Stay Current In Pediatric Surgery

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 need

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 Trau

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 su

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 se

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 Gootee0:00 Introduction0:57 Does Delayed Diagnosis of Hirschsprung Disease Impact Post-operative and Functional Outcomes? A Multi-Center Review From the Pediatric Colorectal and Pelvic Learning Consortium6:47 Management of Gastroschisis: Timing of Delivery, Antibiotic Usage, and Closure Considerations13:56 Validation of the Clavien-Madadi Classification for Unexpected Events in Pediatric Surgery: A Collaborative ERNICA Project18:12 SummaryArticles: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, F

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

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 GooteeDon'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 GooteeKey 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.

Welcome to this educational video presented by GlobalCastMD and Cincinnati Children's Hospital, where we explore the diagnosis and treatment of acute pancreatitis in children. In collaboration with experts from the Pancreas Care Center, Dr. Maisam A. Abu-El-Haija, Dr. Andrew Trout, and Dr. Juan Gurría, we break down the key points of this critical condition.Key Topics Covered:• What is Acute Pancreatitis?: Learn about the inflammation of the pancreas, its causes, and symptoms such as intense upper abdominal pain, nausea, vomiting, and fever.• Diagnosis: We discuss the criteria for diagnosing acute pancreatitis, including the use of ultrasound, CT, and MRI.• Treatment: Fluid resuscitation, the importance of early enteral nutrition, and the use of Lactated Ringer's (LR) solution for better outcomes. Plus, why antibiotics are no longer needed in most cases.This video is part of our series on Pancreatic Pathologies by the Pancreas Care Center at Cincinnati Children's. Stay tuned for more insights to improve child

In this podcast, we cover the basics of neuroblastoma including presentation, differentiation, diagnosis and management with Dr. Meera Kotagal.Host: Em Gootee0:00 Introduction1:00 Case 18:31 Case 211:39 Case 313:02 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 dysplas

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 Gootee0:00 Introduction0:48 Clinical Characteristics and Prognosis of Biliary Atresia with Low Serum Matrix Metalloproteinase-7 Levels5:09 Association of Exclusive Breast Milk Intake and Outcomes in Infants With Uncomplicated Gastroschisis10:57 Transition From Pediatric to Adult Healthcare for Colorectal Conditions: A Systematic Review15:50 Summary16:42 OutroArticles: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:

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

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 m

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 GigenaThis 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 a

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 GigenaIn 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 Introduction00:33 Case Scenario01:15 Cryoablation techniques01:58 Literature Review02:44 Dr. Oyetunji’s protocol03:22 Oral pain medication03:54 Proper time for Same day discharge04:22 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, wit