Nelson Rosen
148 statements · 6 topics · summaries given as host listed separately
Featured statements
Give yourself a 5 minute timer and when that time passes, if you have yet to succeed, ask yourself if you're making significant progress. If so, persist for another 5 minutes. If after 10 minutes you feel that you're not really making forward progress, do not hesitate to ask for the standard length 5 millimeter instrument tray, a 5 millimeter 30 degree scope, and place two additional trocars.
quote ·
Appendicitis
When placing a trochar by open technique, it is usually helpful to start with a skin and fascial incision as large as you can make while still concealing it within the umbilicus. This helps avoid failing to deliver the appendix initially and having to enlarge the incision before a second try.
quote ·
Appendicitis
There is a reflux called the recto anal inhibitory reflex. That when you blow a balloon up in the rectum and stretch the rectum, the sphincter should relax. That is a normal recto anal inhibitory reflex. But if the patient has Hirschsprung disease, that reflex, it's gone.
quote ·
Colorectal / ARM & Hirschsprung
we're going to start off with a water-soluble contrast enema. What is the radiologist looking for? Is the lowest segment of the intestine, the rectum, is that narrower? And then it dilates up above that. That's a sign that we have concern for Hirschsprung's disease.
quote ·
Colorectal / ARM & Hirschsprung
In older children, Hirschsprungs can be missed. Those situations usually establish themselves. Children with Hirschsprungs very rarely thrive and develop normally. Because they're often small for their age group.
quote ·
Hirschsprung disease
We use this term dilation, like we're stretching something that can be stretched up to a certain size, except that's not true. Like when they start out like a pinhole, it's a controlled tear.
quote ·
Anorectal Malformation
Nothing matches these filters — clear the search or widen the filters.
Nelson's statements about Anorectal Malformation 6 statements
Open the Anorectal Malformation collection →
2025 Pediatric Surgery Update Course - Updates in Colorectal: Debunking Dogma
Quotation
We use this term dilation, like we're stretching something that can be stretched up to a certain size, except that's not true. Like when they start out like a pinhole, it's a controlled tear.
Open
Statement
Preoperative fistula dilation is a controlled tear rather than true stretching when the fistula starts as a pinhole; it should be dilated only enough to allow stool passage, then left alone until definitive repair.
Open
Statement
The perineal body-preserving PSARP technique is essentially the same approach used for bulbar fistulas, applied to vestibular fistulas.
Open
Statement
The key technical principle for perineal body-preserving PSARP is to thoroughly mobilize the lateral planes and posterior wall of the rectum before attempting to dissect the anterior common wall with the vagina.
Open
Statement
Excessive bowel mobilization during PSARP may result in injury to blood vessels and nerves, potentially leading to prolonged bowel management problems.
Open
Quotation
Every little flick of the bovie, like that's a blood vessel, that's a nerve, and that's another week in the bowel management clinic.
Open
Nelson's statements about Appendicitis 21 statements
Open the Appendicitis collection →
SILS Appendectomy by Dr. Nelson Rosen
Quotation
While the scope is described as a 10 millimeter scope, it will only fit through a 12 millimeter trocar.
Open
Statement
The specialized laparoscope for SILS appendectomy is described as 10mm but requires a 12mm trocar for insertion.
Open
Statement
The degree of cecal mobilization needed varies depending on baseline appendix mobility and abdominal wall thickness.
Open
Quotation
If the appendix can come up to the liver, then most likely it will be able to be delivered up through the abdominal wall.
Open
Statement
If the appendix can be brought up to the liver laparoscopically, it will most likely be deliverable through the abdominal wall.
Open
Statement
Patient body habitus, duration of illness, and appendix size on imaging should be factored into the decision between 1-port or 3-port approach.
Open
Statement
Obese or extremely muscular patients have thick abdominal walls that make it difficult to deliver even mildly inflamed appendices high enough for safe appendectomy.
Open
Statement
The challenge of appendix delivery is compounded when the appendix is very thick and friable.
Open
Statement
It is reasonable to start with SILS approach even if not confident of finishing that way, using a 5-minute timer to assess progress.
