Best in Pediatric Surgery live event and we are bringing you the top four key takeaways from that day.

4 APSA, Dr. David Grabski “Post-Operative Opioid Reduction Protocol Reduces Racial Disparity of Clinical Outcome in Children”

3 CAPS, Dr. Matthew Urichuk “Individuals with thoracoabdominal congenital surgical anomalies are at increased risk of adverse mental health outcomes"

2 BAPS, Dr. Shruthi Srinivas "Outcomes from Colonic Pull-Through for Cloacal Exstrophy Differ by Colon Length: A Multi-Institutional Study”

1 IPEG, Dr. Dariusz Patkowski “Thoracoscopic Approach for Long Gap Esophageal Atresia Using the Internal Traction Technique”

In this video, we explore groundbreaking research from Dr. Helmrath and his team at Cincinnati Children's CuSTOM lab, where they are developing methods to grow entire human gastrointestinal (GI) tracts from stem cells. These innovative techniques could revolutionize the treatment of GI disorders.

Key Highlights:

Complexity of the Gut: The GI tract is more than just an epithelial lining—it's a complex system involving nerves, muscles, immune responses, and microbiota.
Lab Achievements: The team has successfully grown human intestines from stem cells, which have been transplanted into animals and shown to be fully functional.
Nerve Integration: Adding nerves to the transplanted tissue enhances vascular growth, making the grafts more effective, particularly for structures like the esophagus.
Tissue Engineering: The team developed methods to create long tubes of GI tissue with integrated nerves and demonstrated peristalsis, critical for creating functional organs.
Clinical Applications: The researchers are working on methods to transplant these tissues into patients, using advanced techniques like hydrogels and UV polymerization to secure the cells in place.

Future Prospects:

Esophageal Strictures and Beyond: This research could lead to new treatments for conditions like esophageal strictures, with potential clinical applications expected within this decade.

In this episode we talk about Kidney transplant with Dr. Jonathan Merola, a transplant surgeon from Cincinnati Children's Hospital. (This content was created from the Grand Rounds lecture at CCHMC)

Host: Cecilia Gigena

We are back with another Update Course Rewind video from the Update Course in Pediatric Surgery 2023.

This time we are presenting you "Who to Send Home from the OR: Partial Thyroidectomy" with Drs. Mark Wulkan, Justin Huntington, Tolulope Oyetunji, & Phillip Ben Ham.

Host: Cecilia Gigena

This video explores the considerations for same day discharge following minimally invasive pectus excavatum repair with intercostal neuro-cryoablation and uncomplicated right thyroid lobectomy. Key Points:

Pectus Excavatum Repair:
Discharge Timing: The majority of surgeons prefer a post-op stay of 2-3 days, but up to 20% consider same day discharge. The effectiveness of cryoablation and intercostal nerve blocks plays a significant role in determining discharge timing.
ERAS Protocol Impact: Combining cryoablation with an Enhanced Recovery After Surgery (ERAS) protocol has shown a reduction in opioid use and length of hospital stay, with many patients able to go home by day two.
Patient and Family Education: Setting expectations about post-op pain and recovery is crucial for successful same day or early discharge.
Thyroid Lobectomy:
Same Day Discharge Feasibility: Approximately 30% of surgeons discharge patients on the same day, with the rest keeping them overnight due to concerns about post-op bleeding and recurrent laryngeal nerve injury.
ATA Guidelines: The American Thyroid Association supports same day discharge for suitable patients, considering clinical, social, and procedural factors.
Complication Management: While the risk of post-op hematoma exists, newer technologies and careful monitoring have reduced its occurrence, making same day discharge more viable.

Summary:

Pectus Excavatum Repair: Same day discharge is possible with cryoablation and ERAS, though most patients are discharged on day two or three based on pain control and patient preference.
Thyroid Lobectomy: Same day discharge is increasingly accepted, particularly with newer surgical techniques and careful patient selection, but overnight observation remains common due to the risk of complications like post-op bleeding.

We are back with another Update Course Rewind video from the Update Course in Pediatric Surgery 2023.

This time we are presenting you "Who to Send Home from the OR: Pectus Excavatum Repair 2023" with Drs. Mark Wulkan, Justin Huntington, Tolulope Oyetunji, & Phillip Ben Ham.

Host: Cecilia Gigena

In this session we discuss different Cryoanalgesia and pain management protocols that may help with same day discharge after a minimally invasive repair of pectus excavatum (MIRPE).

00:00 Introduction

00:33 Case Scenario

01:15 Cryoablation techniques

01:58 Literature Review

02:44 Dr. Oyetunji’s protocol

03:22 Oral pain medication

03:54 Proper time for Same day discharge

04:22 Summary

In this video, we explore the diagnosis and management of esophageal strictures, focusing on the importance of a patient-centered approach and the various techniques available for dilation.

Symptom Assessment: Esophageal stricture symptoms vary by age, oral intake, and stenosis severity. Accurate diagnosis involves evaluating nutritional status and secretion management.
Diagnostic Tools: Endoscopy and esophagram are essential for assessing stricture location, diameter, and extent.
Dilation Techniques: Learn about different tools like controlled radial expansion balloons, hurricane balloons, and bougienage. Understand when and how to use each method safely.
Fluoroscopy Guidance: The advantages of using fluoroscopy for pre- and post-dilation esophagrams, ensuring accurate dilation and detecting complications like perforation.
Incremental Dilation: The importance of cautious, gradual dilation to minimize risks and improve outcomes.
Choosing the Right Method: Tailor the dilation technique to each patient’s anatomy, with a focus on careful scar remnant removal.

We are back with another Update Course Rewind video from the Update Course in Pediatric Surgery 2023.

This time we are presenting you "Who to Send Home from the OR: Pyloromyotomy 2023" with Drs. Mark Wulkan, Justin Huntington, Tolulope Oyetunji, & Phillip Ben Ham.

Host: Cecilia Gigena

In this session you will learn when it is safe to discharge a patient after a routine pyloromyotomy, which differs in the gestational age in those who are less or over 37 weeks.

00:00 Introduction

00:41 1st Case Scenario

01:00 Is Same day discharge possible?

01:29 Literature Review

02:51 2nd Case Scenario

04:01 Is Same Day Discharge safe?

05:33 NSQIP data Analysis

06:30 Summary

We are back with another Update Course Rewind video from the Update Course in Pediatric Surgery 2023.

This time we are presenting you "Who to Send Home from the OR: Laparoscopic Cholecystectomy 2023" with Drs. Mark Wulkan, Justin Huntington, Tolulope Oyetunji, & Phillip Ben Ham.

Host: Cecilia Gigena

In this session you will learn when it is safe to discharge a patient after a routine laparoscopic cholecystectomy.

00:00 Introduction

00:37 Case Scenario

01:02 Strategies for Same Day discharge

01:38 Literature Review

02:32 Summary

Learn about the crucial role of ENT surgeons in the multidisciplinary approach to esophageal atresia repair. This video highlights the benefits of a team approach involving pediatric surgeons, ENTs, GIs, pulmonary specialists, speech therapists, and nutritionists.

Key Points:

Team Collaboration: The importance of utilizing diverse skill sets for optimal patient outcomes.

ENT Surgeon's Perspective: Focusing on future swallowing, recurrent laryngeal nerve health, and preventing potential injuries.

Cervical Approach: Isolating the cervical trachea and esophagus, avoiding nerve damage, and creating a tunnel for colonic interposition.

Simultaneous Operations: Coordinated efforts where one surgeon harvests the graft while another prepares the esophagus.

Case Study: Addressing recurrent tracheoesophageal fistulas and achieving successful outcomes with the aid of ENT expertise.

Why ENT Surgeons are Essential: Their knowledge of head and neck anatomy and experience in complex airway management improve care delivery, outcomes, and reduce operative times.

Immediate Involvement: Engaging ENT specialists early in the process to address complications with voice and swallowing.

We are back with another Update Course Rewind video from the Update Course in Pediatric Surgery 2023.

This time we are presenting you "Who to Send Home from the OR: Non-perforated appendicitis 2023" with Drs. Mark Wulkan, Justin Huntington, Tolulope Oyetunji, & Phillip Ben Ham.

Host: Cecilia Gigena

In this session surgeons discuss when a patient should receive antibiotics, if any, after a Laparoscopic appendectomy for non-perforated appendicitis. Non-operative management is also discussed.

00:00 Introduction

00:38 Case Scenario

01:04 Non-operative management

02:31 Same day discharge after surgery

03:08 NSQIP data analysis

04:10 Summary

We are back with another Update Course Rewind video from the Update course in Pediatric Surgery 2023.

This time we are presenting you "Who to Send Home from the OR: Uncomplicated Buttock Abscess and I&D Part 1" with Drs. Justin Huntington, Tolulope Oyetunji, & Phillip Ben Ham.

Host: Cecilia Gigena

In this video we’ll talk about pediatric surgeon’s perspective on improving the care of TEF/EA patients with Dr. Dan von Allmen, Surgeon-in-Chief at Cincinnati Children’s.

Here are some highlights:

• Historical Milestones: From the first description in the 1600s to Cameron Haight's primary repair in 1941.

• Challenges and Complications: Addressing associated anomalies and the high morbidity linked to traditional thoracotomy.

• Team Approach: The necessity of a multidisciplinary team, including pediatric surgery, ENT, pulmonary, GI, and more.

• Innovative Techniques: Adapting procedures like the tracheal slide for complex cases and leveraging the expertise of specialized surgeons.

• Collaborative Success: Benefits of dual-team operations for efficiency and better patient outcomes.

• Barriers and Solutions: Overcoming financial and systemic challenges to provide optimal care.

In this video we’ll talk about benefits of thoracoscopic tracheoesophageal fistula (TEF) repair in reducing tracheomalacia and improving patient outcomes with Dr. Steve Rothenberg from Rocky Mountain Hospital for Children. Here are some highlights:

Reduced Tracheomalacia: Minimizing tracheal manipulation compared to open surgery.

• Case Study:35-week premature baby with a large esophageal pouch corrected thoracoscopically.

• Enhanced Visualization: Precise dissection and improved outcomes using thoracoscopy.

• Pouch Resection: Efficient resection of leftover pouches with a stapler.

• Upper Pouch Mobilization: Key to successful anastomosis, even in long-gap cases.

• H Type Fistulas: Superior approach with less trauma and better visualization.

In this video we’ll talk about minimally invasive thoracoscopic tracheoesophageal fistula (TEF) repair with Dr. Steve Rothenberg from Rocky Mountain Hospital for Children. This video covers:

Anesthesia: Using CO2 to collapse the lung instead of single lung ventilation.

Patient Positioning: Prone and tilted at 60 degrees for better access.

Surgical Technique: Detailed steps from trocar placement to anastomosis, including tips for mobilizing the upper pouch and managing the fistula.

Visualization: Improved view compared to open surgery, especially for complex cases.

Post-Operative Care: Managing chest drains, preventing hiatal hernias, and suture techniques to avoid strictures.

Cosmetic Outcomes: Minimal scarring and reduced risk of chest wall deformities.

In this video we explore the transformative benefits of thoracoscopic repair for esophageal atresia with Dr. Steve Rothenberg from Rocky Mountain Hospital for Children. This video covers:

Advocating for Minimally Invasive Surgery: The significant benefits of thoracoscopic surgery over traditional thoracotomy, which can lead to shoulder girdle weakness, chest wall asymmetry, and scoliosis in infants.

Pioneering Techniques:The journey from initial PDA ligation to the first successful thoracoscopic TEF repair.

Historical Milestones: Live demonstration of the first thoracoscopic esophageal atresia repair at the IPEG meeting in Berlin, 1999.

Case Studies: Early successes, including Connor, the first baby to undergo thoracoscopic TEF repair, who has thrived since his surgery.

In this episode, we're reviewing the management of choledocholithiasis with with Drs. David Vitale from Cincinnati Children's Hospital & Lucas Neff from Wake Forest Baptist.

Host: Dr. Cecilia Gigena

In this episode we talk about Liver transplant with Dr. Jonathan Merola, a transplant surgeon from Cincinnati Children's Hospital. (This content was created from the Grand Rounds lecture at CCHMC)

Host: Cecilia Gigena

It is already public knowledge that thousands of articles on different pathologies are published every day and that it is very difficult to follow them. In this format we bring you a different way of knowing what is the most up-to-date on a particular topic. In this case, we talked about Cholelithiasis with Dr. Todd Ponsky from Cincinnati Children’s Hospital, Dr. Jose Campos, a Chilean pediatric surgeon part of the Journal Hive team. Hosts: Cecilia Gigena & Em Gootee The articles we mentioned are below, enjoy it! Index Admission Cholecystectomy and Recurrence of Pediatric Gallstone Pancreatitis: Multicenter Cohort Analysis. https://pubmed.ncbi.nlm.nih.gov/35213498/ Machine learning to predict pediatric choledocholithiasis: A Western Pediatric Surgery Research Consortium retrospective study https://pubmed.ncbi.nlm.nih.gov/37580219/ Transcystic Laparoscopic Common Bile Duct Exploration for Pediatric Patients with Choledocholithiasis: A Multi-Center Study https://pubmed.ncbi.nlm.nih.gov/37957103/ Indocyanine green fluorescent cholangiography: The new standard practice to perform laparoscopic cholecystectomy in pediatric patients. https://www.sciencedirect.com/science/article/abs/pii/S003960602300822X Don't forget to like and subscribe to see more entertaining medical educational videos! See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

In November 2023 we held the first Intestinal Rehabilitation webinar with Dr. Paul Wales & Dr. Michael Helmrath, 2 experts from the Intestinal Rehab Center at Cincinnati Children's.

These are the top 5 key takeaways from this webinar!!

The 11th annual Pediatric Surgery Update Course was held as a webinar on August 29, 2022. We had a lot of lively discussion and engaging presentations on the latest updates in pediatric surgery. In this video we are reviewing the top ten key takeaways from the update course.

Host: Em Gootee

0:00 Intro

0:21 #10 POEM Procedure for Achalasia Treatment

1:53 #9 Importance of BCVI Screening in Head Trauma Patients

3:12 #8 Who to send home from the OR?

4:37 #7 ICG Application for Identification of Sentinel Nodes

6:21 #6 Anal Dilation Following PSARP

7:58 #5 Ovarian Cryopreservation

9:41 #4 Massive Transfusion Protocol (MTP)

11:24 #3 Management of Ovarian Torsion

12:55 #2 Total Pancreatectomy with Islet Autotransplantation (TPIAT)

14:21 #1 Management of Blunt Liver & Spleen Trauma

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We are back with a new episode of the Journal of pediatric surgery series.

This time we have the first quarter of 2024.

With editors: Dr. Romeo Ignacio for January, APSA edition, Dr. Mark Davenport for February, BAPS, edition & Dr. Pablo Laje for March, IPEG edition.

Authors: Dr. Katie Russell, Dr. Scott Short & Dr. Bruce Jaffray

Articles:

"Cessation of Antibiotics for Complicated Appendicitis at Discharge Does Not Increase Risk of Post-operative Infection" Russell K. et al.

"What Proportion of Children With Complex Oesophageal Atresia Require Oesophageal Lengthening Procedures?" Phillips L & Jaffray B.

"Long-Term Sensory Function 3 years after Minimally Invasive Repair of Pectus Excavatum with Cryoablation" Eldredge RS et l.

In this episode, we review the symptoms, diagnosis and management of pyloric stenosis with Dr. Alex Bondoc, pediatric surgeon from Cincinnati Children's.

Key Topics Covered:

Common Diagnoses: Exploring potential medical and anatomical conditions, including reflux and cow milk allergy.
Risk Factors: Factors increasing the likelihood of pyloric stenosis, including being a first-born male and family history.
Diagnosis Techniques: Importance of physical exams, lab results, and imaging in diagnosing pyloric stenosis.
Medical and Surgical Management: Discussing fluid and electrolyte resuscitation, medical management options, and the pyloromyotomy procedure.
Post-Operative Care: Tips for families and care teams on managing post-operative care and recovery.

Takeaways:

Importance of a thorough family history and reviewing electrolyte panels and ultrasound results.
The critical role of fluid and electrolyte balance in avoiding morbidity or mortality.
Understanding the surgical options and post-op care to ensure a smooth recovery for infants.

Join us at the 12th Annual Pediatric Surgery Update Course, where top hospital experts from around the US will discuss this year’s changes in practices and innovation. Register today to be at the forefront of medical excellence. Register: https://globalcastmd.pulse.ly/lih4hjjv28

We are back with another Update Course Rewind video from the Update course in Pediatric Surgery 2023.

This time we are presenting you "Who to Send Home from the OR: Gastrostomy 2023" with Drs. Mark Wulkan, Justin Huntington, Tolulope Oyetunji, & Phillip Ben Ham.

If you want to see the full video don't forget to check it in our Youtube channel: https://youtu.be/vVnlVlALVMk

Host: Cecilia Gigena

We're back with another Update Course Rewind from the 11th annual Update Course held in Cleveland in August 2023.

This time we have "Management of Recurrent Pancreatitis" with Dr. Juan Gurria, the Surgical Director of the Pancreas Care Center at Cincinnati Children's Hospital.

Host: Cecilia Gigena

We’re featuring Journal of Pediatric Surgery articles to bring you some of the latest news! This week we are discussing 4 articles from December 2023 issue, with editor Dr. Whit Holcomb and authors Drs. David Diamond, Benjamin Zendejas, Ursula Adams & Michael Phillips Hosts: Cecilia Gigena and Em Gootee Articles: "Successful Adolescent Varicocelectomy Improves Total Motile Sperm Count" Lay R. et al. "Surgical Treatment of Esophageal Anastomotic Stricture After Repair of Esophageal Atresia" Kamran A. et al. "The Role of Diversion During Ileal Pouch Anal Anastomosis (IPAA) Creation in Pediatric Ulcerative Colitis" Adams U. et al. "Birth Admission Length-of-Stay and Hospital Readmission in Children With Congenital Diaphragmatic Hernia" Orlinsky R. et al.

In this episode, we have a guest from the pediatric gynecology department here at Cincinnati Children’s, Dr. Lesley Breech. And she will talk about management of an adnexal torsion with a healthy appearing ovary.

Host: Em Gootee

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

Cincinnati Children's hosted the QUAD conference in October 2022 which was a combination of four conferences: The international organization for is Esophageal atresia, the Aerodigestive Society Conference, the Cincinnati Children's Airway course and the Cincinnati Children's pediatric dysphagia series. In this video series, we will summarize the key takeaway points from each session that has been held at QUAD 2022.

Today, we are here to reviewEA/TEF repair - thoracoscopy vs. thoracotomy, role of ENT with Dr. Catherine Hart, a pediatric otolaryngologist from Cincinnati Children's.

Host: Kim Priban

In this video, we have a guest from the pediatric gynecology department here at Cincinnati Children’s, Dr. Lesley Breech. And she will talk about oophoropexy in adnexal torsion.

Host: Em Gootee

Resources:

ACOG Committee Opinion, Number 783, August 2019 - Adnexal Torsion in Adolescents

https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/08/adnexal-torsion-in-adolescents

Akdam A, Bor N, Fouks Y, Ram M, Laskov I, Levin I, Cohen A. Recurrent Ovarian Torsion: Risk Factors and Predictors for Outcome of Oophoropexy. J Minim Invasive Gynecol. 2022 Aug;29(8):1011-1018. doi: 10.1016/j.jmig.2022.05.007. Epub 2022 May 13. PMID: 35577246.

https://pubmed.ncbi.nlm.nih.gov/35577246/

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We’re featuring Journal of Pediatric surgery articles to bring you some of the latest news!

This week we are discussing 3 articles from November 2023 issue, with editor Dr. Mikko Pakarinen and authors Dr. Bailey Lyttle

Hosts: Cecilia Gigena and Em Gootee

Articles:

"Quality Improvement Campaign Improved Utilization of Rapid Sequence MRI for Diagnosis of Pediatric Appendicitis" Lyttle B. et al.

"Paediatric Adhesive Small Bowel Obstruction is Associated with a Substantial Economic Burden and High Frequency of Postoperative Complications" Håkanson C. et al.

"Thoracoscopic Versus Open Repair for Oesophageal Atresia: A Retrospective Cohort Study of 359 Patients at a Single Center" Zou C. et al.

Cincinnati Children's hosted the QUAD conference in October 2022 which was a combination of four conferences: The international organization for is Esophageal atresia, the Aerodigestive Society Conference, the Cincinnati Children's Airway course and the Cincinnati Children's pediatric dysphagia series. In this video series, we will summarize the key takeaway points from each session that has been held at QUAD 2022.

Today, we are here to review anesthesia for thoracoscopic techniques with Dr. Nathan Tighe, an anesthesiologist from Cincinnati Children's.

Host: Em Gootee

We are back with another Update Course Rewind video from the Update course in Pediatric Surgery 2023.

This time we are presenting you “Management of Chronic Pancreatitis" with Dr. Juan Gurría.

Host: Cecilia Gigena

Brought to you by Cincinnat Children's

Cincinnati Children's hosted the QUAD conference in October 2022 which was a combination of four conferences: The international organization for is Esophageal atresia, the Aerodigestive Society Conference, the Cincinnati Children's Airway course and the Cincinnati Children's pediatric dysphagia series. In this video series, we will summarize the key takeaway points from each session that has been held at QUAD 2022.

Today, we are here to review TEF management, otolaryngology approach with Dr. Mike Rutter, a pediatric otolaryngologist from Cincinnati Children's.

Host: Kim Priban

Cincinnati Children's hosted the QUAD conference in October 2022 which was a combination of four conferences: The international organization for is Esophageal atresia, the Aerodigestive Society Conference, the Cincinnati Children's Airway course and the Cincinnati Children's pediatric dysphagia series. In this video series, we will summarize the key takeaway points from each session that has been held at QUAD 2022.

Today, we are here to continue our review of the complications of button battery & caustic ingestion with Dr. Phil Putnam, a pediatric gastroenterologist from Cincinnati Children's.

Host: Kim Priban

Cincinnati Children's hosted the QUAD conference in October 2022 which was a combination of four conferences: The international organization for is Esophageal atresia, the Aerodigestive Society Conference, the Cincinnati Children's Airway course and the Cincinnati Children's pediatric dysphagia series. In this video series, we will summarize the key takeaway points from each session that has been held at QUAD 2022.

Today, we are here to review complications of button battery & caustic ingestion with Dr. Phil Putnam, a pediatric gastroenterologist from Cincinnati Children's.

Host: Kim Priban

We’re featuring Journal of Pediatric surgery articles to bring you some of the latest news!

This week we are discussing 3 articles from October 2023 issue, with editor Dr. Pablo Laje and authors Thomas Wyllie, and Drs. Mallinath Chakriboth and Elizabeth Speck

Hosts: Cecilia Gigena and Em Gootee

Articles:

"Prophylactic Acid-suppression Medication to Prevent Anastomotic Strictures After Oesophageal Atresia Surgery: A Systematic Review and Meta-analysis" Thomas Wyllie et.al.

"Evaluation and Management of Primary Spontaneous Pneumothorax in Adolescents and Young Adults: A Systematic Review From the APSA Outcomes & Evidence-Based Practice Committee" Speck, E. et al.

"Symptoms Affect Treatment and Prognosis in Pediatric Patients with Congenital Pulmonary Airway Malformation: A Propensity Score Matching Retrospective Cohort Study" Zeng G. et al.

We are back with another Update Course Rewind video from the Update course in Pediatric Surgery 2023.

This time we are presenting you “Peroral Endoscopic Myotomy (POEM) for Achalasia" with Drs. Mikael Petrosyan & Tymothy Kane

Hosts: Dr. Cecilia Gigena

Brought to you by Cincinnati Children's Hospital

Cincinnati Children's hosted the QUAD conference in October 2022 which was a combination of four conferences: The international organization for is Esophageal atresia, the Aerodigestive Society Conference, the Cincinnati Children's Airway course and the Cincinnati Children's pediatric dysphagia series. In this video series, we will summarize the key takeaway points from each session that has been held at QUAD 2022.

Today, we are here to review pharyngeal scar management with Dr. Doug von Allmen, a pediatric otolaryngologist from Cincinnati Children's.

Host: Em Gootee

Our 11th Annual Update Course in Pediatric Surgery was held past August. In this video series, we'll recap the sessions and share the main highlights with you. Today, we'll talk about "Massive Transfusion Protocol". Joining the discussion are Drs. Meera Kotagal & Katie Russell.

Host: Em Gootee

Resources:

https://www.jpedsurg.org/article/S0022-3468(21)00676-X/abstract

Reppucci ML, Pickett K, Stevens J, Phillips R, Recicar J, Annen K, Moulton SL. Massive transfusion in pediatric trauma-does more blood predict mortality? J Pediatr Surg. 2022 Feb;57(2):308-313. doi: 10.1016/j.jpedsurg.2021.09.051. Epub 2021 Oct 8. PMID: 34736771.

https://pubmed.ncbi.nlm.nih.gov/35213410/

Spinella PC, Leonard JC, Marshall C, Luther JF, Wisniewski SR, Josephson CD, Leeper CM; Massive Transfusion In Children (MATIC) Investigators and BloodNet. Transfusion Ratios and Deficits in Injured Children With Life-Threatening Bleeding. Pediatr Crit Care Med. 2022 Apr 1;23(4):235-244. doi: 10.1097/PCC.0000000000002907. Epub 2022 Feb 28. PMID: 35213410.

https://journals.lww.com/jtrauma/abstract/2023/01000/recognizing_life_threatening_bleeding_in_pediatric.14.aspx#:~:text=Pediatric%20critical%20administration%20threshold%20(CAT,activation%20of%20massive%20transfusion%20protocols.

Morgan, Katrina M. MD; Gaines, Barbara A. MD; Richardson, Ward M. MD; Strotmeyer, Stephen PhD; Leeper, Christine M. MD, MS. Recognizing life-threatening bleeding in pediatric trauma: A standard for when to activate massive transfusion protocol. Journal of Trauma and Acute Care Surgery 94(1):p 101-106, January 2023. | DOI: 10.1097/TA.0000000000003784

Join our hosts and special international guests Dr. Stuart Hosie and Dr. Mark Malota from Germany. Together they discuss the management of a young adult with anorectal malformation, the collaborative care delivered, followed by opportunities for and challenges of transitional care in this complex population.

It is already public knowledge that thousands of articles on different pathologies are published every day and that it is very difficult to follow them. In this format we bring you a different way of knowing what is the most up-to-date on a particular topic. In this case, we talked about G-Tube & Fundoplication for GERD in 2023 with Dr. Todd Ponsky from Cincinnati Children’s Hospital And Dr. Jose Campos, a Chilean pediatric surgeon part of the Journal Hive team, the group that chose this articles. The articles we mentioned are below, enjoy it!Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and NutritionEffectiveness of fundoplication at the time of gastrostomy in infants with neurological impairmentGastrostomy Tube Use in Pediatrics: A Systematic ReviewBolus versus continuous feeding regimens post gastrostomy tube placement in children

We’re featuring Journal of Pediatric surgery articles to bring you some of the latest news!This week we are discussing 3 articles from May 2023, the CAPS issue, with editor Dr. Sonia Butterworth and authors Drs. Jacob Langer, Reto Baertschiger & Katerina DukleskaHosts: Cecilia Gigena and Em GooteeArticles:"Hirschsprung-associated inflammatory bowel disease: A multicenter study from the APSA Hirschsprung disease interest group" Sutthatarn P. et.al. "Unanticipated consequences of COVID-19 pandemic policies on pediatric acute appendicitis surgery" Quaglietta P.R. et.al."Utilizing a critical airway response team expedites esophageal button battery removal" Brandt K. et.al.

