Jill Knepprath

402 timestamped statements across 21 collections — auto-found in recorded discussions, each timestamp jumps to the exact moment.

Abdominal Wall Defects · episode host Aerodigestive / ENT · episode host Colorectal / ARM & Hirschsprung · series host Fetal Surgery · episode host Inguinal Hernia · episode host Liver Tumors (Hepatoblastoma/HCC) · episode host Neurofibromatosis · episode host Pediatric Robotic Surgery · episode host Peritoneal Dialysis Access · episode host Wilms Tumor · episode host

Featured diaries

▶ Ep 19 · 1:04
One cue gain is the superior prognostic factor when compared to size and number of nodules in patients with favorable histology Wilms and pulmonary metastases.
quote · Wilms Tumor
▶ Ep 4 · 1:03
Overall, this study confirms that resection should be done for these patients whenever possible, even if they show a good response to chemo radiation.
quote · Metastatic Disease
▶ Ep 1 · 1:03
Overall, this study confirms that resection should be done for these patients whenever possible, even if they show a good response to chemo radiation.
quote · Neurofibromatosis
▶ Ep 13 · 0:52
The authors think that blood transfusions were mostly red blood cells, and that is what contributed to the post-op coagulopathy.
quote · Hepatoblastoma
▶ Ep 16 · 0:52
The authors think that blood transfusions were mostly red blood cells, and that is what contributed to the post-op coagulopathy.
quote · Liver Tumors (Hepatoblastoma/HCC)
▶ Ep 47 · 0:22
The authors found that inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence.
quote · Abdominal Wall Defects

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Abdominal Wall Defects 7 entries

Surgeon annual volume impacts recurrence rates of pediatric inguinal hernia repairs: A multi-institutional study

▶ Ep 47 · 0:10
host_summary Heller et al. published a multi-institutional study in the Journal of Pediatric Surgery in 2025 exploring the impact of surgeon volume on patients with inguinal hernias. ↗
▶ Ep 47 · 0:22
quote The authors found that inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence. ↗
▶ Ep 47 · 0:22
host_summary Inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence. ↗
▶ Ep 47 · 0:30
host_summary When broken down by surgical approach, there was no difference in recurrence rates for open inguinal hernia repairs based on surgeon volume. ↗
▶ Ep 47 · 0:35
quote However, laparoscopic repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence. ↗
▶ Ep 47 · 0:35
host_summary Laparoscopic inguinal hernia repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence. ↗
▶ Ep 47 · 0:44
host_summary The authors of the Heller et al. study recommend maintaining a high volume of laparoscopic repairs, and if that's not possible, to seek help from a higher volume surgeon. ↗
Aerodigestive / ENT 7 entries

Surgeon annual volume impacts recurrence rates of pediatric inguinal hernia repairs: A multi-institutional study

▶ Ep 28 · 0:10
host_summary Heller et al. published a multi-institutional study in the Journal of Pediatric Surgery in 2025 exploring the impact of surgeon volume on patients with inguinal hernias. ↗
▶ Ep 28 · 0:22
host_summary Inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence. ↗
▶ Ep 28 · 0:22
quote The authors found that inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence. ↗
▶ Ep 28 · 0:30
host_summary When broken down by surgical approach, there was no difference in recurrence rates for open inguinal hernia repairs based on surgeon volume. ↗
▶ Ep 28 · 0:35
host_summary Laparoscopic inguinal hernia repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence. ↗
▶ Ep 28 · 0:35
quote However, laparoscopic repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence. ↗
▶ Ep 28 · 0:44
host_summary The authors of the Heller et al. study recommend maintaining a high volume of laparoscopic repairs, and if that's not possible, to seek help from a higher volume surgeon. ↗
Anorectal Malformation 54 entries

Patient-reported outcomes of Children with an Anorectal Malformation

▶ Ep 65 · 0:02
quote Are you using the sacral ratio to counsel them? ↗
▶ Ep 65 · 0:10
clinical A 2024 survey by Witt et al. at Nationwide Children's was published in the Annals of Surgery examining patients with anorectal malformation ↗
▶ Ep 65 · 0:11
epidemiological The survey looked at over 900 patients with anorectal malformation ↗
▶ Ep 65 · 0:21
clinical There was no difference in continence for patients based on sacral ratio alone in regards to quality of life ↗
▶ Ep 65 · 0:29
clinical Patients who are incontinent had a 20-point lower quality of life compared to patients who were continent or clean on enemas ↗
▶ Ep 65 · 0:38
opinion Bowel management may actually matter more than sacral ratio in predicting continence outcomes ↗
▶ Ep 65 · 0:38
opinion The sacral ratio may not be as strong a predictor of continence as patients age ↗
▶ Ep 65 · 0:51
clinical Quality of life is significantly lower for patients with incontinence compared to those clean on enemas ↗
▶ Ep 65 · 0:57
quote Does this change this change your practice? ↗

Update Course Rewind 2025: Perineal Body–Preserving PSARP: The New Standard?

▶ Ep 68 · 1:01
host_summary Two-thirds of patients undergoing perineal body-preserving PSARP went home on postoperative day one. ↗
▶ Ep 68 · 1:51
host_summary Perineal body-preserving PSARP is a good choice for patients but can be a trickier approach than standard PSARP. ↗
▶ Ep 68 · 2:00
host_summary Conversion to the standard PSARP approach is a valid pivot when there is doubt about anatomy during perineal body-preserving PSARP. ↗

Update Course Rewind 2025: Do We Still Need Routine Anal Dilations After PSARP?

▶ Ep 69 · 0:21
host_summary For decades, every child received anal dilations after PSARP. ↗
▶ Ep 69 · 0:21
clinical For decades, every child received anal dilations after PSARP. ↗
▶ Ep 69 · 0:40
clinical A study from Spain followed the historical dilation protocol starting two weeks after PSARP, performing dilations twice a day, with the Hagar size increased by 1 millimeter each week until reaching the optimal size. ↗
▶ Ep 69 · 0:40
host_summary A study from Spain followed the historical dilation protocol starting two weeks after PSARP, performing dilations twice a day, with the Hagar size increased by 1 millimeter each week until reaching the optimal size. ↗
▶ Ep 69 · 1:12
clinical The Heineke-Mikulicz anoplasty is a procedure for skin-level strictures in PSARP patients. ↗
▶ Ep 69 · 1:12
host_summary The Heineke-Mikulicz anoplasty is a procedure for skin-level strictures in PSARP patients. ↗
▶ Ep 69 · 1:20
host_summary Heineke-Mikulicz anoplasty is done by making incisions at the 12, 3, 6, and 9 o'clock positions, making a rhomboid shape that opens up the strictured area. ↗
▶ Ep 69 · 1:20
clinical Heineke-Mikulicz anoplasty is done by making incisions at the 12, 3, 6, and 9 o'clock positions, making a rhomboid shape that opens up the strictured area. ↗
▶ Ep 69 · 1:30
clinical Heineke-Mikulicz anoplasty does not require flaps or any mobilization of the rectum. ↗
▶ Ep 69 · 1:30
host_summary Heineke-Mikulicz anoplasty does not require flaps or any mobilization of the rectum. ↗
▶ Ep 69 · 1:34
host_summary Heineke-Mikulicz anoplasty is safe, effective, and minimally invasive. ↗
▶ Ep 69 · 1:34
clinical Heineke-Mikulicz anoplasty is safe, effective, and minimally invasive. ↗
▶ Ep 69 · 1:38
clinical Heineke-Mikulicz anoplasty can be done outpatient as an alternative to long-term dilations after PSARP. ↗
▶ Ep 69 · 1:38
host_summary Heineke-Mikulicz anoplasty can be done outpatient as an alternative to long-term dilations after PSARP. ↗
▶ Ep 69 · 2:09
host_summary There isn't strong evidence to support mandatory anal dilation after PSARP. ↗
▶ Ep 69 · 2:09
host_summary Anal dilation after PSARP can cause stress for families. ↗
▶ Ep 69 · 2:09
clinical Anal dilation after PSARP can cause stress for families. ↗
▶ Ep 69 · 2:09
clinical There isn't strong evidence to support mandatory anal dilation after PSARP. ↗
▶ Ep 69 · 2:17
guideline Age of the patient and access to returning for an outpatient procedure are things to consider when making decisions about anal dilation after PSARP. ↗
▶ Ep 69 · 2:17
host_summary Age of the patient and access to returning for an outpatient procedure are things to consider when making decisions about anal dilation after PSARP. ↗

Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real

▶ Ep 69 · 0:34
quote The correct answer is less than 2%. ↗
▶ Ep 69 · 0:34
epidemiological The rate of Hirschsprung disease and anorectal malformation occurring together is less than 2% ↗
▶ Ep 69 · 0:37
clinical The co-occurrence of Hirschsprung disease and ARM is something to keep in mind for patients with trisomy 21 ↗
▶ Ep 69 · 0:37
quote It's rare, but something to keep in mind for patients with trisomy 21. ↗
▶ Ep 69 · 0:58
clinical Ganglion cells were found in 91% of rectal fistula specimens ↗
▶ Ep 69 · 0:58
clinical Hypo or absent ganglion cells were found in the remaining specimens (9%) ↗
▶ Ep 69 · 1:05
quote But absent cells in fistula tissue doesn't necessarily mean it's Hirschsprung's disease. ↗
▶ Ep 69 · 1:05
clinical Absent ganglion cells in fistula tissue does not necessarily mean the patient has Hirschsprung disease ↗
▶ Ep 69 · 1:11
epidemiological Three patients (4% of the cohort) had both Hirschsprung disease and an anorectal malformation ↗
▶ Ep 69 · 1:15
epidemiological Two of the three patients with both conditions also had trisomy 21 ↗
▶ Ep 69 · 1:31
guideline Complex anorectal malformation patients with chromosomal anomalies who do not respond to laxatives or enemas should be worked up for Hirschsprung disease ↗

Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real

▶ Ep 70 · 0:34
quote The correct answer is less than 2%. ↗
▶ Ep 70 · 0:34
epidemiological The rate of Hirschsprung disease and anorectal malformation occurring together is less than 2% ↗
▶ Ep 70 · 0:37
clinical The co-occurrence of Hirschsprung disease and ARM is something to keep in mind for patients with trisomy 21 ↗
▶ Ep 70 · 0:37
quote It's rare, but something to keep in mind for patients with trisomy 21. ↗
▶ Ep 70 · 0:58
clinical Hypo or absent ganglion cells were found in the remaining rectal fistula specimens ↗
▶ Ep 70 · 0:58
clinical Ganglion cells were found in 91% of rectal fistula specimens ↗
▶ Ep 70 · 1:05
clinical Absent ganglion cells in fistula tissue does not necessarily mean the patient has Hirschsprung disease ↗
▶ Ep 70 · 1:05
quote But absent cells in fistula tissue doesn't necessarily mean it's Hirschsprung's disease. ↗
▶ Ep 70 · 1:11
epidemiological Three patients (4% of the study cohort) had both Hirschsprung disease and anorectal malformation ↗
▶ Ep 70 · 1:15
epidemiological Two of the three patients with both conditions had trisomy 21 ↗
▶ Ep 70 · 1:31
guideline Complex anorectal malformation patients with chromosomal anomalies who do not respond to laxatives or enemas should be worked up for Hirschsprung disease ↗
Colorectal / ARM & Hirschsprung 93 entries

Patient-reported outcomes of Children with an Anorectal Malformation

▶ Ep 187 · 0:02
quote Are you using the sacral ratio to counsel them? ↗
▶ Ep 187 · 0:10
clinical A 2024 survey by Witt et al. at Nationwide Children's was published in the Annals of Surgery examining patients with anorectal malformation ↗
▶ Ep 187 · 0:11
epidemiological The survey looked at over 900 patients with anorectal malformation ↗
▶ Ep 187 · 0:21
clinical There was no difference in continence for patients based on sacral ratio alone in regards to quality of life ↗
▶ Ep 187 · 0:29
clinical Patients who are incontinent had a 20-point lower quality of life compared to patients who were continent or clean on enemas ↗
▶ Ep 187 · 0:38
opinion The sacral ratio may not be as strong a predictor of continence as patients age ↗
▶ Ep 187 · 0:38
opinion Bowel management may actually matter more than sacral ratio in predicting continence outcomes ↗
▶ Ep 187 · 0:51
clinical Quality of life is significantly lower for patients with incontinence compared to those clean on enemas ↗
▶ Ep 187 · 0:57
quote Does this change this change your practice? ↗

Update Course Rewind 2025: Timing of PSARP: Early vs. Delayed—Does It Really Matter?

▶ Ep 194 · 0:23
clinical For patients with rectal vestibular fistulas, some surgeons perform anal rectoplasties immediately while others wait until after discharge. ↗
▶ Ep 194 · 0:37
clinical Dr. Jamie Harris presents a case of a full-term newborn baby girl with rectal vestibular fistula weighing 3 kg with completely negative VACTERL workup. ↗
▶ Ep 194 · 1:49
clinical The panel agreed that it's safe to perform the PSARP either early before discharge or later around 1 to 3 months of age. ↗
▶ Ep 194 · 2:00
clinical The NSQIP study defined early repair as 7 days and delayed repair as between 6 weeks and 8 months. ↗
▶ Ep 194 · 2:07
clinical The NSQIP study found no difference in overall outcomes, including re-operations and readmissions, between early and delayed PSARP. ↗
▶ Ep 194 · 2:26
clinical Wound breakdown and dehiscence was the most common complication for both early and delayed repair groups in the PCPLC study. ↗
▶ Ep 194 · 2:33
clinical There was no significant difference in postoperative complications between early and delayed repair groups in the PCPLC study. ↗
▶ Ep 194 · 3:07
clinical Early repair during the newborn period avoids an additional admission for the surgery. ↗
▶ Ep 194 · 3:23
clinical Both early and delayed PSARP repairs are safe for patients with rectal vestibular fistulas. ↗
▶ Ep 194 · 3:29
opinion What matters most in timing PSARP is the circumstances, family access to care, patient size, and the surgeon's comfort and experience. ↗

Update Course Rewind 2025: Perineal Body–Preserving PSARP: The New Standard?