Open
Quotation
Give yourself a 5 minute timer and when that time passes, if you have yet to succeed, ask yourself if you're making significant progress. If so, persist for another 5 minutes. If after 10 minutes you feel that you're not really making forward progress, do not hesitate to ask for the standard length 5 millimeter instrument tray, a 5 millimeter 30 degree scope, and place two additional trocars.
Open
Statement
If after 10 minutes of attempting SILS there is no significant forward progress, conversion to traditional multi-port technique with two additional trocars should be performed.
Open
Statement
A 12mm trocar placed through the umbilicus by Veress needle technique creates an opening large enough for transumbilical appendectomy in thin, small patients.
Open
Statement
When abdominal wall is thick or appendix is thick and friable, the fascial opening may need enlargement to safely deliver the appendix.
Open
Statement
When placing trocar by open technique, starting with a skin and fascial incision as large as possible while still concealed in the umbilicus helps avoid needing to enlarge the incision after failed initial delivery attempt.
Open
Quotation
When placing a trochar by open technique, it is usually helpful to start with a skin and fascial incision as large as you can make while still concealing it within the umbilicus. This helps avoid failing to deliver the appendix initially and having to enlarge the incision before a second try.
Open
Statement
A large fascial incision can make trocar retention difficult; the trocar can be secured with towel clip or suture, and insufflator flow should be set on high if gas is leaking.
Open
Statement
For aspirating small amounts of fluid, the suction tip can be inserted through the port with the outside end covered by a lap pad, using thumb pressure to alternately press and relax on gauze to allow positive insufflation pressure to push fluid out.
Open
Statement
When ligating mesoappendix, a precaution against losing the divided end into the abdomen is to flash and reclamp the mesentery as the tie is cinched down until the tie is complete.
Open
Statement
When the appendiceal base is deep in the wound and hard to ligate by usual means, endo-loops can be used to position the tie.
Open
Statement
If uncertain whether ligation is at the true appendiceal base, the appendix can be ligated with a long suture held externally, returned to abdomen for laparoscopic inspection, and if inadequate, further dissection performed before completing appendectomy.
Open
Nelson's statements about Colorectal / ARM & Hirschsprung 54 statements
Open the Colorectal / ARM & Hirschsprung collection →
Hirschsprung Disease Workup
Statement
Hirschsprung disease is a congenital condition affecting the lower most aspect of the intestine (rectum or sigmoid), characterized by missing ganglion cells in the submucosal and myenteric plexus that allow the intestine to relax.
Open
Statement
Hirschsprung disease is a congenital condition affecting the lower most aspect of the intestine (rectum or sigmoid), characterized by missing ganglion cells in the submucosal and myenteric plexus that allow the intestine to relax.
Open
Quotation
Hirschsprung's disease is a congenital issue. It is a condition that children are born with. It usually affects the lower most aspect of the intestine. A.K.A. the rectum or the sigmoid.
Open
Quotation
Hirschsprung's disease is a congenital issue. It is a condition that children are born with. It usually affects the lower most aspect of the intestine. A.K.A. the rectum or the sigmoid.
Open
Quotation
the GI system is like a big tube, right? It's like a big tube that goes from your mouth to your anus. But it's not just a pipe. It's also a pump.
Open
Quotation
the GI system is like a big tube, right? It's like a big tube that goes from your mouth to your anus. But it's not just a pipe. It's also a pump.
Open
Quotation
in Hirschsprung's disease, we are missing the system of nerves that allows that to relax.
Open
Quotation
in Hirschsprung's disease, we are missing the system of nerves that allows that to relax.
Open
Statement
In Hirschsprung disease, the rectum and lowest part of the colon are always affected, with the aganglionosis always ending right above the anus.
Open
Statement
In Hirschsprung disease, the rectum and lowest part of the colon are always affected, with the aganglionosis always ending right above the anus.
Open
Quotation
with Hirschsprung's, we know that it always ends right above the anus. But where does it begin? That's where the variability is.
Open
Quotation
with Hirschsprung's, we know that it always ends right above the anus. But where does it begin? That's where the variability is.
