I think anytime it's a Kansas City or an NWSPC, NWPSC. Anytime it's an NWPSC article, I pay attention. Anytime it's a Kansas City article, I pay attention. But other than that, I'm tired of seeing all these gastroschisis articles. I'm waiting for someone to give me something that is really meaningful.
I think anytime it's a Kansas City or an NWSPC, NWPSC. Anytime it's an NWPSC article, I pay attention. Anytime it's a Kansas City article, I pay attention. But other than that, I'm tired of seeing all these gastroschisis articles. I'm waiting for someone to give me something that is really meaningful.
I think anytime it's a Kansas City or an NWSPC, NWPSC. Anytime it's an NWPSC article, I pay attention. Anytime it's a Kansas City article, I pay attention. But other than that, I'm tired of seeing all these gastroschisis articles. I'm waiting for someone to give me something that is really meaningful.
I think anytime it's a Kansas City or an NWSPC, NWPSC. Anytime it's an NWPSC article, I pay attention. Anytime it's a Kansas City article, I pay attention. But other than that, I'm tired of seeing all these gastroschisis articles. I'm waiting for someone to give me something that is really meaningful.
I think anytime it's a Kansas City or an NWSPC, NWPSC. Anytime it's an NWPSC article, I pay attention. Anytime it's a Kansas City article, I pay attention. But other than that, I'm tired of seeing all these gastroschisis articles. I'm waiting for someone to give me something that is really meaningful.
Because think about it, the fetal lung tissue is constantly creating this fluid. That escapes through the trachea normally, but if we occlude the trachea, then that fluid will continue to build up, the pressure will build up in that trachea, and for some reason, that seems to help the lungs develop.
Gastroschisis and sutureless abdominal wall closure
▶Ep 22 · 1:44
quoteIn 2004, Tony Sandler published the first manuscript about suture disclosures to utilize the natural umbilical properties to closing that defect by itself.↗
▶Ep 22 · 1:44
host_summaryIn 2004, Tony Sandler published the first manuscript about sutureless closures utilizing the natural umbilical properties to close the gastroschisis defect by itself.↗
▶Ep 22 · 2:45
quoteI think it's clearly been a massive change in practice. It's one of the examples of a big change that we don't actually operate on those and they can be done at the bedside. And it also is an example of something that took a while to adopt. And now most people are doing it, I think.↗
▶Ep 22 · 2:45
quoteI didn't know about his article. I found out about it as a fellow when he taught us how to treat gastroschisis that way.↗
▶Ep 22 · 3:26
quoteThere have been so many articles in the last few years that go back and forth. I mean, one said gastro suture list is better. One said definitely don't do suture list. So my question is now, I don't know. I almost don't read these articles anymore.↗
▶Ep 22 · 5:29
quoteI think anytime it's a Kansas City or an NWSPC, NWPSC. Anytime it's an NWPSC article, I pay attention. Anytime it's a Kansas City article, I pay attention. But other than that, I'm tired of seeing all these gastroschisis articles. I'm waiting for someone to give me something that is really meaningful.↗
▶Ep 22 · 6:01
host_summaryPatients who underwent sutureless abdominal wall closure had no difference in days on TPN, time to goal feeds, time to initial feeds, or length of stay compared to sutured closure.↗
▶Ep 22 · 6:01
host_summaryThe Midwest Pediatric Surgery Consortium study was a retrospective cohort of infants born with gastroschisis between 2013 and 2016, with a total of 315 patients.↗
▶Ep 22 · 6:01
host_summaryThe study divided patients into sutured versus sutureless abdominal wall closures and required subgroup analysis because some babies received silos and some did not.↗
▶Ep 22 · 6:01
host_summaryThe positive outcomes for sutureless repair were observed even when considering patients who required silo use.↗
▶Ep 22 · 6:01
host_summarySutureless closure patients had less ventilator use compared to sutured closure patients.↗
▶Ep 22 · 6:01
host_summarySutureless closure patients had fewer episodes of general anesthetics compared to sutured closure patients.↗
▶Ep 22 · 6:01
host_summarySutureless closure patients had fewer surgical site and deep space infections compared to sutured closure patients.↗
▶Ep 22 · 6:01
host_summarySutureless closure patients had less antibiotic use compared to sutured closure patients.↗
▶Ep 22 · 11:13
quoteYeah, I think in general, I, I, you're right. I don't know how the pendulum is going to swing, but we are finding more and more. There are things that we don't have to operate on.↗
▶Ep 22 · 11:22
host_summaryGastroschisis is an abdominal wall defect that used to necessitate a trip to the OR and is now more like a safe bedside procedure.↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 23 · 2:24
host_summaryNew guidelines define intestinal failure as requiring parenteral support for at least 60 days due to inadequate intestinal function.↗
▶Ep 23 · 3:33
host_summaryIntestinal rehabilitation requires managing comorbidities including sepsis and liver disease that challenge infant growth.↗
▶Ep 23 · 8:41
host_summaryAccess and availability to intestinal rehabilitation programs is still very rare.↗
▶Ep 23 · 12:34
host_summaryOverall long-term survival in major intestinal rehabilitation programs is usually over 90%.↗
Intestinal Rehabilitation, Episode 1: What is intestinal rehabilitation?
▶Ep 24 · 2:24
host_summaryNew guidelines define intestinal failure as inadequate intestinal function requiring parenteral support for at least 60 days.↗
▶Ep 24 · 3:33
host_summaryIntestinal rehabilitation requires managing comorbidities including sepsis and liver disease that challenge infant growth.↗
▶Ep 24 · 12:34
host_summaryOverall survival in big intestinal rehabilitation programs is usually over 90% long-term.↗
Journal of Pediatric Surgery Article Review: January 2022 APSA Issue
▶Ep 26 · 3:58
host_summaryExternal federal research funding at Nationwide increased from $750,000 to $5.7 million, representing a 7.7-fold increase.↗
Quick Literature Updates Episode 6
▶Ep 30 · 2:50
host_summaryThere was no significant difference in the rate of successful primary closure between intubated and non-intubated neonates with gastroschisis.↗
▶Ep 30 · 2:50
host_summaryMiyata et al. used the Canadian Association of Pediatric Surgery Network to study pediatric patients with gastroschisis who underwent bedside reduction and closure.↗
quoteEndoscopically or endoscopically unless there's a reason to do an open approach.↗
▶Ep 10 · 1:41
host_summaryType 3 laryngeal cleft means it extends down into the trachea.↗
▶Ep 10 · 1:41
host_summaryType 1 laryngeal cleft means the opening is above the vocal cords.↗
▶Ep 10 · 1:41
host_summaryType 2 laryngeal cleft means it extends below the vocal cords.↗
▶Ep 10 · 1:41
quoteYou want raw against raw. Mucosa is a nonstick surface. Get rid of the mucosa. You want a wide strip of raw against a wide strip of raw.↗
▶Ep 10 · 1:41
quoteFlexible bronchoscopy is not adequate for diagnosing a posterior laryngeal cleft.↗
▶Ep 10 · 1:41
quoteWe've been nagging Andy for years, Andy Inglis, to actually modify that classification.↗
▶Ep 10 · 1:41
host_summaryThe mass closure technique developed in Cincinnati uses the same concept as endoscopic tracheoesophageal fistula repair: you want raw against raw, with wide strips of raw tissue opposed after removing the non-stick mucosal surface.↗
▶Ep 10 · 1:41
host_summaryFlexible bronchoscopy is not adequate for diagnosing a posterior laryngeal cleft.↗
▶Ep 10 · 1:41
host_summaryThe Benjamin Inglis classification should be modified to include a type 4 long because type 4 could be proximal above the carina, at the carina, or go straight through the carina.↗
The Colorectal Quiz Episode 1: ARM - Low Bulbar Fistula
▶Ep 34 · 0:09
quoteThese patients can come with anatomic variances, really rare anomalies, their care can be complex, dynamic, multidisciplinary, and pose a lot of clinical challenges to your everyday pediatric surgeon.↗
▶Ep 34 · 0:25
quoteAt those times, it might be nice to just step inside the mind of a pediatric colorectal surgeon who's been around the block.↗
▶Ep 34 · 12:17
host_summaryIn low anorectal malformations, dissecting a small portion of the anterior rectal wall and carefully lifting it off the urinary tract will usually rule out a fistula.↗
Colorectal Quiz Episode 13: Newborn ARM Part 2
▶Ep 38 · 13:38
host_summaryUse Hagar dilators starting low and working up for accurate anal size measurement; do not use fingers because every surgeon has different size glove↗
▶Ep 38 · 13:38
quoteDon't use your fingers because every surgeon has a different size glove.↗
Colorectal Quiz Episode 14: ARM Newborn Part 3
▶Ep 39 · 7:09
host_summaryPosterior rectal wall only mobilization technique is only appropriate in situations where the dot of the fistula is in the sphincteric ellipse.↗
Colorectal Quiz Episode 32: Anorectal Malformations And Cardiac Anomalies
▶Ep 81 · 0:00
quotewhether you are watching us on YouTube, listening to us on Apple Podcasts, Spotify, Stitcher, or Amazon Music, really the best way to get the colorectal quiz is on the Stay Current Pediatric Surgery app↗
▶Ep 81 · 2:44
clinicalWhen a baby in Georgia gets diagnosed with prenatal cardiac disease, the Sibley cardiology group gets called early and involved, including reviewing echocardiogram and meeting with high-risk OB.↗
▶Ep 81 · 6:13
host_summaryFor hospitals that take care of many pediatric cardiac patients, an ostomy is probably the standard choice for ARM with really significant cardiac anomaly.↗
▶Ep 81 · 10:50
clinicalStarting flow rate at 1 liter per minute for laparoscopy in babies is a cautious approach.↗
▶Ep 81 · 10:50
quoteI always start on the babies at a flow rate of one↗
▶Ep 81 · 11:21
host_summaryDr. Tim Jackson's technique involves looking laparoscopically while passing a tube into the distal segment to perform irrigation under direct visualization.↗
Colorectal Quiz Episode 32: Anorectal Malformations And Cardiac Anomalies
▶Ep 82 · 0:00
quotereally the best way to get the colorectal quiz is on the Stay Current Pediatric Surgery app. It's free, it's in the Apple App Store, it's in the Google Play Store.↗
▶Ep 82 · 2:44
clinicalWhenever a baby in Georgia gets diagnosed with prenatal cardiac disease, the Sibley cardiac group gets called early and involvement means going over the echocardiogram and meeting with high risk OB.↗
▶Ep 82 · 4:58
quoteI think a good physical exam and a good listen to the heart with a stethoscope can bypass that need if necessary.↗
▶Ep 82 · 6:13
host_summaryIn a baby with significant cardiac anomaly and ARM, an ostomy is probably the standard choice at hospitals that care for many pediatric cardiac patients.↗
▶Ep 82 · 11:00
host_summaryIf the baby has an umbilical line, consider going into Palmer's Point rather than accessing through the umbilicus, using a Hassan technique.↗
Colorectal Quiz: Episode 2
▶Ep 85 · 0:00
host_summaryAfter anorectoplasty, your first shot might be your only shot to give the patient a good outcome↗