For the first time in recorded history, firearm injuries in children have exceeded motor vehicle crashes. The deaths from suicide and homicide are both on the rise, particularly and very young. In this Update Course Rewind video, we are presenting you "Pediatric Surgeon and Firearm Injury Prevention" with Dr. Peter Masiakos from University of Massachusetts.Host: Todd Ponsky, MDDon't forget to like and subscribe to see more entertaining medical educational videos! See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We are back with another Update Course Rewind video! This time we are presenting you "Congenital Lung Lesions" with Dr. Charles Snyder from APSA Professional Development Committee.Host: Brittany LevyRegister for #UpdateCourse2023 (Aug 29) here https://globalcastmd.wufoo.com/forms/zcvbzfd1xref8x/Don't forget to like and subscribe to see more entertaining medical educational videos!See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

This is another episode of the StayCurrent Podcast. Here we cover all the important things you need to know about Portal Hypertension. And for that we have the expert Dr. Alex Bondoc, a pediatric surgeon from Cincinnati Children's Hospital.Hosts: Cecilia Gigena & Ellen Encisco

We’re back with twelfth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. This episode, we will review three articles covering the most interesting and relevant topics in the field.These articles are either chosen by JPS editors or APSA Articles of Interest. We present these reviews as short news pieces with a summarization of key points.Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".Host: Em TombashRauh JL, Ganapathy AS, Bosley ME, Rangecroft A, Zeller KA, Sieren LM, Petty JK, Pranikoff T, Neff LP. Making common duct exploration common-balloon sphincteroplasty as an adjunct to transcystic laparoscopic common bile duct exploration for pediatric patients. J Pediatr Surg. 2023 Jan;58(1):94-98. doi: 10.1016/j.jpedsurg.2022.09.016. Epub 2022 Sep 24. PMID: 36283848.https://www.jpedsurg.org/article/S0022-3468(22)00602-9/fulltextWu EY, Curran PL, Zukowski M, King TS, Martin KL, Grant CN. Cervical Collar Clearance in Obtunded Children Presenting Without a Known Traumatic Mechanism: Is Imaging Necessary? J Pediatr Surg. 2023 Aug;58(8):1494-1499. doi: 10.1016/j.jpedsurg.2023.03.003. Epub 2023 Mar 14. PMID: 37029027.https://www.jpedsurg.org/article/S0022-3468(23)00189-6/fulltextTreider M, Engebretsen AH, Skari H, Bjørnland K. Is postoperative transanastomotic feeding beneficial in neonates with congenital duodenal obstruction? Pediatr Surg Int. 2022 Mar;38(3):479-484. doi: 10.1007/s00383-021-05053-3. Epub 2021 Dec 15. PMID: 34910223; PMCID: PMC8831256.https://link.springer.com/article/10.1007/s00383-021-05053-3

We are back with another Update Course Rewind video! This time we are presenting you "Preparing for Penetrating Trauma" with Dr. Bindi Naik-Mathuria from APSA Professional Development Committee.Host: Todd PonskyRegister for #UpdateCourse2023 (Aug 29) herehttps://globalcastmd.wufoo.com/forms/zcvbzfd1xref8x/

We’re featuring Journal of Pediatric surgery articles to bring you some of the latest news! This week we are discussing three articles from the April 2023 issue, the IPEG issue with editor Dr. Mark Wulkan and authors Drs. Luzia Toselli, Chad Thorson and Farokh Demeri Hope you enjoy! Hosts: Em Tombash, Ellen Encisco and Cecilia Gigena Articles:"Novel index to estimate the cephalocaudal extent of the excavation in pectus excavatum: The Titanic index" Gaston Bellía-Munzon et.al. https://www.jpedsurg.org/article/S0022-3468(22)00783-7/fulltext "Pediatric button battery ingestion: A single center experience and risk score to predict severe outcomes" P. Nina Scalise et.al. https://www.jpedsurg.org/article/S0022-3468(22)00790-4/fulltext "Outcomes of laparoscopic versus open resection of pediatric choledochal cyst" Walter A. Ramsey et.al. https://www.jpedsurg.org/article/S0022-3468(22)00799-0/fulltext

We’re back with eleventh episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. This episode, we will review three articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or APSA Articles of Interest. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Tombash

0:00 Introduction

0:45 National trends in pediatric firearm and automobile fatalities

2:06 Gabapentin is Associated With Decreased Postoperative Opioid Use and Length of Stay After Appendectomy in Children With Perforated Appendicitis: A Propensity Score-Matched Analysis

3:22 Evaluating the risk of peri-umbilical hernia after sutured or sutureless gastroschisis closure

4:38 Outro

https://www.jpedsurg.org/article/S0022-3468(22)00621-2/fulltext

Stevens J, Pickett K, Reppucci ML, Nolan M, Moulton SL. National trends in pediatric firearm and automobile fatalities. J Pediatr Surg. 2023 Jan;58(1):130-135. doi: 10.1016/j.jpedsurg.2022.09.028. Epub 2022 Sep 26. PMID: 36307297.

https://www.jpedsurg.org/article/S0022-3468(23)00195-1/fulltext

Lascano D, Zamora AK, Mahdi E, Ourshalimian S, Russell CJ, Kim E, Kelley-Quon LI. Gabapentin is Associated With Decreased Postoperative Opioid Use and Length of Stay After Appendectomy in Children With Perforated Appendicitis: A Propensity Score-Matched Analysis. J Pediatr Surg. 2023 Mar 16:S0022-3468(23)00195-1. doi: 10.1016/j.jpedsurg.2023.03.009. Epub ahead of print. PMID: 37029026.

https://www.jpedsurg.org/article/S0022-3468(22)00250-0/fulltext

Fraser JA, Deans KJ, Fallat ME, Helmrath M, Kabre R, Leys CM, Markel TA, Dillon PA, Downard C, Wright TN, Gadepalli SK, Grabowski JE, Hirschl R, Johnson KN, Kohler JE, Landman MP, Mak GZ, Minneci PC, Rymeski B, Sato TT, Slater BJ, Peter SDS, Fraser JD; Midwest Pediatric Surgery Consortium. Evaluating the risk of peri-umbilical hernia after sutured or sutureless gastroschisis closure. J Pediatr Surg. 2022 Dec;57(12):786-791. doi: 10.1016/j.jpedsurg.2022.03.019. Epub 2022 Mar 26. PMID: 35450699.

We are back with another Update Course Rewind video! This time we are presenting you "Laparotomy Over PPD" with Dr. Paul Jeziorczak from APSA Professional Development Committee.

Host: Ellen Encisco

Register for #UpdateCourse2023 (Aug 28) here

https://globalcastmd.wufoo.com/forms/zcvbzfd1xref8x/

We are back with a somewhat new series of the StayCurrent podcast. We've been highlighting JPS articles every month but now we are also highlighting JPS Case Reports! For the First quarter we have three articles with case reports! The editor was Dr. Pablo Laje and we talk to authors Dr. James Dunn and Dr. Dustin FlanneryHosts: Ellen Encisco, Em Tombash & Cecilia GigenaHope you enjoy!!!"Intestinal lengthening via mechanical enterogenesis in an infant with short gut syndrome" Taylor N. Anderson, Claudia Mueller, James C.Y. Dunn Full article: https://www.sciencedirect.com/science/article/pii/S2213576623000209?via%3Dihub"Synthetic patch infection after congenital diaphragmatic hernia repair: A case series" Sabrina J. Flohr a, Sierra D. Land a, Holly L. Hedrick a b, Natalie E. Rintoul a c, Sanjeev K. Swami d, Dustin D. Flannery Full article: https://www.sciencedirect.com/science/article/pii/S221357662300009X?via%3Dihub"Radical approach to traumatic tracheoesophageal fistula: Use of a biliary stent for esophageal repair in an infant" Michaela Gaffleya, b, 1, *, Torrey Fourrierc, Swati Pawad, Rishi Pawad, Daniel J. Kirsee, Thomas Pranikoff Full article: https://www.sciencedirect.com/science/article/pii/S2213576623000210?via%3Dihub

We’re back with tenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. This episode, we will review three articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or APSA Articles of Interest. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Tombash

0:00 Introduction

0:47 Life-Threatening Bleeding in Children: A Prospective Observational Study

1:53 Standardized perioperative care reduces colorectal surgical site infection in children: A Western Pediatric Surgery Research Consortium multicenter analysis

2:57 Routine contrast enema prior to stoma reversal seems only required following treatment for necrotizing enterocolitis: An evaluation of the diagnostic accuracy of the contrast enema

4:09 Outro

https://pubmed.ncbi.nlm.nih.gov/33990098/

Leonard JC, Josephson CD, Luther JF, Wisniewski SR, Allen C, Chiusolo F, Davis AL, Finkelstein RA, Fitzgerald JC, Gaines BA, Goobie SM, Hanson SJ, Hewes HA, Johnson LH, McCollum MO, Muszynski JA, Nair AB, Rosenberg RB, Rouse TM, Sikavitsas A, Singleton MN, Steiner ME, Upperman JS, Vogel AM, Wills H, Winkler MK, Spinella PC. Life-Threatening Bleeding in Children: A Prospective Observational Study. Crit Care Med. 2021 Nov 1;49(11):1943-1954. doi: 10.1097/CCM.0000000000005075. PMID: 33990098; PMCID: PMC8516672.

https://www.jpedsurg.org/article/S0022-3468(22)00624-8/fulltext

Tobias J, Padilla BE, Lee J, Chen S, Wang KS, Kelley-Quon LI, Mueller C, Shew SB, Joskowitz K, Ignacio RC Jr, Evans LL, Jensen AR, Acker SN, Mason A, Johnson A, McConahey J, Hansen E, Pandya SR, Short SS, Russell KW, Nicassio L, Smith CA, Fialkowski E. Standardized perioperative care reduces colorectal surgical site infection in children: A Western Pediatric Surgery Research Consortium multicenter analysis. J Pediatr Surg. 2023 Jan;58(1):45-51. doi: 10.1016/j.jpedsurg.2022.09.026. Epub 2022 Sep 26. PMID: 36289033.

https://www.jpedsurg.org/article/S0022-3468(22)00433-X/fulltext

Eeftinck Schattenkerk RM, Eeftinck Schattenkerk LD, Musters GD, van Schuppen J, de Jong JR, Gorter RR, de Jonge WJ, van Heurn ELW, Derikx JP. Routine contrast enema prior to stoma reversal seems only required following treatment for necrotizing enterocolitis: An evaluation of the diagnostic accuracy of the contrast enema. J Pediatr Surg. 2023 Mar;58(3):440-444. doi: 10.1016/j.jpedsurg.2022.06.013. Epub 2022 Jun 25. PMID: 35871857.

For the first time in recorded history, firearm injuries in children have exceeded motor vehicle crashes. The deaths from suicide and homicide are both on the rise, particularly and very young. In this Update Course Rewind video, we are presenting you " Firearm Advocacy as a Pediatric Surgeon" with Dr. Marion Henry from University of Chicago.Host: Todd Ponsky, MDRegister for #UpdateCourse2023 (Aug 28) here https://globalcastmd.wufoo.com/forms/zcvbzfd1xref8x/Don't forget to like and subscribe to see more entertaining medical educational videos!See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

This our newest podcast on our series of in brief.Here we discuss everything about Duodenal Atresia with Dr. Juan Gurría a pediatric surgeon from Cincinnati Children's Hospital.Host: Cecilia Gigena

We’re back with ninth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review four articles covering the most interesting and relevant topics in the field.These articles are either chosen by JPS editors or APSA Articles of Interest. We present these reviews as short news pieces with a summarization of key points.Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Tombash

0:00 Introduction

00:53 Effect of transanastomotic feeding tubes on anastomotic strictures in patients with esophageal atresia and tracheoesophageal fistula: The Quebec experience

01:48 Natural history and consequence of patent processus vaginalis: An interim analysis from a multi-institutional prospective observational study

03:04 Primary vs. salvage liver transplantation for biliary atresia: A retrospective cohort study

04:43 Pediatric Social Risk Screening: Leveraging Research to Ensure Equity

06:29 Outro

https://www.jpedsurg.org/article/S0022-3468(21)00625-4/fulltext

LaRusso K, Joharifard S, Lakabi R, Nimer N, Shahi A, Kasasni SM, Lévesque D, Moreau B, Aspirot A, Laberge JM, Faure C, Emil S. Effect of transanastomotic feeding tubes on anastomotic strictures in patients with esophageal atresia and tracheoesophageal fistula: The Quebec experience. J Pediatr Surg. 2022 Jan;57(1):41-44. doi: 10.1016/j.jpedsurg.2021.09.014. Epub 2021 Sep 20. PMID: 34666898.

https://www.jpedsurg.org/article/S0022-3468(22)00603-0/fulltext

Fraser JD, Duran YK, Deans KJ, Downard CD, Fallat ME, Gadepalli SK, Hirschl RB, Lal DR, Landman MP, Leys CM, Mak GZ, Markel TA, Minneci PC, Sato TT, St Peter SD; Midwest Pediatric Surgery Consortium. Natural history and consequence of patent processus vaginalis: An interim analysis from a multi-institutional prospective observational study. J Pediatr Surg. 2023 Jan;58(1):142-145. doi: 10.1016/j.jpedsurg.2022.09.012. Epub 2022 Oct 3. PMID: 36307301.

https://www.jpedsurg.org/article/S0022-3468(22)00004-5/fulltext

Yoeli D, Choudhury RA, Sundaram SS, Mack CL, Roach JP, Karrer FM, Wachs ME, Adams MA. Primary vs. salvage liver transplantation for biliary atresia: A retrospective cohort study. J Pediatr Surg. 2022 Oct;57(10):407-413. doi: 10.1016/j.jpedsurg.2021.12.027. Epub 2022 Jan 10. PMID: 35065808.

https://pubmed.ncbi.nlm.nih.gov/34571253/

Cullen D, Wilson-Hall L, McPeak K, Fein J. Pediatric Social Risk Screening: Leveraging Research to Ensure Equity. Acad Pediatr. 2022 Mar;22(2):190-192. doi: 10.1016/j.acap.2021.09.013. Epub 2021 Sep 24. PMID: 34571253; PMCID: PMC8479442.

The 10th annual Pediatric Surgery Update Course was held as a webinar on August 30, 2022. We had a lot of lively discussion and engaging presentations on the latest updates in pediatric surgery. In this video we are reviewing the top ten key takeaways from the update course.Hosts: Ellen Encisco, Brittany Levy & Todd Ponsky00:00 Intro00:31 #10: Gastroschisis feeding protocols01:48 #9: Management of congenital esophageal stenosis03:07 #8: Outpatient management of intussusception04:49 #7: Mechanical bowel prep & surgical site infections05:55 #6: Advocacy for preventing pediatric gunshot injuries07:19 #5: Efficacy of CT of suspected airway foreign body aspiration08:42 #4: Laparotomy vs peritoneal drainage for NEC10:00 #3: Importance of explicit and implicit bias11:18 #2: Can isolated skull fractures be safely discharged from ER?12:46 #1: Antibiotic treatment for complicated appendicitisFeatured faculty:Beth Rymeski, DO, Cincinnati Children's HospitalJason Fraser, MD, Children's Mercy Hospital Kansas CitySteven L. Lee, MD, MBA, Seattle Children's HospitalDan von Allmen, MD, Cincinnati Children's HospitalAjay Kaul, MD, Cincinnati Children's HospitalSeref S. Kilic, MD, Cukurova University, TurkeyElizabeth Speck, Mott Children's HospitalJustin Huntington, MD, Akron Children's HospitalMark Wulkan, MD, Akron Children's HospitalPaul Jeziorczak, MD, MPH, APSA PDCMarion Henry, MD, MPH, University of ChicagoPeter Masiakos, MD, Massachusetts General HospitalBindi Naik-Mathuria, MD, MPH, UTMB Health Richard Pearl, MD, University of Illinois at ChicagoCharles Snyder, MD, APSA PDC Jose Campos, MD, Chilean Society for Pediatric SurgeryCraig Lillehei, MD, APSA PDC See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-downloadDon't forget to like and subscribe to see more entertaining medical educational videos! See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We’re back with eighth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review four articles covering the most interesting and relevant topics in the field.These articles are either chosen by JPS editors or APSA Articles of Interest. We present these reviews as short news pieces with a summarization of key points. Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".Host: Em Tombash0:00 Introduction0:52 Interhospital variability in localization techniques for small pulmonary nodules in children: A pediatric surgical oncology research collaborative study1:56 Same-day discharge following the Nuss repair: A comparison2:47 Transamniotic stem cell therapy (TRASCET) for intrauterine growth restriction (IUGR): A comparison between placental and amniotic fluid donor mesenchymal stem cells4:32 Optimal Timing of Tracheostomy in Injured Adolescents5:55 Outrohttps://www.jpedsurg.org/article/S0022-3468(22)00139-7/fulltextMorgan KM, Anderson KT, Johnston ME, Dasgupta R, Crowley JJ, Fahy AS, Lapidus-Krol E, Baertschiger RM, Lautz TB, Many BT, Marquart JP, Gainer H, Lal DR, Rich BS, Glick RD, MacArthur TA, Polites SF, Kastenberg ZJ, Short SS, Meyers RL, Talbot L, Abdelhafeez A, Prajapati H, Davidoff AM, Rubaclava N, Newman E, Ehrlich PF, Rothstein DH, Roach JP, Ladd P, Janek KC, Le HD, Leraas HJ, Tracy ET, Bisset L, Mora MC, Warren P, Aldrink JH, Malek MM. Interhospital variability in localization techniques for small pulmonary nodules in children: A pediatric surgical oncology research collaborative study. J Pediatr Surg. 2022 Jun;57(6):1013-1017. doi: 10.1016/j.jpedsurg.2022.01.061. Epub 2022 Feb 23. PMID: 35307194.https://www.jpedsurg.org/article/S0022-3468(21)00635-7/fulltextRettig RL, Rudikoff AG, Annie Lo HY, Lee CW, Vazquez WD, Rodriguez K, Shaul DB, Conte AH, Banzali FM, Sydorak RM. Same-day discharge following the Nuss repair: A comparison. J Pediatr Surg. 2022 Jan;57(1):135-140. doi: 10.1016/j.jpedsurg.2021.09.023. Epub 2021 Sep 20. PMID: 34670678.https://www.jpedsurg.org/article/S0022-3468(22)00685-6/fulltextWhitlock AE, Moskowitzova K, Kycia I, Zurakowski D, Fauza DO. Transamniotic stem cell therapy (TRASCET) for intrauterine growth restriction (IUGR): A comparison between placental and amniotic fluid donor mesenchymal stem cells. J Pediatr Surg. 2023 Feb;58(2):305-309. doi: 10.1016/j.jpedsurg.2022.10.021. Epub 2022 Oct 21. PMID: 36372622.https://pubmed.ncbi.nlm.nih.gov/34192728/Butler EK, Killien EY, Groner JI, Arbabi S, Vavilala MS, Rivara FP. Optimal Timing of Tracheostomy in Injured Adolescents. Pediatr Crit Care Med. 2021 Jul 1;22(7):629-641. doi: 10.1097/PCC.0000000000002681. PMID: 34192728; PMCID: PMC8259766.Don't forget to like and subscribe to see more entertaining medical educational videos! See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We are back with another Update Course Rewind video! This time we are presenting you "Effects of Mechanical Bowel Prep on SSIs" with Dr. Paul Jeziorczak from APSA Professional Development Committee.Host: Ellen EnciscoRegister for #UpdateCourse2023 (Aug 28) here👇 https://globalcastmd.wufoo.com/forms/zcvbzfd1xref8x/Don't forget to like and subscribe to see more entertaining medical educational videos!See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We’re back with a new episode from the intestinal rehabilitation center at Cincinnati Children’s Hospital. This time we’re talking about Cholestasis with Drs. Helmrath and Wales. Hosts: Cecilia Gigena & Ellen Encisco. 00:00 Introduction 00:53 Definition 03:40 Prevention of liver failure 09:10 Proximal jejunostomy take down 10:35 Surgical management of cholestasis 12:40 Long term monitorization 13:56 Summary

We are back with another Update Course Rewind video! This time we are presenting you updates in "Staging and Management of Neuroblastoma" with Dr. Paul Jeziorczak from APSA Professional Development Committee.Host: Ellen EnciscoDon't forget to like and subscribe to see more entertaining medical educational videos!See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We’re featuring Journal of Pediatric surgery articles this week to bring you some of the latest news! This week we are discussing three articles from the March 2023 issue, with editor Dr. Marc Levitt and authors Drs Hira Ahmad, Elizaveta Bokova and Laurens and Robert Eeftinck Schattenkerk.Hosts: Em Tombash, Ellen Encisco and Cecilia Gigena Articles:

"Does presence of a VACTERL anomaly predict an associated gynecologic anomaly in females with anorectal malformations?: A Pediatric Colorectal and Pelvic Learning Consortium Study" Hira Ahmad et. al. Full article: https://www.jpedsurg.org/article/S0022-3468(22)00396-7/fulltext
"Reconstructing the anal sphincters to reverse iatrogenic overstretching following a pull-through for Hirschsprung disease. One-year outcomes" Elizaveta Bokova et.al. Full article: https://doi.org/10.1016/j.jpedsurg.2022.10.052
"Routine contrast enema prior to stoma reversal seems only required following treatment for necrotizing enterocolitis: An evaluation of the diagnostic accuracy of the contrast enema" Robert Eeftinck Schattenkerk et. al. Full article: https://doi.org/10.1016/j.jpedsurg.2022.06.013

We’re back with seventh episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review four articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or APSA Articles of Interest. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Tombash

0:00 Intro

0:53 Impact of rectal dissection technique on primary-school-age outcomes for a British and Irish cohort of children with Hirschsprung disease1:46 The Importance of the ileocecal valve and colon in achieving intestinal independence in infants with short bowel syndrome

2:46 Effect of surgeon volume on pediatric thyroid surgery outcomes: A systematic review

3:49 Tissue adhesive, adhesive tape, and sutures for skin closure of paediatric surgical wounds: prospective randomized clinical trial

4:53 Outro

https://www.jpedsurg.org/article/S0022-3468(22)00340-2/fulltext

Allin BSR, Opondo C, Bradnock T, Kenny SE, Kurinczuk JJ, Walker G, Knight M; For and on behalf of the NETS(2HD) collaboration. Impact of rectal dissection technique on primary-school-age outcomes for a British and Irish cohort of children with Hirschsprung disease. J Pediatr Surg. 2022 Dec;57(12):902-911. doi: 10.1016/j.jpedsurg.2022.05.006. Epub 2022 May 20. PMID: 35934524.

https://www.jpedsurg.org/article/S0022-3468(21)00628-X/fulltext

Peters FB, Bone JN, Van Oerle R, Albersheim S, Casey L, Piper H. The Importance of the ileocecal valve and colon in achieving intestinal independence in infants with short bowel syndrome. J Pediatr Surg. 2022 Jan;57(1):117-121. doi: 10.1016/j.jpedsurg.2021.09.028. Epub 2021 Sep 20. PMID: 34696920.

https://www.jpedsurg.org/article/S0022-3468(21)00834-4/fulltext

Olson SL, Ingram ME, Graffy PM, Murphy PM, Tian Y, Samis JH, Josefson JL, Rastatter JC, Raval MV. Effect of surgeon volume on pediatric thyroid surgery outcomes: A systematic review. J Pediatr Surg. 2022 Sep;57(9):208-215. doi: 10.1016/j.jpedsurg.2021.12.005. Epub 2021 Dec 10. PMID: 34980469.

https://pubmed.ncbi.nlm.nih.gov/35913888/

Tandon S, Ensor ND, Pacilli M, Laird AJ, Bortagaray JI, Stunden RJ, Nataraja RM. Tissue adhesive, adhesive tape, and sutures for skin closure of paediatric surgical wounds: prospective randomized clinical trial. Br J Surg. 2022 Oct 14;109(11):1087-1095. doi: 10.1093/bjs/znac254. PMID: 35913888.

Appendicitis is one of the most common conditions seen by pediatric surgeons but still has many controversies in management. Here is the Rewind of this talk given at the annual Update course 2022 with Drs. Meera Kotagal, Tolu Oyetunji, Shawn St. Peter, and Whit Holcomb Articles discussed: An evidence-based definition for perforated appendicitis derived from a prospective randomized trial Computed Tomography Utilization for the Diagnosis of Acute Appendicitis in Children Decreases With a Diagnostic Algorithm Single daily dosing ceftriaxone and metronidazole vs standard triple antibiotic regimen for perforated appendicitis in children: a prospective randomized trial Same-Day Discharge for Nonperforated Appendicitis in Children: An Updated Institutional Protocol Irrigation Versus Suction Alone During Laparoscopic Appendectomy for Perforated Appendicitis: A Prospective Randomized Trial Decreased resource utilization since initiation of institutional clinical pathway for care of children with perforated appendicitis Safety of a new protocol decreasing antibiotic utilization after laparoscopic appendectomy for perforated appendicitis in children: A prospective observational study Association of Nonoperative Management Using Antibiotic Therapy vs Laparoscopic Appendectomy With Treatment Success and Disability Days in Children With Uncomplicated Appendicitis

The Cincinnati Children's Fetal Care Center—one of the few comprehensive fetal care centers worldwide—offers a unique approach to treating complex and rare fetal conditions. Their team of specialists from Cincinnati Children’s, TriHealth and the University of Cincinnati Medical Center provide the multidisciplinary, collaborative care families need in one location.

In this summary video we are bringing you Dr. Maria del Mar Romero López's research on effects of lung compression in CDH patients.

Host: Em Tombash

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We’re back with sixth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review four articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or APSA Articles of Interest. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Tombash

00:00 Introduction

00:52 The hidden mortality of pediatric firearm violence

01:57 Interfacility helicopter transport to a tertiary pediatric trauma center

03:15 Tu-be or not tu-be? Is routine endotracheal intubation necessary for successful bedside reduction and primary closure of gastroschisis?

04:03 It is time for TEG in pediatric trauma: unveiling meaningful alterations in children who undergo massive transfusion

04:55 Outro

https://www.jpedsurg.org/article/S0022-3468(22)00010-0/fulltext

Theodorou CM, Beyer CA, Vanover MA, Brown IE, Salcedo ES, Farmer DL, Hirose S, Beres AL. The hidden mortality of pediatric firearm violence. J Pediatr Surg. 2022 May;57(5):897-902. doi: 10.1016/j.jpedsurg.2021.12.031. Epub 2022 Jan 10. PMID: 35093255.

https://www.jpedsurg.org/article/S0022-3468(22)00345-1/fulltext

Patterson KN, Beyene TJ, Bergus K, Stafford J, Wurster L, Thakkar RK. Interfacility helicopter transport to a tertiary pediatric trauma center. J Pediatr Surg. 2022 Nov;57(11):637-643. doi: 10.1016/j.jpedsurg.2022.05.010. Epub 2022 May 16. PMID: 35672168.

https://www.jpedsurg.org/article/S0022-3468(21)00482-6/fulltext

Miyata S, Joharifard S, Trudeau MO, Villeneuve A, Yang J, Bouchard S; Canadian Pediatric Surgery Network (CAPSNet). Tu-be or not tu-be? Is routine endotracheal intubation necessary for successful bedside reduction and primary closure of gastroschisis? J Pediatr Surg. 2022 Mar;57(3):350-355. doi: 10.1016/j.jpedsurg.2021.06.011. Epub 2021 Jul 7. PMID: 34304903.

https://pubmed.ncbi.nlm.nih.gov/34533617/

Phillips R, Moore H, Bensard D, Shahi N, Shirek G, Reppucci ML, Meier M, Recicar J, Acker S, Kim J, Moulton S. It is time for TEG in pediatric trauma: unveiling meaningful alterations in children who undergo massive transfusion. Pediatr Surg Int. 2021 Nov;37(11):1613-1620. doi: 10.1007/s00383-021-04944-9. Epub 2021 Sep 17. PMID: 34533617; PMCID: PMC8445780.

Don't forget to like and subscribe to see more entertaining medical educational videos! See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We are back with another Update Course Rewind video! This time we are presenting you "CT Evaluation of Suspected Airway Foreign Body" with Dr. Mary Edwards from APSA Professional Development Committee.Host: Brittany LevySee more lectures, articles, and more on the StayCurrent app! https://www.globalcastmd.com/stay-current-app-download

In this podcast, we cover the basics of malrotation including embryology, presentation, differentiation, diagnosis, surgical approach, and post operative management with Dr. Meera Kotagal.

Host: Em Tombash

00:00 Introduction

00:41 Embryology & Anatomy

03:44 Complications of Malrotation

04:58 Associated Anomalies

05:36 Symptoms & Differential Diagnosis

06:54 Diagnosis & Imaging

07:53 Surgical Treatment Options

12:21 Summary

12:57 Outro

Visuals to understand the topic better (animations & illustration)

https://www.youtube.com/watch?v=vJA1A0v6Aa4

https://www.youtube.com/watch?v=07_xTYr5IOM

https://www.youtube.com/watch?v=AscKR_cQExY

https://www.dropbox.com/s/sznvq70u1odrvf7/Malrotation%202%2001%20Artboard%201.png?dl=0

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We’re back with fifth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review four articles covering the most interesting and relevant topics in the field.These articles are either chosen by JPS editors or APSA Articles of Interest. We present these reviews as short news pieces with a summarization of key points.Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".Host: Em Tombashhttps://www.jpedsurg.org/article/S0022-3468(22)00211-1/fulltextRettig RL, Yang CJ, Ashfaq A, Sydorak RM. Cryoablation is associated with shorter length-of-stay and reduced opioid use after the Ravitch procedure. J Pediatr Surg. 2022 Jul;57(7):1258-1263. doi: 10.1016/j.jpedsurg.2022.02.040. Epub 2022 Mar 13. PMID: 35379492.https://www.jpedsurg.org/article/S0022-3468(21)00795-8/fulltextVogel I, Eeftinck Schattenkerk LD, Venema E, Pandey K, de Jong JR, Tanis PJ, Gorter R, van Heurn E, Musters GD, Derikx JPM. Major stoma related morbidity in young children following stoma formation and closure: A retrospective cohort study. J Pediatr Surg. 2022 Oct;57(10):402-406. doi: 10.1016/j.jpedsurg.2021.11.021. Epub 2021 Nov 27. PMID: 34949444.https://www.jpedsurg.org/article/S0022-3468(21)00676-X/fulltextReppucci ML, Pickett K, Stevens J, Phillips R, Recicar J, Annen K, Moulton SL. Massive transfusion in pediatric trauma-does more blood predict mortality? J Pediatr Surg. 2022 Feb;57(2):308-313. doi: 10.1016/j.jpedsurg.2021.09.051. Epub 2021 Oct 8. PMID: 34736771.https://pubmed.ncbi.nlm.nih.gov/34991128/Ghani MOA, Snyder E, Xu MC, McKay KG, Foster J, Tong C, Clayton DB, Greeno A, Azam B, Zhao S, Hernanz-Schulman M, Lovvorn HN 3rd. Urine leaks in children sustaining blunt renal trauma. J Trauma Acute Care Surg. 2022 Sep 1;93(3):376-384. doi: 10.1097/TA.0000000000003532. Epub 2022 Jan 5. PMID: 34991128.

We are back with another Update Course Rewind video! This time we are presenting you "Intraoperative Radiation Safety" with Dr. Mary Edwards from APSA Professional Development Committee.Host: Brittany LevySee more lectures, articles, and more on the StayCurrent app! https://www.globalcastmd.com/stay-current-app-download

Swenson described the first operation for Hirschsprung disease in the 1940s, which involved a full thickness rectal dissection. To respond to complications related to the dissection adjacent to the rectal wall, several surgeons came up with alternative approaches. Duhamel in 1956 published his technique whereby he left behind the original rectum and mated it to a pulled through segment of colon. A submucosal dissection leaving behind the external rectal wall was the next idea – and this was published by two surgeons. The one we know best is Soave, who published his approach in 1964. Dr. Asa Yancey 12 years earlier, in 1952, published the submucosal technique for Hirschsprung disease ultimately in the Journal of the National Medical Association. He had been denied publication in the most widely read journal of his day because of the color of his skin. This podcast discusses this aspect of pediatric surgical history and promotes a new way to honor both surgeons for their contributions.

We’re featuring new Journal of Pediatric surgery articles this week to bring you some of the latest news! This week we are discussing three articles from the February 2023 issue, the BAPS issue We talk to the editor Dr. Mark Davenport and authors Drs Dariusz Patkowski and Govind Murthi. Also have some feedback from Dr. Beth Rymeski Hosts: Em Tombash, Ellen Encisco and Cecilia Gigena Articles: "Thoracoscopic approach for oesophageal atresia: A real game changer?" Dariusz Patkowsky "The role of stomas in the initial and long-term management of Hirschsprung disease" Murthi G et.al. "A randomised control trial using soap in the prevention of surgical site infection in Tanzania" Philipo GS et.al.

We’re back with fourth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review four articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or APSA Articles of Interest. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Tombash

00:00 Intro

00:46 Does the mechanism matter?

01:55 Decreased ER visits and readmissions after implementation of a standardized perioperative toolkit for children with IBD

02:47 Anti-reflux surgery in children with congenital diaphragmatic hernia

04:15 Use of Antifibrinolytics in Pediatric Life-Threatening Hemorrhage

05:29 Outro

Does the mechanism matter? Comparing thrombelastography between blunt and penetrating pediatric trauma patients

Stevens J, Phillips R, Reppucci ML, Pickett K, Moore H, Bensard D. J Pediatr Surg. 2022 Jul;57(7):1363-1369. doi: 10.1016/j.jpedsurg.2021.09.010. Epub 2021 Sep 20. PMID: 34588132.