Open
Statement
About 85% of Hirschsprung cases begin in the very end part of the sigmoid colon or the beginning of the rectum.
Open
Statement
About 85% of Hirschsprung cases begin in the very end part of the sigmoid colon or the beginning of the rectum.
Open
Statement
In newborns with suspected Hirschsprung disease, the initial workup includes a water-soluble contrast enema looking for a narrower distal segment (rectum) with dilation above.
Open
Statement
In newborns with suspected Hirschsprung disease, the initial workup includes a water-soluble contrast enema looking for a narrower distal segment (rectum) with dilation above.
Open
Quotation
we're going to start off with a water-soluble contrast enema. What is the radiologist looking for? Is the lowest segment of the intestine, the rectum, is that narrower? And then it dilates up above that. That's a sign that we have concern for Hirschsprung's disease.
Open
Quotation
we're going to start off with a water-soluble contrast enema. What is the radiologist looking for? Is the lowest segment of the intestine, the rectum, is that narrower? And then it dilates up above that. That's a sign that we have concern for Hirschsprung's disease.
Open
Statement
If contrast enema raises concern for Hirschsprung disease, a suction rectal biopsy is performed to examine tissue for the presence of ganglion cells.
Open
Statement
If contrast enema raises concern for Hirschsprung disease, a suction rectal biopsy is performed to examine tissue for the presence of ganglion cells.
Open
Quotation
In older children, Hirschsprungs can be missed. Those situations usually establish themselves. Children with Hirschsprungs very rarely thrive and develop normally. Because they're often small for their age group.
Open
Statement
In older children, Hirschsprung disease can be missed and typically presents with failure to thrive (small for age) and significant constipation.
Open
Quotation
In older children, Hirschsprungs can be missed. Those situations usually establish themselves. Children with Hirschsprungs very rarely thrive and develop normally. Because they're often small for their age group.
Open
Statement
In older children, Hirschsprung disease can be missed and typically presents with failure to thrive (small for age) and significant constipation.
Open
Statement
In older children with suspected Hirschsprung disease, the diagnostic pathway includes plain films to assess degree of constipation, followed by contrast rectal enema, and then biopsy depending on findings.
Open
Statement
In older children with suspected Hirschsprung disease, the diagnostic pathway includes plain films to assess degree of constipation, followed by contrast rectal enema, and then biopsy depending on findings.
Open
Statement
In older children with low-risk presentations (normal early years, then worsening constipation), biopsy should usually be done only after routine constipation management measures are tried and fail.
Open
Statement
In older children with low-risk presentations (normal early years, then worsening constipation), biopsy should usually be done only after routine constipation management measures are tried and fail.
Open
Statement
Anorectal manometry uses a balloon catheter to measure pressures in the anus and rectum, specifically looking for the rectoanal inhibitory reflex.
Open
Statement
Anorectal manometry uses a balloon catheter to measure pressures in the anus and rectum, specifically looking for the rectoanal inhibitory reflex.
Open
Quotation
There is a reflux called the recto anal inhibitory reflex. That when you blow a balloon up in the rectum and stretch the rectum, the sphincter should relax. That is a normal recto anal inhibitory reflex. But if the patient has Hirschsprung disease, that reflex, it's gone.
Open
Statement
The normal rectoanal inhibitory reflex causes the anal sphincter to relax when a balloon is inflated in the rectum, but this reflex is absent in Hirschsprung disease.
Open
Statement
The normal rectoanal inhibitory reflex causes the anal sphincter to relax when a balloon is inflated in the rectum, but this reflex is absent in Hirschsprung disease.
Open
Quotation
There is a reflux called the recto anal inhibitory reflex. That when you blow a balloon up in the rectum and stretch the rectum, the sphincter should relax. That is a normal recto anal inhibitory reflex. But if the patient has Hirschsprung disease, that reflex, it's gone.
Open
Quotation
It's not very sensitive. In other words, if you have a normal manometry, it doesn't completely rule out Hirschsprungs disease.
Open
Statement
Anorectal manometry is not sufficiently sensitive to rule out Hirschsprung disease; a normal manometry does not completely exclude the diagnosis.