Colorectal Quiz: Episode 2
▶Ep 86 · 0:00
host_summaryAfter anorectal malformation repair, the first operation might be the only shot to give the patient a good outcome and proper anatomy.↗
The Colorectal Quiz Episode 1: ARM - Low Bulbar Fistula
▶Ep 84 · 0:09
quoteThese patients can come with anatomic variances, really rare anomalies, their care can be complex, dynamic, multidisciplinary, and pose a lot of clinical challenges to your everyday pediatric surgeon.↗
▶Ep 84 · 0:25
quoteAt those times, it might be nice to just step inside the mind of a pediatric colorectal surgeon who's been around the block.↗
▶Ep 84 · 12:17
clinicalIn low anorectal malformations, dissecting a small portion of the anterior rectal wall and carefully lifting it off the urinary tract will usually rule out a fistula.↗
The Colorectal Quiz Episode 3.5: Proximal Hirschsprung Disease
▶Ep 87 · 2:07
host_summaryIf a child is sick with bilious emesis and distension, resuscitation should be the first step before diagnostic workup.↗
▶Ep 87 · 2:07
clinicalIf a child is sick with bilious emesis and distension, resuscitation should be the first step before diagnostic workup.↗
host_summaryHirschsprung enterocolitis patients present across a spectrum from mild (slight white count elevation and concerning X-ray distention) to severe (gross distention with obvious shock), requiring different treatment approaches.↗
▶Ep 90 · 5:32
clinicalHirschsprung enterocolitis patients present across a spectrum from mild (slight white count elevation and concerning X-ray distention) to severe (gross distention with obvious shock), requiring different treatment approaches.↗
▶Ep 90 · 8:33
guidelineThe APSA algorithm for post-pull-through obstruction includes decision points starting with rectal exam and contrast enema, potentially moving to rectal biopsy, botulinum toxin injection, and ultimately motility workup that determines need for further colonic resection versus bowel management, stoma, or ACE.↗
▶Ep 90 · 8:33
host_summaryThe APSA algorithm for post-pull-through obstruction includes decision points starting with rectal exam and contrast enema, potentially moving to rectal biopsy, botulinum toxin injection, and ultimately motility workup that determines need for further colonic resection versus bowel management, stoma, or ACE.↗
▶Ep 90 · 11:14
host_summaryThe patient in Case 2 was diagnosed with pseudo-incontinence with hypermotility.↗
▶Ep 90 · 11:14
clinicalThe patient in Case 2 was diagnosed with pseudo-incontinence with hypermotility.↗
▶Ep 90 · 11:21
clinicalAdjusting fiber intake, daily Imodium, and adding cholestyramine successfully managed the hypermotility patient, allowing return to school with other kids within about a year.↗
▶Ep 90 · 11:21
host_summaryAdjusting fiber intake, daily Imodium, and adding cholestyramine successfully managed the hypermotility patient, allowing return to school with other kids within about a year.↗
The Colorectal Quiz Episode 10: Total Colonic Hirschsprung Disease Part 1
▶Ep 94 · 0:00
quoteHey there listeners, it's Rod Gerardo and Amanda Jensen from Cincinnati Children's.↗
▶Ep 94 · 0:00
quoteHey there listeners, it's Rod Gerardo and Amanda Jensen from Cincinnati Children's.↗
▶Ep 94 · 1:17
quoteThat's Doctor Jason Fisher, pediatric colorectal surgeon at Cincinnati Children's Hospital.↗
▶Ep 94 · 1:17
quoteThat's Doctor Jason Fisher, pediatric colorectal surgeon at Cincinnati Children's Hospital.↗
▶Ep 94 · 4:07
host_summaryCommon causes of failure to pass meconium include Hirschsprung disease, meconium plug syndrome, meconium ileus, and anorectal malformation↗
▶Ep 94 · 4:07
clinicalCommon causes of failure to pass meconium include Hirschsprung disease, meconium plug syndrome, meconium ileus, and anorectal malformation↗
The Colorectal Quiz Episode 11: Total Colonic Hirschsprung's Part 2
▶Ep 95 · 2:46
clinicalStudies showed no significant difference in skin excoriation between younger and older patients after pull-through.↗
▶Ep 95 · 2:46
host_summaryStudies showed no significant difference in skin excoriation between younger and older patients after pull-through.↗
▶Ep 95 · 6:26
host_summaryOral sodium supplementation protocol: add 3 mEq/kg/day using a recipe of 1 tablespoon salt plus 40 mL water (yields 2.5 mEq sodium per mL), continue for 1-2 months, then recheck urine sodium.↗
▶Ep 95 · 6:26
clinicalOral sodium supplementation protocol: add 3 mEq/kg/day using a recipe of 1 tablespoon salt plus 40 mL water (yields 2.5 mEq sodium per mL), continue for 1-2 months, then recheck urine sodium.↗
▶Ep 95 · 7:48
clinicalSerum sodium is usually normal even when total body sodium is depleted, which can be misleading.↗
▶Ep 95 · 7:48
host_summarySerum sodium is usually normal even when total body sodium is depleted, which can be misleading.↗
▶Ep 95 · 9:36
host_summaryThe vast majority of Duhamels do fine.↗
clinicalPatients with total colonic Hirschsprung disease are more susceptible to severe enterocolitis compared to traditional rectosigmoid Hirschsprung patients.↗
▶Ep 95 · 11:04
host_summaryPatients with total colonic Hirschsprung disease are more susceptible to severe enterocolitis compared to traditional rectosigmoid Hirschsprung patients.↗
▶Ep 95 · 11:14
host_summaryFirst-line medical management is diet modification, which can be started before pull-through to monitor bowel movements.↗
▶Ep 95 · 11:14
clinicalFirst-line medical management is diet modification, which can be started before pull-through to monitor bowel movements.↗
▶Ep 95 · 11:30
clinicalLoperamide liquid form contains glucose and sugar which can cause hypermotility; crushing the pill and mixing with applesauce is an alternative.↗
▶Ep 95 · 11:30
host_summaryLoperamide liquid form contains glucose and sugar which can cause hypermotility; crushing the pill and mixing with applesauce is an alternative.↗
Colorectal Quiz Episode 13: Newborn ARM Part 2
▶Ep 98 · 13:38
host_summaryUse Hagar dilators starting low and working up for accurate anal size measurement; do not use fingers because every surgeon has different size glove↗
▶Ep 98 · 13:38
quoteDon't use your fingers because every surgeon has a different size glove.↗
▶Ep 98 · 13:38
clinicalUse Hagar dilators starting low and working up for accurate anal size measurement; do not use fingers because every surgeon has different size glove↗
▶Ep 98 · 13:38
quoteDon't use your fingers because every surgeon has a different size glove.↗
Colorectal Quiz Episode 14: ARM Newborn Part 3
▶Ep 99 · 7:09
clinicalPosterior rectal wall only mobilization technique is only appropriate in situations where the dot of the fistula is in the sphincteric ellipse.↗
▶Ep 99 · 7:09
host_summaryPosterior rectal wall only mobilization technique is only appropriate in situations where the dot of the fistula is in the sphincteric ellipse.↗
host_summarySennosides or bisacodyl can be used to induce high-amplitude propagated contractions (HAPCs).↗
▶Ep 104 · 7:15
host_summaryWhen an HAPC occurs, the internal anal sphincter should relax (coloanal reflex) to allow stool evacuation.↗
▶Ep 104 · 8:06
host_summaryFluoroscopy (C-arm) is used during manometry catheter placement to confirm exact positioning.↗
▶Ep 104 · 8:51
host_summaryWhen an HAPC reaches the sigmoid or rectum, the internal anal sphincter relaxes to allow defecation.↗
▶Ep 104 · 9:51
host_summaryDecisions about surgical intervention for segmental dysmotility are based not only on manometry but also on imaging (contrast enema), physical exam, and patient/family history.↗
▶Ep 104 · 13:56
host_summaryPerforming duodenal and colonic manometry in a patient with gastroparesis is valuable because it rules out more widespread dysmotility, which is especially important in patients with anorectal malformations.↗
Hirschsprung Disease Workup
▶Ep 106 · 7:50
opinionEven with suggestive manometry findings, a biopsy is still required before surgical intervention; no surgeon would operate on manometry alone.↗
▶Ep 106 · 7:50
host_summaryEven with suggestive manometry findings, a biopsy is still required before surgical intervention; no surgeon would operate on manometry alone.↗
▶Ep 106 · 8:00
quotenobody I know would operate on a manometry alone. So if there's a suggestive manometry, a biopsy will still be done.↗
▶Ep 106 · 8:00
quotenobody I know would operate on a manometry alone. So if there's a suggestive manometry, a biopsy will still be done.↗
▶Ep 106 · 8:41
clinicalNormal individuals without Hirschsprung disease have no ganglion cells in the very first (distal-most) part of the rectum.↗
▶Ep 106 · 8:41
host_summaryNormal individuals without Hirschsprung disease have no ganglion cells in the very first (distal-most) part of the rectum.↗
▶Ep 106 · 9:05
host_summaryIn children over one year old, the suction biopsy tool cannot obtain adequate tissue depth because the tissue is thicker, necessitating surgical biopsy in the OR.↗
▶Ep 106 · 9:05
clinicalIn children over one year old, the suction biopsy tool cannot obtain adequate tissue depth because the tissue is thicker, necessitating surgical biopsy in the OR.↗
▶Ep 106 · 9:40
clinicalSurgical rectal biopsy in older children is a simple 20-minute procedure with same-day discharge.↗
▶Ep 106 · 9:40
host_summarySurgical rectal biopsy in older children is a simple 20-minute procedure with same-day discharge.↗
Journal of Pediatric Surgery Article Review: October 2021
▶Ep 110 · 2:50
quoteWe might congratulate ourselves for having done a good job in perhaps saving the kid and identifying the problem, but perhaps not aware that we have a responsibility uh for the long-term health and uh we have to be advocates for the children.↗
▶Ep 110 · 2:50
host_summaryComplete metadata for medical education content includes title, description, summary, keywords, duration, content type, specialty area, target audience level, and language.↗
▶Ep 110 · 8:32
quoteIt is obvious that we currently do not have the objective clinical markers, whether they are the uh clinical features or uh novel biomarkers to help us make an earlier decision.↗
▶Ep 110 · 8:32
host_summaryWe currently do not have objective clinical markers, whether clinical features or novel biomarkers, to help make earlier surgical decisions in NEC.↗
▶Ep 110 · 17:03
host_summaryThe Italian study provides sufficient evidence to convince clinicians who are not doing routine spinal cord and spine assessment in anorectal malformation patients that they should be more serious with imaging.↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 112 · 2:24
host_summaryNew guidelines define intestinal failure as requiring parenteral support for at least 60 days due to inadequate intestinal function.↗
▶Ep 112 · 3:33
host_summaryIntestinal rehabilitation requires managing comorbidities including sepsis and liver disease that challenge infant growth.↗
▶Ep 112 · 8:41
host_summaryAccess and availability to intestinal rehabilitation programs is still very rare.↗
▶Ep 112 · 12:34
host_summaryOverall long-term survival in major intestinal rehabilitation programs is usually over 90%.↗
Intestinal Rehabilitation, Episode 1: What is intestinal rehabilitation?