Decreased ER visits and readmissions after implementation of a standardized perioperative toolkit for children with IBDShort SS, Rollins MD, Zobell S, Torres H, Guthery S. J Pediatr Surg. 2022 Apr;57(4):604-609. doi: 10.1016/j.jpedsurg.2021.08.016. Epub 2021 Sep 4. PMID: 34583832.

Anti-reflux surgery in children with congenital diaphragmatic hernia: A prospective cohort study on a controversial practice

Montalva L, Carricaburu E, Sfeir R, Fouquet V, Khen-Dunlop N, Hameury F, Panait N, Arnaud A, Lardy H, Schmitt F, Piolat C, Lavrand F, Ballouhey Q, Scalabre A, Hervieux E, Michel JL, Germouty I, Buisson P, Elbaz F, Lecompte JF, Petit T, Guinot A, Abbo O, Sapin E, Becmeur F, Forgues D, Pons M, Kamdem AF, Berte N, Auger-Hunault M, Benachi A, Bonnard A; French Center for Rare Diseases “Congenital Diaphragmatic Hernia”. J Pediatr Surg. 2022 Dec;57(12):826-833. doi: 10.1016/j.jpedsurg.2022.04.017. Epub 2022 Apr 27. PMID: 35618494.

Use of Antifibrinolytics in Pediatric Life-Threatening Hemorrhage: A Prospective Observational Multicenter Study

Spinella PC, Leonard JC, Gaines BA, Luther JF, Wisniewski SR, Josephson CD, Leeper CM; MAssive Transfusion epidemiology and outcomes In Children (MATIC) Investigators and BloodNet. Crit Care Med. 2022 Apr 1;50(4):e382-e392. doi: 10.1097/CCM.0000000000005383. PMID: 34661553.

Don't forget to like and subscribe to see more entertaining medical educational videos! https://www.youtube.com/channel/UC7tyknq3hgjWGVLgLXqV1pA

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We are back with another Update Course Rewind video! This time we are presenting you “Updates in pre-op fasting and NPO Guidelines" with Dr. Mary Edwards from APSA Professional Development Committee.

Host: Brittany Levy

Don't forget to like and subscribe to our YouTube channel to see more entertaining medical educational videos!

See more lectures, articles, and more on the StayCurrent app!

We’re featuring Journal of Pediatric surgery articles this week to bring you some of the latest news!This week we are discussing three articles from the January 2023 issue, the APSA Edition, with editor Dr. Romeo Ignacio and authors Drs Elizabeth Fialkowski, Dr. Jessica Rauh and Dr. Jason FraserHosts: Em Tombash, Ellen Encisco and Cecilia GigenaArticles:"Standardized perioperative care reduces colorectal surgical site infection in children: A Western Pediatric Surgery Research Consortium multicenter analysis" Joseph Tobias et.al.https://www.jpedsurg.org/article/S0022-3468(22)00624-8/fulltext"Making common duct exploration common-balloon sphincteroplasty as an adjunct to transcystic laparoscopic common bile duct exploration for pediatric patients" Jessica Rauh et. al. https://www.jpedsurg.org/article/S0022-3468(22)00602-9/fulltext "Natural history and consequence of patent processus vaginalis: An interim analysis from a multi-institutional prospective observational study" Jason Fraser et. al. https://www.jpedsurg.org/article/S0022-3468(22)00603-0/fulltext

We’re back with third episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review four articles covering the most interesting and relevant topics in the field.These articles are either chosen by JPS editors or APSA Articles of Interest. We present these reviews as short news pieces with a summarization of key points.Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".Host: Em Tombash0:00 Introduction0:45 Puberty and growth in patients with pediatric intestinal failure1:35 Ultrasound-guided percutaneous insertion of Broviac lines in infants less than 5kg: Prospective study of 100 consecutive procedures3:08 Whether prophylactic intraoperative chest drain insertion in esophageal atresia-tracheoesophageal fistula is an evidence-based practice or just a prejudice: A systematic review and meta-analysis4:16 Evaluation of Emergency Department Pediatric Readiness and Outcomes Among US Trauma Centers5:22 OutroPuberty and growth in patients with pediatric intestinal failureCulbreath K, Keefe G, Staffa SJ, Wynne N, Grimstad F, Jimenez L, Jaksic T, Modi BP. Puberty and growth in patients with pediatric intestinal failure. J Pediatr Surg. 2022 Jun;57(6):1045-1049. doi: 10.1016/j.jpedsurg.2022.01.057. Epub 2022 Feb 14. PMID: 35287963.Ultrasound-guided percutaneous insertion of Broviac lines in infants less than 5kg: Prospective study of 100 consecutive proceduresReddy SM, Soccorso G, Lawrence L, Bennett J, Jester I, Pachl M, McGuirk S, Singh M, Bugg N, Gee O, Stansfield J, Bromley PN, Arul GS. Ultrasound-guided percutaneous insertion of Broviac lines in infants less than 5kg: Prospective study of 100 consecutive procedures. J Pediatr Surg. 2022 Nov;57(11):534-537. doi: 10.1016/j.jpedsurg.2022.01.005. Epub 2022 Jan 15. PMID: 35181123.Whether prophylactic intraoperative chest drain insertion in esophageal atresia-tracheoesophageal fistula is an evidence-based practice or just a prejudice: A systematic review and meta-analysisAnand S, Singh A, Krishnan N, Yadav DK. Whether prophylactic intraoperative chest drain insertion in esophageal atresia-tracheoesophageal fistula is an evidence-based practice or just a prejudice: A systematic review and meta-analysis. J Pediatr Surg. 2022 Aug;57(8):1554-1560. doi: 10.1016/j.jpedsurg.2021.06.015. Epub 2021 Jul 8. PMID: 34284871.Evaluation of Emergency Department Pediatric Readiness and Outcomes Among US Trauma CentersNewgard CD, Lin A, Olson LM, Cook JNB, Gausche-Hill M, Kuppermann N, Goldhaber-Fiebert JD, Malveau S, Smith M, Dai M, Nathens AB, Glass NE, Jenkins PC, McConnell KJ, Remick KE, Hewes H, Mann NC; Pediatric Readiness Study Group. Evaluation of Emergency Department Pediatric Readiness and Outcomes Among US Trauma Centers. JAMA Pediatr. 2021 Sep 1;175(9):947-956. doi: 10.1001/jamapediatrics.2021.1319. PMID: 34096991; PMCID: PMC8185631.

Meconium ileus can present with a range of symptoms so here, we cover the basics of presentation, differentiation, diagnosis, surgical approach, and post operative management with Dr. Beth Rymeski.Host: Em TombashDon't forget to like and subscribe to see more entertaining medical educational videos!See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We are back with another Update Course Rewind video. This time we are presenting you “Fetal Endotracheal Occlusion (FETO) for Congenital Diaphragmatic Hernia (CDH)" with Dr. Craig Lillehei from APSA Professional Development Committee.Hosts: Brittany LevyDon't forget to like and subscribe to see more entertaining medical educational videos!See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We’re back with second episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review four articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or APSA Articles of Interest. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Tombash

Congenital lung malformation patients experience respiratory infections after resection: A population-based cohort study

Markel M, Derraugh G, Lacher M, Iqbal S, Balshaw R, Min SAL, Keijzer R. Congenital lung malformation patients experience respiratory infections after resection: A population-based cohort study. J Pediatr Surg. 2022 May;57(5):829-832. doi: 10.1016/j.jpedsurg.2021.12.042. Epub 2022 Jan 13. PMID: 35151496.

Acid suppression duration does not alter anastomotic stricture rates after esophageal atresia with distal tracheoesophageal fistula repair: A prospective multi-institutional cohort study

Bowder AN, Bence CM, Rymeski BA, Gadepalli SK, Sato TT, Szabo A, Arendonk KV, Minneci PC, Downard CD, Hirschl RB, Markel T, Courtney CM, Deans KJ, Fallat ME, Fraser JD, Grabowski JE, Helmrath MA, Kabre RD, Kohler JE, Landman MP, Lawrence AE, Leys CM, Mak G, Port E, Saito J, Silverberg J, Slidell MB, St Peter SD, Troutt M, Wright TN, Lal DR; Midwest Pediatric Consortium. Acid suppression duration does not alter anastomotic stricture rates after esophageal atresia with distal tracheoesophageal fistula repair: A prospective multi-institutional cohort study. J Pediatr Surg. 2022 Jun;57(6):975-980. doi: 10.1016/j.jpedsurg.2022.02.004. Epub 2022 Feb 14. PMID: 35304025.

Optimizing skin antisepsis for neonatal surgery: A quality improvement initiative

Carr S, Gogal C, Afshar K, Ting J, Skarsgard E. Optimizing skin antisepsis for neonatal surgery: A quality improvement initiative. J Pediatr Surg. 2022 Jul;57(7):1235-1241. doi: 10.1016/j.jpedsurg.2022.02.027. Epub 2022 Mar 13. PMID: 35397873.

Nationwide use of REBOA in adolescent trauma patients: An analysis of the AAST AORTA registry

Theodorou CM, Brenner M, Morrison JJ, Scalea TM, Moore LJ, Cannon J, Seamon M, DuBose JJ, Galante JM; AAST AORTA Study Group. Nationwide use of REBOA in adolescent trauma patients: An analysis of the AAST AORTA registry. Injury. 2020 Nov;51(11):2512-2516. doi: 10.1016/j.injury.2020.08.009. Epub 2020 Aug 8. PMID: 32798039; PMCID: PMC7609470.

We're back with another Update Course Rewind video.

This time we are presenting you Management of Esophageal Leaks with Drs.: Carroll "Mac" Harmon Miguel Guelfand Jorge Godoy Michele Ugazzi

Host: Cecilia Gigena

Resources: Mini Endovac creation for esophageal leaks by Dr. Jorge Godoy: https://www.youtube.com/watch?v=3fBFm-o-y_o

Early Management of Esophageal Leak in Esophageal Atresia: Changing Paradigms: www.liebertpub.com/doi/full/10.1089/lap.2020.0099

The 10th Annual Pediatric Surgery Update Course was held on August 30, 2022 in Cleveland, Ohio and was livestreamed to a global audience. The full day symposium is designed to give an update each year on the contemporary management of common problems in pediatric surgery. We highlight what's new in pediatric surgery that you need to know!

This Year 2023 the Update Course will be held on August 28/29th So Stay tuned for more information

Don't forget to like and subscribe to see more entertaining medical educational podcasts! See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We are back with another Update Course Rewind video. This time we are presenting you “Implicit and Explicit Bias" with Dr. Craig Lillehei from APSA Professional Development Committee.

Hosts: Brittany Levy

Introducing "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review four articles covering the most interesting and relevant topics in the field.

These articles are either chosen by JPS editors or APSA Articles of Interest. We present these reviews as short news pieces with a summarization of key points.

Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates".

Host: Em Tombash

Why do subcutaneous ports get stuck? A case-control study

Crook JL, Lu Z, Wang X, Henderson N, Proctor KE, Maller VG, Prajapati HJ, Gold RE, Abdelhafeez AH, Talbot LJ, Pui CH, Davidoff AM, Hoffman JM, Murphy AJ. Why do subcutaneous ports get stuck? A case-control study. J Pediatr Surg. 2022 Sep;57(9):229-233. doi: 10.1016/j.jpedsurg.2021.08.003. Epub 2021 Aug 8. PMID: 34456040.

Major stoma related morbidity in young children following stoma formation and closure: A retrospective cohort study

Vogel I, Eeftinck Schattenkerk LD, Venema E, Pandey K, de Jong JR, Tanis PJ, Gorter R, van Heurn E, Musters GD, Derikx JPM. Major stoma related morbidity in young children following stoma formation and closure: A retrospective cohort study. J Pediatr Surg. 2022 Oct;57(10):402-406. doi: 10.1016/j.jpedsurg.2021.11.021. Epub 2021 Nov 27. PMID: 34949444.

The natural history of prenatally diagnosed congenital pulmonary airway malformations and bronchopulmonary sequestrations

Karlsson M, Conner P, Ehren H, Bitkover C, Burgos CM. The natural history of prenatally diagnosed congenital pulmonary airway malformations and bronchopulmonary sequestrations. J Pediatr Surg. 2022 Oct;57(10):282-287. doi: 10.1016/j.jpedsurg.2022.03.021. Epub 2022 Mar 26. PMID: 35431039.

Trends in Routine Opioid Dispensing After Common Pediatric Surgeries in the United States: 2014-2019

Sutherland TN, Wunsch H, Newcomb C, Hadland SE, Gaskins L, Neuman MD. Trends in Routine Opioid Dispensing After Common Pediatric Surgeries in the United States: 2014-2019. Pediatrics. 2022 May 1;149(5):e2021054729. doi: 10.1542/peds.2021-054729. PMID: 35373305; PMCID: PMC9386619.

We’re featuring Journal of Pediatric surgery articles earlier this week to bring you some of the latest news! This week we are discussing three articles from October, November & December 2022, with editor Dr. Mikko Pakarinen and authors Drs Jason Fraser, Mikael Petrosyan & Dor Yoeli.

Hosts: Em Tombash, Ellen Encisco and Cecilia Gigena

Articles:

October 2022: "Primary vs. salvage liver transplantation for biliary atresia: A retrospective cohort study" Dor Yoeli, Rashikh A Choudhury, Shikha S Sundaram, Cara L Mack, Jonathan P Roach , Frederick M Karrer, Michael E Wachs, Megan A Adams https://www.jpedsurg.org/article/S0022-3468(22)00004-5/fulltext

November 2022: "Per Oral Endoscopic Myotomy (POEM) for pediatric achalasia: Institutional experience and outcomes" Mikael Petrosyan, Shikib Mostammand, Adil A. Shah, Anil Darbari, Timothy D. Kane https://www.jpedsurg.org/article/S0022-3468(22)00181-6/fulltext

December 2022: "Evaluating the risk of peri-umbilical hernia after sutured or sutureless gastroschisis closure" James A. Fraser, Katherine J. Deans, Mary E. Fallat, Michael Helmrath, Rashmi Kabre, Charles M. Leys, Troy A. Markel, Patrick A. Dillon, Cynthia Downard, Tiffany N. Wright, Samir K. Gadepalli, Julia E. Grabowski, Ronald Hirschl, Kevin N. Johnson, Jonathan E. Kohler, Matthew P. Landman, Grace Z. Mak, Peter C. Minneci, Beth Rymeski, Thomas T. Sato, Bethany J. Slater, Shawn D. St Peter, Jason D. Fraser on behalf of theMidwest Pediatric Surgery Consortium https://www.jpedsurg.org/article/S0022-3468(22)00250-0/fulltext

Don't forget to like and subscribe to see more entertaining medical educational videos! See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

Join our hosts and special international guest Dr. Carlos Reck-Burneo from Vienna, Austria to discuss the case of a fetus with intraabdominal cyst discovered at 28 weeks.

We are back with another Update Course Rewind video. This time we are presenting you “the latest innovations that we believe are transforming healthcare”.

Hosts: Em Tombash, Ramy Shaaban

We separated the latest innovations into two categories; innovations for medical/surgical educational purposes & clinical purposes. In this video we'll explore how medical escape rooms, virtual reality, surgical simulators, game changing patient ID tags and telementoring are innovating healthcare.

A medical escape room is an experience in which a team of players cooperatively discover clues, solve puzzles, and accomplish tasks to complete a medical goal, such as clinical decision making and case management. When used effectively, these rooms can act as a low-cost, high-impact resource for learners.

VR can be used to ease anxiety before procedures or during imaging, and can also help improve post-op pain. In some cases, VR can be used to reduce the need for sedation or general anesthesia during minor surgical procedures.

Telementoring helps experts guide less experienced healthcare professionals from a remote location through telecommunication technology. Previous research has shown that telementoring can be used effectively and reliably as a surgical training aid. There are several technologies available for telementoring, allowing clinicians to virtually ‘scrub in’ to any operating room from anywhere in the world.

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We’re back with the fifth episode of our image guided surgery video series! In this episode we're discussing the advantages and disadvantages of using 3D printed models in orthopedics reconstruction cases in hybrid OR with some of our Interventional Radiology and Orthopedics Surgeon colleagues at Cincinnati Children’s Hospital. Our guests Drs. Joel Sorger, John Racadio and Neil Johnson are joined by Nicole Hilvert.

Hosts: Ellen Encisco, MD, Em Tombash, MD

With image guided surgery, surgeon uses real-time images of the inside of the body during an operation. These images are generally produced by a combination of X-rays, ultrasound, CT's etc.

Hybrid OR (operating room) at Cincinnati Children’s is a collaboration between Radiology’s Dr. John Racadio and Surgeon-in-Chief Dr. Daniel von Allmen. The hybrid OR offers imaging capabilities in a sterile operating room.

It creates an environment for surgeons and interventional radiologists to combine their individual skills and expertise in order to benefit patient care. The room is equipped with X-ray, fluoroscopy (live X-ray), ultrasound and C-arm Cone Beam computed tomography (CBCT). Surgeons work together in the hybrid OR with interventional radiologists, who specialize in using these imaging technologies.

Imaging can be performed just before the surgery to help plan the procedure, during the surgery to identify important anatomy or disease, and after the surgery to evaluate results in the hybrid OR. Any surgery requiring radiologic imaging including open and minimally invasive surgeries, may take place in the hybrid OR.

The hybrid OR at Cincinnati Children’s opened in 2018 and serves for general surgery, urology, orthopedic surgery, neurosurgery, pulmonology, and many more.

Follow StayCurrent MD on social media!

Instagram: www.instagram.com/staycurrentmd/

Twitter: www.twitter.com/StayCurrentMD

Facebook: www.facebook.com/staycurrentsurgery

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

In this session we highlighted the Key points of the talk that Drs. Jason Fraser, Beth Rymeski, and Steven Lee give at the Update Course 2022.

Hope you enjoy it, if you like it give us a like or leave a comment!

And remember this Rewind was made by Cincinnati Children's Hospital to spread information to the world

If you want to see the articles go to the Stay Current app, they are linked below!!!

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We’re back with the fourth episode of our image guided surgery video series! In this episode we're discussing different pulmonary cases in hybrid OR with some of our Interventional Radiology and Pediatric Pulmonologist colleagues at Cincinnati Children’s Hospital. Our guests Drs. Chris Towe, Gregory Burg, Erik Hysinger, John Racadio are joined by Nicole Hilvert and Carolyn Wallace.Hosts: Ellen Encisco, MD, Em Tombash, MD0:00 Introduction2:22 First Case7:02 Second Case15:36 SummaryWith image guided surgery, surgeon uses real-time images of the inside of the body during an operation. These images are generally produced by a combination of X-rays, ultrasound, CT's etc.Hybrid OR (operating room) at Cincinnati Children’s is a collaboration between Radiology’s Dr. John Racadio and Surgeon-in-Chief Dr. Daniel von Allmen. The hybrid OR offers imaging capabilities in a sterile operating room.It creates an environment for surgeons and interventional radiologists to combine their individual skills and expertise in order to benefit patient care. The room is equipped with X-ray, fluoroscopy (live X-ray), ultrasound and C-arm Cone Beam computed tomography (CBCT). Surgeons work together in the hybrid OR with interventional radiologists, who specialize in using these imaging technologies.Imaging can be performed just before the surgery to help plan the procedure, during the surgery to identify important anatomy or disease, and after the surgery to evaluate results in the hybrid OR. Any surgery requiring radiologic imaging including open and minimally invasive surgeries, may take place in the hybrid OR.The hybrid OR at Cincinnati Children’s opened in 2018 and serves for general surgery, urology, orthopedic surgery, neurosurgery, pulmonology, and many more.

Dr. José Campos is back, this time helping us review some of the latest literature on the management of gastroschisis in children. In this podcast, we're reviewing a typical case with Dr. Todd Ponsky and incorporating literature from the last few years.Hosts: Ellen Encisco, Em Tombash and Cecilia GigenaChen Y, Zhao J, Alganabi M, Mesas-Burgos C, Eaton S, Wester T, Pierro A. Elective Delivery versus Expectant Management for Gastroschisis: A Systematic Review and Meta-Analysis. https://pubmed.ncbi.nlm.nih.gov/35817335/Allin BSR, Opondo C, Kurinczuk JJ, Baird R, Puligandla P, Skarsgard E, Knight M; on behalf of the BAPS-CASS/NETS /CAPSNet/CNN gastroschisis collaborations. Management of Gastroschisis: Results From the NETS2G Study, a Joint British, Irish, and Canadian Prospective Cohort Study of 1268 Infants. https://pubmed.ncbi.nlm.nih.gov/33201118/Miyata S, Joharifard S, Trudeau MO, Villeneuve A, Yang J, Bouchard S; Canadian Pediatric Surgery Network (CAPSNet). Tu-be or not tu-be? Is routine endotracheal intubation necessary for successful bedside reduction and primary closure of gastroschisis?https://pubmed.ncbi.nlm.nih.gov/34304903/Fraser JD, Deans KJ, Fallat ME, Helmrath MA, Kabre R, Leys CM, Burns RC, Corkum K, Dillon PA, Downard CD, Gadepalli SK, Grabowski JE, Hernandez E, Hirschl RB, Johnson KN, Kohler JE, Landman MP, Landisch RM, Lawrence AE, Mak GZ, Minneci PC, Rymeski B, Sato TT, Scannell M, Slater BJ, Wilkinson KH, Wright TN, St Peter SD; Midwest Pediatric Surgery Consortium. Sutureless vs sutured abdominal wall closure for gastroschisis: Operative characteristics and early outcomes from the Midwest Pediatric Surgery Consortium. https://pubmed.ncbi.nlm.nih.gov/32151403/

Check out this StayCurrent Short, where Dr. Rebeccah Brown gives us insight into the workup and management of Pilomatrixoma. Don't forget to like and subscribe to see more entertaining medical educational videos!See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

The 10th Annual Pediatric Surgery Update Course was held on August 30, 2022 in Cleveland, Ohio and was livestreamed to a global audience. The full day symposium is designed to give an update each year on the contemporary management of common problems in pediatric surgery. We highlight what's new in pediatric surgery that you need to know!In this session we are summarizing the main topics on this talk.As hosts we have Brittany Levy and Cecilia GigenaTopics and articles discussed:1. Spontaneous pneumothoraxChanging the Paradigm for Management of Pediatric Primary Spontaneous Pneumothorax: A Simple Aspiration Test Predicts Need for OperationConservative versus Interventional Treatment for Spontaneous Pneumothorax2. Asymptomatic spontaneous pneumomediastinumAre esophagrams indicated in pediatric patients with spontaneous pneumomediastinum?3. Equivocal US for appendicitisCost-Effectiveness of Diagnostic Approaches to Suspected Appendicitis in Children4. Straddle injuriesPediatric female genital trauma managed under conscious sedation in the emergency department versus general anesthesia in the operating room- a single center comparison of outcomes and cost5. Loss of consciousness with negative CTAdmission of Pediatric Concussion Injury Patients: Is It Necessary?6. IntussusceptionOutpatient management of intussusception: a systematic review and meta-analysis7. Skull fracturesObservation for isolated traumatic skull fractures in the pediatric population: unnecessary and costly

We are featuring Journal of Pediatric surgery articles earlier this week to bring you some of the latest news!This week we are discussing two articles from the september 2022 issue with editor Dr. Whit Holcomb and authors Drs. Raval Mehul and Roman SydorakHosts: Em Tombash, Ellen Encisco and Cecilia GigenaArticles: "Effect of surgeon volume on pediatric thyroid surgery outcomes: A systematic review" Sydney L. Olson et. al. https://www.jpedsurg.org/article/S0022-3468(21)00834-4/fulltext"Same day discharge for pectus excavatum-is it possible?" Luke Rettig et.al.https://www.jpedsurg.org/article/S0022-3468(21)00114-7/fulltext

We’re back with the third episode of our image guided surgery video series! In this episode we're discussing deep brain electrode placement with ROSA robot in hybrid OR with some of our Interventional Radiology and Pediatric Neurosurgery colleagues at Cincinnati Children’s Hospital. Our guests are Dr. Francesco Mangano, Dr. John Racadio and Nicole Hilvert. And we’re joined by Dr. Denise Liu, radiology resident at University of Toledo.Hosts: Rod Gerardo, MD, Em Tombash, MDWith image guided surgery, surgeon uses real-time images of the inside of the body during an operation. These images are generally produced by a combination of X-rays, ultrasound, CT's etc.Hybrid OR (operating room) at Cincinnati Children’s is a collaboration between Radiology’s Dr. John Racadio and Surgeon-in-Chief Dr. Daniel von Allmen. The hybrid OR offers imaging capabilities in a sterile operating room.It creates an environment for surgeons and interventional radiologists to combine their individual skills and expertise in order to benefit patient care. The room is equipped with X-ray, fluoroscopy (live X-ray), ultrasound and C-arm Cone Beam computed tomography (CBCT). Surgeons work together in the hybrid OR with interventional radiologists, who specialize in using these imaging technologies.Imaging can be performed just before the surgery to help plan the procedure, during the surgery to identify important anatomy or disease, and after the surgery to evaluate results in the hybrid OR. Any surgery requiring radiologic imaging including open and minimally invasive surgeries, may take place in the hybrid OR.The hybrid OR at Cincinnati Children’s opened in 2018 and serves for general surgery, urology, orthopedic surgery, neurosurgery, pulmonology, and many more.

We're featuring Journal of Pediatric Surgery articles earlier in the week to bring you some of the latest news! This week we're discussing two articles from the September 2022 issue, with editor Dr. Whit Holcomb and authors Drs. Andrew Murphy, Michelle Yang, Bradly Yoder & Katie RussellHosts: Ellen Encisco, Cecilia Gigena.Articles:"Why do subcutaneous ports get stuck? A case-control study" Jennifer Crook et.al. https://www.jpedsurg.org/article/S0022-3468(21)00537-6/fulltext "Operative repair in congenital diaphragmatic hernia: How long do we really need to wait?" Kyley Cox https://www.jpedsurg.org/article/S0022-3468(22)00091-4/fulltext

Dr. José Campos is back, this time helping us review some of the latest literature on the diagnosis and management of pilonidal disease in children. In this podcast, we're reviewing a typical case with Dr. Todd Ponsky and incorporating literature from the last few years.Hosts: Ellen Encisco, Em Tombash and Cecilia GigenaHardy EJO, Herrod PJ, Doleman B, Phillips HG, Ranat R, Lund JN. Surgical interventions for the treatment of sacrococcygeal pilonidal sinus disease in children: A systematic review and meta-analysis. https://pubmed.ncbi.nlm.nih.gov/30940347/Prieto JM, Checchi KD, Kling KM, Ignacio RC, Bickler SW, Saenz NC, Fairbanks TJ, Nicholson SI, Lazar DA. Trephination versus wide excision for the treatment of pediatric pilonidal disease. https://pubmed.ncbi.nlm.nih.gov/31301885/Erculiani M, Mottadelli G, Carlini C, Barbetta V, Dusio MP, Pini Prato A. Long-term results of EPSiT in children and adolescents: still the right way to go. https://pubmed.ncbi.nlm.nih.gov/35779104/Şengül S, Güler Y, Çalış H, Kubat M, Karabulut Z. Crystallized phenol treatment vs excision and primary closure in pilonidal sinus disease: A randomized clinical trial in adolescent patients. https://pubmed.ncbi.nlm.nih.gov/33814182/

Join Dr. Todd Ponsky for a refresher on the anatomy, workup, and management of Pediatric Inguinal Hernia. This video has quick hits the surgical trainee needs to know for rounds, exams, and clinical care.

We're featuring Journal of pediatric surgery articles earlier in the week to bring you some of the latest news!This week we're discussing two articles from the September 2022 issue, with the editor Dr. Whit Holcomb and Authors Drs Andrew Murphy and Hafeez AbdelhafeezHosts: Em Tombash and Cecilia Gigena Articles: "Management of intravascular thrombus in cases of bilateral Wilms tumor or horseshoe kidney" Pattamon Sutthatarn a , b , Oswaldo Gomez Quevedo a , Joesph Gleason a , c , Andrew M. Davidoffa , d , Andrew J. Murphya , d , ∗DOI: https://www.jpedsurg.org/article/S0022-3468(21)00534-0/fulltext"Indocyanine green–guided nephron-sparing surgery for pediatric renal tumors" Abdelhafeez H. Abdelhafeez a , b , ∗, Andrew J. Murphy a , b , Rachel Brennan c , Teresa C. Santiago d , Zhaohua Lu e , Matthew J. Krasin f , John J. Bissler g , Joseph M. Gleason a , h , Andrew M. DavidoffDOI: https://www.jpedsurg.org/article/S0022-3468(21)00566-2/fulltext

We’re back with a new episode from the intestinal rehabilitation center at Cincinnati Children’s Hospital. This time we’re talking about peptides that enteroendocrine cells secretes with Drs. Helmrath and Wales.Hosts: Ellen Encisco, Cecilia GigenaArticles for further reading:Safety and Efficacy of Teduglutide in Pediatric Patients with Intestinal Failure due to Short Bowel Syndrome: A 24-Week, Phase III Study. https://aspenjournals.onlinelibrary.wiley.com/doi/full/10.1002/jpen.1690Outcomes from a 12-Week, Open-Label, Multicenter Clinical Trial of Teduglutide in Pediatric Short Bowel Syndrome.https://pubmed.ncbi.nlm.nih.gov/27855998/Experience With Teduglutide in Pediatric Short Bowel Syndrome: First Real-life Datahttps://pubmed.ncbi.nlm.nih.gov/32804906/ Enteroendocrine cells couple nutrient sensing to nutrient absorption by regulating ion transport. https://www.nature.com/articles/s41467-020-18536-z

We're featuring Journal of Pediatric Surgery articles earlier in the week to bring you some of the latest news! This week we're discussing two articles from the August 2022 issue, with editor Dr. Pablo Laje and authors Drs. Reza Shojaeian and Mehran Hiradfar. Hosts: Ellen Encisco, Cecilia Gigena, Em Tombash Articles: "Sentinel lymph node biopsy in pediatric Wilms tumor" Ramin Sadeghi, Reza Shojaeian, Mehran Hiradfar, Ahmad Mohammadipour, Ali Azadmand, Mahdi Parvizi Mashhadi DOI:https://doi.org/10.1016/j.jpedsurg.2021.12.037

Extracorporeal Membrane Oxygenation (ECMO) and its complications in newborns with congenital diaphragmatic hernia" Latoya A. Stewart, Rafael Klein-Cloud, Claire Gerall, Lynn L. Simpson, Wendy K. Chung, Vincent P. Duron DOI:https://doi.org/10.1016/j.jpedsurg.2021.12.028

Listen to Zuopeng Wang gave his presentation of "Rapamycin Induces Autophagy And Apoptosis In Kaposiform Hemangioendothelioma Primary Cells In Vitro" at the first ever Best of the Best in Pediatric Surgery event.