Open
Statement
Anorectal manometry is not sufficiently sensitive to rule out Hirschsprung disease; a normal manometry does not completely exclude the diagnosis.
Open
Quotation
It's not very sensitive. In other words, if you have a normal manometry, it doesn't completely rule out Hirschsprungs disease.
Open
2025 Pediatric Surgery Update Course - Updates in Colorectal: Debunking Dogma
Statement
Preoperative fistula dilation is a controlled tear rather than true stretching when the fistula starts as a pinhole; it should be dilated only enough to allow stool passage, then left alone until definitive repair.
Open
Quotation
We use this term dilation, like we're stretching something that can be stretched up to a certain size, except that's not true. Like when they start out like a pinhole, it's a controlled tear.
Open
Statement
Preoperative fistula dilation is a controlled tear rather than true stretching when the fistula starts as a pinhole; it should be dilated only enough to allow stool passage, then left alone until definitive repair.
Open
Quotation
We use this term dilation, like we're stretching something that can be stretched up to a certain size, except that's not true. Like when they start out like a pinhole, it's a controlled tear.
Open
Statement
The perineal body-preserving PSARP technique is essentially the same approach used for bulbar fistulas, applied to vestibular fistulas.
Open
Statement
The perineal body-preserving PSARP technique is essentially the same approach used for bulbar fistulas, applied to vestibular fistulas.
Open
Statement
The key technical principle for perineal body-preserving PSARP is to thoroughly mobilize the lateral planes and posterior wall of the rectum before attempting to dissect the anterior common wall with the vagina.
Open
Statement
The key technical principle for perineal body-preserving PSARP is to thoroughly mobilize the lateral planes and posterior wall of the rectum before attempting to dissect the anterior common wall with the vagina.
Open
Statement
Excessive bowel mobilization during PSARP may result in injury to blood vessels and nerves, potentially leading to prolonged bowel management problems.
Open
Statement
Excessive bowel mobilization during PSARP may result in injury to blood vessels and nerves, potentially leading to prolonged bowel management problems.
Open
Quotation
Every little flick of the bovie, like that's a blood vessel, that's a nerve, and that's another week in the bowel management clinic.
Open
Quotation
Every little flick of the bovie, like that's a blood vessel, that's a nerve, and that's another week in the bowel management clinic.
Open
Nelson's statements about Hirschsprung disease 54 statements
Open the Hirschsprung disease collection →
Hirschsprung Disease Workup
Quotation
Hirschsprung's disease is a congenital issue. It is a condition that children are born with. It usually affects the lower most aspect of the intestine. A.K.A. the rectum or the sigmoid.
Open
Statement
Hirschsprung disease is a congenital condition affecting the lower most aspect of the intestine (rectum or sigmoid), characterized by missing ganglion cells in the submucosal and myenteric plexus that allow the intestine to relax.
Open
Statement
Hirschsprung disease is a congenital condition affecting the lower most aspect of the intestine (rectum or sigmoid), characterized by missing ganglion cells in the submucosal and myenteric plexus that allow the intestine to relax.
Open
Quotation
Hirschsprung's disease is a congenital issue. It is a condition that children are born with. It usually affects the lower most aspect of the intestine. A.K.A. the rectum or the sigmoid.
Open
Quotation
the GI system is like a big tube, right? It's like a big tube that goes from your mouth to your anus. But it's not just a pipe. It's also a pump.
Open
Quotation
the GI system is like a big tube, right? It's like a big tube that goes from your mouth to your anus. But it's not just a pipe. It's also a pump.
Open
Quotation
in Hirschsprung's disease, we are missing the system of nerves that allows that to relax.
Open
Quotation
in Hirschsprung's disease, we are missing the system of nerves that allows that to relax.
Open
Statement
In Hirschsprung disease, the rectum and lowest part of the colon are always affected, with the aganglionosis always ending right above the anus.
Open
Statement
In Hirschsprung disease, the rectum and lowest part of the colon are always affected, with the aganglionosis always ending right above the anus.