▶Ep 113 · 2:24
host_summaryNew guidelines define intestinal failure as inadequate intestinal function requiring parenteral support for at least 60 days.↗
▶Ep 113 · 3:33
host_summaryIntestinal rehabilitation requires managing comorbidities including sepsis and liver disease that challenge infant growth.↗
▶Ep 113 · 12:34
host_summaryOverall survival in big intestinal rehabilitation programs is usually over 90% long-term.↗
Quick Literature Updates Episode 7
▶Ep 138 · 1:35
host_summaryPatients with less than 50% of their colon had significantly less time on parenteral nutrition as long as they had their ileocecal valve.↗
▶Ep 138 · 1:35
host_summaryPeters et al. retrospectively reviewed 55 pediatric patients with small bowel syndrome to examine whether presence or absence of ileocecal valve and/or colon can predict enteral autonomy.↗
▶Ep 138 · 1:35
host_summaryInfants with an ileocecal valve had significantly shorter duration on parenteral nutrition.↗
Colorectal Quiz Episode 32: Anorectal Malformations And Cardiac Anomalies
▶Ep 231 · 0:00
quotewhether you are watching us on YouTube, listening to us on Apple Podcasts, Spotify, Stitcher, or Amazon Music, really the best way to get the colorectal quiz is on the Stay Current Pediatric Surgery app↗
▶Ep 231 · 0:00
quotewhether you are watching us on YouTube, listening to us on Apple Podcasts, Spotify, Stitcher, or Amazon Music, really the best way to get the colorectal quiz is on the Stay Current Pediatric Surgery app↗
▶Ep 231 · 2:44
clinicalWhen a baby in Georgia gets diagnosed with prenatal cardiac disease, the Sibley cardiology group gets called early and involved, including reviewing echocardiogram and meeting with high-risk OB.↗
▶Ep 231 · 2:44
clinicalWhen a baby in Georgia gets diagnosed with prenatal cardiac disease, the Sibley cardiology group gets called early and involved, including reviewing echocardiogram and meeting with high-risk OB.↗
▶Ep 231 · 6:13
opinionFor hospitals that take care of many pediatric cardiac patients, an ostomy is probably the standard choice for ARM with really significant cardiac anomaly.↗
▶Ep 231 · 6:13
host_summaryFor hospitals that take care of many pediatric cardiac patients, an ostomy is probably the standard choice for ARM with really significant cardiac anomaly.↗
▶Ep 231 · 10:50
quoteI always start on the babies at a flow rate of one↗
▶Ep 231 · 10:50
quoteI always start on the babies at a flow rate of one↗
▶Ep 231 · 10:50
clinicalStarting flow rate at 1 liter per minute for laparoscopy in babies is a cautious approach.↗
▶Ep 231 · 10:50
clinicalStarting flow rate at 1 liter per minute for laparoscopy in babies is a cautious approach.↗
▶Ep 231 · 11:21
host_summaryDr. Tim Jackson's technique involves looking laparoscopically while passing a tube into the distal segment to perform irrigation under direct visualization.↗
▶Ep 231 · 11:21
clinicalDr. Tim Jackson's technique involves looking laparoscopically while passing a tube into the distal segment to perform irrigation under direct visualization.↗
Colorectal Quiz Episode 32: Anorectal Malformations And Cardiac Anomalies
▶Ep 232 · 0:00
quotereally the best way to get the colorectal quiz is on the Stay Current Pediatric Surgery app. It's free, it's in the Apple App Store, it's in the Google Play Store.↗
▶Ep 232 · 0:00
quotereally the best way to get the colorectal quiz is on the Stay Current Pediatric Surgery app. It's free, it's in the Apple App Store, it's in the Google Play Store.↗
▶Ep 232 · 2:44
clinicalWhenever a baby in Georgia gets diagnosed with prenatal cardiac disease, the Sibley cardiac group gets called early and involvement means going over the echocardiogram and meeting with high risk OB.↗
▶Ep 232 · 2:44
clinicalWhenever a baby in Georgia gets diagnosed with prenatal cardiac disease, the Sibley cardiac group gets called early and involvement means going over the echocardiogram and meeting with high risk OB.↗
▶Ep 232 · 4:58
quoteI think a good physical exam and a good listen to the heart with a stethoscope can bypass that need if necessary.↗
▶Ep 232 · 4:58
quoteI think a good physical exam and a good listen to the heart with a stethoscope can bypass that need if necessary.↗
▶Ep 232 · 6:13
host_summaryIn a baby with significant cardiac anomaly and ARM, an ostomy is probably the standard choice at hospitals that care for many pediatric cardiac patients.↗
▶Ep 232 · 6:13
opinionIn a baby with significant cardiac anomaly and ARM, an ostomy is probably the standard choice at hospitals that care for many pediatric cardiac patients.↗
▶Ep 232 · 11:00
clinicalIf the baby has an umbilical line, consider going into Palmer's Point rather than accessing through the umbilicus, using a Hassan technique.↗
▶Ep 232 · 11:00
host_summaryIf the baby has an umbilical line, consider going into Palmer's Point rather than accessing through the umbilicus, using a Hassan technique.↗
Colorectal Quiz: Episode 2
▶Ep 240 · 0:00
opinionAfter anorectoplasty, your first shot might be your only shot to give the patient a good outcome↗
▶Ep 240 · 0:00
host_summaryAfter anorectoplasty, your first shot might be your only shot to give the patient a good outcome↗
Colorectal Quiz: Episode 2
▶Ep 242 · 0:00
host_summaryAfter anorectal malformation repair, the first operation might be the only shot to give the patient a good outcome and proper anatomy.↗
▶Ep 242 · 0:00
opinionAfter anorectal malformation repair, the first operation might be the only shot to give the patient a good outcome and proper anatomy.↗
quoteHe's the surgical director of the Fetal Care Center at Cincinnati Children's Hospital Medical Center.↗
▶Ep 7 · 1:40
host_summaryUltrasound is usually the screening tool to find congenital diaphragmatic hernia in the fetus.↗
▶Ep 7 · 1:48
host_summaryMRI provides higher resolution imaging than ultrasound and yields information about the pulmonary status of the fetus in CDH.↗
▶Ep 7 · 2:35
host_summaryFetuses with severe CDH (liver herniation and bilateral lung hypoplasia) are good candidates for FETO.↗
▶Ep 7 · 3:48
host_summaryFetal lung tissue constantly creates fluid that normally escapes through the trachea; occluding the trachea causes fluid and pressure to build up, which helps the lungs develop.↗
▶Ep 7 · 3:48
quoteBecause think about it, the fetal lung tissue is constantly creating this fluid. That escapes through the trachea normally, but if we occlude the trachea, then that fluid will continue to build up, the pressure will build up in that trachea, and for some reason, that seems to help the lungs develop.↗
▶Ep 7 · 4:18
host_summaryThe balloon is typically removed at about 34 weeks gestation.↗
Journal of Pediatric Surgery Article Review: November 2021
▶Ep 7 · 6:09
clinicalA lung that was infected is going to be a more difficult lung to operate on↗
▶Ep 7 · 6:09
quoteA lung that was infected is gonna be a more difficult lung to operate on.↗
▶Ep 7 · 6:09
quoteA lung that was infected is gonna be a more difficult lung to operate on.↗
▶Ep 7 · 6:09
host_summaryA lung that was infected is going to be a more difficult lung to operate on↗
▶Ep 7 · 9:26
host_summaryThe most common indication for partial splenectomy in the Indianapolis study was hereditary spherocytosis↗
▶Ep 7 · 9:26
epidemiologicalThe most common indication for partial splenectomy in the Indianapolis study was hereditary spherocytosis↗
Neonatal Gastric Volvulus with Dr. Jason Frischer
▶Ep 9 · 1:18
host_summaryGastric volvulus is associated with eventration of the diaphragm about 25% of the time.↗
▶Ep 9 · 1:18
host_summaryGastric volvulus is associated with congenital diaphragmatic hernia about 17% of the time.↗
▶Ep 9 · 2:13
host_summaryAcute gastric volvulus presentations are usually due to anatomic problems like congenital diaphragmatic hernia.↗
▶Ep 9 · 3:27
host_summaryWithout ligamentous attachments, the stomach is kept in place only at two points: the GE junction and the pylorus, and rotations occur about these points.↗
▶Ep 9 · 4:58
host_summaryGastric volvulus typically presents in children in the first year of life with non-bilious emesis, gastric distention, and issues passing an NG tube.↗
▶Ep 9 · 5:41
host_summaryA classic bird's beak appearance may be seen when contrast is swallowed or placed in a tube sitting in the esophagus in gastric volvulus.↗
▶Ep 9 · 7:34
host_summaryGastropexy should be performed at at least one other location in addition to G-tube placement, fixing the stomach in multiple planes to reduce the chance of re-volvulization.↗
▶Ep 9 · 7:47
host_summaryFundoplication is not required in pediatric gastric volvulus repair, unlike in some adult cases.↗
Journal of Pediatric Surgery Article Review: November 2021
▶Ep 26 · 6:09
quoteA lung that was infected is gonna be a more difficult lung to operate on.↗
▶Ep 26 · 6:09
quoteA lung that was infected is gonna be a more difficult lung to operate on.↗
▶Ep 26 · 6:09
clinicalA lung that was infected is going to be a more difficult lung to operate on↗
▶Ep 26 · 6:09
host_summaryA lung that was infected is going to be a more difficult lung to operate on↗
▶Ep 26 · 9:26
epidemiologicalThe most common indication for partial splenectomy in the Indianapolis study was hereditary spherocytosis↗
▶Ep 26 · 9:26
host_summaryThe most common indication for partial splenectomy in the Indianapolis study was hereditary spherocytosis↗
Case Based Journal Review - CPAM in 2022
▶Ep 27 · 2:00
host_summaryA 2017 prospective study in Archives of Disease in Childhood followed 119 prenatally diagnosed congenital cystic lung lesions for a median of 10 years↗
▶Ep 27 · 2:00
clinicalA 2017 prospective study in Archives of Disease in Childhood followed 119 prenatally diagnosed congenital cystic lung lesions for a median of 10 years↗
▶Ep 27 · 4:04
clinicalA 2021 Pediatrics study by the Midwest Pediatric Surgery Consortium retrospectively examined histology of 521 lung lesions resected across 11 children's hospitals↗
▶Ep 27 · 4:04
host_summaryA 2021 Pediatrics study by the Midwest Pediatric Surgery Consortium retrospectively examined histology of 521 lung lesions resected across 11 children's hospitals↗
▶Ep 27 · 4:47
host_summaryOf 177 children with postnatal diagnosis of CPAM, 15 (8.7%) were classified as having a malignant tumor↗
▶Ep 27 · 4:47
epidemiologicalOf 177 children with postnatal diagnosis of CPAM, 15 (8.7%) were classified as having a malignant tumor↗
▶Ep 27 · 6:53
host_summaryA 2021 Journal of Pediatric Surgery study examined whether previous infection matters for thoracoscopic surgery outcomes in congenital lung malformations↗
▶Ep 27 · 6:53
clinicalA 2021 Journal of Pediatric Surgery study examined whether previous infection matters for thoracoscopic surgery outcomes in congenital lung malformations↗
▶Ep 27 · 7:18
clinicalPatients without prior pulmonary infection had shorter operative time, fewer postoperative fevers, less need for postoperative antibiotics, but no significant difference in postoperative complications or conversion rates↗
▶Ep 27 · 7:18
host_summaryPatients without prior pulmonary infection had shorter operative time, fewer postoperative fevers, less need for postoperative antibiotics, but no significant difference in postoperative complications or conversion rates↗
▶Ep 27 · 9:12
host_summaryA 2018 Journal of Pediatric Surgery study examined optimal timing for elective resection of asymptomatic CPAM, dividing patients under 1 year into three groups: 1-3 months, 4-6 months, and 6-12 months↗
▶Ep 27 · 9:12
clinicalA 2018 Journal of Pediatric Surgery study examined optimal timing for elective resection of asymptomatic CPAM, dividing patients under 1 year into three groups: 1-3 months, 4-6 months, and 6-12 months↗
▶Ep 27 · 9:39
host_summaryOperative time increased with each increase in age; at younger ages the tissue planes are easier to dissect↗
▶Ep 27 · 9:39
clinicalOperative time increased with each increase in age; at younger ages the tissue planes are easier to dissect↗
▶Ep 27 · 9:50
clinicalThe 1-3 month group had the shortest operative time at 115 minutes compared to 163 minutes in the 6-12 month group↗
▶Ep 27 · 9:50
host_summaryThe 1-3 month group had the shortest operative time at 115 minutes compared to 163 minutes in the 6-12 month group↗
host_summaryA 2017 prospective study in Archives of Disease in Childhood followed 119 prenatally diagnosed congenital cystic lung lesions for a median of 10 years↗
▶Ep 20 · 4:04
host_summaryA 2021 Pediatrics study by the Midwest Pediatric Surgery Consortium retrospectively examined histology of 521 lung lesions resected across 11 children's hospitals↗
▶Ep 20 · 4:47
host_summaryOf 177 children with postnatal diagnosis of CPAM, 15 (8.7%) were classified as having a malignant tumor↗
▶Ep 20 · 6:53
host_summaryA 2021 Journal of Pediatric Surgery study examined whether previous infection matters for thoracoscopic surgery outcomes in congenital lung malformations↗
▶Ep 20 · 7:18
host_summaryPatients without prior pulmonary infection had shorter operative time, fewer postoperative fevers, less need for postoperative antibiotics, but no significant difference in postoperative complications or conversion rates↗
▶Ep 20 · 9:12
host_summaryA 2018 Journal of Pediatric Surgery study examined optimal timing for elective resection of asymptomatic CPAM, dividing patients under 1 year into three groups: 1-3 months, 4-6 months, and 6-12 months↗
▶Ep 20 · 9:39
host_summaryOperative time increased with each increase in age; at younger ages the tissue planes are easier to dissect↗
▶Ep 20 · 9:50
host_summaryThe 1-3 month group had the shortest operative time at 115 minutes compared to 163 minutes in the 6-12 month group↗
host_summaryHirschsprung enterocolitis patients present across a spectrum from mild (slight white count elevation and concerning X-ray distention) to severe (gross distention with obvious shock), requiring different treatment approaches.↗
▶Ep 17 · 8:33
host_summaryThe APSA algorithm for post-pull-through obstruction includes decision points starting with rectal exam and contrast enema, potentially moving to rectal biopsy, botulinum toxin injection, and ultimately motility workup that determines need for further colonic resection versus bowel management, stoma, or ACE.↗
▶Ep 17 · 11:14
host_summaryThe patient in Case 2 was diagnosed with pseudo-incontinence with hypermotility.↗
▶Ep 17 · 11:21
host_summaryAdjusting fiber intake, daily Imodium, and adding cholestyramine successfully managed the hypermotility patient, allowing return to school with other kids within about a year.↗
Gastroschisis and sutureless abdominal wall closure
▶Ep 31 · 1:44
host_summaryIn 2004, Tony Sandler published the first manuscript about sutureless closures utilizing the natural umbilical properties to close the gastroschisis defect by itself.↗
▶Ep 31 · 1:44
quoteIn 2004, Tony Sandler published the first manuscript about suture disclosures to utilize the natural umbilical properties to closing that defect by itself.↗
▶Ep 31 · 2:45
quoteI didn't know about his article. I found out about it as a fellow when he taught us how to treat gastroschisis that way.↗
▶Ep 31 · 2:45
quoteI think it's clearly been a massive change in practice. It's one of the examples of a big change that we don't actually operate on those and they can be done at the bedside. And it also is an example of something that took a while to adopt. And now most people are doing it, I think.↗
▶Ep 31 · 3:26
quoteThere have been so many articles in the last few years that go back and forth. I mean, one said gastro suture list is better. One said definitely don't do suture list. So my question is now, I don't know. I almost don't read these articles anymore.↗
▶Ep 31 · 5:29
quoteI think anytime it's a Kansas City or an NWSPC, NWPSC. Anytime it's an NWPSC article, I pay attention. Anytime it's a Kansas City article, I pay attention. But other than that, I'm tired of seeing all these gastroschisis articles. I'm waiting for someone to give me something that is really meaningful.↗
▶Ep 31 · 6:01
host_summarySutureless closure patients had fewer episodes of general anesthetics compared to sutured closure patients.↗
▶Ep 31 · 6:01
host_summarySutureless closure patients had fewer surgical site and deep space infections compared to sutured closure patients.↗
▶Ep 31 · 6:01
host_summarySutureless closure patients had less antibiotic use compared to sutured closure patients.↗
▶Ep 31 · 6:01
host_summaryPatients who underwent sutureless abdominal wall closure had no difference in days on TPN, time to goal feeds, time to initial feeds, or length of stay compared to sutured closure.↗
▶Ep 31 · 6:01
host_summaryThe study divided patients into sutured versus sutureless abdominal wall closures and required subgroup analysis because some babies received silos and some did not.↗
▶Ep 31 · 6:01
host_summaryThe Midwest Pediatric Surgery Consortium study was a retrospective cohort of infants born with gastroschisis between 2013 and 2016, with a total of 315 patients.↗
▶Ep 31 · 6:01
host_summarySutureless closure patients had less ventilator use compared to sutured closure patients.↗
▶Ep 31 · 6:01
host_summaryThe positive outcomes for sutureless repair were observed even when considering patients who required silo use.↗
▶Ep 31 · 11:13
quoteYeah, I think in general, I, I, you're right. I don't know how the pendulum is going to swing, but we are finding more and more. There are things that we don't have to operate on.↗
▶Ep 31 · 11:22
host_summaryGastroschisis is an abdominal wall defect that used to necessitate a trip to the OR and is now more like a safe bedside procedure.↗
Journal of Pediatric Surgery Article Review: October 2021
▶Ep 33 · 2:50
host_summaryComplete metadata for medical education content includes title, description, summary, keywords, duration, content type, specialty area, target audience level, and language.↗
▶Ep 33 · 2:50
quoteWe might congratulate ourselves for having done a good job in perhaps saving the kid and identifying the problem, but perhaps not aware that we have a responsibility uh for the long-term health and uh we have to be advocates for the children.↗
▶Ep 33 · 8:32
quoteIt is obvious that we currently do not have the objective clinical markers, whether they are the uh clinical features or uh novel biomarkers to help us make an earlier decision.↗
▶Ep 33 · 8:32
host_summaryWe currently do not have objective clinical markers, whether clinical features or novel biomarkers, to help make earlier surgical decisions in NEC.↗
▶Ep 33 · 17:03
host_summaryThe Italian study provides sufficient evidence to convince clinicians who are not doing routine spinal cord and spine assessment in anorectal malformation patients that they should be more serious with imaging.↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 34 · 2:24
host_summaryNew guidelines define intestinal failure as requiring parenteral support for at least 60 days due to inadequate intestinal function.↗
▶Ep 34 · 3:33
host_summaryIntestinal rehabilitation requires managing comorbidities including sepsis and liver disease that challenge infant growth.↗
▶Ep 34 · 8:41
host_summaryAccess and availability to intestinal rehabilitation programs is still very rare.↗
▶Ep 34 · 12:34
host_summaryOverall long-term survival in major intestinal rehabilitation programs is usually over 90%.↗
Intestinal Rehabilitation, Episode 1: What is intestinal rehabilitation?