Listen to Isabel Hageman gave her presentation of "Perioperative Opioid Use In Pediatric Inguinal Hernia Patients- A Systematic Review And Retrospective Audit Of Practice" at the first ever Best of the Best in Pediatric Surgery event.

Learn about the importance of collaboration between pediatric surgery and pediatric gastroenterology through a variety of pediatric polyposis syndromes.

Listen to Kayla Briggs gave her presentation of "Fundoplication without Esophagocrural Sutures- Long-term Follow-up from a Randomized Trial" at the first ever Best of the Best in Pediatric Surgery event.

Listen to Lucas Neff gave his presentation of "Balloon Sphincteroplasty in Laparoscopic Common Bile Duct Exploration- Tips, Tricks, and Troubleshooting" at the first ever Best of the Best in Pediatric Surgery event.

Listen to Richard Wagner gave his presentation of "Circular RNA profiles isolated from amniotic fluidscan distinguish between CDH survivors and non-survivers" at the first ever Best of the Best in Pediatric Surgery event.

Listen to Kasra Khalaj gave his presentation of "MicroRNAs in amniotic fluid stem cellextracellular vesicles modulate lung development in experimental congenital diaphragmatic hernia" at the first ever Best of the Best in Pediatric Surgery event.

Listen to Sara Choi gave her presentation of "The use of urine sodium to creatinine ratio as a marker of total body sodium in infants with intestinal failure" at the first ever Best of the Best in Pediatric Surgery event.

Listen to Michael Cowap gave his presentation of "Educational Outcomes in School Age Children with a History of Hirschsprung’s Disease" at the first ever Best of the Best in Pediatric Surgery event.

Listen to R. Luke Rettig gave his presentation of "Is same day discharge possible following the Nuss repair for pectus excavatum" at the first ever Best of the Best in Pediatric Surgery event.

Listen to Kathryn LaRusso gave her presentation of "Effect of transanastomotic feeding tubes on anastomotic strictures in patients with esophageal atresia and tracheoesophageal fistula- the Quebec experience" at the first ever Best of the Best in Pediatric Surgery event.

In this episode, hosts Em, Todd and Ramy are talking to Matt Bramlet, MD about his experience on 3D Printing & VR Surgical Planning and implementation of these technologies to their daily practice.

About Dr. Matt Bramlet...

Dr. Matthew Bramlet is the lead investigator for Advanced Imaging and Modeling at Jump Simulation. He specializes in children with congenital heart disease. In his role as the Director of Congenital Cardiac MRI at OSF HealthCare Children’s Hospital of Illinois, Dr. Bramlet combined the program’s resources with those at Jump to pioneer anatomically accurate 3D congenital heart models.

This expertise has led to Dr. Bramlet becoming a curator with the NIH 3D Print Exchange’s Heart Library, a nationwide collaborative effort to improve the education and understanding of congenital cardiac anatomy. He is also an Assistant Professor of Pediatrics in the Pediatric Cardiology department at the University of Illinois College of Medicine Peoria.

Listen all episodes of Transforming Healthcare here: https://rss.com/podcasts/transforming-healthcare/

We're featuring Journal of Pediatric Surgery articles earlier in the week to bring you some of the latest news! This week we're discussing two articles from the August 2022 issue, with editor Dr. Pablo Laje and authors Drs. Shawn St. Peter and Sachit Anand.

Hosts: Ellen Encisco, Cecilia Gigena

Articles: Briggs KB, Svetanoff WJ, Fraser JA. Fundoplication without esophagocrural sutures: Long-term follow-up of a randomized clinical trial. Journal of pediatric surgery. 2022 Aug 1;57(8):1499-503. https://www.jpedsurg.org/article/S0022-3468(21)00836-8/fulltext

Anand S, Singh A, Krishnan N, Yadav DK. Whether prophylactic intraoperative chest drain insertion in esophageal atresia-tracheoesophageal fistula is an evidence-based practice or just a prejudice: a systematic review and meta-analysis. Journal of Pediatric Surgery. 2021 Jul 8. https://www.jpedsurg.org/article/S0022-3468(21)00487-5/fulltext

Check out the app for the companion infographic and more podcasts!

We're back with the second part of discussing surgical management with Drs. Michael Helmrath and Paul Wales from Intestinal Rehabilitation Center at Cincinnati Children's Hospital.

Hosts: Ellen Encisco & Em Tombash

Don't forget to like and subscribe to see more entertaining medical educational videos! www.youtube.com/c/StayCurrentMD

See more lectures, articles, and more on the Stay Current app: globalcastmd.com/stay-current-app-download

Here's the July 2022 issue of JPS article highlights. This time we're talking to Dr. Mary Brindle and authors Drs. Erik Skarsgard, Dunya Moghul and Sophie Carr.

Hosts: Ellen Encisco, Em Tombash, Cecilia Gigena

Articles:

Wang Z, Han Q, Wang J, Yao W, Wang L, Li K. Rapamycin induces autophagy and apoptosis in Kaposiform hemangioendothelioma primary cells in vitro. J Pediatr Surg. 2022 Jul;57(7):1274-1280. doi: 10.1016/j.jpedsurg.2022.02.032. Epub 2022 Mar 13. PMID: 35428493. https://pubmed.ncbi.nlm.nih.gov/35428493/

Moghul D. Mission impossible, made possible: Two GAP Fellows escape from Afghanistan. J Pediatr Surg. 2022 Jul;57(7):1189-1195. doi: 10.1016/j.jpedsurg.2022.02.021. Epub 2022 Feb 27. PMID: 35410710. https://pubmed.ncbi.nlm.nih.gov/35410710/

Carr S, Gogal C, Afshar K, Ting J, Skarsgard E. Optimizing skin antisepsis for neonatal surgery: A quality improvement initiative. J Pediatr Surg. 2022 Jul;57(7):1235-1241. doi: 10.1016/j.jpedsurg.2022.02.027. Epub 2022 Mar 13. PMID: 35397873. https://pubmed.ncbi.nlm.nih.gov/35397873/

Don't forget to like and subscribe to see more entertaining medical educational videos! https://www.youtube.com/c/StayCurrentMD

See more lectures, articles, and more on the Stay Current app: https://globalcastmd.com/stay-current-app-download

We're back with a new topic, discussing surgical management with Drs. Michael Helmrath and Paul Wales from Intestinal Rehabilitation Center at Cincinnati Children's Hospital.

Hosts: Ellen Encisco & Em Tombash

Resources: Bianchi A. Intestinal loop lengthening--a technique for increasing small intestinal length. J Pediatr Surg. 1980 Apr;15(2):145-51. doi: 10.1016/s0022-3468(80)80005-4. PMID: 7373489. https://pubmed.ncbi.nlm.nih.gov/7373489/

Bianchi A. Intestinal lengthening: an experimental and clinical review. J R Soc Med. 1984;77 Suppl 3(Suppl 3):35-41. PMID: 6471060; PMCID: PMC1440516. https://pubmed.ncbi.nlm.nih.gov/6471060/

Bianchi A. Longitudinal intestinal lengthening and tailoring: results in 20 children. J R Soc Med. 1997 Aug;90(8):429-32. doi: 10.1177/014107689709000804. PMID: 9306995; PMCID: PMC1296456. https://pubmed.ncbi.nlm.nih.gov/9306995/

Bianchi A. Experience with longitudinal intestinal lengthening and tailoring. Eur J Pediatr Surg. 1999 Aug;9(4):256-9. doi: 10.1055/s-2008-1072258. PMID: 10532271. https://pubmed.ncbi.nlm.nih.gov/10532271/

Kim HB, Fauza D, Garza J, Oh JT, Nurko S, Jaksic T. Serial transverse enteroplasty (STEP): a novel bowel lengthening procedure. J Pediatr Surg. 2003 Mar;38(3):425-9. doi: 10.1053/jpsu.2003.50073. PMID: 12632361. https://pubmed.ncbi.nlm.nih.gov/12632361/

Kim HB, Lee PW, Garza J, Duggan C, Fauza D, Jaksic T. Serial transverse enteroplasty for short bowel syndrome: a case report. J Pediatr Surg. 2003 Jun;38(6):881-5. doi: 10.1016/s0022-3468(03)00115-5. PMID: 12778385. https://pubmed.ncbi.nlm.nih.gov/12778385/

Garnett GM, Kang KH, Jaksic T, Woo RK, Puapong DP, Kim HB, Johnson SM. First STEPs: serial transverse enteroplasty as a primary procedure in neonates with congenital short bowel. J Pediatr Surg. 2014 Jan;49(1):104-7; discussion 108. doi: 10.1016/j.jpedsurg.2013.09.037. Epub 2013 Oct 5. PMID: 24439591. https://pubmed.ncbi.nlm.nih.gov/24439591/

Don't forget to like and subscribe to see more entertaining medical educational videos! https://www.youtube.com/c/StayCurrentMD

See more lectures, articles, and more on the Stay Current app: https://globalcastmd.com/stay-current-app-download

Check out this week's stay current short for a review of the workup and management of ovarian torsion in the pediatric patient, with Dr. Dasgupta.

Here's the June 2022 issue of JPS article highlights. This time we're talking to Dr. Nicole Chandler and authors Drs. Elizabeth Beierle, Marcus Malek, Biren Modi, Amelia Collings and Katherine Flynn O'Brien.

Hosts: Ellen Encisco, Em Tombash

00:00 Introduction 01:56 Impact of “Stay-at-Home” orders on non-accidental trauma - A multi-institutional study 06:22 Metastatic human hepatoblastoma cells exhibit enhanced tumorigenicity, invasiveness and a stem cell-like phenotype 09:18 Interhospital variability in localization techniques for small pulmonary nodules in children- A pediatric surgical oncology research collaborative study 12:26 Puberty and growth in patients with pediatric intestinal failure 15:08 Conclusion

Articles: Collings AT, Farazi M, Van Arendonk K, Fallat ME, Minneci PC, Sato TT, Speck KE, Deans KJ, Falcone RA, Foley DS, Fraser JD, Keller MS, Kotagal M, Landman MP, Leys CM, Markel T, Rubalcava N, St Peter SD, Flynn-O'Brien KT; Midwest Pediatric Surgery Consortium. Impact of "Stay-at-Home" orders on non-accidental trauma: A multi-institutional study. J Pediatr Surg. 2022 Jun;57(6):1062-1066. https://www.jpedsurg.org/article/S0022-3468(22)00130-0/fulltext

Marayati R, Julson JR, Bownes LV, Quinn CH, Hutchins SC, Williams AP, Markert HR, Beierle AM, Stewart JE, Hjelmeland AB, Mroczek-Musulman E, Beierle EA. Metastatic human hepatoblastoma cells exhibit enhanced tumorigenicity, invasiveness and a stem cell-like phenotype. J Pediatr Surg. 2022 Jun;57(6):1018-1025. https://www.jpedsurg.org/article/S0022-3468(22)00129-4/fulltext

Morgan KM, Anderson KT, Johnston ME, Dasgupta R, Crowley JJ, Fahy AS, Lapidus-Krol E, Baertschiger RM, Lautz TB, Many BT, Marquart JP, Gainer H, Lal DR, Rich BS, Glick RD, MacArthur TA, Polites SF, Kastenberg ZJ, Short SS, Meyers RL, Talbot L, Abdelhafeez A, Prajapati H, Davidoff AM, Rubaclava N, Newman E, Ehrlich PF, Rothstein DH, Roach JP, Ladd P, Janek KC, Le HD, Leraas HJ, Tracy ET, Bisset L, Mora MC, Warren P, Aldrink JH, Malek MM. Interhospital variability in localization techniques for small pulmonary nodules in children: A pediatric surgical oncology research collaborative study. J Pediatr Surg. 2022 Jun;57(6):1013-1017. https://www.jpedsurg.org/article/S0022-3468(22)00139-7/fulltext

Culbreath K, Keefe G, Staffa SJ, Wynne N, Grimstad F, Jimenez L, Jaksic T, Modi BP. Puberty and growth in patients with pediatric intestinal failure. J Pediatr Surg. 2022 Jun;57(6):1045-1049. https://www.jpedsurg.org/article/S0022-3468(22)00132-4/fulltext

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

All surgeons need to know about vascular access. Here we review some preoperative, operative, and postoperative considerations of pediatric vascular access with Dr. Alex Bondoc from Cincinnati Children's Hospital, including indications, contraindications, work-up considerations, tips for placement, and postoperative considerations. Featuring information about locking solutions with Dr. Paul Wales.

Hosts: Rod Gerardo, Ellen Encisco, Brittany Levy

Watch the whole video on the app! https://staycurrentapp.app.link/qwI3bwa9ktb

There is a lot to know when it comes to ovarian tumors! Here, Dr. Roshni Dasgupta, from Cincinnati Children's, breaks down the highlights for us.

Host: Brittany Levy

Check out the video on the app to see all the visuals!

Looking forward to seeing you at our 10th Annual Update Course in Pediatric Surgery August 30th for an exciting day of practice changing learning and debate with our friends from Cincinnati Children's Hospital Medical Center, Children's Mercy Kansas City, #APSA, Akron Children's Hospital, #JPedSurg, Mattel Children’s Hospital UCLA & John R. Oishei Children's Hospital! Register today! https://gcmd.co/3QR4isf Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

Here's the May 2022 issue of JPS article highlights. This time we're talking to Dr. Sonia Buttterworth and authors Drs. Dr. Christina Theodorou, Michael Cowap, Richard Keijzer, Gareth Gilna, and Chad Thorson.

Hosts: Ellen Encisco, Brittany Levy, Em Tombash

Articles: Theodorou CM, Beyer CA, Vanover MA. The hidden mortality of pediatric firearm violence. https://www.jpedsurg.org/article/S0022-3468(22)00010-0/fulltext

Cowap M, Derraugh G, Shawyer AC. Educational outcomes in school age children with a history of isolated Hirschsprung disease are equivalent to their peers. https://www.jpedsurg.org/article/S0022-3468(22)00019-7/fulltext

Gilna GP, Stoler J, Saberi RA. Analyzing pediatric bicycle injuries using geo-demographic data. https://www.jpedsurg.org/article/S0022-3468(22)00013-6/fulltext

Register for the 2022 Pediatric Surgery Update Course: globalcastmd.wufoo.com/forms/zjvig871ne79wa/. And join us on August 30 at 9 am EDT!

Did you miss our 9th Annual Update Course last year?

Don't worry, we are summarizing our favorite sessions from years past.

In this episode, Drs. Steven Lee, Shawn St. Peter, Victor García, Steven Rothenberg, Whit Holcomb, & Justin Wagner will talk you through some updates in pain control management and tricks for the Nuss procedure.

Hosts: Dr Todd Ponsky, Dr Ellen Encisco & Dr Cecilia Gigena

Also, Mark your calendars for our next 10 Annual Update course 2022 in August 30! Join us: https://globalcastmd.wufoo.com/forms/zjvig871ne79wa/

The differential diagnosis for an ovarian cyst is broad. Join Dr. Roshni Dasgupta for tips and tricks for the work up and management of Ovarian Cysts in pediatric patients.

Dr. José Campos is back, this time helping us review some of the latest literature on the diagnosis and management of Esophageal Atresia in children. In this podcast, we're reviewing a typical case with Dr. Todd Ponsky and incorporating literature from the last few years.

Hosts: Rod Gerardo, Ellen Encisco and Em Tombash

Articles if you want to follow along;

Lal DR, Gadepalli SK, Downard CD, Ostlie DJ, Minneci PC, Swedler RM, Chelius TH, Cassidy L, Rapp CT, Billmire D, Bruch S, Burns RC, Deans KJ, Fallat ME, Fraser JD, Grabowski J, Hebel F, Helmrath MA, Hirschl RB, Kabre R, Kohler J, Landman MP, Leys CM, Mak GZ, Raque J, Rymeski B, Saito JM, St Peter SD, von Allmen D, Warner BW, Sato TT; Midwest Pediatric Surgery Consortium. Challenging surgical dogma in the management of proximal esophageal atresia with distal tracheoesophageal fistula: Outcomes from the Midwest Pediatric Surgery Consortium. J Pediatr Surg. 2018 Jul;53(7):1267-1272. doi: 10.1016/j.jpedsurg.2017.05.024. Epub 2017 Jun 1. PMID: 28599967.

https://pubmed.ncbi.nlm.nih.gov/28599967/

LaRusso K, Joharifard S, Lakabi R, Nimer N, Shahi A, Kasasni SM, Lévesque D, Moreau B, Aspirot A, Laberge JM, Faure C, Emil S. Effect of transanastomotic feeding tubes on anastomotic strictures in patients with esophageal atresia and tracheoesophageal fistula: The Quebec experience. J Pediatr Surg. 2022 Jan;57(1):41-44. doi: 10.1016/j.jpedsurg.2021.09.014. Epub 2021 Sep 20. PMID: 34666898.

https://www.jpedsurg.org/article/S0022-3468(21)00625-4/pdf

Anand S, Singh A, Krishnan N, Yadav DK. Whether prophylactic intraoperative chest drain insertion in esophageal atresia-tracheoesophageal fistula is an evidence-based practice or just a prejudice: A systematic review and meta-analysis. J Pediatr Surg. 2022 Aug;57(8):1554-1560. doi: 10.1016/j.jpedsurg.2021.06.015. Epub 2021 Jul 8. PMID: 34284871.

https://pubmed.ncbi.nlm.nih.gov/34284871/

Kainth D, Anand S, Singh A, Bajpai M. Impact of preservation of the azygos vein during surgical repair of esophageal atresia-tracheoesophageal fistula (EA-TEF): a systematic review and meta-analysis. Pediatr Surg Int. 2021 Aug;37(8):983-989. doi: 10.1007/s00383-021-04913-2. Epub 2021 Apr 27. PMID: 33907863.

https://pubmed.ncbi.nlm.nih.gov/33907863/

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

Pediatric trauma is the number one cause of death in kids over 1 year old. Blunt abdominal trauma makes up 80% of those cases. Join Dr. Richard Falcone for a review of work up and management algorithms for pediatric abdominal trauma.

The PAPS winner at the Best of the Best in Pediatric Surgery event on April 8th, 2022 was Sophie Carr with her presentation "Optimizing skin antisepsis for neonatal surgery".

The IPEG winner at the Best of the Best in Pediatric Surgery event on April 8th, 2022 was Caressa Chen with her presentation "NoLapse- The Stomal Prolapse Prevention Device".

The APSA winner at the Best of the Best in Pediatric Surgery event on April 8th, 2022 was Nathan Rubalcava with his presentation "A contrast challenge is safe in children with adhesive small bowel obstruction- a multi-institutional review".

The diagnosis and management of skin and subcutaneous lesions can be vast. Join Dr. Rebeccah Brown for tips and tricks in identification of pediatric skin and subcutaneous lesions in this Staycurrent Short.

We're back with the April issue of JPS article highlights. This time we're talking to Dr. Paul Tam and authors Dr. Natalie Lopyan and Dr. Christina Theodorou.

Hosts: Em Tombash, Rod Gerardo, Brittany Levy

Lopyan NM, Perrone EE, Gadepalli SK, et al. Current status of subspecialization in pediatric surgery: A focus on fetal surgery. J Pediatr Surg. 2022;57(4):610-615. doi:10.1016/j.jpedsurg.2021.05.008

Theodorou CM, Stokes SC, Jackson JE, et al. Efficacy of clinical-grade human placental mesenchymal stromal cells in fetal ovine myelomeningocele repair. J Pediatr Surg. 2022;57(4):753-758. doi:10.1016/j.jpedsurg.2021.05.025

Dzhuma K, Powis M, Vujanic G, et al. Surgical management, staging, and outcomes of Wilms tumours with intravascular extension: Results of the IMPORT study. J Pediatr Surg. 2022;57(4):572-578. doi:10.1016/j.jpedsurg.2021.08.023

We’re back with the second episode of our image guided surgery video series! In the second part of this episode we're discussing lung nodule resection in hybrid OR with some of our Interventional Radiology and Pediatric Surgery colleagues at Cincinnati Children’s Hospital. Our guests are Dr. Anusua "Roshni" Dasgupta, Dr. John Racadio, Dr. Neil Johnson and Nicole Hilvert. And we’re joined by Dr. Denise Liu, radiology resident at University of Toledo.

Hosts: Rod Gerardo, MD, Em Tombash, MD

With image guided surgery, surgeon uses real-time images of the inside of the body during an operation. These images are generally produced by a combination of X-rays, ultrasound, CT's etc.

Hybrid OR (operating room) at Cincinnati Children’s is a collaboration between Radiology’s Dr. John Racadio and Surgeon-in-Chief Dr. Daniel von Allmen. The hybrid OR offers imaging capabilities in a sterile operating room.

It creates an environment for surgeons and interventional radiologists to combine their individual skills and expertise in order to benefit patient care. The room is equipped with X-ray, fluoroscopy (live X-ray), ultrasound and C-arm Cone Beam computed tomography (CBCT). Surgeons work together in the hybrid OR with interventional radiologists, who specialize in using these imaging technologies.

Imaging can be performed just before the surgery to help plan the procedure, during the surgery to identify important anatomy or disease, and after the surgery to evaluate results in the hybrid OR. Any surgery requiring radiologic imaging including open and minimally invasive surgeries, may take place in the hybrid OR.

The hybrid OR at Cincinnati Children’s opened in 2018 and serves for general surgery, urology, orthopedic surgery, neurosurgery, pulmonology, and many more.

Don't forget to like and subscribe to see more entertaining medical educational videos!

Follow StayCurrent MD on social media! Instagram: www.instagram.com/staycurrentmd/ Twitter: www.twitter.com/StayCurrentMD Facebook: www.facebook.com/staycurrentsurgery

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

We’re back with the second episode of our image guided surgery video series! In the first part of this episode we're discussing long nodule localization in hybrid OR with some of our Interventional Radiology and Pediatric Surgery colleagues at Cincinnati Children’s Hospital. Our guests are Dr. Anusua "Roshni" Dasgupta, Dr. John Racadio, Dr. Neil Johnson and Nicole Hilvert. And we’re joined by Dr. Denise Liu, radiology resident at University of Toledo.

Hosts: Rod Gerardo, MD, Em Tombash, MD

Check out this week's episode with everything the surgical trainee needs to know about the work up, management, and types of biliary atresia with Dr. Greg Tiao from Cincinnati Children's Hospital.

Gastric volvulus is a rare pathology for the pediatric surgical patient and when it happens, you want to be ready for potential surgical intervention. In this episode, Dr. Jason Frischer discusses the basics of diagnosis and management for gastric volvulus.

Non operative management for traumatic injuries of the spleen is nothing earth shattering today but that's thanks in part to the work of Dr. David Wesson nearly 4 decades ago. In this episode, we go back in time to when Dr. Wesson and the pediatric surgeons at Toronto's Hospital for Sick Children made a lot of people think twice about when to do a splenectomy.

Host: Rod Gerardo

We've discussed ARM and PSARP plenty of times on this podcast but what if the patient also has a significant cardiac anomaly? What's the best way to proceed? Dr. Marc Levitt and Dr. Jason Frischer discuss the complex considerations with guest Dr. Megan Durham.

Host: Rod Gerardo, MD

Are you having difficulty keeping the 5 types of choledochal cyst straight? Each has unique anatomy and management principles. Join Dr. Alexander Bondoc in an overview of Choledochal Cysts for the surgical trainee.

🚀Join us at the International #aerodigestive #QUAD2022 Conference from October 10th - 14th in Cincinnati, Ohio! (remote attendance option available) Register here: https://bit.ly/3wqUqMa

multidisciplinary #pedsurg #esophagealatresia #dysphagia #airway #SoMe4PedSurg

The surgical management for laryngotracheal stenosis has changed a lot over recent years. Here, Dr. Michael Rutter, MD – the director of the Aerodigestive Center at Cincinnati Children’s Hospital will discuss the principles of both endoscopic and open airway surgery for these complex pediatric patients. https://bit.ly/3wxLLsY If you want to learn more about pediatric ENT surgery, register for the QUAD Conference, October 10-14th in Cincinnati, OH https://bit.ly/3wqUqMa

Today is #NECday so we went back to a conversation between Dr. Todd Ponsky and Dr. Gail Besner about necrotizing enterocolitis. Enjoy this Stay Current Throwback on NEC.

https://pubmed.ncbi.nlm.nih.gov/34506326/

The steps for a Thymic Sling procedure are difficult to understand and sometimes more difficult to see. Here, Dr. Brittany Levy, MD will follow Dr. Mike Rutter, MD as he walks her through this complicated procedure but to make things more easily visible, Dr. Levy will be using play dough!

If you want to learn more about pediatric ENT surgery, register for the QUAD Conference, October 10-14th in Cincinnati, OH https://gcmd.co/3vZRQOn

Kudos to all of the amazing individuals and societies who came together to create a truly unique and enlightening event, but there could only be one winner.... Congratulations to Kasra Khalaj, PhD, MSc and the Canadian Association for Pediatric Surgeons.

"Administration of amniotic fluid stem cell extracellular vesicles regenerates the lung epithelium in fetal rats with CDH at translationally relevant developmental stages"

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

Hernia repair is the second most common operation performed by pediatric surgeons – which is why you do not want to miss our upcoming event: Pediatric Laparoscopic Hernia Repair 2022. Sessions include inguinal hernia controversies, laparoscopic vs open repair, how to manage incarceration and so much more! Mark your calendars: May 20th 9am – 11am EST hosted by Dr. Todd Ponsky, MD from Cincinnati Children's Hospital Medical Center .

pedsurg #pediatricsurgery #SoMe4PedSurg #medicaleducation

Sign up today! https://bit.ly/3kG4ATG

The PAPS winner at the Best of the Best in Pediatric Surgery event on April 8th, 2022 was Sophie Carr with her presentation "Optimizing skin antisepsis for neonatal surgery".

The IPEG winner at the Best of the Best in Pediatric Surgery event on April 8th, 2022 was Caressa Chen with her presentation "NoLapse- The Stomal Prolapse Prevention Device".

pedsurg #pediatricsurgery #SoMe4PedSurg #medicaleducation

Full video: https://bit.ly/3koIuoJ See more lectures, articles, and more on the Stay Current app: https://bit.ly/3KfxMMH

Did you miss the Pediatric Colorectal and Pelvic Learning Consortium session from our 2021 Pediatric Surgery Update Course? Don’t worry, in this Update Course Rewind Dr. Rebecca Rentea from Children's Mercy at Kansas City and Dr. Caitlin Smith from Seattle Children's reviewed the latest literature. Here we present the highlights.

Check out Pediatric Colorectal and Pelvic Learning Consortium (PCPLC) on www.pcplc.org for more information!

Hosted by: Rod Gerardo, Ellen Encisco

Articles: Ahmad H, Skeritt C, Halleran DR, Rentea RM, Reck-Burneo CA, Vilanova-Sanchez A, Weaver L, Langer JC, Diefenbach KA, Gasior AC, Levitt MA, Wood RJ. Are routine postoperative dilations necessary after primary posterior sagittal anorectoplasty? A randomized controlled trial. https://pubmed.ncbi.nlm.nih.gov/34049690/

Irfan A, Hu A, Martin LY, Jelin EB, Garcia AV, Jancelewicz T, Boss E, Nasr IW, Rhee DS. Comparing 30-day outcomes between early versus delayed repair of anorectal malformations with perineal or rectovestibular fistulas: An analysis of the ACS NSQIP-Pediatric database. https://pubmed.ncbi.nlm.nih.gov/33023749/

Kawaguchi AL, Guner YS, Sømme S, Quesenberry AC, Arthur LG, Sola JE, Downard CD, Rentea RM, Valusek PA, Smith CA, Slidell MB, Ricca RL, Dasgupta R, Renaud E, Miniati D, McAteer J, Beres AL, Grabowski J, Peter SDS, Gosain A; American Pediatric Surgical Association Outcomes and Evidence-Based Practice (OEBP) Committee. Management and outcomes for long-segment Hirschsprung disease: A systematic review from the APSA Outcomes and Evidence Based Practice Committee. https://pubmed.ncbi.nlm.nih.gov/33993978/

Vilanova-Sanchez A, Ivanov M, Halleran DR, Wagner A, Reck-Burneo CA, Ruth B, FIsher M, Ahmad H, Weaver L, Nash O, Buker D, Rentea RM, Hoover E, Maloof T, Wood RJ, Levitt MA. Total Colonic Hirschsprung's Disease: The Hypermotility and Skin Rash Protocol. https://pubmed.ncbi.nlm.nih.gov/31430765/

Baxter KJ, Garza JM, Rollins MD, Drake K, Reeder RW, Wood R, Avansino J, Calkins CM, Ralls M, Garvey EM, Durham MM; Pediatric Colorectal and Pelvic Learning Consortium (PCPLC). Multi-institutional review of bowel management strategies in children with anorectal malformations. https://pubmed.ncbi.nlm.nih.gov/32616413/

Kastenberg ZJ, Taylor MA, Durham MM, Calkins CM, Rentea RM, Wood RJ, Avansino JR, Levitt MA, van Leeuwen KD, Lewis KE, Reeder RW, Rollins MD. Perioperative and long-term functional outcomes of neonatal versus delayed primary endorectal pull-through for children with Hirschsprung disease: A pediatric colorectal and pelvic learning consortium study. https://pubmed.ncbi.nlm.nih.gov/34052005/

Halleran DR, Smith CA, Fuller MK, Durhm MM, Dickie B, Avansino JR, Tirrell TF, Vandewalle R, Reeder R, Drake KR, Bates DG, Rollins MD, Levitt MA, Wood RJ; Pediatric Colorectal and Pelvic Learning Consortium. Measure twice and cut once: Comparing endoscopy and 3D cloacagram for the common channel and urethral measurements in patients with cloacal malformations. https://pubmed.ncbi.nlm.nih.gov/31784103/

Rentea RM, Halleran DR, Vilanova-Sanchez A, Lane VA, Reck CA, Weaver L, Booth K, DaJusta D, Ching C, Fuchs ME, Jayanthi RR, Levitt MA, Wood RJ. Diagnosis and management of a remnant of the original fistula (ROOF) in males following surgery for anorectal malformations. https://pubmed.ncbi.nlm.nih.gov/30879755/

Wood RJ, Reck-Burneo CA, Dajusta D, Ching C, Jayanthi R, Bates DG, Fuchs ME, McCracken K, Hewitt G, Levitt MA. Cloaca reconstruction: a new algorithm which considers the role of urethral length in determining surgical planning. https://pubmed.ncbi.nlm.nih.gov/29132797/

Reck-Burneo CA, Lane V, Bates DG, Hogan M, Thompson B, Gasior A, Weaver L, Dingemans AJM, Maloof T, Hoover E, Gagnon R, Wood R, Levitt M. The use of rotational fluoroscopy and 3-D reconstruction in the diagnosis and surgical planning for complex cloacal malformations. https://pubmed.ncbi.nlm.nih.gov/31027906/

We're back with the March issue of JPS article highlights. This time we're talking to editor Dr.Mikko Pakarinen and authors Drs. Selcuk Kilic, Scott Short and Michael Rollins with Dr. Todd Ponsky.