Open
Quotation
with Hirschsprung's, we know that it always ends right above the anus. But where does it begin? That's where the variability is.
Open
Quotation
with Hirschsprung's, we know that it always ends right above the anus. But where does it begin? That's where the variability is.
Open
Statement
About 85% of Hirschsprung cases begin in the very end part of the sigmoid colon or the beginning of the rectum.
Open
Statement
About 85% of Hirschsprung cases begin in the very end part of the sigmoid colon or the beginning of the rectum.
Open
Statement
In newborns with suspected Hirschsprung disease, the initial workup includes a water-soluble contrast enema looking for a narrower distal segment (rectum) with dilation above.
Open
Statement
In newborns with suspected Hirschsprung disease, the initial workup includes a water-soluble contrast enema looking for a narrower distal segment (rectum) with dilation above.
Open
Quotation
we're going to start off with a water-soluble contrast enema. What is the radiologist looking for? Is the lowest segment of the intestine, the rectum, is that narrower? And then it dilates up above that. That's a sign that we have concern for Hirschsprung's disease.
Open
Quotation
we're going to start off with a water-soluble contrast enema. What is the radiologist looking for? Is the lowest segment of the intestine, the rectum, is that narrower? And then it dilates up above that. That's a sign that we have concern for Hirschsprung's disease.
Open
Statement
If contrast enema raises concern for Hirschsprung disease, a suction rectal biopsy is performed to examine tissue for the presence of ganglion cells.
Open
Statement
If contrast enema raises concern for Hirschsprung disease, a suction rectal biopsy is performed to examine tissue for the presence of ganglion cells.
Open
Statement
In older children, Hirschsprung disease can be missed and typically presents with failure to thrive (small for age) and significant constipation.
Open
Quotation
In older children, Hirschsprungs can be missed. Those situations usually establish themselves. Children with Hirschsprungs very rarely thrive and develop normally. Because they're often small for their age group.
Open
Quotation
In older children, Hirschsprungs can be missed. Those situations usually establish themselves. Children with Hirschsprungs very rarely thrive and develop normally. Because they're often small for their age group.
Open
Statement
In older children, Hirschsprung disease can be missed and typically presents with failure to thrive (small for age) and significant constipation.
Open
Statement
In older children with suspected Hirschsprung disease, the diagnostic pathway includes plain films to assess degree of constipation, followed by contrast rectal enema, and then biopsy depending on findings.
Open
Statement
In older children with suspected Hirschsprung disease, the diagnostic pathway includes plain films to assess degree of constipation, followed by contrast rectal enema, and then biopsy depending on findings.
Open
Statement
In older children with low-risk presentations (normal early years, then worsening constipation), biopsy should usually be done only after routine constipation management measures are tried and fail.
Open
Statement
In older children with low-risk presentations (normal early years, then worsening constipation), biopsy should usually be done only after routine constipation management measures are tried and fail.
Open
Statement
Anorectal manometry uses a balloon catheter to measure pressures in the anus and rectum, specifically looking for the rectoanal inhibitory reflex.
Open
Statement
Anorectal manometry uses a balloon catheter to measure pressures in the anus and rectum, specifically looking for the rectoanal inhibitory reflex.
Open
Statement
The normal rectoanal inhibitory reflex causes the anal sphincter to relax when a balloon is inflated in the rectum, but this reflex is absent in Hirschsprung disease.
Open
Quotation
There is a reflux called the recto anal inhibitory reflex. That when you blow a balloon up in the rectum and stretch the rectum, the sphincter should relax. That is a normal recto anal inhibitory reflex. But if the patient has Hirschsprung disease, that reflex, it's gone.
Open
Statement
The normal rectoanal inhibitory reflex causes the anal sphincter to relax when a balloon is inflated in the rectum, but this reflex is absent in Hirschsprung disease.
Open
Quotation
There is a reflux called the recto anal inhibitory reflex. That when you blow a balloon up in the rectum and stretch the rectum, the sphincter should relax. That is a normal recto anal inhibitory reflex. But if the patient has Hirschsprung disease, that reflex, it's gone.