▶Ep 35 · 2:24
host_summaryNew guidelines define intestinal failure as inadequate intestinal function requiring parenteral support for at least 60 days.↗
▶Ep 35 · 3:33
host_summaryIntestinal rehabilitation requires managing comorbidities including sepsis and liver disease that challenge infant growth.↗
▶Ep 35 · 12:34
host_summaryOverall survival in big intestinal rehabilitation programs is usually over 90% long-term.↗
Journal of Pediatric Surgery Article Review: January 2022 APSA Issue
▶Ep 38 · 3:58
host_summaryExternal federal research funding at Nationwide increased from $750,000 to $5.7 million, representing a 7.7-fold increase.↗
Stay Current Throwbacks Necrotizing Enterocolitis with Dr. Gail Besner
▶Ep 40 · 46:18
epidemiologicalThe NEST trial results published in fall 2021 showed no overall difference in death or neurodevelopmental impairment between laparotomy and drainage groups.↗
▶Ep 40 · 47:00
epidemiologicalIn the NEST trial, neonates with a preoperative diagnosis of necrotizing enterocolitis (versus isolated intestinal perforation) had approximately 20% decrease in death rate with laparotomy compared to drainage.↗
Neonatal Gastric Volvulus with Dr. Jason Frischer
▶Ep 43 · 1:18
host_summaryGastric volvulus is associated with congenital diaphragmatic hernia about 17% of the time.↗
▶Ep 43 · 1:18
host_summaryGastric volvulus is associated with eventration of the diaphragm about 25% of the time.↗
▶Ep 43 · 2:13
host_summaryAcute gastric volvulus presentations are usually due to anatomic problems like congenital diaphragmatic hernia.↗
▶Ep 43 · 3:27
host_summaryWithout ligamentous attachments, the stomach is kept in place only at two points: the GE junction and the pylorus, and rotations occur about these points.↗
▶Ep 43 · 4:58
host_summaryGastric volvulus typically presents in children in the first year of life with non-bilious emesis, gastric distention, and issues passing an NG tube.↗
▶Ep 43 · 5:41
host_summaryA classic bird's beak appearance may be seen when contrast is swallowed or placed in a tube sitting in the esophagus in gastric volvulus.↗
▶Ep 43 · 7:34
host_summaryGastropexy should be performed at at least one other location in addition to G-tube placement, fixing the stomach in multiple planes to reduce the chance of re-volvulization.↗
▶Ep 43 · 7:47
host_summaryFundoplication is not required in pediatric gastric volvulus repair, unlike in some adult cases.↗
Quick Literature Updates Episode 6
▶Ep 49 · 2:50
host_summaryThere was no significant difference in the rate of successful primary closure between intubated and non-intubated neonates with gastroschisis.↗
▶Ep 49 · 2:50
host_summaryMiyata et al. used the Canadian Association of Pediatric Surgery Network to study pediatric patients with gastroschisis who underwent bedside reduction and closure.↗
quoteHe's the surgical director of the Fetal Care Center at Cincinnati Children's Hospital Medical Center.↗
▶Ep 15 · 1:40
host_summaryUltrasound is usually the screening tool to find congenital diaphragmatic hernia in the fetus.↗
▶Ep 15 · 1:48
host_summaryMRI provides higher resolution imaging than ultrasound and yields information about the pulmonary status of the fetus in CDH.↗
▶Ep 15 · 2:35
host_summaryFetuses with severe CDH (liver herniation and bilateral lung hypoplasia) are good candidates for FETO.↗
▶Ep 15 · 3:48
host_summaryFetal lung tissue constantly creates fluid that normally escapes through the trachea; occluding the trachea causes fluid and pressure to build up, which helps the lungs develop.↗
▶Ep 15 · 3:48
quoteBecause think about it, the fetal lung tissue is constantly creating this fluid. That escapes through the trachea normally, but if we occlude the trachea, then that fluid will continue to build up, the pressure will build up in that trachea, and for some reason, that seems to help the lungs develop.↗
▶Ep 15 · 4:18
host_summaryThe balloon is typically removed at about 34 weeks gestation.↗
Fetoscopic Repair of Myelomeningocele (MMC)
▶Ep 16 · 0:42
host_summaryNeural tube defects are the most common congenital central nervous system anomaly.↗
▶Ep 16 · 0:42
epidemiologicalNeural tube defects are the most common congenital central nervous system anomaly.↗
▶Ep 16 · 0:55
quoteHe's the director of the Fetal Care Center at Cincinnati Children's Hospital Medical Center.↗
▶Ep 16 · 0:55
quoteHe's the director of the Fetal Care Center at Cincinnati Children's Hospital Medical Center.↗
▶Ep 16 · 1:20
epidemiologicalMyelomeningocele or spina bifida is the most common neural tube defect.↗
▶Ep 16 · 1:20
host_summaryMyelomeningocele or spina bifida is the most common neural tube defect.↗
▶Ep 16 · 1:25
host_summaryIn myelomeningocele, the patient is born with a cleft in the vertebral column and a defect in the skin, so the meninges and the spinal cord are exposed.↗
▶Ep 16 · 1:25
clinicalIn myelomeningocele, the patient is born with a cleft in the vertebral column and a defect in the skin, so the meninges and the spinal cord are exposed.↗
▶Ep 16 · 1:33
host_summaryThe patient may be left with neural defects based on the level of the spinal cord where the lesion is.↗
▶Ep 16 · 1:33
clinicalThe patient may be left with neural defects based on the level of the spinal cord where the lesion is.↗
▶Ep 16 · 2:17
clinicalUnder ultrasound guidance, the first port is placed.↗
▶Ep 16 · 2:17
host_summaryUnder ultrasound guidance, the first port is placed.↗
▶Ep 16 · 2:51
host_summaryAnesthesia is induced on the baby via an intragluteal injection.↗
▶Ep 16 · 2:51
clinicalAnesthesia is induced on the baby via an intragluteal injection.↗
▶Ep 16 · 3:08
host_summaryThe first step is to open the sac, then dissect around the sac circumferentially.↗
▶Ep 16 · 3:08
clinicalThe first step is to open the sac, then dissect around the sac circumferentially.↗
▶Ep 16 · 3:27
host_summaryThe placode is the open area of exposed neural tissue.↗
▶Ep 16 · 3:27
clinicalThe placode is the open area of exposed neural tissue.↗
▶Ep 16 · 3:44
clinicalA skin flap is created to loosen up the skin, which will help form a watertight closure of the spinal defect.↗
▶Ep 16 · 3:44
host_summaryA skin flap is created to loosen up the skin, which will help form a watertight closure of the spinal defect.↗
▶Ep 16 · 5:14
clinicalThe mother and the fetus are monitored postoperatively, and if able, the baby is delivered vaginally at term.↗
▶Ep 16 · 5:14
host_summaryThe mother and the fetus are monitored postoperatively, and if able, the baby is delivered vaginally at term.↗
Treatment for Long Gap Esophageal Atresia: Esophageal Elongation and Replacement
▶Ep 18 · 1:08
host_summaryIn the Foker technique, the surgeon ties sutures to either end of the esophagus through an open incision, brings them out through the chest wall, ties them together in a knot, and places spacers underneath periodically (about every day) until the ends come together for primary anastomosis.↗
▶Ep 18 · 1:08
clinicalIn the Foker technique, the surgeon ties sutures to either end of the esophagus through an open incision, brings them out through the chest wall, ties them together in a knot, and places spacers underneath periodically (about every day) until the ends come together for primary anastomosis.↗
▶Ep 18 · 2:39
clinicalThe Kimura technique involves creating a spit fistula and periodically moving it down the chest wall over time to stretch the proximal pouch closer to the distal pouch, but is not used all that often anymore.↗
▶Ep 18 · 2:39
clinicalThe van der Zee technique uses the same concept as Foker but is done thoracoscopically with no external sutures, so all tension is inside the thorax.↗
▶Ep 18 · 2:39
host_summaryThe van der Zee technique uses the same concept as Foker but is done thoracoscopically with no external sutures, so all tension is inside the thorax.↗
▶Ep 18 · 2:39
host_summaryThe Kimura technique involves creating a spit fistula and periodically moving it down the chest wall over time to stretch the proximal pouch closer to the distal pouch, but is not used all that often anymore.↗
▶Ep 18 · 4:12
quoteWe were all taught the dictum that every effort should be made to conserve the native esophagus as no other conduit can replace its function in transporting food from the oral cavity to the stomach satisfactorily.↗
▶Ep 18 · 4:12
quoteWe were all taught the dictum that every effort should be made to conserve the native esophagus as no other conduit can replace its function in transporting food from the oral cavity to the stomach satisfactorily.↗
▶Ep 18 · 5:08
host_summaryIn colonic interposition, a pyloroplasty is performed to help with gastric emptying.↗
▶Ep 18 · 5:08
clinicalIn colonic interposition, the piece of colon chosen is based on the blood supply and the diameter needed.↗
▶Ep 18 · 5:08
host_summaryIn colonic interposition, the piece of colon chosen is based on the blood supply and the diameter needed.↗
▶Ep 18 · 5:08
clinicalIn colonic interposition, a pyloroplasty is performed to help with gastric emptying.↗
▶Ep 18 · 9:27
opinionThe short interval between time of traction and anastomosis (less than five days) raises the question of whether the mechanism is stretching or growth, which will impact results and likely reflects on complications.↗
▶Ep 18 · 9:27
host_summaryThe short interval between time of traction and anastomosis (less than five days) raises the question of whether the mechanism is stretching or growth, which will impact results and likely reflects on complications.↗
Journal of Pediatric Surgery Article Review: January 2022 APSA Issue
▶Ep 19 · 3:58
host_summaryExternal federal research funding at Nationwide increased from $750,000 to $5.7 million, representing a 7.7-fold increase.↗
Journal of Pediatric Surgery Article Highlights: April 2022
▶Ep 21 · 4:37