▶ Ep 195 · 1:01
clinical Two-thirds of patients undergoing perineal body-preserving PSARP went home on postoperative day one. ↗
▶ Ep 195 · 1:01
host_summary Two-thirds of patients undergoing perineal body-preserving PSARP went home on postoperative day one. ↗
▶ Ep 195 · 1:51
host_summary Perineal body-preserving PSARP is a good choice for patients but can be a trickier approach than standard PSARP. ↗
▶ Ep 195 · 1:51
opinion Perineal body-preserving PSARP is a good choice for patients but can be a trickier approach than standard PSARP. ↗
▶ Ep 195 · 2:00
host_summary Conversion to the standard PSARP approach is a valid pivot when there is doubt about anatomy during perineal body-preserving PSARP. ↗
▶ Ep 195 · 2:00
clinical Conversion to the standard PSARP approach is a valid pivot when there is doubt about anatomy during perineal body-preserving PSARP. ↗

Laparoscopic modified percutaneous internal ring suturing - a mesh-free alternative for indirect inguinal hernia repair in adults. a pilot prospective cohort study

▶ Ep 196 · 0:00
quote High ligation hernia repair, that's for kids. ↗
▶ Ep 196 · 0:03
quote Or is it? ↗
▶ Ep 196 · 0:08
host_summary The study was published in the International Journal of Surgery. ↗
▶ Ep 196 · 0:12
host_summary The study used the modified percutaneous internal ring suturing technique to evaluate whether a laparoscopic non-mesh repair works on indirect inguinal hernias in adults. ↗
▶ Ep 196 · 0:22
quote So did it work? ↗
▶ Ep 196 · 0:23
host_summary There were 20 patients in the study. ↗
▶ Ep 196 · 0:25
host_summary The majority of patients were male. ↗
▶ Ep 196 · 0:26
host_summary No patients had hernia recurrence on follow-up, with a median follow-up of 79 months. ↗
▶ Ep 196 · 0:31
host_summary Patients reported a decrease in pain and an improved activity post-operatively. ↗
▶ Ep 196 · 0:35
opinion This is a small single-center study. ↗
▶ Ep 196 · 0:35
opinion The study shows success with the modified PIRS technique in adults. ↗
▶ Ep 196 · 0:41
quote Would you offer this to your hernia patients? ↗

Update Course Rewind 2025: Do We Still Need Routine Anal Dilations After PSARP?

▶ Ep 197 · 0:21
host_summary For decades, every child received anal dilations after PSARP. ↗
▶ Ep 197 · 0:21
clinical For decades, every child received anal dilations after PSARP. ↗
▶ Ep 197 · 0:40
clinical A study from Spain followed the historical dilation protocol starting two weeks after PSARP, performing dilations twice a day, with the Hagar size increased by 1 millimeter each week until reaching the optimal size. ↗
▶ Ep 197 · 0:40
host_summary A study from Spain followed the historical dilation protocol starting two weeks after PSARP, performing dilations twice a day, with the Hagar size increased by 1 millimeter each week until reaching the optimal size. ↗
▶ Ep 197 · 1:12
host_summary The Heineke-Mikulicz anoplasty is a procedure for skin-level strictures in PSARP patients. ↗
▶ Ep 197 · 1:12
clinical The Heineke-Mikulicz anoplasty is a procedure for skin-level strictures in PSARP patients. ↗
▶ Ep 197 · 1:20
clinical Heineke-Mikulicz anoplasty is done by making incisions at the 12, 3, 6, and 9 o'clock positions, making a rhomboid shape that opens up the strictured area. ↗
▶ Ep 197 · 1:20
host_summary Heineke-Mikulicz anoplasty is done by making incisions at the 12, 3, 6, and 9 o'clock positions, making a rhomboid shape that opens up the strictured area. ↗
▶ Ep 197 · 1:30
host_summary Heineke-Mikulicz anoplasty does not require flaps or any mobilization of the rectum. ↗
▶ Ep 197 · 1:30
clinical Heineke-Mikulicz anoplasty does not require flaps or any mobilization of the rectum. ↗
▶ Ep 197 · 1:34
clinical Heineke-Mikulicz anoplasty is safe, effective, and minimally invasive. ↗
▶ Ep 197 · 1:34
host_summary Heineke-Mikulicz anoplasty is safe, effective, and minimally invasive. ↗
▶ Ep 197 · 1:38
host_summary Heineke-Mikulicz anoplasty can be done outpatient as an alternative to long-term dilations after PSARP. ↗
▶ Ep 197 · 1:38
clinical Heineke-Mikulicz anoplasty can be done outpatient as an alternative to long-term dilations after PSARP. ↗
▶ Ep 197 · 2:09
clinical Anal dilation after PSARP can cause stress for families. ↗
▶ Ep 197 · 2:09
clinical There isn't strong evidence to support mandatory anal dilation after PSARP. ↗
▶ Ep 197 · 2:09
host_summary Anal dilation after PSARP can cause stress for families. ↗
▶ Ep 197 · 2:09
host_summary There isn't strong evidence to support mandatory anal dilation after PSARP. ↗
▶ Ep 197 · 2:17
host_summary Age of the patient and access to returning for an outpatient procedure are things to consider when making decisions about anal dilation after PSARP. ↗
▶ Ep 197 · 2:17
guideline Age of the patient and access to returning for an outpatient procedure are things to consider when making decisions about anal dilation after PSARP. ↗

Update Course Rewind 2025: Hirschsprung’s Pull-Through: Why Family Training May Save Lives

▶ Ep 198 · 0:59
epidemiological The median age of the delayed pull-through group was 98 days at time of surgery. ↗
▶ Ep 198 · 0:59
host_summary The median age of the neonatal pull-through group was 11 days at time of surgery. ↗
▶ Ep 198 · 0:59
epidemiological The median age of the neonatal pull-through group was 11 days at time of surgery. ↗
▶ Ep 198 · 0:59
host_summary The median age of the delayed pull-through group was 98 days at time of surgery. ↗
▶ Ep 198 · 1:06
host_summary The PCPLC study found no difference in preoperative enterocolitis between neonatal and delayed pull-through groups. ↗
▶ Ep 198 · 1:06
host_summary The PCPLC study found no difference in postoperative enterocolitis between neonatal and delayed pull-through groups. ↗
▶ Ep 198 · 1:06
host_summary The PCPLC study found no difference in fecal incontinence at follow-up between neonatal and delayed pull-through groups. ↗
▶ Ep 198 · 1:06
clinical The PCPLC study found no difference in fecal incontinence at follow-up between neonatal and delayed pull-through groups. ↗
▶ Ep 198 · 1:06
clinical The PCPLC study found no difference in postoperative enterocolitis between neonatal and delayed pull-through groups. ↗
▶ Ep 198 · 1:06
clinical The PCPLC study found no difference in preoperative enterocolitis between neonatal and delayed pull-through groups. ↗

Update Course Rewind 2025: Botox for Hirschsprung’s: Where, When, and Why

▶ Ep 199 · 0:45
epidemiological A 2022 multi-center study found that 24% of patients undergoing pull-through procedure also received Botox ↗
▶ Ep 199 · 1:09
clinical Patients that received Botox had a higher chance of diaper rash ↗
▶ Ep 199 · 1:37
clinical Injecting Botox during pull-through procedure for Hirschsprung's disease has been shown to reduce enterocolitis risk ↗
▶ Ep 199 · 1:41
epidemiological Dosing and guidance for Botox injection varies widely ↗

Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real

▶ Ep 200 · 0:34
quote The correct answer is less than 2%. ↗
▶ Ep 200 · 0:34
epidemiological The rate of Hirschsprung disease and anorectal malformation occurring together is less than 2% ↗
▶ Ep 200 · 0:37
quote It's rare, but something to keep in mind for patients with trisomy 21. ↗
▶ Ep 200 · 0:37
clinical The co-occurrence of Hirschsprung disease and ARM is something to keep in mind for patients with trisomy 21 ↗
▶ Ep 200 · 0:58
clinical Hypo or absent ganglion cells were found in the remaining specimens (9%) ↗
▶ Ep 200 · 0:58
clinical Ganglion cells were found in 91% of rectal fistula specimens ↗
▶ Ep 200 · 1:05
quote But absent cells in fistula tissue doesn't necessarily mean it's Hirschsprung's disease. ↗
▶ Ep 200 · 1:05
clinical Absent ganglion cells in fistula tissue does not necessarily mean the patient has Hirschsprung disease ↗
▶ Ep 200 · 1:11
epidemiological Three patients (4% of the cohort) had both Hirschsprung disease and an anorectal malformation ↗
▶ Ep 200 · 1:15
epidemiological Two of the three patients with both conditions also had trisomy 21 ↗
▶ Ep 200 · 1:31
guideline Complex anorectal malformation patients with chromosomal anomalies who do not respond to laxatives or enemas should be worked up for Hirschsprung disease ↗

Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real

▶ Ep 201 · 0:34
quote The correct answer is less than 2%. ↗
▶ Ep 201 · 0:34
epidemiological The rate of Hirschsprung disease and anorectal malformation occurring together is less than 2% ↗
▶ Ep 201 · 0:37
clinical The co-occurrence of Hirschsprung disease and ARM is something to keep in mind for patients with trisomy 21 ↗
▶ Ep 201 · 0:37
quote It's rare, but something to keep in mind for patients with trisomy 21. ↗
▶ Ep 201 · 0:58
clinical Ganglion cells were found in 91% of rectal fistula specimens ↗
▶ Ep 201 · 0:58
clinical Hypo or absent ganglion cells were found in the remaining rectal fistula specimens ↗
▶ Ep 201 · 1:05
quote But absent cells in fistula tissue doesn't necessarily mean it's Hirschsprung's disease. ↗
▶ Ep 201 · 1:05
clinical Absent ganglion cells in fistula tissue does not necessarily mean the patient has Hirschsprung disease ↗
▶ Ep 201 · 1:11
epidemiological Three patients (4% of the study cohort) had both Hirschsprung disease and anorectal malformation ↗
▶ Ep 201 · 1:15
epidemiological Two of the three patients with both conditions had trisomy 21 ↗
▶ Ep 201 · 1:31
guideline Complex anorectal malformation patients with chromosomal anomalies who do not respond to laxatives or enemas should be worked up for Hirschsprung disease ↗
Congenital Diaphragmatic Hernia 17 entries

Improving Outcomes for Congenital Diaphragmatic Hernia (CDH): Protocol Changes at Cincinnati Children's

▶ Ep 13 · 0:20
host_summary Protocol changes began in August 2023 and were implemented in spring of 2024 ↗
▶ Ep 13 · 1:26
host_summary Previously, peak pressures were limited to 25 to 26 cmH2O and mean airway pressures to less than 16 to 17 cmH2O ↗
▶ Ep 13 · 2:12
host_summary Previously, babies were fed once they had return of bowel function after repair ↗
▶ Ep 13 · 2:44
host_summary Previously, babies received as-needed sedation ↗
▶ Ep 13 · 3:31
host_summary ECMO use increased from 14% to 22% in the new cohort ↗
▶ Ep 13 · 3:31
host_summary The new cohort had 36 babies compared to 99 in the previous cohort ↗
▶ Ep 13 · 4:09
host_summary Survival for ECMO patients increased from 39% to 55% ↗
▶ Ep 13 · 4:29
host_summary ECMO use was around 41% in the old cohort versus 45% in the new cohort ↗

Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski

▶ Ep 14 · 0:47
host_summary The goal of FETO is to allow fluid to stay in the lungs and allow the lungs to expand and grow. ↗
▶ Ep 14 · 0:53
host_summary FETO helps prevent pulmonary hypoplasia, which is a big factor in poor outcomes for CDH babies. ↗
▶ Ep 14 · 3:08
host_summary The balloon is filled with around 0.65 to 0.8 mL of water, depending on the size of the trachea. ↗
▶ Ep 14 · 3:33
host_summary Sometimes the trocar advances into the mouth during the procedure and needs to be backed out. ↗
▶ Ep 14 · 3:40
host_summary Final confirmation includes advancing the scope one more time to verify the balloon is below the vocal cords and in the main trachea. ↗

Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski

▶ Ep 15 · 0:47
host_summary The goal of FETO is to allow fluid to stay in the lungs and allow the lungs to expand and grow. ↗
▶ Ep 15 · 0:53
host_summary FETO helps prevent pulmonary hypoplasia, which is a big factor in poor outcomes for CDH babies. ↗
▶ Ep 15 · 3:08
host_summary The balloon is filled with water, around 0.65 to 0.8 mL, depending on the size of the trachea. ↗
▶ Ep 15 · 3:40
host_summary After balloon deployment, the scope is advanced one more time to confirm that the balloon is below the vocal cords and in the main trachea. ↗
Enterocolitis 4 entries

Update Course Rewind 2025: Botox for Hirschsprung’s: Where, When, and Why

▶ Ep 22 · 0:45
epidemiological A 2022 multi-center study found that 24% of patients undergoing pull-through procedure also received Botox ↗
▶ Ep 22 · 1:09
clinical Patients that received Botox had a higher chance of diaper rash ↗
▶ Ep 22 · 1:37
clinical Injecting Botox during pull-through procedure for Hirschsprung's disease has been shown to reduce enterocolitis risk ↗
▶ Ep 22 · 1:41
epidemiological Dosing and guidance for Botox injection varies widely ↗
Esophageal Atresia 15 entries

Esophageal Atresia & Tracheoesophageal Fistula (EA/TEF) Types Explained for Pediatric Surgery

▶ Ep 27 · 0:00
quote Today I'm going to walk through esophageal atresia and tracheoesophageal fistula, or TEF. ↗
▶ Ep 27 · 0:05
opinion EA/TEF is a basic concept in pediatric surgery. ↗
▶ Ep 27 · 0:10
clinical In normal anatomy, the esophagus goes straight down to the stomach with no atresia or interruptions, and the trachea goes straight down to the lungs with no connections between the two. ↗
▶ Ep 27 · 0:29
clinical Type A EA/TEF consists of esophageal atresia proximally and distally in the esophagus, preventing solids and liquids from reaching the stomach, with no connection between esophagus and trachea. ↗
▶ Ep 27 · 0:45
clinical Type B EA/TEF has distal esophageal atresia and a proximal fistula, allowing solids and liquids to enter the trachea while the stomach remains empty. ↗
▶ Ep 27 · 1:08
quote Type C is the most common ↗
▶ Ep 27 · 1:08
epidemiological Type C EA/TEF is the most common type. ↗
▶ Ep 27 · 1:13
clinical Type C EA/TEF has proximal esophageal atresia and a distal fistula, allowing air to reach both lungs and stomach while solids and liquids cannot reach the stomach. ↗
▶ Ep 27 · 1:28
clinical Type D EA/TEF has both a distal fistula and a proximal fistula, allowing solids and liquids into the trachea and air into both lungs and stomach. ↗
▶ Ep 27 · 1:43
clinical Type E EA/TEF has no atresia but does have a tracheoesophageal fistula, which is often pretty high. ↗
▶ Ep 27 · 1:52
quote This is also known as H. You can see the H right here. ↗
▶ Ep 27 · 1:52
clinical Type E EA/TEF is also known as H-type because of its anatomical appearance. ↗
▶ Ep 27 · 1:56
quote And this is the one with the best results and usually the easiest to fix. ↗
▶ Ep 27 · 1:56
clinical Type E (H-type) EA/TEF has the best results and is usually the easiest to fix. ↗
▶ Ep 27 · 2:01
clinical Children with Type E (H-type) EA/TEF may present with symptoms later because they are still able to get solids and liquids down to the stomach and air to the lungs. ↗
Fetal Surgery 18 entries

Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski

▶ Ep 29 · 0:47
clinical The goal of FETO is to allow fluid to stay in the lungs and allow the lungs to expand and grow. ↗
▶ Ep 29 · 0:47
host_summary The goal of FETO is to allow fluid to stay in the lungs and allow the lungs to expand and grow. ↗
▶ Ep 29 · 0:53
host_summary FETO helps prevent pulmonary hypoplasia, which is a big factor in poor outcomes for CDH babies. ↗
▶ Ep 29 · 0:53
clinical FETO helps prevent pulmonary hypoplasia, which is a big factor in poor outcomes for CDH babies. ↗
▶ Ep 29 · 3:08
clinical The balloon is filled with around 0.65 to 0.8 mL of water, depending on the size of the trachea. ↗
▶ Ep 29 · 3:08
host_summary The balloon is filled with around 0.65 to 0.8 mL of water, depending on the size of the trachea. ↗
▶ Ep 29 · 3:33
host_summary Sometimes the trocar advances into the mouth during the procedure and needs to be backed out. ↗
▶ Ep 29 · 3:33
clinical Sometimes the trocar advances into the mouth during the procedure and needs to be backed out. ↗
▶ Ep 29 · 3:40
host_summary Final confirmation includes advancing the scope one more time to verify the balloon is below the vocal cords and in the main trachea. ↗
▶ Ep 29 · 3:40
clinical Final confirmation includes advancing the scope one more time to verify the balloon is below the vocal cords and in the main trachea. ↗

Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski

▶ Ep 30 · 0:47
host_summary The goal of FETO is to allow fluid to stay in the lungs and allow the lungs to expand and grow. ↗
▶ Ep 30 · 0:47
clinical The goal of FETO is to allow fluid to stay in the lungs and allow the lungs to expand and grow. ↗
▶ Ep 30 · 0:53
clinical FETO helps prevent pulmonary hypoplasia, which is a big factor in poor outcomes for CDH babies. ↗
▶ Ep 30 · 0:53
host_summary FETO helps prevent pulmonary hypoplasia, which is a big factor in poor outcomes for CDH babies. ↗
▶ Ep 30 · 3:08
clinical The balloon is filled with water, around 0.65 to 0.8 mL, depending on the size of the trachea. ↗
▶ Ep 30 · 3:08
host_summary The balloon is filled with water, around 0.65 to 0.8 mL, depending on the size of the trachea. ↗
▶ Ep 30 · 3:40
host_summary After balloon deployment, the scope is advanced one more time to confirm that the balloon is below the vocal cords and in the main trachea. ↗
▶ Ep 30 · 3:40
clinical After balloon deployment, the scope is advanced one more time to confirm that the balloon is below the vocal cords and in the main trachea. ↗
Hepatoblastoma 16 entries

Characteristics of Transfusion and Association With Oncologic Outcomes in Hepatoblastoma Resection

▶ Ep 13 · 0:00
clinical It is not uncommon for a patient with hepatoblastoma to need a transfusion during resection ↗
▶ Ep 13 · 0:00
quote It's not uncommon for a patient with hepatoblastoma to need a transfusion during resection. ↗
▶ Ep 13 · 0:13
epidemiological The study was multi-institutional and published in Pediatric Blood and Cancer in 2025 ↗
▶ Ep 13 · 0:19
epidemiological The study examined how intraoperative transfusion may affect recurrence and survival in hepatoblastoma resection patients ↗
▶ Ep 13 · 0:25
epidemiological Of those transfused, the majority received red blood cells ↗
▶ Ep 13 · 0:25
epidemiological Only 11% of transfused patients received platelets ↗
▶ Ep 13 · 0:32
clinical Intraoperative blood transfusions had no effect on recurrence ↗
▶ Ep 13 · 0:32
clinical Intraoperative blood transfusions were associated with increased death ↗
▶ Ep 13 · 0:32
quote Intraoperative blood transfusions had no effect on recurrence, however, they were associated with increased death. ↗
▶ Ep 13 · 0:39
clinical There were instances of unnecessary blood transfusions ↗
▶ Ep 13 · 0:43
clinical Transfused patients still required more plasma and platelets postoperatively ↗
▶ Ep 13 · 0:43
clinical Patients who were transfused had higher post-op hemoglobin ↗
▶ Ep 13 · 0:52
opinion The authors think that blood transfusions were mostly red blood cells, and that is what contributed to the post-op coagulopathy ↗
▶ Ep 13 · 0:52
quote The authors think that blood transfusions were mostly red blood cells, and that is what contributed to the post-op coagulopathy. ↗
▶ Ep 13 · 1:00
guideline The authors recommend a balanced transfusion approach ↗
▶ Ep 13 · 1:00
guideline The authors recommend more careful patient selection for intraoperative transfusions ↗
Hirschsprung disease 31 entries

Update Course Rewind 2025: Hirschsprung’s Pull-Through: Why Family Training May Save Lives

▶ Ep 82 · 0:59
epidemiological The median age of the neonatal pull-through group was 11 days at time of surgery. ↗
▶ Ep 82 · 0:59
epidemiological The median age of the delayed pull-through group was 98 days at time of surgery. ↗
▶ Ep 82 · 1:06
clinical The PCPLC study found no difference in fecal incontinence at follow-up between neonatal and delayed pull-through groups. ↗
▶ Ep 82 · 1:06
clinical The PCPLC study found no difference in postoperative enterocolitis between neonatal and delayed pull-through groups. ↗
▶ Ep 82 · 1:06
clinical The PCPLC study found no difference in preoperative enterocolitis between neonatal and delayed pull-through groups. ↗

Update Course Rewind 2025: Botox for Hirschsprung’s: Where, When, and Why

▶ Ep 83 · 0:45
epidemiological A 2022 multi-center study found that 24% of patients undergoing pull-through procedure also received Botox ↗
▶ Ep 83 · 1:09
clinical Patients that received Botox had a higher chance of diaper rash ↗
▶ Ep 83 · 1:37
clinical Injecting Botox during pull-through procedure for Hirschsprung's disease has been shown to reduce enterocolitis risk ↗
▶ Ep 83 · 1:41
epidemiological Dosing and guidance for Botox injection varies widely ↗

Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real

▶ Ep 84 · 0:34
quote The correct answer is less than 2%. ↗
▶ Ep 84 · 0:34
epidemiological The rate of Hirschsprung disease and anorectal malformation occurring together is less than 2% ↗
▶ Ep 84 · 0:37
quote It's rare, but something to keep in mind for patients with trisomy 21. ↗
▶ Ep 84 · 0:37
clinical The co-occurrence of Hirschsprung disease and ARM is something to keep in mind for patients with trisomy 21 ↗
▶ Ep 84 · 0:58
clinical Ganglion cells were found in 91% of rectal fistula specimens ↗
▶ Ep 84 · 0:58
clinical Hypo or absent ganglion cells were found in the remaining specimens (9%) ↗
▶ Ep 84 · 1:05
clinical Absent ganglion cells in fistula tissue does not necessarily mean the patient has Hirschsprung disease ↗
▶ Ep 84 · 1:05
quote But absent cells in fistula tissue doesn't necessarily mean it's Hirschsprung's disease. ↗
▶ Ep 84 · 1:11
epidemiological Three patients (4% of the cohort) had both Hirschsprung disease and an anorectal malformation ↗
▶ Ep 84 · 1:15
epidemiological Two of the three patients with both conditions also had trisomy 21 ↗
▶ Ep 84 · 1:31
guideline Complex anorectal malformation patients with chromosomal anomalies who do not respond to laxatives or enemas should be worked up for Hirschsprung disease ↗