Hosts: Ellen Encisco, Em Tombash & Brittany Levy

Articles:

Neogi S, Banerjee A, Panda SS, Ratan SK, Narang R. Laparoscopic versus open appendicectomy for complicated appendicitis in children: A systematic review and meta-analysis. J Pediatr Surg. 2022 Mar;57(3):394-405. doi: 10.1016/j.jpedsurg.2021.07.005. Epub 2021 Jul 13. PMID: 34332757.

Kılıç ŞS, Serdar İskit H. Management and clinical outcomes of congenital esophageal stenosis in pediatric patients: Experience of a tertiary referral center. J Pediatr Surg. 2022 Mar;57(3):518-525. doi: 10.1016/j.jpedsurg.2021.06.006. Epub 2021 Jun 25. PMID: 34229876.

Short SS, Zobell S, Gaddis K, Mammen L, Wynne E, Rollins MD. Use of expedited post-operative protocol for children undergoing appendicostomy reduces length of hospitalization. J Pediatr Surg. 2022 Mar;57(3):406-409. doi: 10.1016/j.jpedsurg.2021.03.053. Epub 2021 Apr 5. PMID: 33962760.

The EUPSA winner at the Best of the Best in Pediatric Surgery event on April 8th, 2022 was Maja Joosten & Joyce-Manyi Bakia with their presentation "Training of the steps of the transanal endorectal pull-trough on a take home simulation model".

The APSA winner at the Best of the Best in Pediatric Surgery event on April 8th, 2022 was Nathan Rubalcava with his presentation "A contrast challenge is safe in children with adhesive small bowel obstruction- a multi-institutional review".

Jeffrey Ponsky, Professor Emeritus of Surgery and Nathaniel Soper, Chairman of Surgery, go back to the basics on Laparoscopic Cholecystectomy on this episode of the StayCurrent Forum.

Rod Gerardo, CCHMC Research Fellow and Brittany Levy, CCHMC Research Fellow, talk about the education of public healthcare on this week's episode of the StayCurrent Forums.

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

Deciding when to perform a tracheotomy and when another procedure is indicated is only the tip of the iceberg when approaching the pediatric airway. Join Dr. Michael Rutter from the Aerodigestive Center at Cincinnati Children's Hospital Medical Center for a discussion on pediatric tracheotomy.

This is a "snack size" bonus episode of 'Peds Umbilical Pathologies in Brief: Presentation, Workup, Diagnosis, Perioperative Considerations' video. For full video: gcmd.co/3JOUtpW

-Original Video Description- Umbilical pathologies can present with a wide range of symptoms so here, we cover the basics of presentation, differentiation, diagnosis, surgical approach, and post operative management with Dr. Meera Kotagal and host Drs. Rod Gerardo & Ellen Encisco.

Dr. José Campos is back, this time helping us review some of the latest literature on the diagnosis and management of CPAM in children. In this podcast, we're reviewing a typical case with Dr. Todd Ponsky and incorporating literature from the last few years.

Hosts: Rod Gerardo and Ellen Encisco

Articles if you want to follow along;

Kunisaki SM, Lal DR, Saito JM, Fallat ME, St Peter SD, Fox ZD, Heider A, Chan SS, Boyd KP, Burns RC, Deans KJ, Gadepalli SK, Hirschl RB, Kabre R, Landman MP, Leys CM, Mak GZ, Minneci PC, Wright TN, Helmrath MA; MIDWEST PEDIATRIC SURGERY CONSORTIUM. Pleuropulmonary Blastoma in Pediatric Lung Lesions. Pediatrics. 2021 Apr;147(4):e2020028357. doi: 10.1542/peds.2020-028357. Epub 2021 Mar 24. PMID: 33762310.

https://pubmed.ncbi.nlm.nih.gov/33762310/

Jelin EB, O'Hare EM, Jancelewicz T, Nasr I, Boss E, Rhee DS. Optimal timing for elective resection of asymptomatic congenital pulmonary airway malformations. J Pediatr Surg. 2018 May;53(5):1001-1005. doi: 10.1016/j.jpedsurg.2018.02.032. Epub 2018 Feb 10. PMID: 29514740.

https://pubmed.ncbi.nlm.nih.gov/29514740/

Elhattab A, Elsaied A, Wafa T, Jugie M, Delacourt C, Sarnacki S, Aly K, Khen-Dunlop N. Thoracoscopic surgery for congenital lung malformations: Does previous infection really matter? J Pediatr Surg. 2021 Nov;56(11):1982-1987. doi: 10.1016/j.jpedsurg.2021.01.036. Epub 2021 Jan 27. PMID: 33573805.

https://pubmed.ncbi.nlm.nih.gov/33573805/

Downard CD, Calkins CM, Williams RF, Renaud EJ, Jancelewicz T, Grabowski J, Dasgupta R, McKee M, Baird R, Austin MT, Arnold MA, Goldin AB, Shelton J, Islam S. Treatment of congenital pulmonary airway malformations: a systematic review from the APSA outcomes and evidence based practice committee. Pediatr Surg Int. 2017 Sep;33(9):939-953. doi: 10.1007/s00383-017-4098-z. Epub 2017 Jun 6. PMID: 28589256.

https://pubmed.ncbi.nlm.nih.gov/28589256/

Cook J, Chitty LS, De Coppi P, Ashworth M, Wallis C. The natural history of prenatally diagnosed congenital cystic lung lesions: long-term follow-up of 119 cases. Arch Dis Child. 2017 Sep;102(9):798-803. doi: 10.1136/archdischild-2016-311233. Epub 2017 Jun 5. PMID: 28584070.

https://pubmed.ncbi.nlm.nih.gov/28584070/

In this episode we will discuss the rate, diagnosis and treatment of Mullerian anomalies in patients with anorectal malformation. Dr. Levitt and Dr. Frischer invited special guests from the gynecology site: Dr. Lesley Breech from Cincinnati Children's Hospital, and Dr. Veronica Gomez-Lobo from Children’s National.

Rod Gerardo, CCHMC Research Fellow and Trevor Skrobut, Emergency Medicine Physician, talk about how important it is for residents to take care of their health and wellness on this week's episode of the StayCurrent Forums. Download the Stay Current app: https://bit.ly/3KfxMMH

Introducing StayCurrent Spaces, a digital, shareable file box within StayCurrent. All of the content you have come to love along with your own virtual file cabinet of personally relevant resources.

pediatricsurgery #SoMe4Peds #pedsurg

Download the Stay Current app: https://bit.ly/3KfxMMH

Hey StayCurrent listeners we would love to hear from you! Please share your thoughts https://bit.ly/3uPtHIq

We're back with the February issue of JPS article highlights. This time we're talking to editor Dr. Mark Davenport and authors David Cunningham, Prof Marc Wijnen, Dr. Adrian Woolf, and Ms Kirsty Brennan with Dr. Todd Ponsky.

Hosts: Ellen Encisco, Em Tombash & Rod Gerardo

Articles:

Woolf et al. Building Human Renal Tracts https://www.jpedsurg.org/article/S0022-3468(21)00735-1/fulltext

Wijnen et al. https://www.jpedsurg.org/article/S0022-3468(21)00734-X/fulltext

Cunningham et al. https://www.jpedsurg.org/article/S0022-3468(21)00737-5/fulltext

Brennan et al. https://www.jpedsurg.org/article/S0022-3468(21)00745-4/fulltext

Rod Gerardo, CCHMC Research Fellow and Nikhil Shah, UTMB General Surgery PGY3, talk about how to find dedicated pediatric surgery research on this episode of the StayCurrent Forums.

Jeffrey Ponsky, Professor Emeritus of Surgery and Stephanie Walsh, Associate Professor of Surgery and Pediatrics, talk about obesity in children and what to do on this episode of the StayCurrent Forum.

The British Association of Pediatric Surgeons sought to highlight the history of the Percutaneous Gastrostomy tube (PEG). So they asked Dr. Ponsky to teach us about the humble beginnings of the PEG – Well, they asked Dr. Jeff Ponsky. But his son, Dr. Todd Ponsky, couldn’t help but jump in too. Here, the father-son duo explain how the PEG was invented all those decades ago!

A gastrostomy tube -- commonly abbreviated as "G-tube" -- is a tube that is placed into a patient's stomach. The word "gastrostomy" comes from two Latin root words for "stomach" (gastr) and "new opening" (stomy). This tube is used to give a child an alternate way to get their fluid, nutrition, and / or medications. It may also be used to vent a patient's stomach for air.

We’re starting a new series on image guided surgery with some of our Interventional Radiology colleagues at Cincinnati Children’s Hospital. In this introductory episode, we’re talking to Dr. John Racadio, Dr. Dan von Allmen, and Nicole Hilvert. And we’re joined by Dr. Denise Liu, radiology resident at University of Toledo.

Hosts: Rod Gerardo, MD, Ellen Encisco, MD, Em Tombash, MD

We're back with the second part of episode 3, enteral autonomy along with Drs. Michael Helmrath and Paul Wales from Intestinal Rehabilitation Center at Cincinnati Children's Hospital.

Hosts: Ellen Encisco & Rod Gerardo

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

In this week’s Colorectal Quiz, Dr. Marc Levitt welcomes his Children’s National collaborative team members from Neurosurgery, Dr. John Myseros, and from Urology, Dr. Christine Ho, to discuss the evaluation and impact of the suspected tethered spinal cord in ARM patients. Hosted by Shimon Jacobs

The full episode of our first GlobalcastMD Forum with Dr. Laura Bukavina joining Dr. Rod Gerardo to discuss her work at the Ukrainian border. 🇺🇦

To support Dr. Bukavina's efforts or other organizations working to assist in the crisis, click the links below. https://bit.ly/37E0sR8 https://bit.ly/3q9ZD8P https://bit.ly/34OrAvy

pedsurg #pediatricsurgery #SoMe4PedSurg

If you missed our 2021 Pediatric Surgery Update Course, don’t worry. We will recap the event right here on our podcast and today’s episode will highlight one of our favorite sessions on DEI or Diversity, Equity, and Inclusion with Dr. Meera Kotagal, MD, MPH.

Host: Rod Gerardo

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

Join Dr. Kathy van Leeuwen and Dr. Cristine Velazco at Phoenix Children’s as they discuss the nuances of post-operative anorectal malformation management following the PSARP procedure with Dr. Marc Levitt and Dr. Jason Frischer

Hosted by Amanda Jensen

Umbilical pathologies can present with a wide range of symptoms so here, we cover the basics of presentation, differentiation, diagnosis, surgical approach, and post operative management with Dr. Meera Kotagal and host Drs. Rod Gerardo & Ellen Encisco.

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

Don't forget to mark your calendar for "Best of the Best: Pediatric Surgery 2022," happening Friday, April 8! Featuring presentations from APSA, IPEG, EUPSA, CAPS, and PAPS. Register now! https://globalcastmd.com/event-details/best-of-the-best

some4pedsurg #pediatricsurgery

We're back with a new episode from the Intestinal Rehabilitation Center at Cincinnati Children's Hospital. This time we're talking about enteral autonomy with Drs. Helmrath and Wales. This is the first of two parts on this topic, stay tuned for part 2!

Hosts: Ellen Encisco & Rod Gerardo

Don't forget to like and subscribe to see more entertaining medical educational videos!

See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download

GlobalCastMD is revealing brand new content that is different from our normal youtube videos or podcasts that take a deep dive into Pediatric Surgery! Rod Gerardo along with Jeffrey Ponsky are interviewing people from around the globe, residents, fellows, attendings, etc. about all types of content whether that be resident wellness, general surgery concepts, new technology, etc.! See you on the next episode of the StayCurrent Forums!

ICG technology has become popular in minimally invasive surgery. Dr. Ciro Esposito from the University of Naples Federico II reviewed the latest literature and uses for ICG in pediatric surgery at the 2021 Pediatric Surgery Update Course. Here we present the highlights.

Hosted by: Ellen Encisco

Colorectal Quiz Episode 28: Female ARM Management - Perineal Fistula by GlobalCastMD

Esophageal atresia is an important diagnosis for pediatric surgeons to understand. Here, we review the basics of esophageal atresia and tracheoesophageal fistula with Dr. Daniel von Allmen and Dr. Aaron Garrison from Cincinnati Children's Hospital Medical Center.

Hosts: Ellen Encisco, Rod Gerardo, Todd Ponsky

We're back with the January issue of JPS article highlights. This time we're talking to editor Dr. Cassandra Kelleher and authors Drs. Gail Besner, Shahrazad Joharifard and Sarah Stokes with Dr. Todd Ponsky.

Hosts: Ellen Encisco, Em Tombash & Rod Gerardo

Articles:

Brigstock NM, Besner GE. Development of an academic RVU (aRVU) system to promote pediatric surgical academic productivity. Journal of Pediatric Surgery. 2021 Sep 20. https://www.jpedsurg.org/article/S0022-3468(21)00632-1/fulltext

Joharifard S, Trudeau MO, Miyata S, et al. Implementing a standardized gastroschisis protocol significantly increases the rate of primary sutureless closure without compromising closure success or early clinical outcomes. Journal of pediatric surgery. 2021 Sep 30. https://www.jpedsurg.org/article/S0022-3468(21)00641-2/fulltext

Stokes SC, Theodorou CM, Jackson JE, et al. Long-term safety evaluation of placental mesenchymal stromal cells for in utero repair of myelomeningocele in a novel ovine model. Journal of pediatric surgery. 2021 Sep 20. https://www.jpedsurg.org/article/S0022-3468(21)00640-0/fulltext

Anal fissures, hemorrhoids, and abscesses are not a very comfortable topic, but they are fairly common in the pediatric population. Join Dr. Nelson Rosen for the latest treatment algorithms and recommendations regarding pediatric anal pathology.

Rentea RM, St Peter SD. Pediatric Rectal Prolapse. Clin Colon Rectal Surg. 2018;31(2):108-116. doi:10.1055/s-0037-1609025 https://pubmed.ncbi.nlm.nih.gov/29487493/

Christison-Lagay ER, Hall JF, Wales PW, et al. Nonoperative management of perianal abscess in infants is associated with decreased risk for fistula formation. Pediatrics. 2007;120(3):e548-e552. doi:10.1542/peds.2006-3092 https://pubmed.ncbi.nlm.nih.gov/17682038/

Rosen NG, Gibbs DL, Soffer SZ, Hong A, Sher M, Peña A. The nonoperative management of fistula-in-ano. J Pediatr Surg. 2000;35(6):938-939. doi:10.1053/jpsu.2000.6931 https://pubmed.ncbi.nlm.nih.gov/10873039/

Goddard GR, Lim IIP, Cheng YC, et al. A child presents with perianal symptoms - how often is this Crohn's disease?. J Pediatr Surg. 2021;56(9):1618-1622. doi:10.1016/j.jpedsurg.2020.11.016 https://pubmed.ncbi.nlm.nih.gov/33280851/

00:00 Introduction 01:12 Anal Anatomy 02:18 Anal Fissure 05:26 Hemorrhoids 07:20 Rectal Prolapse 10:26 Perianal Abscess 16:18 Pilonidal Disease

Dr. Jose Campos is back, this time helping us review some of the latest literature on the diagnosis and management of intussusception in children. In this podcast, we're reviewing a typical case with Dr. Todd Ponsky and incorporating literature from the last few years.

Hosts: Rod Gerardo and Ellen Encisco

Tsou, Po-Yang, et al. "Accuracy of point-of-care ultrasound and radiology-performed ultrasound for intussusception: a systematic review and meta-analysis." The American Journal of Emergency Medicine 37.9 (2019): 1760-1769. Accuracy of point-of-care ultrasound and radiology-performed ultrasound for intussusception: A systematic review and meta-analysis

Liu, Shu Ting, et al. "Ultrasound-guided hydrostatic reduction versus fluoroscopy-guided air reduction for pediatric intussusception: a multi-center, prospective, cohort study." World Journal of Emergency Surgery 16.1 (2021): 1-7. Ultrasound-guided hydrostatic reduction versus fluoroscopy-guided air reduction for pediatric intussusception: a multi-center, prospective, cohort study - World Journal of Emergency Surgery

Patel, Dhruv M., et al. "Radiographic findings predictive of irreducibility and surgical resection in ileocolic intussusception." Pediatric Radiology 50.9 (2020): 1249-1254. Radiographic findings predictive of irreducibility and surgical resection in ileocolic intussusception

Gondek, Andrea Soria, et al. "Ileocolic intussusception: Predicting the probability of success of ultrasound guided saline enema from clinical and sonographic data." Journal of Pediatric Surgery 53.4 (2018): 599-604. https://doi.org/10.1016/j.jpedsurg.2017.10.050

Feldman, Oren, et al. "Success rate of pneumatic reduction of intussusception with and without sedation." Pediatric Anesthesia 27.2 (2017): 190-195. https://doi.org/10.1111/pan.13045

van de Bunt, Jascha A., et al. "Effects of esketamine sedation compared to morphine analgesia on hydrostatic reduction of intussusception: A case‐cohort comparison study." Pediatric Anesthesia 27.11 (2017): 1091-1097. https://doi.org/10.1111/pan.13226

Litz, Cristen N., et al. "Outpatient management of intussusception: a systematic review and meta-analysis." Journal of pediatric surgery 54.7 (2019): 1316-1323. https://doi.org/10.1016/j.jpedsurg.2018.09.019

Vo, Andrea, et al. "Management of intussusception in the pediatric emergency department: risk factors for recurrence." Pediatric Emergency Care 36.4 (2020): e185-e188. Pediatric Emergency Care

Ferrantella, Anthony, et al. "Incidence of recurrent intussusception in young children: A nationwide readmissions analysis." Journal of pediatric surgery 55.6 (2020): 1023-1025. https://doi.org/10.1016/j.jpedsurg.2020.02.034

In Episode 27 we discuss how to evaluate, work up, and treat a complicated case of constipation in a toddler and answer the question, “could this be delayed Hirschsprung Disease?” Host: Shimon Jacobs

Omphalocele and Gastroschisis are abdominal wall defects encountered in the newborn. Join Dr. Foong-Yen Lim and Dr. Todd Ponsky to discuss the diagnosis and management of abdominal wall defects.

We're back with the second part of episode 2, management of overwhelming intestinal damage along with Drs. Michael Helmrath and Paul Wales from Intestinal Rehabilitation Center at Cincinnati Children's Hospital.

Article for further reading: Predicting Intestinal Adaptation in Pediatric Intestinal Failure - A Retrospective Cohort Study

https://journals.lww.com/annalsofsurgery/Abstract/2019/05000/Predicting_Intestinal_Adaptation_in_Pediatric.31.aspx

Hosts: Ellen Encisco & Rod Gerardo

Hepatoblastoma is the most common malignant liver tumor in the pediatric population but treatment strategies have changed dramatically over the past couple of decades so today we will review the basics of hepatoblastoma with Dr. Greg Tiao, MD - pediatric transplant surgeon at Cincinnati Children's Hospital Medical Center.

We're back with a new episode from the Intestinal Rehabilitation Center at Cincinnati Children's Hospital. This time we're talking about the management of overwhelming intestinal damage in conditions such as necrotizing enterocolitis and volvulus. This is the first of two parts on this topic, stay tuned for part 2!

Hosts: Ellen Encisco & Rod Gerardo

Here's your latest podcast with the highlights from the December issue of JPS. We're joined by Editor-in-Chief, Dr. Whit Holcomb, as well as authors, Drs. Louise Montalva, Shaun Kunisaki, and Shawn St. Peter.

Hosts: Ellen Encisco & Rod Gerardo

Articles: Dagorno C, Montalva L, Ali L, et al. Enhancing recovery after minimally invasive surgery in children: A systematic review of the literature and meta-analysis. Journal of Pediatric Surgery. 2021 Apr 20. https://www.jpedsurg.org/article/S0022-3468(21)00306-7/fulltext

Etchill EW, Giuliano KA, Boss EF, et al. Association of operative approach with outcomes in neonates with esophageal atresia and tracheoesophageal fistula. Journal of pediatric surgery. 2021 Apr 20. https://www.jpedsurg.org/article/S0022-3468(21)00308-0/fulltext

Fraser JA, Briggs KB, Svetanoff WJ, Peter SD. Long-term outcomes and satisfaction rates after costal cartilage resection for slipping Rib syndrome. Journal of Pediatric Surgery. 2021 Jan 27. https://www.jpedsurg.org/article/S0022-3468(21)00084-1/fulltext

In this week's episode, Dr. Levitt and Dr. Frischer discuss perianal Crohn's disease with Dr. Lisa McMahon, director of the IBD center at Phoenix Children's Hospital and pediatric surgery fellow, Dr. Cristine Velazco.

We'll go over how to approach a patient with perianal symptoms, when and how to evaluate for underlying IBD, and strategies for treatment in the OR and post operative period.

Hosted by Dr. Shimon Jacobs

Pediatric surgeons Dr. Daniel Von Allmen and Dr. Todd Ponsky from Cincinnati children's Hospital discussing the technique for treating long gap esophageal atresia.

For additional info please visit:

https://www.youtube.com/c/CincinnatiChildrens/featured https://www.jpedsurg.org/article/S0022-3468(15)00181-5/fulltext

In this episode, Dr. Marc Levitt and Dr. Jason Frischer discuss the complexities of the perineal groove with Dr. Jonathan Sutcliffe.

Hosted by Dr. Amanda Jensen

We're back with the November issue of JPS article highlights. This time we're talking to Dr. Pablo Laje and authors Dr. Frederick Rescorla and Dr. Niloufar Hafezi.

Hosts: Ellen Encisco & Rod Gerardo

Articles:

Rubalcava NS, Overman RE, Hirschl RB, Thirumoorthi AS. Central Line Placement at ECMO Decannulation: A Missed Opportunity. Journal of Pediatric Surgery. https://www.jpedsurg.org/article/S0022-3468(21)00184-6/fulltext

Hafezi N, Carpenter KL, Colgate CL, et al. Partial splenectomy in children: Long-term reoperative outcomes☆. Journal of Pediatric Surgery. 2021 Jan 8. https://www.jpedsurg.org/article/S0022-3468(21)00018-X/fulltext

Elhattab A, Elsaied A, Wafa T, et al. Thoracoscopic surgery for congenital lung malformations: Does previous infection really matter?. Journal of Pediatric Surgery. 2021 Jan 27. https://www.jpedsurg.org/article/S0022-3468(21)00086-5/fulltext

The treatment for cloacal malformations are a great example of collaboration between pediatric colorectal surgery, gynecology, and urology. In today's episode, Dr. Marc Levitt and Dr. Jason Frischer talk to Dr. Richard Wood about the operative treatment for these patients.

Hosted by Dr. Amanda Jensen and Dr. Hira Ahmad

At Pediactric Surgery Update Course 2021, Dr. Bethany Slater from UChicago Comer Children's Hospital and Dr. Steven Rothenberg from Rocky Mountain Hospital for Children sharing their cases on using magnet therapy as an alternative treatment option for esophageal atresia.

Hosted by: Todd Ponsky, Rod Gerardo, Ellen Encisco

We’re starting a new series about intestinal rehabilitation and all of its intricacies. We’re joined by Drs. Michael Helmrath and Paul Wales, leaders of the Intestinal Rehabilitation Program at Cincinnati Children’s.

Hosted by: Todd Ponsky, Rod Gerardo, Ellen Encisco

In the last few episodes of the Colorectal Quiz, we discussed obstructions in Hirschsprung disease. Now we're turning to another issue in Hirschsprung disease - the soiling patient. Along with Dr. Levitt and Dr. Frischer, we're joined by Dr. Hira Ahmad from Seattle Children's Hospital.

Host: Amanda Jensen

There are recent updates about the management of lung metastases in osteosarcoma and deciding thoracotomy vs VATS is our topic for today. At the recent 2021 Pediatric Surgery Update Course, Dr. Anusua "Roshni" Dasgupta reviewed the latest literature. And now we're giving you the highlights in this video.

Hosted by: Rod Gerardo, Ellen Encisco, Todd Ponsky

Congenital heart disease can become a complex mix of physiology and anomalous anatomy so today, we discuss the basics with Dr. Colleen Pater - a cardiologist at Cincinnati Children's Hospital Medical Center.

Adrenal cortical tumors only make up <0.2% of all pediatric tumors. But to understand these rare lesions, you have to know the complex physiology of the adrenal gland. Here we review the workup, surgical management, and perioperative care with Dr. Dan von Allmen.

We're back with the October issue of JPS article highlights. This time we're talking to JPS Editor Dr. Paul Tam and authors Dr. Brittany Johnson, Dr. Nigel Hall, Dr. Richard Wood, and Dr. Giacomo Esposito. Hosts: Ellen Encisco & Rod Gerardo

Articles: What Happens after the Hospital? An Analysis of Longitudinal Care Needs in Children Treated for Child Physical Abuse. https://www.jpedsurg.org/article/S0022-3468(21)00428-0/fulltext

Surgical necrotizing enterocolitis: Association between surgical indication, timing, and outcomes. https://www.jpedsurg.org/article/S0022-3468(21)00368-7/fulltext

One-year impact of a bowel management program in treating fecal incontinence in patients with anorectal malformations https://www.jpedsurg.org/article/S0022-3468(21)00369-9/fulltext

Predictive value of spinal bone anomalies for spinal cord abnormalities in patients with anorectal malformations https://www.jpedsurg.org/article/S0022-3468(21)00387-0/fulltext

In this episode, we discuss the diagnosis and treatment of multigestation pregnancies with Dr. Beth Kline-Fath, Chief of Fetal and Neonatal Imaging at Cincinnati Children's Hospital.

To see all the images watch the video: https://youtu.be/AXHwmSAcKzc

Host: Todd Ponsky

In the last few episodes of the Colorectal Quiz, we discussed obstructions in Hirschsprung disease. Now we're turning to another issue in Hirschsprung disease - the soiling patient. Along with Dr. Levitt and Dr. Frischer, we're joined by Dr. Hira Ahmad from Seattle Children's Hospital.

Host: Amanda Jensen

Krois W, Reck CA, Darbari A, et al. A technique to reconstruct the anal sphincters following iatrogenic stretching related to a pull-through for Hirschsprung disease. Journal of Pediatric Surgery. 2021;56:1242-6. https://www.jpedsurg.org/article/S0022-3468(20)30902-7/fulltext

We've seen a lot of recent updates about the management of primary spontaneous pneumothoraces. At the recent 2021 Pediatric Surgery Update Course, Dr. Ronnie Sullins reviewed the latest literature. And now we're giving you the highlights in this video.

Hosted by: Rod Gerardo, Ellen Encisco, Todd Ponsky

Download the StayCurrent: Pediatric Surgery app here: https://apps.apple.com/us/app/staycurrent-pediatric-surgery/id1254498901

The surgical management for Hirschsprung disease has changed dramatically over the past few decades. So here, we discuss the basics of workup, diagnosis, and surgical treatment for aganglionic megacolon AKA Hirschsprung disease with Dr. Aaron Garrison and Dr. Jason Frischer from Cincinnati Children's Hospital Medical Center.

CCHMC HAEC resource: https://staycurrentapp.app.link/62V0jx2Dxkb

Hosted by Dr. Rod Gerardo, Dr. Ellen Encisco, and Dr. Todd Ponsky

Watch this podcast on YouTube here: https://youtu.be/BQtKUwcX6JI

Download the StayCurrent: Pediatric Surgery app here: https://apps.apple.com/us/app/staycurrent-pediatric-surgery/id1254498901

The 9th annual Pediatric Surgery Update Course was held as a webinar on August 27, 2021. We had a lot of lively discussion and engaging presentations on the latest updates in pediatric surgery. In this podcast we are reviewing the top ten key takeaways from the update course.

Hosted by Ellen Encisco, Rod Gerardo, and Todd Ponsky

Download the StayCurrent: Pediatric Surgery app here: https://apps.apple.com/us/app/staycurrent-pediatric-surgery/id1254498901

To see the images referenced, the associated video can be viewed on YouTube: https://youtu.be/jHZbXL1eW64

In this episode, we hear important 2021 ATLS updates for the care of pediatric trauma patients from Dr. Rich Falcone, Director of Trauma Services at Cincinnati Children's Hospital Medical Center.

Hosted by Rod Gerardo, Ellen Encisco, and Todd Ponsky

We're highlighting three articles from the September 2021 issue of the Journal of Pediatric Surgery. We review the articles with Dr. Mikko Pakarinen (JPS Editor for Europe), Dr. Todd Ponsky, and two of the authors from one of the articles (Drs. Gillian Goddard and Iris Lim-Beutel).

Hosts: Rod Gerardo & Ellen Encisco

Articles featured: Peng Y, Xiao D, Xiao S, et al. Early enteral feeding versus traditional feeding in neonatal congenital gastrointestinal malformation undergoing intestinal anastomosis: A randomized multicenter controlled trial of an enhanced recovery after surgery (ERAS) component. Journal of Pediatric Surgery. 2021 Mar 18. https://www.jpedsurg.org/article/S0022-3468(21)00209-8/fulltext

Jaramillo C, Jensen MK, McClain A, et al. Clinical diagnostic predictive score for Meckel diverticulum. Journal of Pediatric Surgery. 2021 Sep 1;56(9):1673-7. https://www.jpedsurg.org/article/S0022-3468(20)30935-0/fulltext

Goddard GR, Lim II, Cheng YC, et al. A child presents with perianal symptoms-how often is this Crohn's disease?. Journal of Pediatric Surgery. 2021 Sep 1;56(9):1618-22. https://www.jpedsurg.org/article/S0022-3468(20)30846-0/fulltext

Download the StayCurrent: Pediatric Surgery app here: https://apps.apple.com/us/app/staycurrent-pediatric-surgery/id1254498901

The treatment for Hirschsprung disease has undergone tremendous evolution over the past century. Here, Dr. Marc Levitt and Dr. Jason Frischer discuss the history of Hirschsprung disease and how the treatment has improved to what we know today. Host: Dr. Amanda Jensen

Advances in imaging and minimally invasive techniques have allowed fetal surgeons to treat previously impossible diagnoses. In this video, Dr. Jose Peiro discusses the workup and treatment for fetal urinary tract obstruction.