host_summaryThe third article is titled 'Current Status of Sub-specialization in Pediatric Surgery, a Focus on fetal Surgery' and surveys practice patterns in fetal surgery across the country.↗
▶Ep 21 · 4:37
clinicalThe third article is titled 'Current Status of Sub-specialization in Pediatric Surgery, a Focus on fetal Surgery' and surveys practice patterns in fetal surgery across the country.↗
Gastroschisis and sutureless abdominal wall closure
▶Ep 14 · 1:44
host_summaryIn 2004, Tony Sandler published the first manuscript about sutureless closures utilizing the natural umbilical properties to close the gastroschisis defect by itself.↗
▶Ep 14 · 1:44
quoteIn 2004, Tony Sandler published the first manuscript about suture disclosures to utilize the natural umbilical properties to closing that defect by itself.↗
▶Ep 14 · 2:45
quoteI think it's clearly been a massive change in practice. It's one of the examples of a big change that we don't actually operate on those and they can be done at the bedside. And it also is an example of something that took a while to adopt. And now most people are doing it, I think.↗
▶Ep 14 · 2:45
quoteI didn't know about his article. I found out about it as a fellow when he taught us how to treat gastroschisis that way.↗
▶Ep 14 · 3:26
quoteThere have been so many articles in the last few years that go back and forth. I mean, one said gastro suture list is better. One said definitely don't do suture list. So my question is now, I don't know. I almost don't read these articles anymore.↗
▶Ep 14 · 5:29
quoteI think anytime it's a Kansas City or an NWSPC, NWPSC. Anytime it's an NWPSC article, I pay attention. Anytime it's a Kansas City article, I pay attention. But other than that, I'm tired of seeing all these gastroschisis articles. I'm waiting for someone to give me something that is really meaningful.↗
▶Ep 14 · 6:01
host_summaryThe study divided patients into sutured versus sutureless abdominal wall closures and required subgroup analysis because some babies received silos and some did not.↗
▶Ep 14 · 6:01
host_summaryThe Midwest Pediatric Surgery Consortium study was a retrospective cohort of infants born with gastroschisis between 2013 and 2016, with a total of 315 patients.↗
▶Ep 14 · 6:01
host_summarySutureless closure patients had fewer episodes of general anesthetics compared to sutured closure patients.↗
▶Ep 14 · 6:01
host_summaryThe positive outcomes for sutureless repair were observed even when considering patients who required silo use.↗
▶Ep 14 · 6:01
host_summarySutureless closure patients had less ventilator use compared to sutured closure patients.↗
▶Ep 14 · 6:01
host_summarySutureless closure patients had fewer surgical site and deep space infections compared to sutured closure patients.↗
▶Ep 14 · 6:01
host_summarySutureless closure patients had less antibiotic use compared to sutured closure patients.↗
▶Ep 14 · 6:01
host_summaryPatients who underwent sutureless abdominal wall closure had no difference in days on TPN, time to goal feeds, time to initial feeds, or length of stay compared to sutured closure.↗
▶Ep 14 · 11:13
quoteYeah, I think in general, I, I, you're right. I don't know how the pendulum is going to swing, but we are finding more and more. There are things that we don't have to operate on.↗
▶Ep 14 · 11:22
host_summaryGastroschisis is an abdominal wall defect that used to necessitate a trip to the OR and is now more like a safe bedside procedure.↗
Journal of Pediatric Surgery Article Review: January 2022 APSA Issue
▶Ep 16 · 3:58
host_summaryExternal federal research funding at Nationwide increased from $750,000 to $5.7 million, representing a 7.7-fold increase.↗
Intestinal Rehabilitation, Episode 3: Enteral Autonomy, Part 1
▶Ep 4 · 10:34
clinicalA full-term baby is born with approximately 160 centimeters of small bowel↗
▶Ep 4 · 12:58
clinicalBacterial colonization of the intestines is part of the adaptive response↗
Quick Literature Updates Episode 6
▶Ep 7 · 2:50
host_summaryMiyata et al. used the Canadian Association of Pediatric Surgery Network to study pediatric patients with gastroschisis who underwent bedside reduction and closure.↗
▶Ep 7 · 2:50
host_summaryThere was no significant difference in the rate of successful primary closure between intubated and non-intubated neonates with gastroschisis.↗
host_summaryHirschsprung enterocolitis patients present across a spectrum from mild (slight white count elevation and concerning X-ray distention) to severe (gross distention with obvious shock), requiring different treatment approaches.↗
▶Ep 38 · 5:32
clinicalHirschsprung enterocolitis patients present across a spectrum from mild (slight white count elevation and concerning X-ray distention) to severe (gross distention with obvious shock), requiring different treatment approaches.↗
▶Ep 38 · 8:33
guidelineThe APSA algorithm for post-pull-through obstruction includes decision points starting with rectal exam and contrast enema, potentially moving to rectal biopsy, botulinum toxin injection, and ultimately motility workup that determines need for further colonic resection versus bowel management, stoma, or ACE.↗
▶Ep 38 · 8:33
host_summaryThe APSA algorithm for post-pull-through obstruction includes decision points starting with rectal exam and contrast enema, potentially moving to rectal biopsy, botulinum toxin injection, and ultimately motility workup that determines need for further colonic resection versus bowel management, stoma, or ACE.↗
▶Ep 38 · 11:14
clinicalThe patient in Case 2 was diagnosed with pseudo-incontinence with hypermotility.↗
▶Ep 38 · 11:14
host_summaryThe patient in Case 2 was diagnosed with pseudo-incontinence with hypermotility.↗
▶Ep 38 · 11:21
host_summaryAdjusting fiber intake, daily Imodium, and adding cholestyramine successfully managed the hypermotility patient, allowing return to school with other kids within about a year.↗
▶Ep 38 · 11:21
clinicalAdjusting fiber intake, daily Imodium, and adding cholestyramine successfully managed the hypermotility patient, allowing return to school with other kids within about a year.↗
The Colorectal Quiz Episode 10: Total Colonic Hirschsprung Disease Part 1
▶Ep 42 · 0:00
quoteHey there listeners, it's Rod Gerardo and Amanda Jensen from Cincinnati Children's.↗
▶Ep 42 · 0:00
quoteHey there listeners, it's Rod Gerardo and Amanda Jensen from Cincinnati Children's.↗
▶Ep 42 · 1:17
quoteThat's Doctor Jason Fisher, pediatric colorectal surgeon at Cincinnati Children's Hospital.↗
▶Ep 42 · 1:17
quoteThat's Doctor Jason Fisher, pediatric colorectal surgeon at Cincinnati Children's Hospital.↗
▶Ep 42 · 4:07
host_summaryCommon causes of failure to pass meconium include Hirschsprung disease, meconium plug syndrome, meconium ileus, and anorectal malformation↗
▶Ep 42 · 4:07
clinicalCommon causes of failure to pass meconium include Hirschsprung disease, meconium plug syndrome, meconium ileus, and anorectal malformation↗
Hirschsprung Disease Workup
▶Ep 43 · 7:50
opinionEven with suggestive manometry findings, a biopsy is still required before surgical intervention; no surgeon would operate on manometry alone.↗
▶Ep 43 · 7:50
host_summaryEven with suggestive manometry findings, a biopsy is still required before surgical intervention; no surgeon would operate on manometry alone.↗
▶Ep 43 · 8:00
quotenobody I know would operate on a manometry alone. So if there's a suggestive manometry, a biopsy will still be done.↗
▶Ep 43 · 8:00
quotenobody I know would operate on a manometry alone. So if there's a suggestive manometry, a biopsy will still be done.↗
▶Ep 43 · 8:41
host_summaryNormal individuals without Hirschsprung disease have no ganglion cells in the very first (distal-most) part of the rectum.↗
▶Ep 43 · 8:41
clinicalNormal individuals without Hirschsprung disease have no ganglion cells in the very first (distal-most) part of the rectum.↗
▶Ep 43 · 9:05
clinicalIn children over one year old, the suction biopsy tool cannot obtain adequate tissue depth because the tissue is thicker, necessitating surgical biopsy in the OR.↗
▶Ep 43 · 9:05
host_summaryIn children over one year old, the suction biopsy tool cannot obtain adequate tissue depth because the tissue is thicker, necessitating surgical biopsy in the OR.↗
▶Ep 43 · 9:40
host_summarySurgical rectal biopsy in older children is a simple 20-minute procedure with same-day discharge.↗
▶Ep 43 · 9:40
clinicalSurgical rectal biopsy in older children is a simple 20-minute procedure with same-day discharge.↗
Journal of Pediatric Surgery Article Review: January 2022 APSA Issue
▶Ep 50 · 3:58
host_summaryExternal federal research funding at Nationwide increased from $750,000 to $5.7 million, representing a 7.7-fold increase.↗
Quick Literature Updates Episode 7
▶Ep 58 · 1:35
host_summaryPeters et al. retrospectively reviewed 55 pediatric patients with small bowel syndrome to examine whether presence or absence of ileocecal valve and/or colon can predict enteral autonomy.↗
▶Ep 58 · 1:35
host_summaryInfants with an ileocecal valve had significantly shorter duration on parenteral nutrition.↗
▶Ep 58 · 1:35
host_summaryPatients with less than 50% of their colon had significantly less time on parenteral nutrition as long as they had their ileocecal valve.↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 8 · 2:24
host_summaryNew guidelines define intestinal failure as requiring parenteral support for at least 60 days due to inadequate intestinal function.↗
▶Ep 8 · 3:33
host_summaryIntestinal rehabilitation requires managing comorbidities including sepsis and liver disease that challenge infant growth.↗
▶Ep 8 · 8:41
host_summaryAccess and availability to intestinal rehabilitation programs is still very rare.↗
▶Ep 8 · 12:34
host_summaryOverall long-term survival in major intestinal rehabilitation programs is usually over 90%.↗
Intestinal Rehabilitation, Episode 1: What is intestinal rehabilitation?