Update Course Rewind 2025: Hirschsprung + ARM: Rare but Real

▶ Ep 85 · 0:34
epidemiological The rate of Hirschsprung disease and anorectal malformation occurring together is less than 2% ↗
▶ Ep 85 · 0:34
quote The correct answer is less than 2%. ↗
▶ Ep 85 · 0:37
clinical The co-occurrence of Hirschsprung disease and ARM is something to keep in mind for patients with trisomy 21 ↗
▶ Ep 85 · 0:37
quote It's rare, but something to keep in mind for patients with trisomy 21. ↗
▶ Ep 85 · 0:58
clinical Ganglion cells were found in 91% of rectal fistula specimens ↗
▶ Ep 85 · 0:58
clinical Hypo or absent ganglion cells were found in the remaining rectal fistula specimens ↗
▶ Ep 85 · 1:05
clinical Absent ganglion cells in fistula tissue does not necessarily mean the patient has Hirschsprung disease ↗
▶ Ep 85 · 1:05
quote But absent cells in fistula tissue doesn't necessarily mean it's Hirschsprung's disease. ↗
▶ Ep 85 · 1:11
epidemiological Three patients (4% of the study cohort) had both Hirschsprung disease and anorectal malformation ↗
▶ Ep 85 · 1:15
epidemiological Two of the three patients with both conditions had trisomy 21 ↗
▶ Ep 85 · 1:31
guideline Complex anorectal malformation patients with chromosomal anomalies who do not respond to laxatives or enemas should be worked up for Hirschsprung disease ↗
Inguinal Hernia 19 entries

Surgeon annual volume impacts recurrence rates of pediatric inguinal hernia repairs: A multi-institutional study

▶ Ep 22 · 0:10
host_summary Heller et al. published a multi-institutional study in the Journal of Pediatric Surgery in 2025 exploring the impact of surgeon volume on patients with inguinal hernias. ↗
▶ Ep 22 · 0:22
quote The authors found that inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence. ↗
▶ Ep 22 · 0:22
host_summary Inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence. ↗
▶ Ep 22 · 0:30
host_summary When broken down by surgical approach, there was no difference in recurrence rates for open inguinal hernia repairs based on surgeon volume. ↗
▶ Ep 22 · 0:35
quote However, laparoscopic repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence. ↗
▶ Ep 22 · 0:35
host_summary Laparoscopic inguinal hernia repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence. ↗
▶ Ep 22 · 0:44
host_summary The authors of the Heller et al. study recommend maintaining a high volume of laparoscopic repairs, and if that's not possible, to seek help from a higher volume surgeon. ↗

Laparoscopic modified percutaneous internal ring suturing - a mesh-free alternative for indirect inguinal hernia repair in adults. a pilot prospective cohort study

▶ Ep 23 · 0:00
quote High ligation hernia repair, that's for kids. ↗
▶ Ep 23 · 0:03
quote Or is it? ↗
▶ Ep 23 · 0:08
host_summary The study was published in the International Journal of Surgery. ↗
▶ Ep 23 · 0:12
host_summary The study used the modified percutaneous internal ring suturing technique to evaluate whether a laparoscopic non-mesh repair works on indirect inguinal hernias in adults. ↗
▶ Ep 23 · 0:22
quote So did it work? ↗
▶ Ep 23 · 0:23
host_summary There were 20 patients in the study. ↗
▶ Ep 23 · 0:25
host_summary The majority of patients were male. ↗
▶ Ep 23 · 0:26
host_summary No patients had hernia recurrence on follow-up, with a median follow-up of 79 months. ↗
▶ Ep 23 · 0:31
host_summary Patients reported a decrease in pain and an improved activity post-operatively. ↗
▶ Ep 23 · 0:35
opinion The study shows success with the modified PIRS technique in adults. ↗
▶ Ep 23 · 0:35
opinion This is a small single-center study. ↗
▶ Ep 23 · 0:41
quote Would you offer this to your hernia patients? ↗
Liver Tumors (Hepatoblastoma/HCC) 16 entries

Characteristics of Transfusion and Association With Oncologic Outcomes in Hepatoblastoma Resection

▶ Ep 16 · 0:00
clinical It is not uncommon for a patient with hepatoblastoma to need a transfusion during resection ↗
▶ Ep 16 · 0:00
quote It's not uncommon for a patient with hepatoblastoma to need a transfusion during resection. ↗
▶ Ep 16 · 0:13
epidemiological The study was multi-institutional and published in Pediatric Blood and Cancer in 2025 ↗
▶ Ep 16 · 0:19
epidemiological The study examined how intraoperative transfusion may affect recurrence and survival in hepatoblastoma resection patients ↗
▶ Ep 16 · 0:25
epidemiological Only 11% of transfused patients received platelets ↗
▶ Ep 16 · 0:25
epidemiological Of those transfused, the majority received red blood cells ↗
▶ Ep 16 · 0:32
quote Intraoperative blood transfusions had no effect on recurrence, however, they were associated with increased death. ↗
▶ Ep 16 · 0:32
clinical Intraoperative blood transfusions had no effect on recurrence ↗
▶ Ep 16 · 0:32
clinical Intraoperative blood transfusions were associated with increased death ↗
▶ Ep 16 · 0:39
clinical There were instances of unnecessary blood transfusions ↗
▶ Ep 16 · 0:43
clinical Transfused patients still required more plasma and platelets postoperatively ↗
▶ Ep 16 · 0:43
clinical Patients who were transfused had higher post-op hemoglobin ↗
▶ Ep 16 · 0:52
quote The authors think that blood transfusions were mostly red blood cells, and that is what contributed to the post-op coagulopathy. ↗
▶ Ep 16 · 0:52
opinion The authors think that blood transfusions were mostly red blood cells, and that is what contributed to the post-op coagulopathy ↗
▶ Ep 16 · 1:00
guideline The authors recommend more careful patient selection for intraoperative transfusions ↗
▶ Ep 16 · 1:00
guideline The authors recommend a balanced transfusion approach ↗
Lymphatic Malformation 4 entries

Update Course Rewind 2025: Neck Pathologies - The Diagnostic Challenge

▶ Ep 3 · 0:50
host_summary A ranula is a benign cyst that forms under the tongue caused by saliva leaking from a blocked sublingual gland. ↗
▶ Ep 3 · 0:58
host_summary Lymphatic malformations are clusters of lymph vessels that are often present at birth. ↗
▶ Ep 3 · 2:43
host_summary For lymphatic malformations, there are 3 procedural treatments: laser, sclerotherapy, and excision. ↗
▶ Ep 3 · 2:49
host_summary There are 3 medical therapies for lymphatic malformations that are still undergoing clinical trials. ↗
Metastatic Disease 15 entries

Malignant peripheral nerve sheath tumors: a report from Children’s Oncology Group study ARST0332