Hosted by Dr. Todd Ponsky

Here we cover Congenital Pulmonary Airway Malformations (CPAMs) through a story with the help of Dr. Todd Ponsky, Dr. Pam Choi, Dr. Beth Rymeski, Dr. Jacob Langer, and Dr. Steven Rothenberg.

Hosts: Ellen Encisco & Rod Gerardo

For more details visit the Stay Current app: https://staycurrentapp.app.link/tLOMBVmYAjb

We've discussed Hirschsprung Disease at length before but today we visit a complicated topic that many deal with, obstruction. Dr. Levitt and Dr. Frischer speak with Dr. Rentea from Children's Mercy at Kansas City about the obstructed patient with Hirschsprung Disease.

Hosts: Amanda Jensen and Hira Ahmad

Today, we hear from Dr. Ron Herschl about pediatric ECMO from an Update Course session back in 2018.

Sign up for the 2021 Pediatric Surgery Update Course here: https://conference.globalcastmd.com/update-course

We all know how commonly pediatric surgeons see patients with appendicitis and how frequently new literature is published on its management. Dr. Jose Campos helped us find some of the latest publications on appendicitis management and we discussed a few of the articles featured in this podcast.

Hosts: Rodrigo Gerardo & Ellen Encisco

Featured articles plus more: RIFT study group. Appendicitis risk prediction models in children presenting with right iliac fossa pain (RIFT study): a prospective, multicentre validation study. April 2020. https://doi.org/10.1016/S2352-4642(20)30006-7

Unsdorfer KML, An JY, Binkovitz, LA. Pediatric appendiceal ultrasoun: maintaining accuracy, increasing determinacy and improving clinical outcomes following the introduction of a standardized reporting template. September 2020. https://doi.org/10.1007/s00247-020-04820-z

Patkova B, Svenningsson A, et al. Nonoperative Treatment Versus Appendectomy for Acute Nonperforated Appendicitis in Children. June 2020. https://doi.org/10.1097/SLA.0000000000003646

Kashtan MA, Graham DA, et al. Ceftriaxone Combined With Metronidazole is Superior to Cefoxitin Alone in the Management of Uncomplicated Appendicitis in Children. March 2020. https://doi.org/10.1097/SLA.0000000000003704

Cameron DB, Anandalwar SP, et al. Development and Implications of an Evidence-based and Public Health-relevant Definition of Complicated Appendicitis in Children. May 2020. https://doi.org/10.1097/SLA.0000000000003059

Mennie N, Panabokke G, et al. Are Postoperative Intravenous Antibiotics Indicated After Laparoscopic Appendectomy for Simple Appendicitis? A Prospective Double-blinded Randomized Controlled Trial. August 2020. https://doi.org/10.1097/SLA.0000000000003732

Farr BJ, Ranstrom L, Mooney DP. Eliminating Opiate Prescribing for Children after Non-Perforated Appendectomy. June 2020. https://doi.org/10.1016/j.jamcollsurg.2020.03.023

See more articles on the StayCurrent app.

The guidance for treatment of tracheomalacia has evolved over time so today, Dr. Dan von Allmen discusses the surgical management including aortopexy and posterior tracheopexy.

Host: Rod Gerardo

Checkout our YouTube page here: https://youtube.com/c/GlobalCastMD

Download the StayCurrent: Pediatric Surgery app here: https://apps.apple.com/us/app/staycurrent-pediatric-surgery/id1254498901

Dr. Ami Shah and Dr. Gwyneth Sullivan recently published an article about the disruption score, a new bibliometric tool, in the Journal of Pediatric Surgery. We discussed the article, entitled "Shifting paradigms: The top 100 most disruptive papers in core pediatric surgery journals," with the authors, JPS Editor Dr. Mark Davenport, and Dr. Todd Ponsky.

Hosts: Rodrigo Gerardo and Ellen Encisco

The full article: https://doi.org/10.1016/j.jpedsurg.2021.02.002

We've discussed Hirschsprung Disease at length before but today we visit a complicated topic that many deal with, obstruction. Dr. Levitt and Dr. Frischer speak with Dr. Rentea from Children's Mercy at Kansas City about the obstructed patient with Hirschsprung Disease.

Hosts: Amanda Jensen and Hira Ahmad

Abdominal wall defects like omphalocele and gastroschisis can present in interesting ways. At last year's Update Course, Drs. Shawn St. Peter, Miguel Guelfand, and Saleem Islam presented some interesting cases and updates in the management of these abnormalities. Don't forget to mark your calendar for our next Update Course on August 27, 2021.

Host: Ellen Encisco and Rodrigo Gerardo

Continuing our series on Fetal Surgery, today's episode reviews the basics of fetoscopic repair of myelomeningocele with Dr. Foong-Yen Lim, M.D.

Host: Rod Gerardo

Download the StayCurrent: Pediatric Surgery app to get videos, podcasts, guidelines and interactive surgical cases on your phone: https://apps.apple.com/us/app/staycurrent-pediatric-surgery/id1254498901

Pediatric Colorectal Surgery is a team sport. That's why this episode is about how the pediatric colorectal surgery team, lead by Dr. Jason Frischer, collaborates with the neurogastroenterology department at Cincinnati Children's Hospital Medical Center. Guest speaker, Dr. Ajay Kaul, M.D.

Host: Rodrigo Gerardo

Is there any case that gets a pediatric surgery fellow more excited than the repair of an Esophageal Atresia with a Tracheoesophageal Fistula? In today's episode, we hear from Dr. Dan von Allmen, Dr. Mike Rutter, Dr. Aaron Garrison, and Dr. Todd Ponsky about the preoperative planning and surgical approach to this bread and butter pediatric surgery case. Hosted by Rod Gerardo

The treatment for cloacal malformations are a great example of collaboration between pediatric colorectal surgery, gynecology, and urology. In today's episode, Dr. Marc Levitt and Dr. Jason Frischer talk to Dr. Richard Wood about the operative treatment for these patients.

Hosted by Dr. Amanda Jensen and Dr. Hira Ahmad

Did you know that we can do surgery on a fetus? In today's episode, we hear from Dr. Foon-Yen Lim, M.D. about Fetoscopic Endoluminal Tracheal Occlusion or FETO to treat Congenital Diaphragmatic Hernia (CDH) with Host Rod Gerardo, M.D.

The treatment for cloacal malformations are a great example of collaboration between pediatric colorectal surgery, gynecology, and urology. In today's episode, Dr. Marc Levitt and Dr. Jason Frischer talk to Dr. Richard Wood about the initial workup for these patients.

Hosted by Dr. Amanda Jensen and Dr. Hira Ahmad

Bowel management can be difficult on its own but for patients with spinal disorders, it can be exponentially more complex. Today, Dr. Levitt and Dr. Frischer discuss bowel management for this subset of patients and they brought some friends: Dr. Rebecca Rentea, Wendy Lewis, and Christine Warner.

Host: Amanda Jensen

The workup for Hirschsprung disease is bread-and-butter pediatric surgery but it can certainly get confusing. Dr. Nelson Rosen is the Associate Director of the Colorectal Center at the Cincinnati Children's Hospital Medical Center and here he is discussing the basics of how to workup a patient with Hirschsprung disease.

Host: Rod Gerardo, M.D.

Download the StayCurrent Pediatric Surgery App here: https://apps.apple.com/us/app/staycurrent-pediatric-surgery/id1254498901

Bowel management can be difficult on its own but for patients with spinal disorders, it can be exponentially more complex. Today, Dr. Levitt and Dr. Frischer discuss bowel management for this subset of patients and they brought some friends: Dr. Rebecca Rentea, Wendy Lewis, and Christine Warner.

Host: Amanda Jensen

Dr. Michael Rutter is an ENT surgeon and the director of the Aerodigestive Center at Cincinnati Children's Hospital Medical Center. In this podcast, he discusses some surgical approaches to laryngeal clefts. This episode is available as an audio or video podcast

Watch on YouTube here: https://youtu.be/hS-mzchgJBw

Download the app here: https://apps.apple.com/us/app/staycurrent-pediatric-surgery/id1254498901

Surgeons, neonatologists, pediatricians, and anyone who cares for the newborn child needs to understand how to evaluate anorectal malformations. To clear things up, Dr. Marc Levitt and Dr. Jason Frischer explain how to make sense of various ARM presentations in this 3 part series. Special guests Amanda Jensen

This is the presidential address from the International Pediatric Endosurgery Group 2021 Annual meeting. The exponential growth of information, the failure of journals, textbooks, and societies and how AI, machine learning, crowd sourcing, and platforms will be the future of medical learning.

YouTube link for the full video: https://youtu.be/T40KML_rYbQ

King's Chessboard Credits: https://youtu.be/t3d0Y-JpRRg and https://youtu.be/byk3pA1GPgU

Neural link Credit: https://youtu.be/S6n26bBBr80

Machine, Platform, Crowd: Harnessing Our Digital Future https://smile.amazon.com/dp/039335606X/ref=cm_sw_r_cp_api_glt_fabc_57BR2F8Z1DVWTQHYD1RE

The Wisdom of Crowds: https://smile.amazon.com/dp/0385721706/ref=cm_sw_r_cp_api_glt_fabc_TPQ5PNWRJNKGDMQGPND7

Music in this video

Surgeons, neonatologists, pediatricians, and anyone who cares for the newborn child needs to understand how to evaluate anorectal malformations. To clear things up, Dr. Marc Levitt and Dr. Jason Frischer explain how to make sense of various ARM presentations in this 3 part series. Featuring Amanda Jensen

Host: Rod Gerardo

In today's episode, we want to introduce you to a pediatric surgeon whose reach expands beyond the walls of Cincinnati Children's Hospital Medical Center - Dr. Vic Garcia. His career in the OR is arguably as impressive as his career researching and improving public health. Here, he talks about how social determinants of health can greatly impact our patients.

Surgeons, neonatologists, pediatricians, and anyone who cares for the newborn child needs to understand how to evaluate anorectal malformations. To clear things up, Dr. Marc Levitt and Dr. Jason Frischer explain how to make sense of various ARM presentations in this 3 part series. Featuring Amanda Jensen

Host: Rodrigo Gerardo

It's hard to decide which blunt trauma patients need a CT scan. That's why Dr. Christian Streck reviewed the literature and recommendations on when to send a patent to the CT scanner during our 2017 Pediatric Surgery Update Course. Mark your calendars for the next meeting on August 27th, 2021.

Host: Rodrigo Gerardo

Ya know that spring loaded needle we use to create pneumoperitoneum? How do you spell that? Because you're wrong. It's named after Dr. Janos Veres. Jorge and Belen walked us through the history of the man, the needle, and the spelling.

Host: Rodrigo Gerardo

TEG, also known as thromboelastography is gaining popularity. So Dr. Elizabeth Beierle talked about the basics at our 2019 Pediatric Surgery Update Course. Mark your calendars for the next one on August 27, 2021.

Host: Rodrigo Gerardo

Cervical spine clearance in the pediatric trauma patient can be difficult - especially in those patients less than 3 years old. That's why Dr. Meera Kotagal reviewed the C-spine literature and recommendations during our 2019 Pediatric Surgery Update Course. Mark your calendars for the next meeting on August 27th, 2021.

Host: Rodrigo Gerardo

Did you miss our annual Update Course? Don't worry, we are summarizing our favorite sessions from years past. In this episode, Dr. Dan von Allmen talks us through the treatment of complicated GERD. Mark your calendars for the next Update Course: August 27, 2021

Host: Rodrigo Gerardo

Did you miss our annual Update Course? Don't worry, we are summarizing our favorite sessions from years past. In this episode, Dr. Whit Holcomb talks us through the diagnosis and management of perforated appendicitis. Mark your calendars for the next Update Course: August 27, 2021

Host: Rodrigo Gerardo

Part 2 of our series on Total Colonic Hirschsprung Disease. Here Dr. Levitt and Dr. Frischer discuss the diagnosis and management with a case scenario. Special guests - Amanda Jensen and Hira Ahmad

Host: Rodrigo Gerardo

Did you miss our annual Update Course? Don't worry, we are summarizing our favorite sessions from years past. In this episode, Dr. Steven Lee talks us through the basics of minimally invasive excision for pilonidal disease. Mark your calendars for the next Update Course: August 27, 2021

Host: Rodrigo Gerardo

We've discussed Hirschsprung Disease a lot on this podcast but we've never talked about one of the most complex forms - total colonic hirschsprung disease. Here Dr. Levitt and Dr. Frischer discuss the diagnosis and management with a case scenario. Special guest - Amanda Jensen

Host: Rodrigo Gerardo

Inguinal hernia repair is the second most common surgery performed by pediatric surgeons. Here, we discuss the basics of diagnosis and management for inguinal hernias with Dr. Meera Kotagal. Special guests Rae Hanke and Gillian Goddard.

Host: Rodrigo Gerardo

Motility disorder is a team sport - that's why today, we're talking to our colleagues in Pediatric Gastroenterology, Dr. Anil Drabari from Children's National Hospital and Dr. Kahleb Graham from Cincinnati Children's Hospital. Special guest - Amanda Jensen

Host: Rodrigo Gerardo

Despite an abundance of skilled gastroenterologists, the modern day general surgeon still needs to be comfortable operating for common bile duct stones. That's why we talked to Dr. Jeff Ponsky about the keys to diagnosis and management of choledocholithiasis with special guest Rae Hanke.

Host: Rodrigo Gerardo

Did you miss our annual Update Course? Don't worry, we are summarizing our favorite sessions from years past. In this episode, Dr. Eunice Huang and Dr. Megan Durham talk you through the workup and management for rectal prolapse. Mark your calendars for the next Update Course: August 27, 2021

Host: Rodrigo Gerardo

Motility disorder is a team sport - that's why today, we're talking to our colleagues in Pediatric Gastroenterology, Dr. Anil Darbari from Children's National Hospital and Dr. Kahleb Graham from Cincinnati Children's Hospital. Special guest - Amanda Jensen

Host: Rodrigo Gerardo

Did you miss our annual Update Course? Don't worry, we are summarizing our favorite sessions from years past. In this episode, Dr. Megan Durham and Dr. Eunice Huang talk you through some perioperative considerations for patients with Hirschsprung Disease. Mark your calendars for the next Update Course: August 27, 2021

Host: Rodrigo Gerardo

Surgery is only one piece of the puzzle when it comes to treating the colorectal patient. That's why this episode is all about the perioperative approach to bowel management with special guests Monica Holder and Katie Worst - nurses who manage patients and families in the colorectal clinic every day.

Host: Rodrigo Gerardo

Kids will eat any and everything if given the chance. But what if they eat something like a coin or worse - a button battery? In this episode, we brought in a pediatric gastroenterologist to talk about the treatment and management of digested foreign bodies with Dr. Aaron Garrison, Rae Hanke, and Alex Gibbons.

Host: Rodrigo Gerardo

Surgery is only one piece of the puzzle when it comes to treating the colorectal patient. That's why this episode is all about the perioperative approach to bowel management with special guests Monica Holder and Katie Worst - nurses who manage patients and families in the colorectal clinic every day.

Host: Rodrigo Gerardo

If you're like Rod, just the thought of an airway foreign body gives you a lump in your throat. That's why we reached out to Dr. Catherine Hart about the diagnosis and treatment of airway foreign bodies with special guests Rae Hanke and Alex Gibbons.

Host: Rodrigo Gerardo

In this episode of the colorectal quiz, Dr. Marc Levitt and Dr. Jason Frischer discuss the surgical considerations when a patient with Hirschsprung disease presents with a more proximal transition zone in the transverse colon or hepatic flexure. They're joined by special guests Dr. Andrea Badillo from Children's National hospital and Dr. Aaron Garrison from Cincinnati Children's.

Host: Rodrigo Gerardo

Did you miss our annual virtual conference, the Update Course? Don't worry, we're highlighting our favorite presentations here. In this episode, Dr. Mary Brindle and Dr. Kurt Heiss discuss the importance of ERAS in the pediatric patient and how they operationalized ERAS programs at their institutions.

Host: Rodrigo Gerardo

In this episode of the Colorectal Quiz, Dr. Marc Levitt and Dr. Jason Frischer discuss considerations when operating on a patient with classic distal sigmoid Hirschsprung disease with special guests Dr. Aaron Garrison and Dr. Andrea Badillo.

Host: Rodrigo Gerardo

Introducing the StayCurrent Pediatric Surgery Journal club - run by residents across the country. In this episode, Vik Gupta and Joe L'Huillier talk about the role of ventricular dysfunction in congenital diaphragmatic hernia and how ERAS can improve outcomes for patients undergoing a Nuss repair for pectus.

Host: Rodrigo Gerardo

In this episode, Dr. Levitt and Dr. Frischer discuss the workup and management for a patient with suspected proximal Hirschsprung disease. Listen as they walk you through a their thought process and what to consider in these complex patients.

Host: Rodrigo Gerardo

In medicine, there's a 4 letter word that we use every day from rounds to the OR: "Pimp". It's that constant barrage of clinical questions that we use to teach or even to learn. But where did this word come from? In this episode, our medical students take Rod and Todd through the history of pimping and some predictions on its future.

Credit to our medical student guests: Krithika Sundaram, Prachi Lele, Sanjana Datla, Vardhan Avasarala, Varun Aitharaju

Host: Rodrigo Gerardo

In the third episode of the Colorectal Quiz series, Dr. Levitt and Dr. Frischer discuss the basics of the initial management and diagnosis of Hirschsprung disease.

Host: Rodrigo Gerardo

We can all agree that there are too many scientific publications pushed out by journals every month. How is a clinical surgeon supposed to keep up with the constantly increasing volume of literature? Jose and his team in Chile have created a way to find impactful journal articles on pediatric surgery and narrow a monthly list down to a top 10. Rod and Todd had some questions . . .

Chilean Society of Pediatric Surgery (SChCP)

Dr. Tyare Fuentes, Dr. Bárbara Rivera, Dr. Carola San Martín, Dr. Camila Bastías, Dr. Albert Pasten, Dr. Alberto Torres, Dr. Josefina Sáez, Dr. Paula Aylwin, Dr. Mónica Ferrero, Dr. María Santos, Dr. Karen Morales, Dr. M. Consuelo Puentes, Dr. José M. Campos, Dr. Angela Cristino, Dr. Camila Pincheira, Dr. Hugo Urrutia, Dr. Javier González, Dr. Constanza Gallardo, Dr. Javiera Guiñez, Dr. Kate Ellsworth, Dr. Natalia de la Cruz, Dr. Andres Martinez, Dr. Catalina Arredondo

One of the most common procedures that surgeons and gastroenterologists perform is a percutaneous endoscopic gastrostomy tube (PEG tube). But have you ever wondered how this procedure and the PEG tube were invented? Check out our latest podcast with the co-creator of the PEG tube, Dr. Jeff Ponsky to hear a story about endoscopes, surgical innovation, and Jeff.

Host: Rodrigo Gerardo

In the second installment of the Colorectal quiz, Dr. Jason Frischer and Dr. Marc Levitt discuss a topic of debate - when is the right time to redo an anorectoplasty? Listen as they walk you through their thought process on 2 different cases before a deep dive into a recent JPS article on redo outcomes.

Read the article here: https://pubmed.ncbi.nlm.nih.gov/32682544/

Host: Rodrigo Gerardo

Dr. Rod Gerardo and Dr. Todd Ponsky talk to Dr. Jason Fraser about the paradigm shift in gastroschisis management that is still in flux. Plus a deep dive into Dr. Fraser's recent publication: "Sutureless vs sutured abdominal wall closure for gastroschisis: Operative characteristics and early outcomes from the Midwest Pediatric Surgery Consortium"

https://www.jpedsurg.org/article/S0022-3468(20)30118-4/abstract

Host: Rodrigo Gerardo

Pediatric colorectal surgeons Dr. Marc Levitt and Dr. Jason Frischer discuss a case of a new born with a low anorectal malformation. Listen as they take you through the workup, diagnosis, and treatment of an ARM with an ending that you might not have predicted.

Host: Rodrigo Gerardo

Dr. Rod Gerardo and Dr. Todd Ponsky speak with Dr. Shawn St. Peter as he explains how the management of empyema has evolved over time including a deep dive into Dr. St. Peter's recent publication "Declining frequency of thoracoscopic decortication for empyema — redefining failure after fibrinolysis".

Download our app, StayCurrent: Pediatric Surgery Follow us on Twitter, Facebook, Instagram

Host: Rodrigo Gerardo

Dr. Beth Rymeski, Dr. Rod Gerardo, and Dr. Todd Ponsky discuss the recent Midwest Pediatric Surgery Consortium publication on acute appendicitis and how it might change management in 2020 and on.

"Association of Nonoperative Management Using Antibiotic Therapy vs Laparoscopic Appendectomy With Treatment Success and Disability Days in Children With Uncomplicated Appendicitis"

Host: Rodrigo Gerardo

In this podcast, Dr. Alex Bondoc and Dr. Rae Hanke discuss the intricacies of choledochal cysts. Contributing editor: Dr. Rod Gerardo.

00:00 | Introduction 00:26 | Definition of Choledochal cyst 00:36 | Epidemiology 01:06 | Etiology 02:00 | Todani Classification 03:20 | Presentation 05:08 | Differential diagnosis 05:42 | Workup 07:54 | Why only surgical treatment options? 09:18 | When to operate 10:12 | Preoperative evaluation 11:10 | Surgical goals of care 13:17 | Surgical technique 16:42 | Type II cyst 17:40 | Type III cyst 18:43 | Post operative care 20:29 | Key clinical takeaways

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

Dr. Rae Hanke, Dr. Alex Casar, Dr. Jason Frischer, and Dr. Aaron Garrison come together to provide you the essentials on diagnosis and management of Hirschprung's Disease.

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

Dr. Meera Kotagal, Dr. Rae Hanke, and Dr. Gillian Goddard come together to provide you the essential on diagnosis and management of pediatric umbilical hernias.

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

Drs Jaimie Nathan, Rae Hanke, Alex Gibbons, and Todd Ponsky discuss the diagnosis and management of pancreatic masses.

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

This podcast is an interactive discussion about Neurogenic Bladder between Dr. Rae Hanke, Dr. Lynn Woo, and Dr. Al Ray

Dr. Lynn Woo is an Associate Professor of Urology and Program Director at Case Western and Cleveland Medical Center. She is also a Pediatric Urologist at Rainbow Babies & Children's Hospital.

Dr. Al Ray is a urology PGY-4 at Case Western and currently on his research year.

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

Dr. @lynnlwoo & Dr. Al Ray from @CaseUrology

Dr. Beth Rymeski (Fetal Surgeon) and Dr. Rae Hanke (Pediatric Surgical Education Fellow) from Cincinnati Children’s Hospital bring you highlights from the 2019 International Fetal Medicine and Surgical Society (IFMSS) meeting. Part III includes interviews focusing on clinical studies.

Special guests include: •Stephen Fenton, MD, Director of Fetal Center and Pediatric Surgeon at Primary Children’s Hospital in Salt Lake City, Utah, USA •Uchenna Kennedy, MD, Pediatric Surgeon at University Children’s Hospital Zurich, Switzerland, and previous Fellow at Children’s Hospital of Philadelphia, Pennsylvania, USA •Oluyinka Olutoye, MD, PhD, Surgeon-In-Chief at Nationwide Children’s Hospital, Ohio, USA •Christina (Nina) Bence, MD, Pediatric Surgical Research Fellow at Milwaukee, Medical College of Wisconsin, USA

IFMSS facilitates international collaboration, networking and exchange of ideas, with the goal of advancing the field of fetal diagnosis and therapy.

Check out the Stay Current: Pediatric Surgery app at https://staycurrent.globalcastmd.com/download.

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626.

Dr. Beth Rymeski (Fetal Surgeon) and Dr. Rachel (Rae) Hanke (Pediatric Surgical Education Fellow) from Cincinnati Children’s Hospital bring you highlights from the 2019 International Fetal Medicine and Surgical Society (IFMSS) meeting. Part II includes interviews focusing on technical and educational innovation.

Special guests include: •Stephen Emery, MD, Director of Center for Innovative Fetal Intervention at University of Pittsburgh Medical Center & Associate Professor of Obstetrics and Gynecology at Pittsburgh Magee Hospital, Pennsylvania, USA •Jose Peiro, MD, Director of Endoscopic Fetal Surgery at the Cincinnati Fetal Center and Associate Professor at the University of Cincinnati Department of Surgery, Ohio, USA •Anouk van der Schot, MSc, technical physician at Radboud University Medical Center, Netherlands •Jena Miller, MD, Assistant Professor of Gynecology and Obstetrics at Johns Hopkins Center for Fetal Therapy and Lead of Fetoscopic Spina Bifida Repair Program, Maryland USA

IFMSS facilitates international collaboration, networking and exchange of ideas, with the goal of advancing the field of fetal diagnosis and therapy.

Check out the Stay Current: Pediatric Surgery app at https://staycurrent.globalcastmd.com/download.

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626.

Dr. Beth Rymeski (Fetal Surgeon) and Dr. Rachel (Rae) Hanke (Pediatric Surgical Education Fellow) from Cincinnati Children’s Hospital bring you highlights from the 2019 International Fetal Medicine and Surgical Society (IFMSS) meeting. Part I includes interviews focusing on translational research and clinical trials.

Special guests include: •Ueli Moehrlen, MD, Pediatric Surgeon at University Children’s Hospital Zurich, Switzerland •Benjamin Amberg, MD/PHD student at Monash University, Melbourne, Australia •Barbara Coons, MD, recent Research Fellow at Children’s Hospital of Philadelphia and General Surgery Resident at Columbia-Presbyterian, New York, USA •David Stitelman, MD, Pediatric Surgeon at Yale University, Connecticut, USA •Adele Ricciardi, MD/PhD student at Yale University, Connecticut, USA •Anna David, MD, Obstetrician and Maternal Fetal Medicine specialist and Director of the Institute of Women’s Health at the University College London Hospital, UK •Eric Jelin, MD, Pediatric Surgeon and Fetal Program Director at John’s Hopkins Children’s Center, Maryland, USA

IFMSS facilitates international collaboration, networking and exchange of ideas, with the goal of advancing the field of fetal diagnosis and therapy.

Check out the Stay Current: Pediatric Surgery app at https://staycurrent.globalcastmd.com/download.

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626.

This is a guest podcast and collaboration with the EAST Traumacast, which highlights the Sixth Annual Pediatric Trauma Society Meeting in November 2019.

Dr. Ian Mitchell from Children's Hospital San Antonio, Dr. Alexander Gibbons from Akron Children's Hospital, and Dr. Alejandra Casar Berazaluce from Cincinnati Children's Hospital hosted several interviews to discuss some of the main topics from the meeting.

EAST Traumacast focuses on bringing the leaders of the trauma community together to address upcoming research and its application to the injured patient, education efforts related to trauma, and novel methods in the management of injury. Find more at https://www.east.org/education/online/traumacasts.

Dr. Pramod Puligandla, Pediatric Surgeon and Intensivist at Montreal Children’s Hospital, joins the Stay Current in Pediatric Surgery team to discuss the essentials on burn resuscitation.

Podcast edited and narrated by Rachel (Rae) Hanke, MD at Cincinnati Children's Hospital.

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626.

Director of Interventional Radiology Innovation Dr. John Racadio and Pediatric Surgeon-in-Chief Dr. Daniel von Allmen of Cincinnati Children’s Hospital discuss their experiences in the Hybrid OR, how they built it, and how cross-specialty collaboration with pulmonary, urology, and orthopedic surgeons has greatly improved patient care.

This episode is hosted by Dr. Aaron Fritts, interventional radiologist with Interventional & Vascular Care in Dallas, Texas. The BackTable Podcast is a resource for vascular and interventional specialists to learn tips, techniques, and the ins and outs of the devices in their cabinets. Find out more at https://www.backtable.com/podcast.

Dr. Pramod Puligandla, Traumatic Pediatric Surgeon and Intensivist at Montreal Children’s Hospital, joins the Stay Current Team to review the Cliff Notes on traumatic brain injury (TBI).

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626.

This podcast is an interactive discussion about the management of coagulopathy, analgesia, sedation, and delirium in critically ill pediatric patients between Dr. Adam Vogel and Dr. Alexander Gibbons.

00:00:00:00 Introduction 00:01:22:01 Case Scenario: 12-year-old male in helmeted MVC vs. bicycle accident 00:02:36:10 See Where You Are 00:05:22:17 Initial Therapy 00:06:26:04 General Management 00:07:00:04 Viscoelastic Monitoring 00:08:05:01 Phases of Viscoelastic Monitoring 00:10:47:02 Targeted Therapy 00:11:42:25 Real Time Monitoring 00:14:38:13 Management of Fibrinolysis 00:16:06:18 Balanced Resuscitation 00:17:26:16 Efficiency 00:18:12:29 Pediatric Evidence 00:19:07:08 Massive Transfusion and Balanced Resuscitation 00:19:42:28 Case Scenario: Pain Control After Laparotomy 00:21:02:12 Narcotics 00:22:08:19 Regional Analgesia 00:23:29:12 Anxiety 00:25:43:24 Case Scenario: Sedation 00:27:51:13 Validated Pain Scores 00:29:53:14 Validated Sedation Scores 00:31:23:23 Sedation Holidays and ABCDEF Bundles 00:32:09:08 A: Assessing Pain 00:32:20:29 B: Breathing and Awakening Trials 00:33:30:15 C: Choice of Analgesia and Sedation 00:34:24:15 D: Delirium 00:34:31:25 E: Early Mobility and Exercise 00:34:37:24 F: Family Engagement 00:35:47:28 Case Scenario: Post-Operative/ICU Delirium 00:36:38:04 Risk Factors for Delirium 00:37:21:15 Delirium Assessment Tools 00:39:23:20 Evaluating for Causes of Altered Mental Status 00:40:36:16 Multimodal Treatment for Delirium 00:42:51:23 Preventing Delirium 00:43:58:22 Conclusion 00:44:21:22 Outro/Teaser

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

This episode is a review of pediatric ECMO with Dr. Samir Gadepalli, Dr. Alejandra Casar Berazaluce, and Dr. Todd Ponsky.