▶Ep 9 · 2:24
host_summaryNew guidelines define intestinal failure as inadequate intestinal function requiring parenteral support for at least 60 days.↗
▶Ep 9 · 3:33
host_summaryIntestinal rehabilitation requires managing comorbidities including sepsis and liver disease that challenge infant growth.↗
▶Ep 9 · 12:34
host_summaryOverall survival in big intestinal rehabilitation programs is usually over 90% long-term.↗
Pediatric Vascular Access in Brief: Preoperative, Operative, and Postoperative Considerations
▶Ep 15 · 0:13
host_summaryIn the United States, approximately 5 million central venous catheter lines are placed annually, with several thousand in pediatric surgical patients.↗
▶Ep 15 · 1:00
host_summaryCentral venous catheters are non-tunneled, typically for temporary hospital use, and can have 1 to 3 lumens.↗
▶Ep 15 · 1:25
host_summaryBroviac catheters are tunneled lines with cuffs, used for months to years for chemotherapy, parenteral nutrition, or frequent blood transfusions, and can have 1 or 2 lumens.↗
▶Ep 15 · 4:43
host_summaryFor very small neonates, many surgeons prefer a cut-down approach over percutaneous access.↗
▶Ep 15 · 9:21
host_summaryLong-term complications include thrombosis, catheter displacement, kinking, and eventual line degradation over extended periods.↗
Gastroschisis and sutureless abdominal wall closure
▶Ep 40 · 1:44
host_summaryIn 2004, Tony Sandler published the first manuscript about sutureless closures utilizing the natural umbilical properties to close the gastroschisis defect by itself.↗
▶Ep 40 · 1:44
quoteIn 2004, Tony Sandler published the first manuscript about suture disclosures to utilize the natural umbilical properties to closing that defect by itself.↗
▶Ep 40 · 2:45
quoteI didn't know about his article. I found out about it as a fellow when he taught us how to treat gastroschisis that way.↗
▶Ep 40 · 2:45
quoteI think it's clearly been a massive change in practice. It's one of the examples of a big change that we don't actually operate on those and they can be done at the bedside. And it also is an example of something that took a while to adopt. And now most people are doing it, I think.↗
▶Ep 40 · 3:26
quoteThere have been so many articles in the last few years that go back and forth. I mean, one said gastro suture list is better. One said definitely don't do suture list. So my question is now, I don't know. I almost don't read these articles anymore.↗
▶Ep 40 · 5:29
quoteI think anytime it's a Kansas City or an NWSPC, NWPSC. Anytime it's an NWPSC article, I pay attention. Anytime it's a Kansas City article, I pay attention. But other than that, I'm tired of seeing all these gastroschisis articles. I'm waiting for someone to give me something that is really meaningful.↗
▶Ep 40 · 6:01
host_summaryPatients who underwent sutureless abdominal wall closure had no difference in days on TPN, time to goal feeds, time to initial feeds, or length of stay compared to sutured closure.↗
▶Ep 40 · 6:01
host_summarySutureless closure patients had less antibiotic use compared to sutured closure patients.↗
▶Ep 40 · 6:01
host_summaryThe study divided patients into sutured versus sutureless abdominal wall closures and required subgroup analysis because some babies received silos and some did not.↗
▶Ep 40 · 6:01
host_summarySutureless closure patients had fewer surgical site and deep space infections compared to sutured closure patients.↗
▶Ep 40 · 6:01
host_summarySutureless closure patients had fewer episodes of general anesthetics compared to sutured closure patients.↗
▶Ep 40 · 6:01
host_summarySutureless closure patients had less ventilator use compared to sutured closure patients.↗
▶Ep 40 · 6:01
host_summaryThe positive outcomes for sutureless repair were observed even when considering patients who required silo use.↗
▶Ep 40 · 6:01
host_summaryThe Midwest Pediatric Surgery Consortium study was a retrospective cohort of infants born with gastroschisis between 2013 and 2016, with a total of 315 patients.↗
▶Ep 40 · 11:13
quoteYeah, I think in general, I, I, you're right. I don't know how the pendulum is going to swing, but we are finding more and more. There are things that we don't have to operate on.↗
▶Ep 40 · 11:22
host_summaryGastroschisis is an abdominal wall defect that used to necessitate a trip to the OR and is now more like a safe bedside procedure.↗
host_summarySennosides or bisacodyl can be used to induce high-amplitude propagated contractions (HAPCs).↗
▶Ep 44 · 7:15
host_summaryWhen an HAPC occurs, the internal anal sphincter should relax (coloanal reflex) to allow stool evacuation.↗
▶Ep 44 · 8:06
host_summaryFluoroscopy (C-arm) is used during manometry catheter placement to confirm exact positioning.↗
▶Ep 44 · 8:51
host_summaryWhen an HAPC reaches the sigmoid or rectum, the internal anal sphincter relaxes to allow defecation.↗
▶Ep 44 · 9:51
host_summaryDecisions about surgical intervention for segmental dysmotility are based not only on manometry but also on imaging (contrast enema), physical exam, and patient/family history.↗
▶Ep 44 · 13:56
host_summaryPerforming duodenal and colonic manometry in a patient with gastroparesis is valuable because it rules out more widespread dysmotility, which is especially important in patients with anorectal malformations.↗
Journal of Pediatric Surgery Article Review: October 2021
▶Ep 45 · 2:50
host_summaryComplete metadata for medical education content includes title, description, summary, keywords, duration, content type, specialty area, target audience level, and language.↗
▶Ep 45 · 2:50
quoteWe might congratulate ourselves for having done a good job in perhaps saving the kid and identifying the problem, but perhaps not aware that we have a responsibility uh for the long-term health and uh we have to be advocates for the children.↗
▶Ep 45 · 8:32
quoteIt is obvious that we currently do not have the objective clinical markers, whether they are the uh clinical features or uh novel biomarkers to help us make an earlier decision.↗
▶Ep 45 · 8:32
host_summaryWe currently do not have objective clinical markers, whether clinical features or novel biomarkers, to help make earlier surgical decisions in NEC.↗
▶Ep 45 · 17:03
host_summaryThe Italian study provides sufficient evidence to convince clinicians who are not doing routine spinal cord and spine assessment in anorectal malformation patients that they should be more serious with imaging.↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 46 · 2:24
host_summaryNew guidelines define intestinal failure as requiring parenteral support for at least 60 days due to inadequate intestinal function.↗
▶Ep 46 · 3:33
host_summaryIntestinal rehabilitation requires managing comorbidities including sepsis and liver disease that challenge infant growth.↗
▶Ep 46 · 8:41
host_summaryAccess and availability to intestinal rehabilitation programs is still very rare.↗
▶Ep 46 · 12:34
host_summaryOverall long-term survival in major intestinal rehabilitation programs is usually over 90%.↗
Intestinal Rehabilitation, Episode 1: What is intestinal rehabilitation?
▶Ep 47 · 2:24
host_summaryNew guidelines define intestinal failure as inadequate intestinal function requiring parenteral support for at least 60 days.↗
▶Ep 47 · 3:33
host_summaryIntestinal rehabilitation requires managing comorbidities including sepsis and liver disease that challenge infant growth.↗
▶Ep 47 · 12:34
host_summaryOverall survival in big intestinal rehabilitation programs is usually over 90% long-term.↗
Journal of Pediatric Surgery Article Review: January 2022 APSA Issue
▶Ep 51 · 3:58
host_summaryExternal federal research funding at Nationwide increased from $750,000 to $5.7 million, representing a 7.7-fold increase.↗
Stay Current Throwbacks Necrotizing Enterocolitis with Dr. Gail Besner
▶Ep 55 · 46:18
epidemiologicalThe NEST trial results published in fall 2021 showed no overall difference in death or neurodevelopmental impairment between laparotomy and drainage groups.↗
▶Ep 55 · 46:18
host_summaryThe NEST trial results published in fall 2021 showed no overall difference in death or neurodevelopmental impairment between laparotomy and drainage groups.↗
▶Ep 55 · 47:00
host_summaryIn the NEST trial, neonates with a preoperative diagnosis of necrotizing enterocolitis (versus isolated intestinal perforation) had approximately 20% decrease in death rate with laparotomy compared to drainage.↗
▶Ep 55 · 47:00
epidemiologicalIn the NEST trial, neonates with a preoperative diagnosis of necrotizing enterocolitis (versus isolated intestinal perforation) had approximately 20% decrease in death rate with laparotomy compared to drainage.↗
Neonatal Gastric Volvulus with Dr. Jason Frischer
▶Ep 59 · 1:18
host_summaryGastric volvulus is associated with congenital diaphragmatic hernia about 17% of the time.↗
▶Ep 59 · 1:18
host_summaryGastric volvulus is associated with eventration of the diaphragm about 25% of the time.↗
▶Ep 59 · 2:13
host_summaryAcute gastric volvulus presentations are usually due to anatomic problems like congenital diaphragmatic hernia.↗
▶Ep 59 · 3:27
host_summaryWithout ligamentous attachments, the stomach is kept in place only at two points: the GE junction and the pylorus, and rotations occur about these points.↗
▶Ep 59 · 4:58
host_summaryGastric volvulus typically presents in children in the first year of life with non-bilious emesis, gastric distention, and issues passing an NG tube.↗
▶Ep 59 · 5:41
host_summaryA classic bird's beak appearance may be seen when contrast is swallowed or placed in a tube sitting in the esophagus in gastric volvulus.↗
▶Ep 59 · 7:34
host_summaryGastropexy should be performed at at least one other location in addition to G-tube placement, fixing the stomach in multiple planes to reduce the chance of re-volvulization.↗
▶Ep 59 · 7:47
host_summaryFundoplication is not required in pediatric gastric volvulus repair, unlike in some adult cases.↗
Pediatric Vascular Access in Brief: Preoperative, Operative, and Postoperative Considerations
▶Ep 63 · 0:13
host_summaryIn the United States, approximately 5 million central venous catheter lines are placed annually, with several thousand in pediatric surgical patients.↗
▶Ep 63 · 1:00
host_summaryCentral venous catheters are non-tunneled, typically for temporary hospital use, and can have 1 to 3 lumens.↗
▶Ep 63 · 1:25
host_summaryBroviac catheters are tunneled lines with cuffs, used for months to years for chemotherapy, parenteral nutrition, or frequent blood transfusions, and can have 1 or 2 lumens.↗
▶Ep 63 · 4:43
host_summaryFor very small neonates, many surgeons prefer a cut-down approach over percutaneous access.↗
▶Ep 63 · 9:21
host_summaryLong-term complications include thrombosis, catheter displacement, kinking, and eventual line degradation over extended periods.↗
Quick Literature Updates Episode 6
▶Ep 71 · 2:50
host_summaryThere was no significant difference in the rate of successful primary closure between intubated and non-intubated neonates with gastroschisis.↗
▶Ep 71 · 2:50
host_summaryMiyata et al. used the Canadian Association of Pediatric Surgery Network to study pediatric patients with gastroschisis who underwent bedside reduction and closure.↗
Quick Literature Updates Episode 7
▶Ep 72 · 1:35
host_summaryInfants with an ileocecal valve had significantly shorter duration on parenteral nutrition.↗
▶Ep 72 · 1:35
host_summaryPeters et al. retrospectively reviewed 55 pediatric patients with small bowel syndrome to examine whether presence or absence of ileocecal valve and/or colon can predict enteral autonomy.↗
▶Ep 72 · 1:35
host_summaryPatients with less than 50% of their colon had significantly less time on parenteral nutrition as long as they had their ileocecal valve.↗
quoteFlexible bronchoscopy is not adequate for diagnosing a posterior laryngeal cleft.↗
▶Ep 1 · 1:41
quoteWe've been nagging Andy for years, Andy Inglis, to actually modify that classification.↗
▶Ep 1 · 1:41
host_summaryFlexible bronchoscopy is not adequate for diagnosing a posterior laryngeal cleft.↗
▶Ep 1 · 1:41
host_summaryThe Benjamin Inglis classification should be modified to include a type 4 long because type 4 could be proximal above the carina, at the carina, or go straight through the carina.↗
▶Ep 1 · 1:41
quoteYou want raw against raw. Mucosa is a nonstick surface. Get rid of the mucosa. You want a wide strip of raw against a wide strip of raw.↗
▶Ep 1 · 1:41
host_summaryThe mass closure technique developed in Cincinnati uses the same concept as endoscopic tracheoesophageal fistula repair: you want raw against raw, with wide strips of raw tissue opposed after removing the non-stick mucosal surface.↗
▶Ep 1 · 1:41
host_summaryType 3 laryngeal cleft means it extends down into the trachea.↗
▶Ep 1 · 1:41
host_summaryType 1 laryngeal cleft means the opening is above the vocal cords.↗
▶Ep 1 · 1:41
host_summaryType 2 laryngeal cleft means it extends below the vocal cords.↗
▶Ep 1 · 1:41
quoteEndoscopically or endoscopically unless there's a reason to do an open approach.↗
Treatment for Long Gap Esophageal Atresia: Esophageal Elongation and Replacement
▶Ep 2 · 1:08
host_summaryIn the Foker technique, the surgeon ties sutures to either end of the esophagus through an open incision, brings them out through the chest wall, ties them together in a knot, and places spacers underneath periodically (about every day) until the ends come together for primary anastomosis.↗
▶Ep 2 · 2:39
host_summaryThe Kimura technique involves creating a spit fistula and periodically moving it down the chest wall over time to stretch the proximal pouch closer to the distal pouch, but is not used all that often anymore.↗
▶Ep 2 · 2:39
host_summaryThe van der Zee technique uses the same concept as Foker but is done thoracoscopically with no external sutures, so all tension is inside the thorax.↗
▶Ep 2 · 4:12
quoteWe were all taught the dictum that every effort should be made to conserve the native esophagus as no other conduit can replace its function in transporting food from the oral cavity to the stomach satisfactorily.↗
▶Ep 2 · 5:08
host_summaryIn colonic interposition, a pyloroplasty is performed to help with gastric emptying.↗
▶Ep 2 · 5:08
host_summaryIn colonic interposition, the piece of colon chosen is based on the blood supply and the diameter needed.↗
▶Ep 2 · 9:27
host_summaryThe short interval between time of traction and anastomosis (less than five days) raises the question of whether the mechanism is stretching or growth, which will impact results and likely reflects on complications.↗
host_summarySennosides or bisacodyl can be used to induce high-amplitude propagated contractions (HAPCs).↗
▶Ep 4 · 7:15
host_summaryWhen an HAPC occurs, the internal anal sphincter should relax (coloanal reflex) to allow stool evacuation.↗
▶Ep 4 · 8:06
host_summaryFluoroscopy (C-arm) is used during manometry catheter placement to confirm exact positioning.↗
▶Ep 4 · 8:51
host_summaryWhen an HAPC reaches the sigmoid or rectum, the internal anal sphincter relaxes to allow defecation.↗
▶Ep 4 · 9:51
host_summaryDecisions about surgical intervention for segmental dysmotility are based not only on manometry but also on imaging (contrast enema), physical exam, and patient/family history.↗
▶Ep 4 · 13:56
host_summaryPerforming duodenal and colonic manometry in a patient with gastroparesis is valuable because it rules out more widespread dysmotility, which is especially important in patients with anorectal malformations.↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 5 · 2:24
host_summaryNew guidelines define intestinal failure as requiring parenteral support for at least 60 days due to inadequate intestinal function.↗
▶Ep 5 · 3:33
host_summaryIntestinal rehabilitation requires managing comorbidities including sepsis and liver disease that challenge infant growth.↗
▶Ep 5 · 8:41
host_summaryAccess and availability to intestinal rehabilitation programs is still very rare.↗
▶Ep 5 · 12:34
host_summaryOverall long-term survival in major intestinal rehabilitation programs is usually over 90%.↗
Intestinal Rehabilitation, Episode 1: What is intestinal rehabilitation?