▶ Ep 4 · 0:00
quote Is there a role for chemo radiation in peripheral nerve sheath tumors, or is excision all that is needed? ↗
▶ Ep 4 · 0:11
clinical The Children's Oncology Group published a prospective trial on malignant peripheral nerve sheath tumors in the Journal of the National Cancer Institute in 2025. ↗
▶ Ep 4 · 0:24
clinical Patients were assigned to four treatment groups: observation, adjuvant radiation, adjuvant chemoradiation, and neoadjuvant chemoradiation. ↗
▶ Ep 4 · 0:35
clinical Resection has a major influence on survival for patients with malignant peripheral nerve sheath tumors. ↗
▶ Ep 4 · 0:35
quote Overall results confirmed that resection has a major influence on survival for these patients. ↗
▶ Ep 4 · 0:40
clinical Low-risk patients had improved outcomes. ↗
▶ Ep 4 · 0:40
clinical Patients without metastatic disease had improved outcomes. ↗
▶ Ep 4 · 0:40
epidemiological Female patients with malignant peripheral nerve sheath tumors had improved outcomes. ↗
▶ Ep 4 · 0:46
clinical In patients receiving neoadjuvant therapy, 45% were stable. ↗
▶ Ep 4 · 0:46
clinical In patients receiving neoadjuvant therapy, 23% showed a response. ↗
▶ Ep 4 · 0:46
clinical In patients receiving neoadjuvant therapy, 32% had progressive disease. ↗
▶ Ep 4 · 0:59
clinical There was no difference in survival based on the response to neoadjuvant therapy among patients who went on to have resection. ↗
▶ Ep 4 · 0:59
quote There was no difference in survival based on the response to neoadjuvant therapy. ↗
▶ Ep 4 · 1:03
quote Overall, this study confirms that resection should be done for these patients whenever possible, even if they show a good response to chemo radiation. ↗
▶ Ep 4 · 1:03
guideline Resection should be done for patients with malignant peripheral nerve sheath tumors whenever possible, even if they show a good response to chemoradiation. ↗
Neurofibromatosis 15 entries

Malignant peripheral nerve sheath tumors: a report from Children’s Oncology Group study ARST0332

▶ Ep 1 · 0:00
quote Is there a role for chemo radiation in peripheral nerve sheath tumors, or is excision all that is needed? ↗
▶ Ep 1 · 0:11
clinical The Children's Oncology Group published a prospective trial on malignant peripheral nerve sheath tumors in the Journal of the National Cancer Institute in 2025. ↗
▶ Ep 1 · 0:24
clinical Patients were assigned to four treatment groups: observation, adjuvant radiation, adjuvant chemoradiation, and neoadjuvant chemoradiation. ↗
▶ Ep 1 · 0:35
quote Overall results confirmed that resection has a major influence on survival for these patients. ↗
▶ Ep 1 · 0:35
clinical Resection has a major influence on survival for patients with malignant peripheral nerve sheath tumors. ↗
▶ Ep 1 · 0:40
epidemiological Female patients with malignant peripheral nerve sheath tumors had improved outcomes. ↗
▶ Ep 1 · 0:40
clinical Low-risk patients had improved outcomes. ↗
▶ Ep 1 · 0:40
clinical Patients without metastatic disease had improved outcomes. ↗
▶ Ep 1 · 0:46
clinical In patients receiving neoadjuvant therapy, 32% had progressive disease. ↗
▶ Ep 1 · 0:46
clinical In patients receiving neoadjuvant therapy, 23% showed a response. ↗
▶ Ep 1 · 0:46
clinical In patients receiving neoadjuvant therapy, 45% were stable. ↗
▶ Ep 1 · 0:59
quote There was no difference in survival based on the response to neoadjuvant therapy. ↗
▶ Ep 1 · 0:59
clinical There was no difference in survival based on the response to neoadjuvant therapy among patients who went on to have resection. ↗
▶ Ep 1 · 1:03
guideline Resection should be done for patients with malignant peripheral nerve sheath tumors whenever possible, even if they show a good response to chemoradiation. ↗
▶ Ep 1 · 1:03
quote Overall, this study confirms that resection should be done for these patients whenever possible, even if they show a good response to chemo radiation. ↗
Pediatric Robotic Surgery 26 entries

Update Course Rewind 2025: Robotics in Pediatric Surgery: Which indications benefit the most?

▶ Ep 7 · 0:33
opinion All pediatric surgical patients are good candidates for robotic surgery. ↗
▶ Ep 7 · 0:33
host_summary All pediatric surgical patients are good candidates for robotic surgery. ↗
▶ Ep 7 · 1:02
host_summary Robotic surgery reduces postoperative pain and infection risk, leading to faster recovery. ↗
▶ Ep 7 · 1:02
clinical Robotic surgery reduces postoperative pain and infection risk, leading to faster recovery. ↗
▶ Ep 7 · 2:09
clinical Robotic surgery improves depth perception compared to laparoscopic surgery. ↗
▶ Ep 7 · 2:09
host_summary Robotic surgery improves depth perception compared to laparoscopic surgery. ↗
▶ Ep 7 · 2:14
host_summary Robotic surgery reduces surgeon fatigue compared to laparoscopic surgery. ↗
▶ Ep 7 · 2:14
clinical Robotic surgery reduces surgeon fatigue compared to laparoscopic surgery. ↗
▶ Ep 7 · 2:23
clinical Laparoscopy has a higher conversion rate to open surgery than robotic surgery in colorectal cases. ↗
▶ Ep 7 · 2:23
clinical In colorectal surgery, robotic operative time is longer than laparoscopic. ↗
▶ Ep 7 · 2:23
host_summary In colorectal surgery, robotic operative time is longer than laparoscopic. ↗
▶ Ep 7 · 2:23
host_summary Laparoscopy has a higher conversion rate to open surgery than robotic surgery in colorectal cases. ↗
▶ Ep 7 · 2:32
host_summary Both robotic and laparoscopic surgery have comparable oncologic results. ↗
▶ Ep 7 · 2:32
clinical Both robotic and laparoscopic surgery have comparable oncologic results. ↗
▶ Ep 7 · 2:57
clinical It takes half the number of cases to become proficient in robotic surgery versus laparoscopy. ↗
▶ Ep 7 · 2:57
host_summary It takes half the number of cases to become proficient in robotic surgery versus laparoscopy. ↗
▶ Ep 7 · 3:14
host_summary Robotics can be indicated for surgeries in the chest, pelvic reconstruction, abdominal tumors, and urology. ↗
▶ Ep 7 · 3:14
clinical Robotics can be indicated for surgeries in the chest, pelvic reconstruction, abdominal tumors, and urology. ↗
▶ Ep 7 · 3:24
clinical In smaller patients, ports should be measured 3 centimeters apart. ↗
▶ Ep 7 · 3:24
host_summary In smaller patients, ports should be measured 3 centimeters apart. ↗
▶ Ep 7 · 3:38
host_summary Robotic surgery in pediatric patients is ideal in select cases including adrenal masses, polyoco cysts, and nephrectomies. ↗
▶ Ep 7 · 3:38
clinical Robotic surgery in pediatric patients is ideal in select cases including adrenal masses, polyoco cysts, and nephrectomies. ↗
▶ Ep 7 · 3:52
opinion Reported cons of robotic surgery include cost, setup time, the size of the ports, and a steep learning curve. ↗
▶ Ep 7 · 3:52
host_summary Reported cons of robotic surgery include cost, setup time, the size of the ports, and a steep learning curve. ↗
▶ Ep 7 · 4:06
host_summary Once proficiency is achieved, operative times and conversions to open surgery are lower for robotic surgery compared to laparoscopy. ↗
▶ Ep 7 · 4:06
clinical Once proficiency is achieved, operative times and conversions to open surgery are lower for robotic surgery compared to laparoscopy. ↗
Peritoneal Dialysis Access 7 entries