Open
Statement
Anorectal manometry is not sufficiently sensitive to rule out Hirschsprung disease; a normal manometry does not completely exclude the diagnosis.
Open
Quotation
It's not very sensitive. In other words, if you have a normal manometry, it doesn't completely rule out Hirschsprungs disease.
Open
Statement
Anorectal manometry is not sufficiently sensitive to rule out Hirschsprung disease; a normal manometry does not completely exclude the diagnosis.
Open
Quotation
It's not very sensitive. In other words, if you have a normal manometry, it doesn't completely rule out Hirschsprungs disease.
Open
2025 Pediatric Surgery Update Course - Updates in Colorectal: Debunking Dogma
Statement
Preoperative fistula dilation is a controlled tear rather than true stretching when the fistula starts as a pinhole; it should be dilated only enough to allow stool passage, then left alone until definitive repair.
Open
Quotation
We use this term dilation, like we're stretching something that can be stretched up to a certain size, except that's not true. Like when they start out like a pinhole, it's a controlled tear.
Open
Quotation
We use this term dilation, like we're stretching something that can be stretched up to a certain size, except that's not true. Like when they start out like a pinhole, it's a controlled tear.
Open
Statement
Preoperative fistula dilation is a controlled tear rather than true stretching when the fistula starts as a pinhole; it should be dilated only enough to allow stool passage, then left alone until definitive repair.
Open
Statement
The perineal body-preserving PSARP technique is essentially the same approach used for bulbar fistulas, applied to vestibular fistulas.
Open
Statement
The perineal body-preserving PSARP technique is essentially the same approach used for bulbar fistulas, applied to vestibular fistulas.
Open
Statement
The key technical principle for perineal body-preserving PSARP is to thoroughly mobilize the lateral planes and posterior wall of the rectum before attempting to dissect the anterior common wall with the vagina.
Open
Statement
The key technical principle for perineal body-preserving PSARP is to thoroughly mobilize the lateral planes and posterior wall of the rectum before attempting to dissect the anterior common wall with the vagina.
Open
Statement
Excessive bowel mobilization during PSARP may result in injury to blood vessels and nerves, potentially leading to prolonged bowel management problems.
Open
Statement
Excessive bowel mobilization during PSARP may result in injury to blood vessels and nerves, potentially leading to prolonged bowel management problems.
Open
Quotation
Every little flick of the bovie, like that's a blood vessel, that's a nerve, and that's another week in the bowel management clinic.
Open
Quotation
Every little flick of the bovie, like that's a blood vessel, that's a nerve, and that's another week in the bowel management clinic.
Open
Nelson's statements about Pectus Carinatum 7 statements
Open the Pectus Carinatum collection →
Pediatric Surgery Updates for the PCP - Full Show
Statement
Real pilonidal disease always presents in patients who have started puberty; cases in much younger patients are exceedingly rare exceptions
Open
Statement
Crohn's disease and pilonidal disease can occur together and may be difficult to distinguish
Open
Statement
For acute pilonidal infections, a 5 to 7 day course of broad spectrum antibiotics like Augmentin, Clindamycin, or Cipro and Flagyl is usually sufficient
Open
Statement
GIPS procedure can be done under local anesthesia, requires only Tylenol or ibuprofen for pain, and most wounds heal within a couple weeks without packing or activity restriction
Open
Statement
Cleft lift procedure requires general anesthesia for about 90 minutes, patients need Percocet for pain management, and have a drain for about 5 days
Open
Nelson's statements about Recto-vestibular Fistula 6 statements
Open the Recto-vestibular Fistula collection →
2025 Pediatric Surgery Update Course - Updates in Colorectal: Debunking Dogma
Quotation
We use this term dilation, like we're stretching something that can be stretched up to a certain size, except that's not true. Like when they start out like a pinhole, it's a controlled tear.
Open
Statement
Preoperative fistula dilation is a controlled tear rather than true stretching when the fistula starts as a pinhole; it should be dilated only enough to allow stool passage, then left alone until definitive repair.
Open
Statement
The perineal body-preserving PSARP technique is essentially the same approach used for bulbar fistulas, applied to vestibular fistulas.
