So if there's a procedure that requires bilateral vats with low morbidity and a very well-defined pathology such that you won't, um, you know, encounter. Any surprises, I think this is the sort of case that you should consider supines.
Lateral decubous positioning has been adopted from the transition from open thoracotomy to vats. It provides ease of exposure and rapid conversion to open thoracotomy. With advancements in vats, this no longer applies.
The data seems like the inflection point for having a lead point is about over 5 years old, where depending on the series, it's about 30 to 60% have a pathologic lead point if they're over 5.
48 patients were sent home from the ED and only one recurred in 48 hours, and that patient did not even need an operation. They just got reduced again.
The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.
The 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.
host_summaryThe negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database.↗
▶Ep 4 · 2:44
host_summaryFor incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.↗
▶Ep 4 · 3:10
host_summaryThe 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.↗
▶Ep 4 · 4:28
host_summaryA Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays.↗
Hirschsprung Disease Part I with Marc Levitt
▶Ep 7 · 1:59
host_summaryThe negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database.↗
▶Ep 7 · 2:44
host_summaryFor incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.↗
▶Ep 7 · 3:10
host_summaryThe 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.↗
▶Ep 7 · 4:28
host_summaryA Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays.↗
epidemiologicalThe negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database.↗
▶Ep 28 · 1:59
host_summaryThe negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database.↗
▶Ep 28 · 2:44
host_summaryFor incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.↗
▶Ep 28 · 2:44
guidelineFor incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.↗
▶Ep 28 · 3:10
guidelineThe 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.↗
▶Ep 28 · 3:10
host_summaryThe 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.↗
▶Ep 28 · 4:28
host_summaryA Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays.↗
▶Ep 28 · 4:28
epidemiologicalA Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays.↗
Hirschsprung Disease Part I with Marc Levitt
▶Ep 77 · 1:59
host_summaryThe negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database.↗
▶Ep 77 · 1:59
epidemiologicalThe negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database.↗
▶Ep 77 · 2:44
host_summaryFor incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.↗
▶Ep 77 · 2:44
guidelineFor incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.↗
▶Ep 77 · 3:10
guidelineThe 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.↗
▶Ep 77 · 3:10
host_summaryThe 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.↗
▶Ep 77 · 4:28
epidemiologicalA Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays.↗
▶Ep 77 · 4:28
host_summaryA Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays.↗
epidemiologicalThe negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database.↗
▶Ep 4 · 2:44
guidelineFor incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.↗
▶Ep 4 · 3:10
guidelineThe 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.↗
▶Ep 4 · 4:28
epidemiologicalA Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays.↗
Hirschsprung Disease Part I with Marc Levitt
▶Ep 11 · 1:59
epidemiologicalThe negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database.↗
▶Ep 11 · 1:59
host_summaryThe negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database.↗
▶Ep 11 · 2:44
host_summaryFor incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.↗
▶Ep 11 · 2:44
guidelineFor incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.↗
▶Ep 11 · 3:10
guidelineThe 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.↗
▶Ep 11 · 3:10
host_summaryThe 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.↗
▶Ep 11 · 4:28
host_summaryA Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays.↗
▶Ep 11 · 4:28
epidemiologicalA Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays.↗
epidemiologicalThe negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database.↗
▶Ep 28 · 1:59
host_summaryThe negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database.↗
▶Ep 28 · 2:44
host_summaryFor incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.↗
▶Ep 28 · 2:44
guidelineFor incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.↗
▶Ep 28 · 3:10
guidelineThe 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.↗
▶Ep 28 · 3:10
host_summaryThe 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.↗
▶Ep 28 · 4:28
host_summaryA Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays.↗
▶Ep 28 · 4:28
epidemiologicalA Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays.↗
epidemiologicalThe negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database.↗
▶Ep 13 · 2:44
guidelineFor incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.↗
▶Ep 13 · 3:10
guidelineThe 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.↗
▶Ep 13 · 4:28
epidemiologicalA Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays.↗
Hirschsprung Disease Part I with Marc Levitt
▶Ep 31 · 1:59
host_summaryThe negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database.↗
▶Ep 31 · 1:59
epidemiologicalThe negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database.↗
▶Ep 31 · 2:44
guidelineFor incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.↗
▶Ep 31 · 2:44
host_summaryFor incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.↗
▶Ep 31 · 3:10