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

Ponsky fellows Rae Hanke, Alex Casar and Alex Gibbons join forces to bring you highlights from IPEG 2019. Interviews with Drs Jordan Taylor, Daniel von Allmen, Bethany Slater, Philipp Szavay, Aayed Alqahtani, Steven Rothenberg and Whit Holcomb cover a breadth of topics, including using virtual reality to reduce sedation, repairing esophageal atresia with magnets, innovations in bariatric surgery and more!

Enjoying Stay Current podcasts? Then you should check out the StayCurrent app for an even better listening experience including the ability to skip straight to the sections and topics you want, read the key points and highlights, resume where you left off, join comments and discussions, watch videos, and much more! Find in the app store--StayCurrent: Pediatric Surgery--or follow this link to download https://staycurrent.globalcastmd.com/.

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

483618

Drs Daniel von Allmen, Todd Ponsky and Rae Hanke come together to provide you the essentials on the diagnosis and management of Neuroblastoma.

Time Stops: 00:00 | Introduction 00:23 | Epidemiology 00:37 | Presentation 01:01 | Work Up 02:36 | Pre-biopsy staging 03:53 | Management 05:09 | Post-biopsy risk stratification 09:00 | Clinical Pearls

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

This episode is a panel discussion by members of the Benjy Brooks (Women of APSA) Committee during the APSA 50th Anniversary Meeting in celebration of Women in Medicine Month. It is part of our collaboration with the Behind the Knife podcast.

Join Dr. Kathryn Anderson, Dr. Diana Farmer, and Dr. Marion Henry as they share their stories of flat heads from breaking glass ceilings and paving the way for women in Pediatric Surgery.

Edited by Alejandra M. Casar Berazaluce, MD.

Music tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

This episode reviews the Top Educational Content sessions from the APSA 50th Anniversary meeting. It is part of our collaboration with the Behind the Knife podcast.

-Dr. Aaron Jensen discusses Cervical Spine Clearance in Pediatric Trauma. -Dr. Shawn Rangel covers Antibiotic Stewardship in Pediatric Surgery. -Dr. Samir Gadepalli addresses Sepsis as a Surgical Problem. (Tweetorial at https://twitter.com/alejandracasar/status/1130466960943267840)

Remember to review the 2018 Pediatric Surgery Practice Gaps by the APSA Professional Development Committee. (Available in the StayCurrentApp Video Library and at https://twitter.com/StayCurrentApp/status/1141048992782069761)

Edited by Alejandra M. Casar Berazaluce, MD.

Music tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

Drs Erika Newman, Dan von Allmen and Tony Sandler join Dr. Todd Ponsky in a discussion covering the latest in neuroblastoma.

Time Stops 00:00:31 Introductions 00:01:39 Case 1: Prenatal 26 week consult 00:01:55 Differential Diagnosis 00:02:29 Family counseling 00:04:05 Postnatal evaluation 00:04:33 Axial imaging 00:06:53 MIBG scan 00:07:05 Metastasis in neonatal phase 00:07:19 Observe? 00:08:23 Surveillance 00:12:35 To operate or not to operate? 00:13:49 Surgical Approach 00:14:44 Case 1: Now with metastasis 00:16:21 When to biopsy 00:18:08 Case 2: 3 year old with abdominal mass 00:18:29 Initial evaluation 00:20:31 Case 2 continued...management 00:21:49 Do you need a PET scan? 00:23:28 Laparoscopic vs Percutaneous vs Open Biopsy 00:31:18 Staging 00:36:56 Case 2 continued...further management 00:40:54 When to perform surgery in relation to chemotherapy 00:43:56 Surgical Approach 00:53:33 Immunotherapy

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

Topics in 10: Drs Andrew Davidoff, Todd Ponsky and Rae Hanke come together to provide you the essentials on the diagnosis and management of Wilms Tumor.

Contributing editor: Rachel (Rae) Hanke, MD

00:00:00:00 Introduction 00:00:15:24 What is Wilms tumor? 00:01:16:27 How does it present? 00:01:41:05 What do you do to work up suspected renal mass? 00:02:55:00 Staging (1 through 5) 00:04:03:13 Management 00:04:08:09 Unilateral disease 00:06:49:00 Bilateral disease 00:07:26:07 Solitary kidney or unilateral tumor but predisposed to developing second tumor 00:08:37:04 Intravascular tumor extension 00:09:52:29 Metastasis 00:11:03:14 Wilms Tumor Clinical Pearls

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

This podcast is an interactive discussion about the management of spontaneous pneumothorax between Dr. Todd Ponsky and Dr. Dan Ostlie.

Dr. Ostlie is Surgeon-in-Chief, Chair of Surgery, and Executive Vice-President at Phoenix Children’s Hospital, and has helped carry out multiple studies looking at the optimal way to manage spontaneous pneumothorax in pediatric patients.

00:00:00:00 Introduction 00:01:24:19 Case Scenario: 16-year-old male with right-sided chest pain 00:02:21:12 Historical Management of Spontaneous Pneumothorax 00:05:01:18 What We Know Now 00:07:29:03 Option of Immediate VATS 00:08:58:07 Midwest Consortium 00:10:27:03 Rationale of Aspiration 00:12:16:03 Aspiration Study from Midwest Consortium 00:17:30:26 Algorithm from the Aspiration Study 00:17:53:20 Outcomes in Patients Discharged Home after Aspiration Alone 00:20:18:14 How would you counsel a family based on this study? 00:22:07:23 Technique for Aspiration 00:22:59:07 Technical Considerations for VATS 00:23:21:21 Is there a role for pleurodesis? 00:24:55:15 Talc or Chemical Pleurodesis 00:26:00:17 Role of CT 00:27:22:16 Management of Multiply Recurrent Pneumothorax 00:29:46:27 Small Recurrence after VATS with Pleurodesis 00:31:16:24 Conclusion and Future Steps 00:32:48:23 Teaser

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

Next in our #APSA50 series, comes a thoughtful discussion regarding academic surgery and future transformations. Dr. Ron Hirschl starts us off with a discussion on the changes they implemented at this years’ conference, including focused TED-style talks and presentations beyond the field of surgery. Dr. Allan Goldstein shares his thoughts on the shifting general surgery paradigm. We wrap it up with a continued debate on the role of social media in academic medicine. Drs Allan Goldstein and Todd Ponksy share their differing opinions.

Have a listen, and tell us—what do you think? How do you think academic medicine will change? How can we harness the benefits of social media without losing the validity assigned to publications and presentations are attributed with?

Join the discussion and let us know what you think!

Timestops: 00:00:00 Introduction 00:00:31 Dr. Ron Hirschl discusses changes at #APSA50 00:03:07 Other possible changes in surgical training 00:05:07 What is social media’s role in academic medicine 00:06:15 The Allan Goldstein perspective 00:07:58 The Todd Ponsky perspective 00:11:15 Conclusion

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

The 50th APSA meeting featured a debate moderated by Dr. Jacob Langer from The Hospital for Sick Children. The topic debated was: "Be it resolved that I would NOT encourage my daughter or son to become a pediatric surgeon."

Representing the side supporting this statement were Dr. Cathy Burnweit from Nicklaus Children's Hospital and Dr. Daniel Ostlie from Phoenix Children's Hospital. Representing the side against this statement were Dr. Andrea Hayes-Jordan from North Carolina Children's Hospital and Dr. Douglas Barnhart from Primary Children's Hospital.

00:00:00 Introduction 00:36:05 Dr. Langer’s Preface 03:25:00 Dr. Burnweit’s Opening Argument (Pro) 08:39:07 Dr. Hayes-Jordan’s Opening Argument (Con) 13:25:04 Dr. Ostlie's Continued Argument (Pro) 18:32:16 Dr. Barnhart’s Continued Argument (Con) 24:19:24 Dr. Ostlie’s Rebuttal (Pro) 28:02:20 Dr. Hayes-Jordan’s Rebuttal (Con) 32:03:06 What are your thoughts about the effect of having more women in the specialty? 37:12:26 How can we change APSA to make it more effective? 46:34:15 What are your thoughts on the huge number of unanswered questions in pediatric surgery? 48:53:13 Dr. Barnhart’s Closing Arguments (Con) 52:52:26 Dr. Ostlie’s Closing Arguments (Pro) 54:39:19 Dr. Hayes-Jordan’s Closing Arguments (Con) 56:06:23 Dr. Burnweit’s Closing Arguments (Pro) 58:47:27 Conclusion

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

This episode is the third in our #APSA50 series, where we teamed up with the Behind the Knife Podcast to cover the 50th Anniversary Meeting of the American Pediatric Surgical Association. In this episode, we interviewed Dr. Michael Muelly, who gave the first of the meeting's PED (Pediatric Surgery, Education, and Disruption) talks on the topic of artificial intelligence in healthcare.

Dr. Muelly is a product manager at Google Cloud’s Healthcare & Lifesciences team and is a radiology faculty member at Stanford University. He has spent time researching machine learning, and has co-founded companies dedicated to bringing radiology to the cloud.

Stay tuned for more coverage of the 50th annual APSA meeting.

00:00:00:00 Introduction 00:01:11:07 How has AI already changed healthcare? 00:02:20:10 Examples of AI in Radiology 00:02:53:27 Will AI replace physicians? 00:03:43:02 AI and evidence-based medicine 00:04:19:01 Potential AI applications for surgery 00:06:19:18 AI in the ICU 00:07:39:15 Limitations of AI 00:11:03:12 Using the Cloud to gather datasets 00:12:02:28 Ethical concerns of AI 00:13:21:00 Future of AI in medicine 00:14:23:21 Outro

Intro and outro tracks are adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

This is the next episode in our #APSA50 series, where we teamed up with the Behind the Knife Podcast to cover the 50th Anniversary Meeting of the American Pediatric Surgical Association. The coverage of the conference wouldn’t be complete without a little history lesson and guidance for the future. Drs Jim O’Neill, Jr. and Jo Shapiro join Rae Hanke, Alex Casar and Alex Gibbons to take a journey through the past and peak into the future.

Throughout the discussion, we first review the journey of three pediatric surgery pioneers, Drs William Ladd, Herbert Coe, and Oswald Wyatt. Dr. O’Neill shares the efforts of H. William Clatworthy as he approached the American Board of Surgery to identify the reasoning for refusing Pediatric Surgery Board Certification. In brief this was due to the belief that we held no unique body of knowledge beyond general surgery, had no association with surgical roots, had no standard curriculum or standards for certification, and finally did not have a structure of governance. He goes on to detail how these objections were overcome, involving the foundation of APSA and JPS. Dr. O’Neill goes on to highlight the clinical, technical and educational advancements made over the past 50 years. He challenges us to even more so increase our educational collaboration amongst other pediatric specialists.

In continuity with this call for change from Dr. O’Neill, Dr. Shapiro discusses another exciting opportunity for the future of pediatric surgery—improving physician well-being. She emphasizes the challenges we face and the necessity for operationalizing proactive peer support programs. By facing the traumatic events we experience, we will improve patient care by decreasing physician burnout, depression and suicide.

Will you accept their challenge to increase educational collaboration and encourage wellness amongst those around you? Continue this conversation on the StayCurrentApp.

Stay tuned for a few more APSA 2019 highlights captured by the Behind the Knife Podcast team.

Time Stops: 00:00:23 Introduction 00:00:49 Journey of pediatric surgery pioneers 00:01:20 Three pioneers devoted to Pediatric Surgery: William Ladd, Herbert Coe, and Oswald Wyatt 00:03:48 H. William Clatworthy and his insight 00:04:09 Why can't pediatric surgery obtain boards? 00:05:13 Objection 1: no unique body of knowledge beyond general surgery 00:05:37 Objection 2: no association with surgical roots 00:05:55 Objection 3: no approved curriculum or metrics for certification 00:06:56 Objection 4: no structure of governance 00:07:28 Linchpins: APSA and JPS designed to meet perceived deficiencies 00:07:59 Since board approval: clinically, technologically, and educationally 00:09:16 Endorsement of other pediatric surgery subspecialties 00:09:45 Call for future collaboration—particularly in education 00:12:11 Opportunity for impact through APSA 00:12:58 Along with this incredible profession comes significant challenges 00:13:29 Operationalizing proactive Peer Support Program 00:14:06 Not facing traumatic events leads to burnout, depression and suicide 00:14:40 Our emotional and physical well-being impacts patient care 00:14:54 As caring individuals, we deserve care 00:15:07 Shift to embrace our humanity 00:15:42 Now, let's do something to improve well-being

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

This episode is the first in our #APSA50 series, where we teamed up with the Behind the Knife Podcast to cover the 50th Anniversary Meeting of the American Pediatric Surgical Association. It is a conversation between Alex Casar, Alex Gibbons, Rae Hanke, and our invited guest.

It presents an interactive discussion and thoughtful reflection on the topic of Social Determinants of Health, which was a cornerstone of this year’s meeting.

Social determinants of health refer to factors like economic stability, housing, transportation, physical and psychological safety, zip code and geography, literacy and education, hunger, poverty, community support and engagement, discrimination, stress, and linguistic and cultural competencies from providers that affect healthcare outcomes like quality of care, mortality, morbidity, life expectancy, and even healthcare costs.

We had the opportunity to interview Adam Foss – a lawyer, former District Attorney, and founder of Prosecutor Impact, a nonprofit organization improving community safety in the United States through culture change in the criminal justice system.

We hope you feel as simultaneously uncomfortable and enlightened by his message as the audience did in person.

Our role as pediatric surgeons extends way further than the walls of our operating rooms. It is our responsibility as medical providers and community leaders to identify areas of opportunity within our reach and tackle them to improve healthcare outcomes.

Join the conversation and share with us the steps you are taking to alleviate these disparities. Remember that your actions and commitment are contagious.

Stay tuned for more updates from APSA 2019.

Time Stops: 00:00:00 Introduction 00:00:24 Opening Remarks 00:01:45 Adam Foss 00:02:38 How are kids in the US at a disadvantage? 00:04:06 What can we do as Pediatric Surgeons? 00:06:22 Inequities in Medicine 00:11:00 Can diversifying our workforce improve patient care? 00:12:42 Message to Pediatric Surgeons 00:13:54 Here’s what you missed! 00:14:16 Presidential Symposium Introduction 00:14:57 Swords and Shields: A Discussion of Power, Privilege, and Opportunity 00:46:49 Closing Remarks

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

This podcast is an interactive discussion about gallstone disease between Dr. Todd Ponsky and his father, Dr. Jeffrey Ponsky.

Dr. Jeffrey Ponsky is a professor of surgery at Cleveland Clinic Lerner College of Medicine, and is an expert in advanced therapeutic endoscopic treatment of biliary disease.

00:00:00:00 Introduction 00:01:55:10 Work-Up for Right Upper Quadrant Abdominal Pain 00:03:41:03 Case 1: 14-year-old overweight female 00:06:33:01 Laparoscopic Cholecystectomy Tips and Tricks: Port Placement 00:10:22:05 Tips for the Difficult Laparoscopic Cholecystectomy 00:12:58:16 Tips for the “Easy” Laparoscopic Cholecystectomy 00:14:48:12 Tips and Tricks for Cholangiography 00:18:33:29 Same-Day Discharge? 00:19:35:25 Case 2: One Week of Symptoms 00:20:17:19 Case 3: Excessive Post-Operative Pain 00:23:22:22 Case 4: Biliary Dyskinesia 00:23:44:28 Case 5: Gallstone Pancreatitis 00:27:27:14 Gallstone Pancreatitis: OR vs. ERCP 00:29:31:13 Maneuvers to Clear the Common Bile Duct 00:34:01:07 Todd’s Takeaway: Gallstone Pancreatitis 00:34:41:11 Laparoscopic Common Bile Duct Exploration 00:39:02:05 Case 6: Severe Gallstone Pancreatitis 00:39:43:12 Choledochoduodenostomy 00:40:30:08 Case 7: Pericholecystic Phlegmon 00:42:20:17 Pitfalls: Why Do CBD Injuries Occur? 00:43:34:20 Pitfalls: What to Do with a CBD Injury 00:45:26:13 Pitfalls: Complete CBD Transection 00:45:59:17 Closing Remarks 00:46:23:27 Teaser

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

This episode is an interactive discussion about Unconscious Bias between Dr. Todd Ponsky, Dr. Julie Freischlag, Dr. Mary Brandt, Dr. Quinn Capers IV, Dr. Alejandra (Alex) Casar Berazaluce, Dr. Rachel (Rae) Hanke, and Dr. Alexander Gibbons.

Dr. Julie Freischlag is CEO of Wake Forest Baptist Medical Center and Dean of Wake Forest School of Medicine. Dr. Mary Brandt is a Professor of Surgery, Pediatrics, and Medical Ethics at Baylor College of Medicine and a Pediatric Surgeon and Director of the Adolescent Bariatric Surgery Program at Texas Children’s Hospital. Dr. Quinn Capers IV is the Associate Dean for Admissions, Associate Professor of Medicine (Cardiovascular Medicine), and Program Director of the Interventional Cardiology Fellowship at The Ohio State University College of Medicine.

Time stops: 00:01:06:17 Introduction 00:04:05:20 What is unconscious bias? How has it affected your career? 00:16:59:16 How does unconscious bias relate to social identity? 00:21:34:12 How do you approach a colleague putting together a manel? 00:23:23:09 How can we identify talent outside of our immediate group? 00:27:42:05 What can we do to counteract implicit bias? 00:40:05:08 What are your take home messages about discrimination in medicine? 00:50:10:09 How do we use and interpret the results of an Implicit Association Test? 00:51:45:14 How do we bring attention to unconscious bias without being labeled as radicals? 00:56:48:00 Closing remarks

Music track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

This podcast is a discussion of the international approach to diagnosis and management of biliary atresia, amongst Dr. Todd Ponsky, Dr. Yamataka Atsuyuki, Dr. Greg Tiao, Dr. Mark Davenport, and Dr. Jorge Bezerra.

Dr. Greg Tiao is the Director of General and Thoracic Surgery, Frederick C. Ryckman Chair in Pediatric Surgery, Surgical Director of Liver Transplantation, and Associate Director of the Pediatric Surgery Fellowship at Cincinnati Children’s Hospital. Dr. Yamataka Atsuyuki is Professor and Head of Pediatric General and Urogenital Surgery at Juntendo University in Tokyo, Japan. Dr. Mark Davenport is the Head of Department of Pediatric Surgery and Professor at King’s College Hospital, London, and immediate past President of BAPS. Dr. Jorge Bezerra is the Director of the Division of Gastroenterology, Hepatology and Nutrition, and Medical Director of the Pediatric Liver Care Center at Cincinnati Children’s Hospital.

Time Stops: 00:01:41 Gastroenterology: Back to beginning for evaluation 00:04:10 Future Evaluation Options 00:05:48 Post-operative Steroids 00:11:15 Steroid Regimens 00:16:17 Potential side effects of steroids 00:18:07 Timing of steroid initiation 00:19:03 Post-Operative Antibiotics 00:20:14 Post-Operative Nutrition 00:21:08 Case 2: 100-day-old infant with a similar presentation 00:25:23 Case 3: Patient younger than two weeks with similar presentation 00:27:08 Post-Operative Complications 00:27:19 Cholangitis 00:30:17 Non-clearance of bilirubin 00:32:30 Role of cytomegalovirus (CMV) 00:37:24 Patients with initial clearance of jaundice who then require transplantation

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

This podcast is a discussion of the international approach to diagnosis and management of biliary atresia, amongst Dr. Todd Ponsky, Dr. Yamataka Atsuyuki, Dr. Greg Tiao, Dr. Mark Davenport, and Dr. Jorge Bezerra.

Dr. Greg Tiao is the Director of General and Thoracic Surgery, Frederick C. Ryckman Chair in Pediatric Surgery, Surgical Director of Liver Transplantation, and Associate Director of the Pediatric Surgery Fellowship at Cincinnati Children’s Hospital. Dr. Yamataka Atsuyuki is Professor and Head of Pediatric General and Urogenital Surgery at Juntendo University in Tokyo, Japan. Dr. Mark Davenport is the Head of Department of Pediatric Surgery and Professor at King’s College Hospital, London, and immediate past President of BAPS. Dr. Jorge Bezerra is the Director of the Division of Gastroenterology, Hepatology and Nutrition, and Medical Director of the Pediatric Liver Care Center at Cincinnati Children’s Hospital.

Time stops: 00:02:28 Case 1: 50-day-old male with jaundice and clay-colored stools 00:03:26 Stool Card 00:05:20 Differential diagnosis 00:06:01 Bloodwork 00:07:48 Initial imaging: Ultrasound 00:09:38 Absence of gallbladder on ultrasound, now what? 00:09:49 Biopsy? 00:11:13 Scintography and diagnostic laparoscopy? 00:13:50 NASPHGAN Guidelines 00:14:44 Biopsy results 00:17:14 Role of ERCP 00:18:21 After positive biopsy, exploration and cholangiogram 00:19:09 Performing the Kasai procedure 00:19:29 Open Kasai (Davenport) 00:20:19 Open Kasai (Tiao) 00:21:36 Laparoscopic Exploration and Kasai (Yama) 00:25:48 US: Tips & Tricks for the operation 00:28:15 London: Tips & Tricks for the operation 00:30:31 Japan: Tips & Tricks for the operation

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

This podcast is a multidisciplinary discussion on a controversial topic, management of pediatric Gastroesophageal Reflux Disease, amongst Dr. Todd Ponsky, Dr. Rachel Rosen, and Dr. George "Whit" Holcomb.

Dr. Rachel Rosen is Director of the Aerodigestive Center and Pediatric Gastroenterologist at Boston Children's Hospital, and Associate Professor of Pediatrics at Harvard Medical School. Dr. George "Whit" Holcomb is the Senior Vice President at Children's Mercy Hospital, Director of the Center for Minimally Invasive Surgery, Professor of Pediatric Surgery at University of Missouri-Kansas City School of Medicine, and Editor in Chief of the Journal of Pediatric Surgery.

Time stops: Introduction| 00:24:00 Work up of a patient with GERD like symptoms| 02:50:27 Esophagoscopy| 08:22:11 Normal Endoscopy - What next | 15:57:17 Management of "suspected GERD" who are unable to feed | 24:40:07 pH impedance testing| 40:07:14 When to do surgery? | 43:15:25 Neurological impairment | 50:21:22 Botox injections | 53:43:15 The perfect Fundoplication | 56:23:15 Post Nissen Retching | 61:32:28 Pyloroplasty | 64:17:00 Gastric stimulation| 65:17:00 Transoral Incisionless Fundoplication | 66:06:02 Failed fundoplication| 70:11:02 Esophageal dissociation| 75:25:11 Ruminators| 77:51:13 Conclusion | 80:00:20

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626

This podcast is an interactive discussion about pediatric trauma between Dr. Todd Ponsky, Dr. Mark McCollum, and Dr. David Notrica.

Dr. David Notrica is the trauma medical director at Phoenix Children's Hospital and is associate professor of surgery at the Mayo Clinic College of Medicine and Associate Professor of Surgery at the University of Arizona College of Medicine in Phoenix. 00:01:30 Dr. David Notrica 00:02:28 Can you tell us a little bit more about what ATOMIC is and what you guys did about it? 00:05:12 In patient with blunt solid organ injury, what is the evidence to support non-operative management based on hemodynamic status as opposed to a grade of injury? 00:07:45 Can you describe some of the other factors that we would use to define hemodynamic stability? 00:10:22 Do you use that in your center? Are the vital signs indexes like the shock index or laboratory values like serum lactate in addition to physical exam findings? 00:12:44 From a crystalloid infusion standpoint, what are your thoughts as far as limiting crystalloid infusion and patients that you know are actively bleeding not crystalloid, but bleeding blood? 00:15:57 What about the complications of transfusion short term and long term and how do we know that that is now not going up because we're giving more blood? 00:19:08 It seems like now real viscoelastic assays TEG and Rotem are getting a lot more traction so that we're directing component therapy specifically as opposed to shot gunning a transfusion. I would love your thoughts on that? 00:19:11 In a patient who has ongoing bleeding is he hemodynamically unstable and you're in the process of resuscitating them with blood products. What are your thoughts on angioembolization its safety and efficacy in pediatric of blunt liver and spleen injury? 00:22:05 So once we have these patients resuscitated and stable in kids with solid organ injury should ICU admission be determined then by injury grade, hemodynamics or a combination of both? 00:23:18 Do you have a threshold of volume of transfusion that would then indicate failure or is it a case by case? 00:24:33 What are your thoughts as far as time frame for bedrest? How long and what are the parameters that help you decide? 00:26:15 In hemodynamically stable patients, do you use a timeframe for observation or are they able to be fast tracked and may be discharged within 24 hours? 00:27:47 Do you have criteria or a threshold, Hematocrit or hemoglobin point that indicates lab variability versus actual continued bleeding? 00:29:31 So, whenever these kids are ready to go home, do you have a standard follow up regimen of a week, two weeks, four weeks. The rest issue I'll let you discuss as well, as far as time frame where they really stay off of activities until you see them back? 00:31:05 is there a type of injury a finding on imaging or a symptom that would then maybe move you to schedule additional imaging in follow up to avoid a complication like a pseudoaneurysm or AV fistula or something along those lines? 00:33:00 So, then it even in a grade 4 or a grade 5 injury with an active extravasation there's no real utility van and scheduling a post or a follow up ultrasound or additional imaging? 00:34:52 For a patient who is stabilized to the point that he is ready for discharge, what criteria do you use then for timeframe of follow up? 00:37:07 Review 00:41:23 Resources 00:43:11 Final comment

An interactive discussion between Dr. Ponsky and Dr. Rescorla about the management of ovarian tumors in pediatric patients.

Dr. Frederick Rescorla is surgeon-in-chief at Riley Children's Hospital, Anna Olivia Healey Professor of Pediatric Surgery at Indiana University School of Medicine, and COG germ cell committee member.

Timestops: 00:00:00 Introduction 02:17:12 Case 1: Ovarian cystic mass with solid components 04:09:16 Overview of ovarian tumors 05:18:22 Workup of Case 1 08:02:10 Operative technique 11:06:21 Exploring retroperitoneal lymph nodes 12:40:13 Ovarian Salvage 14:20:07 Case 2: Large ovarian cystic mass in adolescent 16:59:00 Operative technique 18:23:23 Case 3: Solid ovarian mass in adolescent 20:27:09 Preoperative workup 21:10:02 Surgical approach 23:41:06 Chemotherapy 24:01:05 Cryopreservation 24:31:14 Case 4: Ovarian torsion 26:31:15 Role of oophoropexy 28:42:13 Follow up after torsion without a mass 29:11:22 Outcomes 31:57:20 Conclusion

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: creativecommons.org/licenses/by/3.0/

An interactive discussion between Dr. Ponsky, Dr. Harmon and Dr. Inge about the role of bariatric surgery in pediatric patients.

Dr. Inge is Chief of Pediatric Surgery, Akers Endowed Chair in Pediatric Surgery, and Director of Adolescent Bariatric Surgery at Children’s Hospital of Colorado.

Dr. Harmon is professor of Surgery at University of Buffalo and Surgeon-in-Chief at Oishei Childrne’s Hospital.

Timestamps: 00:00:00 Introduction 00:01:37 Need for Bariatric Surgery in the current era 00:03:05 Non-operative therapy for obesity 00:06:13 Pharmacotherapy for obesity in adolescents 00:07:13 Timing of bariatric surgery 00:09:46 Patient referral 00:12:12 Multidisciplinary pre-operative management 00:15:55 How often is surgery recommended 00:19:44 Surgical options 00:23:48 Technical steps of operation: Sleeve gastrectomy 00:30:21 Technical steps of operation: Roux-en-Y gastric bypass 00:33:20 Postoperative protocol 00:34:55 Complications 00:37:52 Weight loss outcomes 00:39:03 Health benefits 00:40:46 Long-term outcomes 00:43:48 Research directions 00:48:54 Conclusion

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: creativecommons.org/licenses/by/3.0/

An interactive discussion between Todd Ponsky, MD and Max Langham, MD on the management of hepatoblastomas.

Dr. Max Langham is a Professor of Surgery and Pediatrics and the Vice Chairman of the Department of Surgery at the University of Tennessee Health Science Center.

Table of Contents 00:00 - Introduction 01:15 - Work-up of a newly diagnosed liver mass 04:20 - Differential diagnosis of liver mass 08:03 - Tumor biopsy 10:11 - Pretext staging system 14:43 - Upfront resection 16:18 - How to use the pretext system to determine resectability 20:14 - Annotation factors 22:25 - Histologic subtypes 25:17 - Management of unresectable tumors 28:44 - What makes hepatoblastoma high-risk? 30:52 - Approach to pulmonary metastases 34:01 - Chemotherapy regimen for metastatic hepatoblastoma 35:29 - Maneuvers to improve safety and success of liver resection 38:27 - Anesthesia care during resection 39:32 - Key surgical steps 41:58 - When to consider extreme resection and Vascular reconstruction 44:35 - Recurrent disease 46:36 - Post-resection care 47:49 - Management of pretext 4 lesions 49:45 - Summary

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: creativecommons.org/licenses/by/3.0/

This podcast is a discussion between Dr. Todd Ponsky and Dr. Patricio C. Gargollo who is the senior associate consultant pediatric urology at the Mayo Clinic Rochester and associate professor of urology at the Mayo medical school. It is a bout pediatric urology mostly regarding external genitalia and this is going to be an overview for pediatric surgeons to get an idea about all the things that we probably should know about external genitalia as a relates to pediatric urology. Facilitator: Dr. Todd Ponsky Editors: Dr. Todd Ponsky, Dr. Sophia Abdulhai, Dr. Abdulraouf Lamoshi and Dr. Raghavendra Rao

Speaker: Dr. Robert L. Sheridan Facilitator: Dr. Todd Ponsky Editors: Dr. Todd Ponsky, Dr. Sophia Abdulhai, Dr. Abdulraof Lamoshi and Dr. Raghavendra Rao

Dr. Maisam A. Abu-El-Haija acute pancreatitis presentation, she is the medical director of pancreas care center, division of pediatric gastroenterology at Cincinnati Children's Hospital, with participation from some experts and audience

An interactive discussion about Wilms tumor between Todd Ponsky, MD, Avraham Schlager, and Peter Ehrlich, MD.

Dr. Peter Ehrlich is a professor of pediatrics surgery at the University of Michigan C.S. Mott Children’s Hospital who is also a vice chair of surgery and renal tumor section of the children oncology group.