Open
Statement
The key technical principle for perineal body-preserving PSARP is to thoroughly mobilize the lateral planes and posterior wall of the rectum before attempting to dissect the anterior common wall with the vagina.
Open
Statement
Excessive bowel mobilization during PSARP may result in injury to blood vessels and nerves, potentially leading to prolonged bowel management problems.
Open
Quotation
Every little flick of the bovie, like that's a blood vessel, that's a nerve, and that's another week in the bowel management clinic.
Open
Summaries Nelson gave as host · 30 summaries
Recaps of other experts' statements, not Nelson's own clinical position.
Summaries Nelson gave as host · Anorectal Malformation 5 summaries
Open the Anorectal Malformation collection →
2025 Pediatric Surgery Update Course - Updates in Colorectal: Debunking Dogma
Host summary
Nelson Rosen summarizing the discussion: A 2021 PCPLC retrospective multi-center study of Hirschsprung disease found no difference in preoperative enterocolitis, postoperative enterocolitis, or fecal incontinence between neonatal pull-through (median age 11 days) and delayed primary pull-through (median age 98 days).
Open
Host summary
Nelson Rosen summarizing the discussion: A 2022 multi-center retrospective study found that 24% of Hirschsprung disease patients received at least one Botox injection.
Open
Host summary
Nelson Rosen summarizing the discussion: A prospective Cincinnati Children's study (2020-2024, unpublished) found that Botox injection at time of Hirschsprung pull-through reduced enterocolitis risk within 31 days postoperatively from approximately 50% to 30%.
Open
Host summary
Nelson Rosen summarizing the discussion: The same Cincinnati Children's Botox study found that 60% of patients who received Botox at pull-through developed diaper rash.
Open
Host summary
Nelson Rosen summarizing the discussion: Early work from Boston (Sam Nurko's group) used weight-based Botox dosing up to a maximum of 100 units for Hirschsprung disease.
Open
Summaries Nelson gave as host · Colorectal / ARM & Hirschsprung 10 summaries
Open the Colorectal / ARM & Hirschsprung collection →
2025 Pediatric Surgery Update Course - Updates in Colorectal: Debunking Dogma
Host summary
Nelson Rosen summarizing the discussion: A 2021 PCPLC retrospective multi-center study of Hirschsprung disease found no difference in preoperative enterocolitis, postoperative enterocolitis, or fecal incontinence between neonatal pull-through (median age 11 days) and delayed primary pull-through (median age 98 days).
Open
Host summary
Nelson Rosen summarizing the discussion: A 2021 PCPLC retrospective multi-center study of Hirschsprung disease found no difference in preoperative enterocolitis, postoperative enterocolitis, or fecal incontinence between neonatal pull-through (median age 11 days) and delayed primary pull-through (median age 98 days).
Open
Host summary
Nelson Rosen summarizing the discussion: A 2022 multi-center retrospective study found that 24% of Hirschsprung disease patients received at least one Botox injection.
Open
Host summary
Nelson Rosen summarizing the discussion: A 2022 multi-center retrospective study found that 24% of Hirschsprung disease patients received at least one Botox injection.
Open
Host summary
Nelson Rosen summarizing the discussion: A prospective Cincinnati Children's study (2020-2024, unpublished) found that Botox injection at time of Hirschsprung pull-through reduced enterocolitis risk within 31 days postoperatively from approximately 50% to 30%.
Open
Host summary
Nelson Rosen summarizing the discussion: A prospective Cincinnati Children's study (2020-2024, unpublished) found that Botox injection at time of Hirschsprung pull-through reduced enterocolitis risk within 31 days postoperatively from approximately 50% to 30%.
Open
Host summary
Nelson Rosen summarizing the discussion: The same Cincinnati Children's Botox study found that 60% of patients who received Botox at pull-through developed diaper rash.
Open
Host summary
Nelson Rosen summarizing the discussion: The same Cincinnati Children's Botox study found that 60% of patients who received Botox at pull-through developed diaper rash.