host_summaryThe 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.↗
▶Ep 31 · 3:10
guidelineThe 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.↗
▶Ep 31 · 4:28
epidemiologicalA Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays.↗
▶Ep 31 · 4:28
host_summaryA Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays.↗
epidemiologicalThe negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database.↗
▶Ep 37 · 1:59
host_summaryThe negative appendectomy rate among hospitals is a median of 2.6% with a range from 0 to 17%, according to Kurt Newman's 2003 paper in Journal of Pediatric Surgery reviewing the PHIS database.↗
▶Ep 37 · 2:44
guidelineFor incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.↗
▶Ep 37 · 2:44
host_summaryFor incidental Meckel's diverticulum during laparoscopy, Zani's 2008 Annals of Surgery review recommended leaving it, stating the risk of complications is not worth the extremely low mortality rate of 0.001%.↗
▶Ep 37 · 3:10
guidelineThe 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.↗
▶Ep 37 · 3:10
host_summaryThe 50-year Mayo Clinic experience (Park et al., 2005, Annals of Surgery) recommended selective resection of Meckel's diverticulum based on four features: age less than 50, male sex, length greater than 2 cm, or presence of histologically abnormal tissue.↗
▶Ep 37 · 4:28
host_summaryA Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays.↗
▶Ep 37 · 4:28
epidemiologicalA Miami Children's Hospital paper (Al-Khoury et al., JAMA Surgery 2012) studied 200 consecutive non-perforated appendicitis patients. 80% were same-day discharges with similar complication and readmission rates compared to overnight stays.↗
host_summaryIn a series of 48 intussusception patients discharged from the ED, only one recurred within 48 hours and that patient did not require operation, only repeat reduction.↗
▶Ep 4 · 2:01
quote48 patients were sent home from the ED and only one recurred in 48 hours, and that patient did not even need an operation. They just got reduced again.↗
▶Ep 4 · 2:44
quoteThere was a study about 20 years ago in which, uh, they, they attribute it to ileocecal edema that it won't reflux.↗
▶Ep 4 · 2:44
host_summaryWhen contrast fills the appendix but does not reflux into small bowel after intussusception reduction, this is attributed to ileocecal edema; the recommendation is to observe and repeat the study in a few hours.↗
▶Ep 4 · 5:28
quoteThe data seems like the inflection point for having a lead point is about over 5 years old, where depending on the series, it's about 30 to 60% have a pathologic lead point if they're over 5.↗
▶Ep 4 · 5:28
host_summaryAge over 5 years is the inflection point for pathologic lead point in intussusception, with 30-60% of cases in this age group having a lead point depending on the series.↗
▶Ep 4 · 8:44
epidemiologicalIn a retrospective review of abscess I&D cases discharged same-day from the OR, treatment failure (readmission or repeat I&D within 2 weeks) occurred in only 0.9% of patients.↗
▶Ep 4 · 9:11
epidemiologicalAmong patients with leukocytosis (white count up to 35), only 2 out of 138 had treatment failure after same-day discharge, and only one febrile patient had treatment failure.↗
quoteLateral decubous positioning has been adopted from the transition from open thoracotomy to vats. It provides ease of exposure and rapid conversion to open thoracotomy. With advancements in vats, this no longer applies.↗
▶Ep 2 · 0:45
opinionLateral decubitus positioning has been adopted from the transition from open thoracotomy to VATS and provides ease of exposure and rapid conversion to open thoracotomy, but with advancements in VATS this no longer applies.↗
▶Ep 2 · 1:30
clinicalLateral positioning may add unnecessary morbidity including brachial plexus injury and decubitus ulcers.↗
▶Ep 2 · 1:30
quoteLateral positioning may add unnecessary morbidity, including brachial plexus injury and decubitous ulcers.↗
▶Ep 2 · 1:40
clinicalThe patient is a 17-year-old male with history of asthma who presented with shortness of breath and chest tightness when running, found to have bilateral apical blebs and a large right spontaneous pneumothorax treated with chest tube, later developing a small left spontaneous pneumothorax that resolved with observation.↗
▶Ep 2 · 2:20
clinicalBilateral VATS with bilateral apical bleb resections and mechanical pleurodesis was performed in the supine position due to the routine nature of the procedure.↗
▶Ep 2 · 2:40
clinicalPort placement for supine VATS included 25mm ports at the 7th intercostal space midclavicular line and 6th intercostal space mid-axillary line, plus a 12mm port at the 4th intercostal space mid-axillary line to accommodate the GIA stapler.↗
▶Ep 2 · 2:40
quoteNote both surgeons have adequate working space with their hands unencumbered.↗
▶Ep 2 · 3:20
quoteNote the excellent visualization and minimal interference between the instruments.↗
▶Ep 2 · 4:40
quoteBilateral vats was safely completed in the supine position. This provides simplicity, convenience, decreased operative time, and decreased positioning-related morbidity.↗
▶Ep 2 · 4:40
opinionBilateral VATS was safely completed in the supine position, providing simplicity, convenience, decreased operative time, and decreased positioning-related morbidity.↗
▶Ep 2 · 6:09
clinicalPatient selection for supine VATS is important; appropriate cases include bilateral VATS with low morbidity and well-defined pathology where you won't encounter surprises.↗
▶Ep 2 · 6:09
quoteSo if there's a procedure that requires bilateral vats with low morbidity and a very well-defined pathology such that you won't, um, you know, encounter. Any surprises, I think this is the sort of case that you should consider supines.↗