Table of Contents 00:00 - Introduction 01:09 - Typical clinical case? 03:27 - Wilms tumor CT scan 04:48 - What after CT scan 06:10 - Therapeutic options 09:15 - Management of widespread tumor 10:18 - Intestinal invasion 10:57 - tumor upstaging 12:35 - Different therapeutic approaches 14:57 - Crossing midline tumor 15:35 - Lung lesion impact on the approach 17:15 - Biopsy technique 18:39 - Possibility of negative biopsy 19:18 - Central line type 23:02 - Chemotherapy regimen 25:02 - Stage I and II with lung lesion 27:39 - Need for lung lesion biopsy 29:02 - Lung lesion after nephrectomy 29:19 - Treatment without biopsy 30:08 - Differences between COG and SIOP 31:16 - Abdominal radiation criteria 32:20 - Impact of spillage 33:09 - Unclear imaging 34:12 - preoperative preparation 37:15 - patient position and incision 40:15 - Artery versus vein 40:40 - Placing metal clip 41:10 - significance of the surgical margins 42:12 - Frozen section 43:23 - Surgery alone 45:50 - Caval extension management 48:41 - Effect of chemotherapy on the tumor 49:23 - Technical steps to remove thrombus 52:29 - Pathological results 56:48 - Surprises: other types 57:40 - Bilateral wilms 01:00:28 - Role of the biopsy 01:02:35 - radiation after the biopsy 01:03:11 - Closure

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: creativecommons.org/licenses/by/3.0/

An interactive discussion between Todd Ponsky, MD and Don Nakayama, MD about the history of pediatric surgery, specifically the evolution of the management of pyloric stenosis, Hirschprung disease and esophageal atresia.

Dr. Nakayama is an adjunct professor of the department of surgery at the Herbert Wertheim College of Medicine at Florida International University and pediatric surgeon at Sacred Heart Medical Group.

Table of Contents 00:00:00 Introduction 00:01:54 Origin of Pediatric Surgery 00:05:47 Historical events in medicine involving pediatric patients 00:07:21 How Dr. Nakayama became interested in the history of pediatric surgery 00:08:59 History of pyloric stenosis 00:11:38 First pyloric stenosis operations 00:14:46 Start of perioperative care of pyloric stenosis patients 00:18:04 History of Hirschsprung disease 00:23:08 The contributions of Dr. Swenson 00:25:16 Feud between Dr. Swenson and Dr. Gross 00:28:16 History of the Soave procedure 00:30:33 Story of the first PDA ligation 00:36:41 Feud between Dr. Gross and Dr. Ladd 00:37:21 History of esophageal atresia 00:44:29 First successful esophageal atresia repair 00:46:36 Management of the first esophageal leak 00:50:36 Closing remarks

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: creativecommons.org/licenses/by/3.0/

An interactive discussion about intestinal failure between Todd Ponsky, MD and Brad Warner, MD.

Dr. Warner is the Jessie L. Ternberg, MD, PhD Distinguished Professor of Pediatric Surgery at Washington University School of Medicine and surgeon-in-chief for St. Louis Children’s Hospital in St. Louis, Missouri.

Table of Contents 00:00 - Introduction 01:39 - What is intestinal failure? 02:50 - Required bowel length 05:39 - Nature history of short gut 07:07 - Mortality in intestinal failure 07:39 - Small bowel transplant candidacy 09:15 - Causes of short gut 09:42 - Medical management of short gut syndrome 12:40 - Primary prevention of TPN cholestasis 16:15 - Summary of medical management 18:03 - Importance of breast milk 19:19 - Formula selection 20:13 - Management of volume administered 21:47 - Surgical management of intestinal failure 24:21 - Surgical evaluation 27:26 - Surgical options 28:47 - Bowel lengthening procedures 29:59 - Bianchi procedure 31:45 - STEP procedure 36:07 - Bianchi procedure pearls 38:10 - Role of tapering 38:43 - Secondary prevention of TPN cholestasis 40:16 - Medical management of intestinal bacterial overgrowth 43:39 - Role of growth factors 46:34 - Intestinal transplant 49:33 - Management of central line-associated infections 50:06 - Intestinal transplant as last resort

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: creativecommons.org/licenses/by/3.0/

An discussion of the medical and operative management of necrotizing enterocolitis between Todd Ponsky, MD and Gail Besner, MD.

Dr. Besner is a H. William Clatworthy Professor of Pediatric Surgery, Chief of the Department of Pediatric Surgery, Principal Investigator of the Center of Perinatal Research, and Associate Director of the Pediatric Surgery Training Program at Nationwide Children's Hospital.

Table of Contents 00:00:00 Introduction 00:02:41 Work-up of NEC 00:04:02 Medications associated with NEC 00:05:24 Physical Examination 00:07:04 Laboratory Work 00:08:44 Imaging studies 00:09:15 When to Operate on NEC 00:10:45 Medical Management of NEC 00:12:23 Antibiotic regimen 00:13:19 Frequency of imaging studies 00:13:55 Length to continue medical management 00:14:39 Stricture after NEC 00:15:43 When to operate after medical management without absolute indication 00:17:11 Peritoneal drain versus laparotomy 00:19:42 Randomized control trials comparing peritoneal drain and laparotomy 00:22:51 How to choose between peritoneal drain and laparotomy 00:26:03 Peritoneal drain placement technique 00:28:12 Operating after placement of a peritoneal drain 00:29:34 Management of patient after peritoneal drain placement 00:30:59 Laparotomy technique 00:33:39 Operative management of focal necrotic area 00:34:41 Creating a stoma 00:36:50 Management of Diffuse NEC 00:37:58 Management of skip lesions 00:39:21 When to reverse the stoma 00:40:34 Re-feeding mucous fistula 00:42:04 Management of NEC totalis 00:44:05 Management of tension pneumoperitoneum

Intro and outro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: http://creativecommons.org/licenses/by/3.0/

An interactive discussion about gastroschisis and omphalocele between Todd Ponsky, MD and Jacob "Jack" Langer, MD.

Dr. Langer is professor of surgery at the University of Toronto and Head of the Division of General and Thoracic Surgery at The Hospital for Sick Children in Toronto, Canada.

Table of Contents 00:00 - Introduction 03:56 - Prenatal counseling for gastroschisis 05:34 - Mode of delivery for gastroschisis 06:22 - Timing of delivery in gastroschisis 07:29 - Induction of labor in gastroschisis 08:34 - Location of delivery in gastroschisis 09:45 - Management of simple gastroschisis 11:46 - Bedside closure of gastroschisis 15:05 - Role of intubation in gastroschisis 16:54 - Does every patient require staged closure? 18:46 - Intestinal atresia and gastroschisis 20:50 - Management of association intestinal atresia 23:48 - Awaiting bowel function after gastroschisis repair 27:54 - Cryptorchidism and gastroschisis 28:26 - Prenatal counseling for omphalocele 30:06 - Mode, location, and timing of delivery in omphalocele 32:28 - Approach to giant omphalocele 35:04 - Use of the sac as the silo 39:26 - Role of silver sulfadiazine in omphalocele 42:03 - Flip flop” and mesh for omphalocele 44:44 - Pentalogy of Cantrell 45:56 - GERD and omphalocele 48:42 - Role of Ladd’s procedure in abdominal wall defects 49:57 - Kinking of hepatic vessels

This podcast discusses the work up and management of umbilical cord defects.

Dr. Todd A. Ponsky is an associate professor of surgery and pediatrics and pediatric surgeon at Akron Children's Hospital. Dr. Kenneth S. Azarow is surgeon-in-chief for Doernbecher Children’s Hospital and Helen B. Tracy professor of pediatric surgery at Oregan Health and Science University.

Time Markers: 00:00:00 Introduction 00:02:04 Timing of surgery 00:05:18 Diagnosing an incarcerated umbilical hernia 00:07:23 Anesthesia 00:08:24 Suture preference 00:08:49 Antibiotic use 00:10:09 Umbilicoplasty 00:12:30 Management of Gastroschisis 00:14:37 Management of Omphalocele 00:16:39 Use of mesh for umbilical hernia repairs 00:17:00 Do asymptomatic umbilical hernias require operative repair? 00:18:33 Work-up and management of drainage from umbilicus 00:20:54 Management of a granuloma 00:22:01 Operative management of urachal remnant 00:23:57 Workup and management of urachal anomalies 00:26:11 Operative management of a patent omphalomesenteric duct 00:27:53 Management of an epigastric hernia

Intro and outro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: http://creativecommons.org/licenses/by/3.0/

This podcast discusses the work up, operative management, and follow-up management of tracheoesophageal fistulas.

Dr. Todd Ponsky is an associate professor of surgery and pediatrics and pediatric surgeon at Akron Children's Hospital. Dr. Avraham Schlager is a pediatric surgeon at Akron Children's Hospital. Dr. Daniel von Allmen is the surgeon-in-chief, Lester W. Martin chair of pediatric surgery, senior vice president of the surgical services, and professor at University of Cincinnati department of surgery.

Audio Index 00:00:00 Introduction 00:03:27 Diagnosis of TEF 00:06:21 Preoperative planning 00:07:09 Management of TEF with right sided aortic arch 00:09:00 Timing of Repair in stable patient 00:09:56 Management of patient with respiratory compromise prior to OR 00:10:58 Temporizing maneuvers to help improve respiratory function 00:13:26 Management of TEF in patients with duodenal atresia 00:14:29 Role of preoperative bronchoscopy 00:16:20 Positioning of endotracheal tube 00:17:09 Approaches to open technique and benefits of dividing azygous vein 00:17:59 Techniques to divide the tracheoesophageal fistula 00:19:25 Steps to gain exposure 00:20:58 Mobilization of esophagus 00:22:51 Managing an injury to the trachea 00:23:56 Creation of anastomosis 00:24:26 Elongating techniques for long gap esophageal atresia 00:29:06 Approaches to thoracoscopic repair 00:31:42 Techniques and pearls in performing thoracoscopic anastomosis 0034:15 Lung isolation techniques 00:35:46 Postoperative management 00:36:57 Drain management 00:37:44 Managing an anastomotic stricture 00:39:43 Managing an anastomotic leak 00:41:09 Postoperative and long term follow-up 00:42:45 Indications to perform anti-reflux surgery 00:43:46 Management of pure esophageal atresia 00:44:38 Closing remarks

Intro and outro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: http://creativecommons.org/licenses/by/3.0/

An interactive discussion about malignant and benign pediatric thyroid disorders between Todd Ponsky, MD and Diana Diesen, MD.

Dr. Diesen is assistant professor of surgery and pediatric surgery fellowship program director at the University of Texas Southwestern Medical Center and is a member of the Children's Health Pediatric Thyroid Center at the Children's Medical Center of Dallas.

Contents 00:00 Introduction 02:31 Asymptomatic thyroid nodule 03:00 History 04:08 Risks factors for thyroid nodules and cancers 04:25 Family history 04:56 Physical exam 05:24 Physical exam pearls 06:03 Concerning physical exam findings 06:56 Laboratory evaluation 07:42 Thyroid scintigraphy 08:08 Hot thyroid nodules 09:13 Nodule with normal TSH 09:26 Thyroid ultrasound 10:15 Thyroid cysts 10:52 Lesion size and FNA biopsy 11:53 Anesthesia for FNA 12:30 Lymph node evaluation 13:12 Suspicious lymph node features 13:40 Papillary thyroid cancer 14:34 Lobectomy vs thyroidectomy 16:05 Thyroidecomy technique 17:07 Use of nerve monitor 17:40 Lymph node dissection 18:59 Post-operative management 20:37 Follow up 21:43 Radioactive iodine ablation 22:38 Thyroid hormone replacement therapy 22:54 Follicular cells on FNA 24:59 Frozen section for follicular lesions 25:55 Follicular carcinoma 26:36 Follicular adenoma 27:14 Pharmacologic TSH suppression 28:12 Benign FNA 29:45 Inadequate FNA specimen 30:32 Medullary carcinoma 33:22 Multiple endocrine neoplasia 37:26 Management of pheochromocytoma and hyperparathyroidism in MEN 2B 38:27 Central lymph node dissection in medullary thyroid cancer 39:42 Post-op medullary thyroid care 41:08 Recurrent/persistent medullary thyroid cancer 41:38 Systemic chemotherapy for MTC 42:03 Grave’s disease 42:57 Painful thyroid

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: http://creativecommons.org/licenses/by/3.0/

An interactive discussion about gastroesophageal reflux disease between Jeffrey Ponsky, MD and Michael Rosen, MD.

Dr. Rosen is a professor of surgery at the Cleveland Clinic Lerner College of Medicine, and general surgery staff in department of surgery at Cleveland Clinic in Cleveland, OH. Dr. Ponsky, is a professor of surgery at the Cleveland Clinic Lerner College of Medicine and Department of Surgery at Cleveland Clinic.

Table of Contents 00:01:06|GERD 00:01:16|Case presentation 40 year old woman with heartburn(00:01:16:30) 00:02:56|H2-blockers 00:03:19|Refractory symptoms after PPI 00:04:23|Role of EGD- assess esophagitis, and rule out Barrett’s 00:04:57|Frequency of EGD 00:06:17|Bravo-study performed with patient off PPI 00:07:13|Use of manometry done prior to operative intervention 00:07:41|Management after Bravo results 00:09:30|Workup for patient not responding to PPI management 00:11:04|What is manometry? 00:13:18|Surgical interventions to consider for GERD 00:13:54|Nissen Fundoplication 00:17:05|Nissen Technique 00:17:36|Crural closure 00:18:32|Manometry to tailor operation 00:19:38|Description of Toupet 00:21:09|Complications of anti-reflux surgery 00:22:31|Loose wrap 00:23:07|Management of rare case of long-term dysphagia-postoperative symptomatic dysphagia to solids 00:23:52|Management of rare case of long-term dysphagia- patient 1-year postoperative symptomatic dysphagia to solids 00:27:12|Management of patient with recurrent symptoms 00:29:37|Slipped Nissen surgically? 00:32:30|Injury to the anterior vagus nerve what do you do?

An interactive discussion about colorectal cancer between Jeffrey Ponsky, MD and Conor Delaney, MD, PhD.

Dr. Delaney, is the chairman of the Digestive Disease and Surgery Institute at Cleveland Clinic, Cleveland, OH. Dr. Delaney is also a professor of surgery at Cleveland Clinic Lerner College of Medicine. Dr. Ponsky, is a professor of surgery at the Cleveland Clinic Lerner College of Medicine and staff surgeon in the department of Surgery at Cleveland Clinic, Cleveland, OH.

Table of Contents 01:04:09|Role Of Colonoscopy For Screening And For Serrated Polyps 04:15:59|Rectal Cancers At 6cm In Today’s Era 08:17:45|Endoscopic Ultrasound And Preoperative Radiation 13:05:22|Preoperative radiation in node negative cancer 14:08:53|Differences Between T1a And T1b 15:58:44 |Endoscopic Submucosal Resection For Rectal Cancer 17:18:09|Preoperative Radiation For Rectal Cancer 18:57:32|Sigmoid Cancer 22:30:40|Approach To Cecal Cancer 23:57:48 |Laparoscopic Anastomosis 24:14:00|Genetic Workup

An interactive discussion about acute cholecystitis disease between Jeffrey Ponsky, MD and John Rodriguez, MD.

Dr. Rodriguez is a general surgery staff surgeon in department of surgery at Cleveland Clinic in Cleveland, OH. Dr. Ponsky, is a professor of surgery at the Cleveland Clinic Lerner College of Medicine and Department of Surgery at Cleveland Clinic.

Table of Contents 00:57:01|Acute Cholecystitis: Simple Versus Mitigating Cases 07:12:11|Management Of Cholecystostomy Tube 08:59:20|After The Tube: Operative Planning For Sick Patients 11:17:32|Operative Technique For Simple Acute Cholecystitis 15:18:54|Intra-operative Challenges 20:33:55|Cholangiograms 23:27:10|Transcystic Antegrade Sphincteroplasty 25:37:32|Difficult Dissections

In this episode, Dr. Marc Levitt from Nationwide Children’s Hospital discusses complications of anorectal malformations. This episode is brought to you by the Center for Colorectal and Pelvic Reconstruction at Nationwide Children’s Hospital. Our collaborative team performs more than 1,000 procedures each year for kids from around the world. Visit nationwidechildrens.org/CCPR for more information.

Table of contents: 00:00 – Play from the beginning 02:29 – Missed perineal fistula in a male 04:47 – Does surgical correction of a missed perineal fistula improve constipation? 05:57 – Physical exam for perineal fistula 07:27 – Perineal fistula in a female 09:50 – Anal sphincter stimulation 12:12 – Recto-urethral fistula 13:53 – Missed cloaca 16:42 – Common colostomy problems 17:39 – Incompletely diverting loop colostomy 18:28 – Transverse colostomy 19:14 – Dr Levitt’s preferred colostomy 20:53 – Anoplasty techniques 23:17 – Distal colostogram 26:34 – Identifying the distal rectum 29:54 – PSARP vs laparoscopy 32:50 – Rectal prolapse 35:27 – Perineal body dehiscence 38:31 – Problems with laparoscopy 40:12 – Problems with PSARP 41:36 – Postoperative soiling 44:33 – Redo pull-through 45:44 – Closing remarks

In this episode, Dr Jennifer Dietrich from Texas Children’s Hospital discusses ovarian torsion.

Table of contents: 00:00 – PLAY FROM THE BEGINNING 01:33 – Evaluation of the adolescent with lower abdominal pain 02:49 – Ultrasound 04:29 – Ovarian blood flow 07:06 – Peripherally located follicle 08:06 – Ovarian mass or lesion 11:14 – What findings are suggestive of malignancy? 12:13 – Role for CT or MRI 13:16 – Are pelvic exams necessary? 13:58 – Labs 15:01 – Tumor markers 16:50 – When to operate with normal blood flow 19:40 – Classic presenation of ovarian torsion 21:09 – Difference between symptomatic ovarian cyst and ovarian torsion 22:38 – Operative technique 23:48 – Cystectomy vs fenestration 26:08 – Ovarian salvage 27:51 – Ovarian bivalve procedure 30:48 – Oophoropexy 35:00 – Tubo-ovarian abscess 35:53 – Pregnancy 37:57 – Ectopic pregnancy 39:49 – Endometriosis 42:15 – Post-operative management 43:26 – Oral contraceptives 44:19 – Surveillance 45:33 – Closing remarks

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: creativecommons.org/licenses/by/3.0/

An interactive discussion about pediatric lung lesions between Todd Ponsky, MD and Steve Rothenberg, MD.

Dr. Rothenberg is Chief of Pediatric Surgery and the Chairman of the Department of Pediatrics at the Rocky Mountain Hospital for Children in Denver, CO. He is also faculty at Columbia University, College of Physicians and Surgeons in the Division of Pediatric Surgery as a Senior Consultant in Pediatric Minimal Access Surgery.

Table of Contents 00:00 Introduction 02:46 Prenatal evaluation 04:11 Role of fetal MRI 04:30 Fetal imaging features 05:11 Choice of delivery location 06:01 Role of fetal intervention 07:09 Administration of corticosteroids 07:49 Cyst volume ratio 08:32 Spectrum of CPAM 11:16 Routine neonatal care 13:45 Role of neonatal MRI 15:15 Institutional variations in management 17:41 Decision to operate 20:10 Too small for thoracoscopic surgery? 21:59 Preoperative preparation 23:31 Anesthetic considerations 25:15 Avoidance of over-ventilation 26:36 Avoidance of high peak ventilator pressures 28:28 Patient positioning 30:02 Port placement 32:56 Instrument selection 35:17 Technique for vessel sealing 35:51 Vascular control 37:12 Vessel sealing devices 41:28 Left lower lobe technique 42:01 LLL-Take down inferior pulmonary ligament 42:31 LLL-Exposure of inferior pulmonary vein 42:44 LLL-Major fissure 43:46 LLL-Exposure of pulmonary artery 44:53 LLL-Dissection of superior segmental branch 45:11 LLL-Dissection of trunk to basal segments 45:33 LLL-Division of trunk 47:26 LLL-Division of the bronchus 49:33 LLL-Dissection of the pulmonary vein 50:33 Key point-Do not divide the trunk near the pericardium 51:02 Right lower lobe technique 51:46 Left upper lobe technique 52:17 LUL-Retraction 52:48 LUL-Identification of the pulmonary trunk 53:23 LUL- Exposure of the superior pulmonary vein 53:59 LUL- Isolation of venous supply to the lingula 54:25 LUL-Attention to the fissure 54:33 LUL-Lingular artery 54:54 LUL-Bronchus 55:12 LUL-Overview 55:40 Right middle lobe technique 56:43 RML-Pulmonary artery 57:05 Lobectomy technical pearls 57:38 Popping of lung cysts 58:33 Extralobar sequestration technique 59:48 Never use vessel sealer and clips on the same vessel 01:01:01 Alternative to resection of extralobar pulmonary sequestration 01:02:33 Role of segmental resection 01:04:41 Lobectomy post-operative course 01:05:50 Conclusion

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: creativecommons.org/licenses/by/3.0/

An interactive discussion about inguinal hernia between Jeffrey Ponsky, MD and Michael Rosen, MD.

Dr. Rosen is professor of surgery at Cleveland Clinic Lerner College of Medicine.

Table of Contents 1:00:44 1 Introductions 2:02:45Work up for groin bulge 4:02:16 Role of watchful waiting 5:30:26 Contraindications to repair 7:02:27 Open versus laparoscopic approach 10:48:40 Front door or ceiling: TAPP vs TEP laparoscopic repair 12:11:05 Patient counseling 14:24:46 Incidental contralateral hernia: To fix or not to fix? 15:29:07 Special cases: Check your minimally invasive ego 17:26:17 Laparoscopic repair: technical tenants 21:10:48 You’ve stepped into it now: Which mesh? 24:19:40 Fixation of mesh? 25:21:55 Contaminated field: To mesh or not to 26:15:14 Femoral hernias: Best approach? 28:34:32 Complicated hernias: recurrent, bilateral, incarcerated 30:35:18 Summary

This episode is our first audio journal club. We discuss 5 papers today with our guests, Dr Dan von Allmen, Dr George Whit Holcomb, and Dr Aaron Lipskar.

Table of contents: 00:00 Introduction 00:55 Corticosteroids for biliary atresia 05:21 Dr von Allmen’s comments 10:54 Antiseptic agents and surgical site infection 14:15 Dr Holcomb’s comments 20:17 Non-operative management of non-perforated appendicitis 25:19 Dr Holcomb’s comments 30:41 Enteral autonomy after intestinal failure 33:37 Dr Lipskar’s comments 36:41 Anesthesia neurotoxicity 40:27 Dr Lipskar’s comments

Use of Corticosteroids After Hepatoportoenterostomy for Bile Drainage in Infants With Biliary Atresia: the START randomized clinical trial

Discussed by Dr Dan von Allmen

Bezerra JA, et al. Use of Corticosteroids After Hepatoportoenterostomy for Bile Drainage in Infants With Biliary Atresia: the START randomized clinical trial. JAMA. 2014 May 7;311(17):1750–10.

Dr von Allmen’s comments: • Dr von Allmen would not use corticosteroids after Kasai procedure. • The difference of bile drainage in the steroid group versus control (58.6% vs 48.6%) was not significant enough to continue use of corticosteroids.

Comparative Effectiveness of Skin Antiseptic Agents in Reducing Surgical Site Infections: A Report from the Washington State Surgical Care and Outcomes Assessment Program

Discussed by Dr George Whit Holcomb

Hakkarainen TW, et al. Comparative Effectiveness of Skin Antiseptic Agents in Reducing Surgical Site Infections: A Report from the Washington State Surgical Care and Outcomes Assessment Program. J Am Coll Surg. 2014 Mar 1;218(3):336–44.

Dr Holcomb’s comments: • This paper would not change his choice of antiseptic agent. Dr Holcomb feels that iodine based agents and chlorhexidine agents are equally appropriate based on these results. • Dr Holcomb uses chlorhexidine and isopropyl alcohol for skin preparation.

Nonoperative Treatment With Antibiotics Versus Surgery for Acute Nonperforated Appendicitis in Children: a pilot randomized controlled trial

Discussed by Dr George Whit Holcomb

Svensson JF, et al. Nonoperative Treatment With Antibiotics Versus Surgery for Acute Nonperforated Appendicitis in Children: a pilot randomized controlled trial. Annals of Surgery. 2015 Jan;261(1):67–71.

Dr Holcomb’s comments: • This is a well done pilot study that shows that a larger randomized trial is needed. • Long term follow-up is needed to determine the true risk of recurrent appendicitis after non-operative management.

Predictors of Enteral Autonomy in Children with Intestinal Failure: A Multicenter Cohort Study

Discussed by Dr Aaron Lipskar

Khan FA, et al. Predictors of Enteral Autonomy in Children with Intestinal Failure: A Multicenter Cohort Study. J Pediatr. 2015 Jul;167(1):29–34.e1.

Dr Lipskar’s comments: • It is counterintuitive that NEC is a protective factor for enteral autonomy. • It is difficult to make sense of the data as centers with transplant programs likely attract sicker patients. • This highlights the importance of intestinal failure patients being managed in a multidisciplinary intestinal failure program.

Anesthetic neurotoxicity--clinical implications of animal models

Discussed by Dr Aaron Lipskar

Rappaport BA, et al. Anesthetic neurotoxicity--clinical implications of animal models. N Engl J Med. 2015 Feb 26;372(9):796–7.

Dr Lipskar’s comments: • Until further trials in humans are conducted and provide more conclusive evidence, elective cases should be deferred until the age of 3. • It may be difficult to define what constitutes an elective procedure in pediatric surgery.

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: creativecommons.org/licenses/by/3.0/

An interactive discussion about cloacal exstrophy between Todd Ponsky, MD and Alberto Peña, MD.

Dr. Peña is is the founding director of the Peña Colorectal Center at Cincinnati Children's Hospital and clinical professor of surgery at the University of Cincinnati

Table of Contents 00:00 Introduction 01:24 What is cloacal exstrophy? 06:24 Management of cloacal exstrophy 07:56 Sexual function in males 11:38 Team approach 12:50 Role of the pediatric surgeon 13:21 Differentiating urothelium from intestinal mucosa 13:51 Bladder closure 14:04 End colostomy creation 15:11 Consequences of end ileostomy creation 16:41 Rescue operation 18:51 Common mistake: Failure to separate bowel from bladder 20:15 Pelvic osteotomies for pelvic approximation 21:37 End colostomy complications 23:23 Reversal of colostomy and pull-through 24:09 Bladder augmentation 24:41 Stoma reversal candidates 25:43 Importance of colon length preservation 26:29 Bowel management program through stoma 27:31 Age for stoma reversal 27:59 Bladder augmentation options 29:22 How to determine if patient has an ileostomy 30:43 Surgical planning 32:56 Surgical technique 37:13 Prognosis 38:42 Female reproduction in cloacal exstrophy 40:40 Role of Mitrofanoff 42:17 Patient follow-up 43:42 The Pull-Thru Network 45:46 Summary 47:49 Prenatal diagnosis

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: creativecommons.org/licenses/by/3.0/

An interactive discussion about vascular access in the pediatric patient population between Todd Ponsky, MD and Mark Wulkan, MD.

Dr. Wulkan is Professor of Surgery and Chief, Division of Pediatric Surgery, Department of Surgery, Emory University School of Medicine, Emory Children's Center, Atlanta, Georgia

Table of Contents 01:15 - Catheter selection 02:48 - Neck cutdown technique 06:38 - Catheter selection, continued 07:02 - Neck cutdown technique, continued 07:18 - Determine catheter length 09:34 - Percutaneous technique 13:24 - Long-term access 15:22 - Utility of vascular studies 17:50 - Choice of vessel 19:17 - Line infections 20:06 - Choice of vessel, continued 22:44 - Groin cutdown technique 23:17 - Preoperative workup 24:38 - Heparin use 25:20 - Ethanol use 26:14 - Line infections, continued 27:35 - Antibiotic-coated catheters 27:47 - Heparin-coated catheters 28:04 - Exhaustion of vessel options 31:15 - Skin preparation 32:37 - Tunneled catheter removal

Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque. Artist URL: ccmixter.org/files/grapes/16626 License: http://creativecommons.org/licenses/by/3.0/

Discussion with Dr Marc Levitt, Dr Scott Engum and Dr Todd Ponsky regarding the use of BoTox in the post-pullthrough patient as well as management of dilated post-pullthrough colon.

Table of contents: 01:17 - Algorithm for BoTox 07:07 - BoTox technique 09:11 - Management of dilated post-pullthrough colon

http://www.globalcastmd.com/

soundcloud.com/globalcastmd/hirschsprung-disease-listener

Please send any questions or comments to staycurrentpodcast@gmail.com

Discussion with Dr. Andrea Bischoff and Dr. Todd Ponsky regarding evaluation and management of anorectal malformations.

Table of contents: 01:19 - Evaluation of the male baby with an anorectal malformation 03:08 - Distinguishing a normal anus from a perineal fistula 04:39 - Associated anomalies 10:19 - Timing of surgical repair 12:45 - Evaluation of the female baby with an anorectal malformation 13:57 - Evaluation of the older child with an anorectal malformation 16:08 - Evaluation of the male baby with a high anorectal malformation 17:38 - What is the ideal colostomy? 19:31 - Distal colostogram 22:19 - Choice of procedure for different anorectal malformations 24:30 - Evaluation of cloacal anomaly 27:28 - Prognosis after repair of anorectal malformations 32:45 - Enema technique 35:58 - Bowel management for incontinence 39:48 - Malone stoma 41:33 - Bowel management for constipation

Please send questions and comments to staycurrentpodcast@gmail.com

Dr. Shawn St. Peter and Dr. Todd Ponsky discuss contemporary diagnosis and management of empyema

Table of contents: 2:37 - Evaluation of patient with pleural effusion 07:26 - Treatment algorithm for empyema 11:23 - Duration of antibiotic therapy 14:51 - Imaging for empyema 16:03 - Fibrinolysis 23:15 - Post-procedure chest x-ray 23:45 - Determining failure of therapy 26:44 - Pulmonary necrosis 31:57 - Pulmonary abscess 33:44 - Resection for pulmonary necrosis? 34:26 - Agents for fibrinolysis

Continuation of our previous podcast on Hirschsprung disease with Dr Marc Levitt that focuses on the evaluation and management of post-pull-through complications.

Table of contents: 04:12 - Evaluation of post-pull-through problems 08:08 - Post-pull-through enterocolitis 12:49 - Contrast enema 15:39 - Exam under anesthesia 17:26 - Repeat biopsy 19:19 - Redo transanal dissection 20:13 - Persistent cuff 21:45 - Myectomy 23:43 - BoTox 27:46 - Twisted bowel 29:40 - Duhamel complications 32:35 - Evaluation for persistent soiling 42:20 - Surgical treatment for soiling