Collection
Lectures, Courses and Honors
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Ladd Medal Award Presentation Honoring Dr. Steven Rothenberg's Pioneering Minimally Invasive Pediatric Surgery
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Surgical content by Dr. Steve Rothenberg — Lectures & Presentations
video33:12 · May 2026
Storz Lecture IPEG
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Surgical content by Dr. Steve Rothenberg — Lectures & Presentations
article · May 2026
Sybil Storz Lecture
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Surgical content by Dr. Steve Rothenberg — Lectures & Presentations
article · May 2026
JRS surgeon presentation
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Surgical content by Dr. Steve Rothenberg — Lectures & Presentations
article · May 2026
Rothenberg Vail
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Surgical content by Dr. Steve Rothenberg — Lectures & Presentations
article · May 2026
SAGES Oncology talk
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Surgical content by Dr. Steve Rothenberg — Lectures & Presentations
article · May 2026
WOFAPS 2016 Neo MIS
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Surgical content by Dr. Steve Rothenberg — Lectures & Presentations
article · May 2026
World Vet Meeting 2021
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Surgical content by Dr. Steve Rothenberg — Lectures & Presentations
article · May 2026
Bar passage direction (left-to-right versus right-to-left) is surgeon preference and probably does not make much difference as long as the substernal space is well dissected and everything is clear. Update Course Rewind: Pectus Excavatum 2021 · 10:12
IPEG 2019 Highlights: From Virtual Reality and Magnets to Robots at the Bedside
video · Jan 2021Private
Update Course Rewind: 2021 Top Ten Key Takeaways
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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 video we are reviewing the top ten key
video16:02 · Oct 2021
Update Course Rewind: Pectus Excavatum 2021
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Did you miss our 9th Annual Update Course last year?
Don't worry, we are summarizing our favorite sessions in this podcast!
In this Episode Drs. Steven Lee, Shawn St. Peter, Victor García, Steven Rothenberg, Whit Holcomb, & Justin W
video11:56 · Sep 2022
Featured picks for families are being prepared — the summaries above are written for you.
Recent evidence challenges traditional management paradigms across several pediatric surgical domains. For acute uncomplicated appendicitis, the Petcova et al. randomized trial (Annals of Surgery 2020) demonstrated that while medical management may be safe, 46% of children ultimately required appendectomy at 5-year follow-up, compared to zero complications in the surgical cohort. Timing controversies have been resolved for common neonatal procedures: both anorectal malformation repair and Hirschsprung pull-through show equivalent outcomes whether performed before or after 14-31 days of life, with delayed pull-through plus irrigations representing a safe alternative to neonatal operation.
Pain management after pectus repair has evolved dramatically with cryoanalgesia (intercostal nerve freezing of ribs 4-7), reducing median length of stay from 4 days to 1 day and substantially decreasing opioid requirements, though long-term outcome data remain absent. Erector spinae catheters offer an alternative, achieving 2-day stays with reduced opioid use both inpatient and outpatient. Pediatric trauma resuscitation now emphasizes earlier transfusion: new ATLS guidelines recommend blood products after a single 20 mL/kg crystalloid bolus, with balanced transfusion protocols (10-20 mL/kg PRBC plus FFP and platelets) associated with reduced total fluid volumes. Representation in medicine demonstrably affects outcomes—black newborn mortality decreases 58% when cared for by black physicians.
- Medical management of uncomplicated appendicitis carries 46% failure rate at 5 years; surgery remains definitive with zero complications in randomized trial.[e4578-c1][e4578-c2][e4578-c3]
- Cryoanalgesia (ribs 4-7, avoiding ≤8) reduces pectus LOS from 4 to 1 day and dramatically cuts opioid use, but lacks long-term safety data.[e5807-c2][e5807-c3][e5807-c4][e5807-c5][e5807-c6]
- Early neonatal repair versus delayed operation (14-31 days) yields equivalent outcomes for anorectal malformations and Hirschsprung disease; irrigations enable safe delay.[e4578-c13][e4578-c14][e4578-c15]
- New ATLS pediatric shock protocol: transfuse blood after single 20 mL/kg crystalloid bolus; balanced transfusion reduces total fluid volume administered.[e4578-c23][e4578-c24][e4578-c25]
- Physician-patient racial concordance matters: black newborns treated by black physicians show 58% mortality reduction versus treatment by white physicians.[e4578-c31][e4578-c32]
For patients & families
Pediatric surgeons are constantly refining how they care for children, from deciding when surgery is truly needed to finding better ways to manage pain afterward. For appendicitis that hasn't ruptured, doctors have studied whether antibiotics alone might work instead of surgery; while antibiotics can be safe, nearly half of children eventually need the operation anyway [e4578-c2, e4578-c3]. When cancer spreads to the lungs in children with bone tumors, removing those spots can help them survive longer . For chest wall deformities like pectus excavatum, newer pain control methods—including freezing the nerves with cold (cryoanalgesia) or using special catheters—have allowed children to go home in one or two days instead of four, with much less need for strong pain medicines [e4578-c16, e5807-c4, e5807-c10, e5807-c12]. Doctors have also learned that certain surgeries for bowel problems can be done safely either very early in a baby's life or a bit later, giving families more flexibility [e4578-c13, e4578-c14, e4578-c15]. Research continues to show that the timing, technique, and even the diversity of the care team can all influence how well children do [e4578-c30, e4578-c31, e4578-c32].
