Episodes
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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!
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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.
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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.
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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.
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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.
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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!
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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!
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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!
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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/
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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.
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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
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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.
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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 health worldwide!
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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
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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
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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.
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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”
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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. - Show more