Open
Host summary
Nelson Rosen summarizing the discussion: Early work from Boston (Sam Nurko's group) used weight-based Botox dosing up to a maximum of 100 units for Hirschsprung disease.
Open
Host summary
Nelson Rosen summarizing the discussion: Early work from Boston (Sam Nurko's group) used weight-based Botox dosing up to a maximum of 100 units for Hirschsprung disease.
Open
Summaries Nelson gave as host · Hirschsprung disease 10 summaries
Open the Hirschsprung disease collection →
2025 Pediatric Surgery Update Course - Updates in Colorectal: Debunking Dogma
Host summary
Nelson Rosen summarizing the discussion: A 2021 PCPLC retrospective multi-center study of Hirschsprung disease found no difference in preoperative enterocolitis, postoperative enterocolitis, or fecal incontinence between neonatal pull-through (median age 11 days) and delayed primary pull-through (median age 98 days).
Open
Host summary
Nelson Rosen summarizing the discussion: A 2021 PCPLC retrospective multi-center study of Hirschsprung disease found no difference in preoperative enterocolitis, postoperative enterocolitis, or fecal incontinence between neonatal pull-through (median age 11 days) and delayed primary pull-through (median age 98 days).
Open
Host summary
Nelson Rosen summarizing the discussion: A 2022 multi-center retrospective study found that 24% of Hirschsprung disease patients received at least one Botox injection.
Open
Host summary
Nelson Rosen summarizing the discussion: A 2022 multi-center retrospective study found that 24% of Hirschsprung disease patients received at least one Botox injection.
Open
Host summary
Nelson Rosen summarizing the discussion: A prospective Cincinnati Children's study (2020-2024, unpublished) found that Botox injection at time of Hirschsprung pull-through reduced enterocolitis risk within 31 days postoperatively from approximately 50% to 30%.
Open
Host summary
Nelson Rosen summarizing the discussion: A prospective Cincinnati Children's study (2020-2024, unpublished) found that Botox injection at time of Hirschsprung pull-through reduced enterocolitis risk within 31 days postoperatively from approximately 50% to 30%.
Open
Host summary
Nelson Rosen summarizing the discussion: The same Cincinnati Children's Botox study found that 60% of patients who received Botox at pull-through developed diaper rash.
Open
Host summary
Nelson Rosen summarizing the discussion: The same Cincinnati Children's Botox study found that 60% of patients who received Botox at pull-through developed diaper rash.
Open
Host summary
Nelson Rosen summarizing the discussion: Early work from Boston (Sam Nurko's group) used weight-based Botox dosing up to a maximum of 100 units for Hirschsprung disease.
Open
Host summary
Nelson Rosen summarizing the discussion: Early work from Boston (Sam Nurko's group) used weight-based Botox dosing up to a maximum of 100 units for Hirschsprung disease.
Open
Summaries Nelson gave as host · Recto-vestibular Fistula 5 summaries
Open the Recto-vestibular Fistula collection →
2025 Pediatric Surgery Update Course - Updates in Colorectal: Debunking Dogma
Host summary
Nelson Rosen summarizing the discussion: A 2021 PCPLC retrospective multi-center study of Hirschsprung disease found no difference in preoperative enterocolitis, postoperative enterocolitis, or fecal incontinence between neonatal pull-through (median age 11 days) and delayed primary pull-through (median age 98 days).
Open
Host summary
Nelson Rosen summarizing the discussion: A 2022 multi-center retrospective study found that 24% of Hirschsprung disease patients received at least one Botox injection.
Open
Host summary
Nelson Rosen summarizing the discussion: A prospective Cincinnati Children's study (2020-2024, unpublished) found that Botox injection at time of Hirschsprung pull-through reduced enterocolitis risk within 31 days postoperatively from approximately 50% to 30%.
Open
Host summary
Nelson Rosen summarizing the discussion: The same Cincinnati Children's Botox study found that 60% of patients who received Botox at pull-through developed diaper rash.
Open
Host summary
Nelson Rosen summarizing the discussion: Early work from Boston (Sam Nurko's group) used weight-based Botox dosing up to a maximum of 100 units for Hirschsprung disease.
Open