Pediatric surgeons are constantly refining how they care for children, from deciding when surgery is truly needed to finding better ways to manage pain afterward. For appendicitis that hasn't ruptured, doctors have studied whether antibiotics alone might work instead of surgery; while antibiotics can be safe, nearly half of children eventually need the operation anyway [e4578-c2, e4578-c3]. When cancer spreads to the lungs in children with bone tumors, removing those spots can help them survive longer . For chest wall deformities like pectus excavatum, newer pain control methods—including freezing the nerves with cold (cryoanalgesia) or using special catheters—have allowed children to go home in one or two days instead of four, with much less need for strong pain medicines [e4578-c16, e5807-c4, e5807-c10, e5807-c12]. Doctors have also learned that certain surgeries for bowel problems can be done safely either very early in a baby's life or a bit later, giving families more flexibility [e4578-c13, e4578-c14, e4578-c15]. Research continues to show that the timing, technique, and even the diversity of the care team can all influence how well children do [e4578-c30, e4578-c31, e4578-c32].
Expert statements from the recordings in this collection.
Update Course Rewind: 2021 Top Ten Key Takeaways
In the Petcova et al. study published in Annals of Surgery 2020, children with uncomplicated appendicitis were randomized to medical management with antibiotics or surgery, with 5-year follow-up.
In the Petcova et al. appendicitis study, the surgery group had no complications, while 46% of patients in the non-surgical management group required appendectomy during follow-up.
Medical management of acute uncomplicated appendicitis may be safe but is associated with a high failure rate, with many children ultimately requiring laparoscopic appendectomy.
Metastectomy for osteosarcoma lung metastases improves survival and can make patients long-term survivors.
Approximately 10% of 1 millimeter lung nodules in osteosarcoma patients contain malignant disease.
The Children's Oncology Group is starting a study to determine whether thoracotomy or thoracoscopy is superior for resection of pulmonary metastases in osteosarcoma, with enrollment expected late 2021 or early 2022.
The Flourish device is a catheter-based device that places magnets in proximal and distal esophageal pouches to create a compression anastomosis by causing ischemia of tissue between the magnets, which then sloughs off.
Inclusion criteria for the Flourish device are: atretic gap less than 4 centimeters long, fistula repaired or absent, and G-tube able to accommodate an 18 French catheter.
The Flourish device is associated with a high stricture rate and known serious life-threatening complications, and should only be used by centers with capabilities to treat the many issues associated with esophageal atresia.
Indocyanine green (ICG) has become a topic of interest in the last few years for use in pediatric surgery, especially in minimally invasive procedures to improve visualization of structures.
For laparoscopic cholecystectomy, ICG must be administered intravenously 12 to 18 hours prior to surgery to allow time for accumulation in the extrahepatic ducts, or can be injected directly into the gallbladder during surgery.
ICG applications in pediatric surgery include laparoscopic cholecystectomies, varicocele repairs, partial nephrectomies, and tumor excisions.
For anorectal malformations with rectal-perineal or rectal-vestibular fistula, outcomes including complications are similar whether the procedure is done before or after 14 days of life.
A PCPLC consortium study comparing endorectal pull-through for Hirschsprung disease at less than 31 days versus greater than 31 days found that preoperative enterocolitis, postoperative enterocolitis, constipation, and incontinence were the same between both groups.
Delayed pull-through with irrigations is a safe alternative to an operation in the neonatal period for Hirschsprung disease.
Cryoanalgesia is probably effective at improving post-operative pain and decreasing length of stay for pectus patients, with length of stay reduced from 4 days to 1 day.
There are no long-term studies on the effects of cryoanalgesia for pectus repair.
The double rim sign or halo sign on X-ray indicates a child has swallowed a button battery rather than a coin.
The main goal of button battery ingestion treatment is to remove the battery within 2 hours of ingestion.
Sucralfate or honey can help reduce damage from button batteries on the child's esophagus as temporizing measures.
Children less than 1 year old should not receive honey due to risk of botulism and should instead receive 10 mL of sucralfate every 10 minutes for up to 3 doses for button battery ingestion.
Children over age 1 with button battery ingestion should receive honey 10 mL every 10 minutes for up to 6 doses.
New ATLS recommendations for pediatric trauma patients in hemorrhagic shock call for earlier transfusion: after 1 bolus of 20 cc per kilogram of crystalloid fluid, blood should be given.
Balanced transfusion protocol for pediatric hemorrhagic shock typically includes 10 to 20 mLs per kilogram of packed red blood cells, plus inclusion of FFP and platelets.
Earlier transfusion in pediatric trauma was associated with shorter median time to transfusion and a decrease in total fluid volume administered.
Whole blood in trauma patients requires less volume compared to component therapy.
Research shows that observation of spontaneous pneumothorax in adults is non-inferior to immediate intervention with tube thoracostomy.
The Midwest Pediatric Surgery Consortium study on spontaneous pneumothorax management with simple aspiration showed 48% success rate, but 44% of patients in the simple aspiration group recurred.
83% of patients who failed simple aspiration for spontaneous pneumothorax ultimately ended up with VATS or blebectomy.
Greenwood et al. showed that mortality amongst black newborns is 3 times that of white newborns.