▶Ep 6 · 2:24
host_summaryNew guidelines define intestinal failure as inadequate intestinal function requiring parenteral support for at least 60 days.↗
▶Ep 6 · 3:33
host_summaryIntestinal rehabilitation requires managing comorbidities including sepsis and liver disease that challenge infant growth.↗
▶Ep 6 · 12:34
host_summaryOverall survival in big intestinal rehabilitation programs is usually over 90% long-term.↗
epidemiologicalNeural tube defects are the most common congenital central nervous system anomaly.↗
▶Ep 3 · 0:42
host_summaryNeural tube defects are the most common congenital central nervous system anomaly.↗
▶Ep 3 · 0:55
quoteHe's the director of the Fetal Care Center at Cincinnati Children's Hospital Medical Center.↗
▶Ep 3 · 0:55
quoteHe's the director of the Fetal Care Center at Cincinnati Children's Hospital Medical Center.↗
▶Ep 3 · 1:20
host_summaryMyelomeningocele or spina bifida is the most common neural tube defect.↗
▶Ep 3 · 1:20
epidemiologicalMyelomeningocele or spina bifida is the most common neural tube defect.↗
▶Ep 3 · 1:25
clinicalIn myelomeningocele, the patient is born with a cleft in the vertebral column and a defect in the skin, so the meninges and the spinal cord are exposed.↗
▶Ep 3 · 1:25
host_summaryIn myelomeningocele, the patient is born with a cleft in the vertebral column and a defect in the skin, so the meninges and the spinal cord are exposed.↗
▶Ep 3 · 1:33
host_summaryThe patient may be left with neural defects based on the level of the spinal cord where the lesion is.↗
▶Ep 3 · 1:33
clinicalThe patient may be left with neural defects based on the level of the spinal cord where the lesion is.↗
▶Ep 3 · 2:17
host_summaryUnder ultrasound guidance, the first port is placed.↗
▶Ep 3 · 2:17
clinicalUnder ultrasound guidance, the first port is placed.↗
▶Ep 3 · 2:51
clinicalAnesthesia is induced on the baby via an intragluteal injection.↗
▶Ep 3 · 2:51
host_summaryAnesthesia is induced on the baby via an intragluteal injection.↗
▶Ep 3 · 3:08
clinicalThe first step is to open the sac, then dissect around the sac circumferentially.↗
▶Ep 3 · 3:08
host_summaryThe first step is to open the sac, then dissect around the sac circumferentially.↗
▶Ep 3 · 3:27
clinicalThe placode is the open area of exposed neural tissue.↗
▶Ep 3 · 3:27
host_summaryThe placode is the open area of exposed neural tissue.↗
▶Ep 3 · 3:44
clinicalA skin flap is created to loosen up the skin, which will help form a watertight closure of the spinal defect.↗
▶Ep 3 · 3:44
host_summaryA skin flap is created to loosen up the skin, which will help form a watertight closure of the spinal defect.↗
▶Ep 3 · 5:14
host_summaryThe mother and the fetus are monitored postoperatively, and if able, the baby is delivered vaginally at term.↗
▶Ep 3 · 5:14
clinicalThe mother and the fetus are monitored postoperatively, and if able, the baby is delivered vaginally at term.↗
Journal of Pediatric Surgery Article Review: January 2022 APSA Issue
▶Ep 4 · 3:58
host_summaryExternal federal research funding at Nationwide increased from $750,000 to $5.7 million, representing a 7.7-fold increase.↗
Journal of Pediatric Surgery Article Highlights: April 2022
▶Ep 5 · 4:37
clinicalThe third article is titled 'Current Status of Sub-specialization in Pediatric Surgery, a Focus on fetal Surgery' and surveys practice patterns in fetal surgery across the country.↗
Journal of Pediatric Surgery Article Review: October 2021
▶Ep 8 · 2:50
host_summaryComplete metadata for medical education content includes title, description, summary, keywords, duration, content type, specialty area, target audience level, and language.↗
▶Ep 8 · 2:50
quoteWe might congratulate ourselves for having done a good job in perhaps saving the kid and identifying the problem, but perhaps not aware that we have a responsibility uh for the long-term health and uh we have to be advocates for the children.↗
▶Ep 8 · 8:32
quoteIt is obvious that we currently do not have the objective clinical markers, whether they are the uh clinical features or uh novel biomarkers to help us make an earlier decision.↗
▶Ep 8 · 8:32
host_summaryWe currently do not have objective clinical markers, whether clinical features or novel biomarkers, to help make earlier surgical decisions in NEC.↗
▶Ep 8 · 17:03
host_summaryThe Italian study provides sufficient evidence to convince clinicians who are not doing routine spinal cord and spine assessment in anorectal malformation patients that they should be more serious with imaging.↗
Stay Current Throwbacks Necrotizing Enterocolitis with Dr. Gail Besner
▶Ep 11 · 46:18
host_summaryThe NEST trial results published in fall 2021 showed no overall difference in death or neurodevelopmental impairment between laparotomy and drainage groups.↗
▶Ep 11 · 47:00
host_summaryIn the NEST trial, neonates with a preoperative diagnosis of necrotizing enterocolitis (versus isolated intestinal perforation) had approximately 20% decrease in death rate with laparotomy compared to drainage.↗
Update Course Rewind: Thoracotomy vs VATS for Lung Metastases
▶Ep 2 · 1:29
epidemiologicalAbout 20% of osteosarcoma patients already have lung metastases by the time of diagnosis, usually picked up on staging chest CT.↗
▶Ep 2 · 5:03
clinicalWith thoracotomy, surgeons can typically remove 15 to 20 nodules, but with thoracoscopy the number is more limited.↗
▶Ep 2 · 5:23
epidemiologicalA multi-institution study of 200 patients with metastatic osteosarcoma—the largest study ever done—compared outcomes between open resection and thoracoscopy.↗
quoteDon't use your fingers because every surgeon has a different size glove.↗
▶Ep 7 · 13:38
host_summaryUse Hagar dilators starting low and working up for accurate anal size measurement; do not use fingers because every surgeon has different size glove↗
Case-Based Journal Review- Intussusception in 2022
▶Ep 14 · 2:12
host_summaryPoint-of-care ultrasound for intussusception diagnosis achieved 95% sensitivity and 99% specificity in a 2019 American Journal of Emergency Medicine study.↗
▶Ep 14 · 2:12
clinicalPoint-of-care ultrasound for intussusception diagnosis achieved 95% sensitivity and 99% specificity in a 2019 American Journal of Emergency Medicine study.↗
▶Ep 14 · 5:08
clinicalUltrasound-guided hydrostatic reduction had 95.8% success rate versus 93.1% for fluoroscopy-guided air reduction in a 2021 World Journal of Emergency Surgery study from China.↗
▶Ep 14 · 5:08
host_summaryUltrasound-guided hydrostatic reduction had 95.8% success rate versus 93.1% for fluoroscopy-guided air reduction in a 2021 World Journal of Emergency Surgery study from China.↗
▶Ep 14 · 7:20
host_summaryObstructive bowel gas pattern on radiograph is associated with decreased air enema success and increased need for surgical bowel resection in a 2020 Pediatric Radiology study.↗
▶Ep 14 · 7:20
clinicalObstructive bowel gas pattern on radiograph is associated with decreased air enema success and increased need for surgical bowel resection in a 2020 Pediatric Radiology study.↗
▶Ep 14 · 8:29
clinicalA 2018 Journal of Pediatric Surgery prediction model using clinical and sonographic data (free fluid, extension beyond splenic flexure, altered Doppler) identified 80% of failed saline enema reductions before the procedure.↗
▶Ep 14 · 8:29
host_summaryA 2018 Journal of Pediatric Surgery prediction model using clinical and sonographic data (free fluid, extension beyond splenic flexure, altered Doppler) identified 80% of failed saline enema reductions before the procedure.↗
▶Ep 14 · 10:59
host_summaryS-ketamine sedation versus morphine analgesia showed non-significant differences in success rate (90% vs 70%) and recurrence (10% vs 15%) with no perforations in either group.↗
▶Ep 14 · 10:59
clinicalS-ketamine sedation versus morphine analgesia showed non-significant differences in success rate (90% vs 70%) and recurrence (10% vs 15%) with no perforations in either group.↗
▶Ep 14 · 12:48
host_summaryA 2019 JPS systematic review and meta-analysis of 10 studies found no significant difference in ED returns, recurrence, need for operation, or mortality between inpatient and outpatient management after successful air enema reduction.↗
▶Ep 14 · 12:48
clinicalA 2019 JPS systematic review and meta-analysis of 10 studies found no significant difference in ED returns, recurrence, need for operation, or mortality between inpatient and outpatient management after successful air enema reduction.↗
▶Ep 14 · 14:55
epidemiologicalA 2020 Journal of Pediatric Surgery database study of 8,289 patients found 3.7% readmission and recurrence rate after intussusception reduction.↗
▶Ep 14 · 14:55
host_summaryA 2020 Journal of Pediatric Surgery database study of 8,289 patients found 3.7% readmission and recurrence rate after intussusception reduction.↗
Case Based Journal Review - CPAM in 2022
▶Ep 15 · 2:00
host_summaryA 2017 prospective study in Archives of Disease in Childhood followed 119 prenatally diagnosed congenital cystic lung lesions for a median of 10 years↗
▶Ep 15 · 2:00
clinicalA 2017 prospective study in Archives of Disease in Childhood followed 119 prenatally diagnosed congenital cystic lung lesions for a median of 10 years↗
▶Ep 15 · 4:04
clinicalA 2021 Pediatrics study by the Midwest Pediatric Surgery Consortium retrospectively examined histology of 521 lung lesions resected across 11 children's hospitals↗
▶Ep 15 · 4:04
host_summaryA 2021 Pediatrics study by the Midwest Pediatric Surgery Consortium retrospectively examined histology of 521 lung lesions resected across 11 children's hospitals↗
▶Ep 15 · 4:47
epidemiologicalOf 177 children with postnatal diagnosis of CPAM, 15 (8.7%) were classified as having a malignant tumor↗
▶Ep 15 · 4:47
host_summaryOf 177 children with postnatal diagnosis of CPAM, 15 (8.7%) were classified as having a malignant tumor↗
▶Ep 15 · 6:53
host_summaryA 2021 Journal of Pediatric Surgery study examined whether previous infection matters for thoracoscopic surgery outcomes in congenital lung malformations↗
▶Ep 15 · 6:53
clinicalA 2021 Journal of Pediatric Surgery study examined whether previous infection matters for thoracoscopic surgery outcomes in congenital lung malformations↗
▶Ep 15 · 7:18
host_summaryPatients without prior pulmonary infection had shorter operative time, fewer postoperative fevers, less need for postoperative antibiotics, but no significant difference in postoperative complications or conversion rates↗
▶Ep 15 · 7:18
clinicalPatients without prior pulmonary infection had shorter operative time, fewer postoperative fevers, less need for postoperative antibiotics, but no significant difference in postoperative complications or conversion rates↗
▶Ep 15 · 9:12
clinicalA 2018 Journal of Pediatric Surgery study examined optimal timing for elective resection of asymptomatic CPAM, dividing patients under 1 year into three groups: 1-3 months, 4-6 months, and 6-12 months↗
▶Ep 15 · 9:12
host_summaryA 2018 Journal of Pediatric Surgery study examined optimal timing for elective resection of asymptomatic CPAM, dividing patients under 1 year into three groups: 1-3 months, 4-6 months, and 6-12 months↗
▶Ep 15 · 9:39
clinicalOperative time increased with each increase in age; at younger ages the tissue planes are easier to dissect↗
▶Ep 15 · 9:39
host_summaryOperative time increased with each increase in age; at younger ages the tissue planes are easier to dissect↗
▶Ep 15 · 9:50
clinicalThe 1-3 month group had the shortest operative time at 115 minutes compared to 163 minutes in the 6-12 month group↗
▶Ep 15 · 9:50
host_summaryThe 1-3 month group had the shortest operative time at 115 minutes compared to 163 minutes in the 6-12 month group↗
Update Course Rewind: Thoracotomy vs VATS for Lung Metastases
▶Ep 18 · 1:29
epidemiologicalAbout 20% of osteosarcoma patients already have lung metastases by the time of diagnosis, usually picked up on staging chest CT.↗
▶Ep 18 · 1:29
host_summaryAbout 20% of osteosarcoma patients already have lung metastases by the time of diagnosis, usually picked up on staging chest CT.↗
▶Ep 18 · 5:03
host_summaryWith thoracotomy, surgeons can typically remove 15 to 20 nodules, but with thoracoscopy the number is more limited.↗
▶Ep 18 · 5:03
clinicalWith thoracotomy, surgeons can typically remove 15 to 20 nodules, but with thoracoscopy the number is more limited.↗
▶Ep 18 · 5:23
epidemiologicalA multi-institution study of 200 patients with metastatic osteosarcoma—the largest study ever done—compared outcomes between open resection and thoracoscopy.↗
▶Ep 18 · 5:23
host_summaryA multi-institution study of 200 patients with metastatic osteosarcoma—the largest study ever done—compared outcomes between open resection and thoracoscopy.↗
Commercial Audio Only (1080p)
▶Ep 36 · 0:00
clinicalThe speaker is Rod Gerardo from Cincinnati Children's↗
▶Ep 36 · 0:00
quoteHi, it's Rod Gerardo from Cincinnati Children's, and we have some brand new content for you.↗
▶Ep 36 · 0:06
quoteNo, it's not like our YouTube videos or our podcast where we get deep in the weeds with pediatric surgery.↗
▶Ep 36 · 0:10
opinionThe new content format differs from existing YouTube videos and podcasts that go deep in the weeds with pediatric surgery↗
▶Ep 36 · 0:20
clinicalDr. Jeff Ponsky will co-conduct interviews with Rod Gerardo↗
▶Ep 36 · 0:20
quoteI and Dr. Jeff Ponsky are going to interview our friends from around the globe, residents, fellows, attendings.↗
▶Ep 36 · 0:24
clinicalInterview subjects will include residents, fellows, and attendings from around the globe↗
▶Ep 36 · 0:28
clinicalTopics will cover resident wellness, general surgery concepts, and new technologies↗
▶Ep 36 · 0:32
clinicalEpisodes will be available on the Stay Current Pediatric Surgery app and social media channels↗
Intestinal rehabilitation: What is intestinal rehab? - Episode 1
▶Ep 3 · 2:24
host_summaryNew guidelines define intestinal failure as requiring parenteral support for at least 60 days due to inadequate intestinal function.↗
▶Ep 3 · 3:33
host_summaryIntestinal rehabilitation requires managing comorbidities including sepsis and liver disease that challenge infant growth.↗
▶Ep 3 · 8:41
host_summaryAccess and availability to intestinal rehabilitation programs is still very rare.↗
▶Ep 3 · 12:34
host_summaryOverall long-term survival in major intestinal rehabilitation programs is usually over 90%.↗
Intestinal Rehabilitation, Episode 1: What is intestinal rehabilitation?