Surgeon annual volume impacts recurrence rates of pediatric inguinal hernia repairs: A multi-institutional study

▶ Ep 8 · 0:10
host_summary Heller et al. published a multi-institutional study in the Journal of Pediatric Surgery in 2025 exploring the impact of surgeon volume on patients with inguinal hernias. ↗
▶ Ep 8 · 0:22
host_summary Inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence. ↗
▶ Ep 8 · 0:22
quote The authors found that inguinal hernias repaired by lower volume surgeons had a 1.5 fold increase in the odds of recurrence. ↗
▶ Ep 8 · 0:30
host_summary When broken down by surgical approach, there was no difference in recurrence rates for open inguinal hernia repairs based on surgeon volume. ↗
▶ Ep 8 · 0:35
host_summary Laparoscopic inguinal hernia repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence. ↗
▶ Ep 8 · 0:35
quote However, laparoscopic repairs done by lower volume surgeons had a 3.3 fold increase in the odds of recurrence. ↗
▶ Ep 8 · 0:44
host_summary The authors of the Heller et al. study recommend maintaining a high volume of laparoscopic repairs, and if that's not possible, to seek help from a higher volume surgeon. ↗
Pulmonary Hypoplasia 8 entries

Inside a FETO Procedure: Fetoscopic Balloon Tracheal Occlusion with Dr. Beth Rymeski

▶ Ep 6 · 0:47
clinical The goal of FETO is to allow fluid to stay in the lungs and allow the lungs to expand and grow. ↗
▶ Ep 6 · 0:47
host_summary The goal of FETO is to allow fluid to stay in the lungs and allow the lungs to expand and grow. ↗
▶ Ep 6 · 0:53
clinical FETO helps prevent pulmonary hypoplasia, which is a big factor in poor outcomes for CDH babies. ↗
▶ Ep 6 · 0:53
host_summary FETO helps prevent pulmonary hypoplasia, which is a big factor in poor outcomes for CDH babies. ↗
▶ Ep 6 · 3:08
clinical The balloon is filled with water, around 0.65 to 0.8 mL, depending on the size of the trachea. ↗
▶ Ep 6 · 3:08
host_summary The balloon is filled with water, around 0.65 to 0.8 mL, depending on the size of the trachea. ↗
▶ Ep 6 · 3:40
host_summary After balloon deployment, the scope is advanced one more time to confirm that the balloon is below the vocal cords and in the main trachea. ↗
▶ Ep 6 · 3:40
clinical After balloon deployment, the scope is advanced one more time to confirm that the balloon is below the vocal cords and in the main trachea. ↗
Tracheoesophageal Fistula 15 entries

Esophageal Atresia & Tracheoesophageal Fistula (EA/TEF) Types Explained for Pediatric Surgery

▶ Ep 13 · 0:00
quote Today I'm going to walk through esophageal atresia and tracheoesophageal fistula, or TEF. ↗
▶ Ep 13 · 0:05
opinion EA/TEF is a basic concept in pediatric surgery. ↗
▶ Ep 13 · 0:10
clinical In normal anatomy, the esophagus goes straight down to the stomach with no atresia or interruptions, and the trachea goes straight down to the lungs with no connections between the two. ↗
▶ Ep 13 · 0:29
clinical Type A EA/TEF consists of esophageal atresia proximally and distally in the esophagus, preventing solids and liquids from reaching the stomach, with no connection between esophagus and trachea. ↗
▶ Ep 13 · 0:45
clinical Type B EA/TEF has distal esophageal atresia and a proximal fistula, allowing solids and liquids to enter the trachea while the stomach remains empty. ↗
▶ Ep 13 · 1:08
epidemiological Type C EA/TEF is the most common type. ↗
▶ Ep 13 · 1:08
quote Type C is the most common ↗
▶ Ep 13 · 1:13
clinical Type C EA/TEF has proximal esophageal atresia and a distal fistula, allowing air to reach both lungs and stomach while solids and liquids cannot reach the stomach. ↗
▶ Ep 13 · 1:28
clinical Type D EA/TEF has both a distal fistula and a proximal fistula, allowing solids and liquids into the trachea and air into both lungs and stomach. ↗
▶ Ep 13 · 1:43
clinical Type E EA/TEF has no atresia but does have a tracheoesophageal fistula, which is often pretty high. ↗
▶ Ep 13 · 1:52
quote This is also known as H. You can see the H right here. ↗
▶ Ep 13 · 1:52
clinical Type E EA/TEF is also known as H-type because of its anatomical appearance. ↗
▶ Ep 13 · 1:56
clinical Type E (H-type) EA/TEF has the best results and is usually the easiest to fix. ↗
▶ Ep 13 · 1:56
quote And this is the one with the best results and usually the easiest to fix. ↗
▶ Ep 13 · 2:01
clinical Children with Type E (H-type) EA/TEF may present with symptoms later because they are still able to get solids and liquids down to the stomach and air to the lungs. ↗
Vestibular Fistula 3 entries

Update Course Rewind 2025: Perineal Body–Preserving PSARP: The New Standard?

▶ Ep 5 · 1:01
clinical Two-thirds of patients undergoing perineal body-preserving PSARP went home on postoperative day one. ↗
▶ Ep 5 · 1:51
opinion Perineal body-preserving PSARP is a good choice for patients but can be a trickier approach than standard PSARP. ↗
▶ Ep 5 · 2:00
clinical Conversion to the standard PSARP approach is a valid pivot when there is doubt about anatomy during perineal body-preserving PSARP. ↗
Wilms Tumor 12 entries

Impact of Pulmonary Tumor Burden in Favorable Histology Wilms Tumor Outcomes: A Report From the Children's Oncology Group Study AREN053

▶ Ep 19 · 0:00
quote Your patient has a Wilms tumor with favorable histology, but workup shows that they also have lung metastases. ↗
▶ Ep 19 · 0:14
clinical Dick et al. published a report from a Children's Oncology Group study in the Journal of Clinical Oncology in 2025 ↗
▶ Ep 19 · 0:19
clinical The study examined factors in patients with favorable histology Wilms tumor and pulmonary metastases and how those factors may affect outcomes ↗
▶ Ep 19 · 0:30
clinical Factors studied included the number of metastases, the size of the metastases, and different biological markers ↗
▶ Ep 19 · 0:36
clinical There was no difference in survival based on the number of metastases ↗
▶ Ep 19 · 0:41
clinical Patients with larger nodules and rapid response to chemotherapy showed no changes in overall survival ↗
▶ Ep 19 · 0:41
clinical Patients who had a rapid response to chemotherapy with larger nodules showed worse event-free survival ↗
▶ Ep 19 · 0:49
clinical In multivariable models, neither the size nor the number of nodules had any effect on survival ↗
▶ Ep 19 · 0:55
clinical 1q gain was associated with worse event-free survival ↗
▶ Ep 19 · 0:55
clinical 1q gain was associated with worse overall survival ↗
▶ Ep 19 · 1:04
clinical 1q gain is the superior prognostic factor when compared to size and number of nodules in patients with favorable histology Wilms tumor and pulmonary metastases ↗
▶ Ep 19 · 1:04
quote One cue gain is the superior prognostic factor when compared to size and number of nodules in patients with favorable histology Wilms and pulmonary metastases. ↗