▶Ep 4 · 2:24
host_summaryNew guidelines define intestinal failure as inadequate intestinal function requiring parenteral support for at least 60 days.↗
▶Ep 4 · 3:33
host_summaryIntestinal rehabilitation requires managing comorbidities including sepsis and liver disease that challenge infant growth.↗
▶Ep 4 · 12:34
host_summaryOverall survival in big intestinal rehabilitation programs is usually over 90% long-term.↗
Quick Literature Updates Episode 7
▶Ep 6 · 1:35
host_summaryPeters et al. retrospectively reviewed 55 pediatric patients with small bowel syndrome to examine whether presence or absence of ileocecal valve and/or colon can predict enteral autonomy.↗
▶Ep 6 · 1:35
host_summaryPatients with less than 50% of their colon had significantly less time on parenteral nutrition as long as they had their ileocecal valve.↗
▶Ep 6 · 1:35
host_summaryInfants with an ileocecal valve had significantly shorter duration on parenteral nutrition.↗
host_summaryNeural tube defects are the most common congenital central nervous system anomaly.↗
▶Ep 5 · 0:55
quoteHe's the director of the Fetal Care Center at Cincinnati Children's Hospital Medical Center.↗
▶Ep 5 · 1:20
host_summaryMyelomeningocele or spina bifida is the most common neural tube defect.↗
▶Ep 5 · 1:25
host_summaryIn myelomeningocele, the patient is born with a cleft in the vertebral column and a defect in the skin, so the meninges and the spinal cord are exposed.↗
▶Ep 5 · 1:33
host_summaryThe patient may be left with neural defects based on the level of the spinal cord where the lesion is.↗
▶Ep 5 · 2:17
host_summaryUnder ultrasound guidance, the first port is placed.↗
▶Ep 5 · 2:51
host_summaryAnesthesia is induced on the baby via an intragluteal injection.↗
▶Ep 5 · 3:08
host_summaryThe first step is to open the sac, then dissect around the sac circumferentially.↗
▶Ep 5 · 3:27
host_summaryThe placode is the open area of exposed neural tissue.↗
▶Ep 5 · 3:44
host_summaryA skin flap is created to loosen up the skin, which will help form a watertight closure of the spinal defect.↗
▶Ep 5 · 5:14
host_summaryThe mother and the fetus are monitored postoperatively, and if able, the baby is delivered vaginally at term.↗
The Colorectal Quiz Episode 10: Total Colonic Hirschsprung Disease Part 1
▶Ep 8 · 0:00
quoteHey there listeners, it's Rod Gerardo and Amanda Jensen from Cincinnati Children's.↗
▶Ep 8 · 1:17
quoteThat's Doctor Jason Fisher, pediatric colorectal surgeon at Cincinnati Children's Hospital.↗
▶Ep 8 · 4:07
host_summaryCommon causes of failure to pass meconium include Hirschsprung disease, meconium plug syndrome, meconium ileus, and anorectal malformation↗
Treatment for Long Gap Esophageal Atresia: Esophageal Elongation and Replacement
▶Ep 7 · 1:08
host_summaryIn the Foker technique, the surgeon ties sutures to either end of the esophagus through an open incision, brings them out through the chest wall, ties them together in a knot, and places spacers underneath periodically (about every day) until the ends come together for primary anastomosis.↗
▶Ep 7 · 2:39
host_summaryThe Kimura technique involves creating a spit fistula and periodically moving it down the chest wall over time to stretch the proximal pouch closer to the distal pouch, but is not used all that often anymore.↗
▶Ep 7 · 2:39
host_summaryThe van der Zee technique uses the same concept as Foker but is done thoracoscopically with no external sutures, so all tension is inside the thorax.↗
▶Ep 7 · 4:12
quoteWe were all taught the dictum that every effort should be made to conserve the native esophagus as no other conduit can replace its function in transporting food from the oral cavity to the stomach satisfactorily.↗
▶Ep 7 · 5:08
host_summaryIn colonic interposition, the piece of colon chosen is based on the blood supply and the diameter needed.↗
▶Ep 7 · 5:08
host_summaryIn colonic interposition, a pyloroplasty is performed to help with gastric emptying.↗
▶Ep 7 · 9:27
host_summaryThe short interval between time of traction and anastomosis (less than five days) raises the question of whether the mechanism is stretching or growth, which will impact results and likely reflects on complications.↗
The Colorectal Quiz Episode 1: ARM - Low Bulbar Fistula
▶Ep 6 · 0:25
quoteI mean, just me mentioning this, I bet there's a case that popped up in your mind that was a real head scratcher that you've never seen before.↗
The Colorectal Quiz: Episode 1
▶Ep 12 · 0:00
quotePediatric colorectal surgery. It just sounds really complex, right? These patients can come with anatomic variances, really rare anomalies. Their care can be complex, dynamic, multidisciplinary, and pose a lot of clinical challenges to your everyday pediatric surgeon.↗
▶Ep 12 · 6:01
clinicalFor cross-table lateral, the baby is positioned prone with a bump under the buttocks to make the buttock the highest point where air will rise↗
▶Ep 12 · 12:16
clinicalIn patients with low rectum, dissecting a little bit of the anterior wall and carefully lifting it off the urinary tract will usually rule out fistula↗
The Colorectal Quiz: Episode 1
▶Ep 13 · 0:00
quotePediatric colorectal surgery. It just sounds really complex, right? These patients can come with anatomic variances, really rare anomalies. Their care can be complex, dynamic, multidisciplinary, and pose a lot of clinical challenges to your everyday pediatric surgeon.↗
▶Ep 13 · 6:01
clinicalCross-table lateral can be obtained at bedside in neonatal unit by placing baby on bump under buttocks↗
▶Ep 13 · 6:01
clinicalFor cross-table lateral, baby is positioned prone with buttock at highest point where air will rise to↗
Gastroschisis and sutureless abdominal wall closure
▶Ep 3 · 1:44
host_summaryIn 2004, Tony Sandler published the first manuscript about sutureless closures utilizing the natural umbilical properties to close the gastroschisis defect by itself.↗
▶Ep 3 · 1:44
quoteIn 2004, Tony Sandler published the first manuscript about suture disclosures to utilize the natural umbilical properties to closing that defect by itself.↗
▶Ep 3 · 2:45
quoteI think it's clearly been a massive change in practice. It's one of the examples of a big change that we don't actually operate on those and they can be done at the bedside. And it also is an example of something that took a while to adopt. And now most people are doing it, I think.↗
▶Ep 3 · 2:45
quoteI didn't know about his article. I found out about it as a fellow when he taught us how to treat gastroschisis that way.↗
▶Ep 3 · 3:26
quoteThere have been so many articles in the last few years that go back and forth. I mean, one said gastro suture list is better. One said definitely don't do suture list. So my question is now, I don't know. I almost don't read these articles anymore.↗
▶Ep 3 · 5:29
quoteI think anytime it's a Kansas City or an NWSPC, NWPSC. Anytime it's an NWPSC article, I pay attention. Anytime it's a Kansas City article, I pay attention. But other than that, I'm tired of seeing all these gastroschisis articles. I'm waiting for someone to give me something that is really meaningful.↗
▶Ep 3 · 6:01
host_summaryThe positive outcomes for sutureless repair were observed even when considering patients who required silo use.↗
▶Ep 3 · 6:01
host_summarySutureless closure patients had less ventilator use compared to sutured closure patients.↗
▶Ep 3 · 6:01
host_summaryThe Midwest Pediatric Surgery Consortium study was a retrospective cohort of infants born with gastroschisis between 2013 and 2016, with a total of 315 patients.↗
▶Ep 3 · 6:01
host_summaryThe study divided patients into sutured versus sutureless abdominal wall closures and required subgroup analysis because some babies received silos and some did not.↗
▶Ep 3 · 6:01
host_summaryPatients who underwent sutureless abdominal wall closure had no difference in days on TPN, time to goal feeds, time to initial feeds, or length of stay compared to sutured closure.↗
▶Ep 3 · 6:01
host_summarySutureless closure patients had less antibiotic use compared to sutured closure patients.↗
▶Ep 3 · 6:01
host_summarySutureless closure patients had fewer surgical site and deep space infections compared to sutured closure patients.↗
▶Ep 3 · 6:01
host_summarySutureless closure patients had fewer episodes of general anesthetics compared to sutured closure patients.↗
▶Ep 3 · 11:13
quoteYeah, I think in general, I, I, you're right. I don't know how the pendulum is going to swing, but we are finding more and more. There are things that we don't have to operate on.↗
▶Ep 3 · 11:22
host_summaryGastroschisis is an abdominal wall defect that used to necessitate a trip to the OR and is now more like a safe bedside procedure.↗
Journal of Pediatric Surgery Article Highlights: April 2022
▶Ep 12 · 4:37
clinicalThe third article is titled 'Current Status of Sub-specialization in Pediatric Surgery, a Focus on fetal Surgery' and surveys practice patterns in fetal surgery across the country.↗
▶Ep 12 · 4:37
host_summaryThe third article is titled 'Current Status of Sub-specialization in Pediatric Surgery, a Focus on fetal Surgery' and surveys practice patterns in fetal surgery across the country.↗
