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Congenital Pulmonary Airway Malformation
Compiled from across the library · built automatically
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Chest wall deformity from early shunt placement is related to collapse of the chest wall as opposed to the harpoon placement of the shunt. Prenatal Management of CPAMs: Lung Lesions · 12:34
Prenatal Management of CPAMs: Lung Lesions
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Dr. Alan Flake discusses prenatal management of congenital pulmonary airway malformations (CPAMs). It includes two videos of examples of fetal surgery.
video18:16 · Jan 2019
After fetal surgery hysterotomy (equivalent to classical cesarean in upper uterus), patients should never labor with future pregnancies. — Alan, Lung Lesions: Fetal Interventions Parts I+II · 2:59
Postnatal Management of Lung Lesions Part I: Pediatric Thoracic Surgery Part...
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Course directors Drs Alan Flake, Steve Rothenberg and Todd Ponsky, along with additional faculty including Drs Jean Martin Laberge, Ramesh Santhanakrishnan, Giovanna Riccipetitoni, Mark Wulkan, Alexander Razumovskiy, Starla Martinez, Marcel
video31:07 · Sep 2018
Fetal Interventions Part II: Lung Lesions
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Dr. Alan Flake leads a discussion in fetal interventions for prenatally-diagnosed lung lesions.
video16:30 · Jan 2019
Thoracoscopic Left Lower Lobectomy Technique by Dr. Steven Rothenberg: How I...
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Dr. Steven Rothenberg from Rocky Mountain Hospital for Children describes his technique for performing a thoracoscopic left lower lobectomy.
video18:52 · Jan 2019
Open Fetal Surgery Overview: Fetal Surgery 2012
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Dr. Flake, attending surgeon and director of the General Surgery Fellowship Program at The Children's Hospital of Philadelphia,presents a brief overview of open fetal surgery. Topics discussed include the prenatal diagnosis of an abnormal f
video37:55 · Jan 2019
Lung Lesions: Fetal Interventions Parts I+II
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Dr. Alan Flake leads a discussion in fetal interventions for prenatally-diagnosed lung lesions.
video30:56 · Jan 2019
Fetal Interventions Part I: Lung Lesions
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Dr. Alan Flake leads a discussion in fetal interventions for prenatally-diagnosed lung lesions.
video14:27 · Jan 2019
Should We Resect Asymptomatic CPAM Flake vs Langer
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Great Debate from 2017! Watch Alan Flake and Steve Rothenberg debate Jack Langer and Jean Matin Laberge on wether or not asymptomatic CPAM's need to be resected. Originally aired March 23, 2017
video14:03 · May 2019
Thoracoscopic Upper Lobectomies for Symptomatic Congenital Pulmonary Airway...
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This video appears in a new pediatric surgery textbook, Clinical Pediatric Surgery: A Case-Based Interactive Approach," by Dr. Sherif Emil. The book is an innovative educational resource that focuses on judgment and decision-making in pedia
video5:58 · Feb 2020
Thoracoscopic Left Lower Lobectomy for Congenital Pulmonary Airway Malformation
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This video appears in a new pediatric surgery textbook, Clinical Pediatric Surgery: A Case-Based Interactive Approach," by Dr. Sherif Emil. The book is an innovative educational resource that focuses on judgment and decision-making in pedia
video9:59 · Feb 2020
Thoracoscopic Upper Lobectomies for Symptomatic Congenital Pulmonary Airway...
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This video appears in a new pediatric surgery textbook, Clinical Pediatric Surgery: A Case-Based Interactive Approach," by Dr. Sherif Emil. The book is an innovative educational resource that focuses on judgment and decision-making in pedia
video5:58 · Feb 2020
Neonatal Lung Lesions with Dr. Steven Rothenberg
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Dr. Steven Rothenberg discusses Newborn Lung Lesions with Dr Todd Ponsky. Edited by Ian C. Glenn, MD & Nicholas E. Bruns, MDPrenatal evaluationPatients with prenatal diagnosis of cystic lung lesions are referred for prenatal evaluation and
podcast1:06:58 · Dec 2020
Kansas City group has eliminated posterior crural sutures in fundoplication using minimal dissection technique, creating retroesophageal window but leaving posterior crura alone — Sean Barnhart, Complications and Beyond · 41:51
Complications and Beyond
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This clip from the 2020 Pediatric Surgery Update Course features an entertaining debate from the full panel surrounding unique and complicated cases presented by Jason Fraser, MD; and Miguel Guelfand, MD.
Highlighted Topics Include:
- M
video1:06:36 · Sep 2020
Thoracoscopic lobectomy should not be performed unless the surgeon is experienced; in experienced hands, thoracoscopic lobectomy should have no more morbidity than open lobectomy. — Steve, Management of Asymptomatic Lung Lesions: Pediatric Thoracic Surgery Part... · 8:08
Postnatal Management of Lung Lesions Part III: Pediatric Thoracic Surgery...
Watch →
Course directors Drs Alan Flake, Steve Rothenberg and Todd Ponsky, along with additional faculty including Drs Jean Martin Laberge, Ramesh Santhanakrishnan, Giovanna Riccipetitoni, Mark Wulkan, Alexander Razumovskiy, Starla Martinez, Marcel
video27:56 · Sep 2018
Management of Asymptomatic Lung Lesions: Pediatric Thoracic Surgery Part...
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Course directors Drs Alan Flake, Steve Rothenberg and Todd Ponsky, along with additional faculty including Drs Jean Martin Laberge, Ramesh Santhanakrishnan, Giovanna Riccipetitoni, Mark Wulkan, Alexander Razumovskiy, Starla Martinez, Marcel
video20:11 · Jan 2019
Case Based Journal Review - CPAM in 2022
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Dr. José Campos is back, this time helping us review some of the latest literature on the diagnosis and management of CPAM in children. In this podcast, we're reviewing a typical case with Dr. Todd Ponsky and incorporating literature from t
podcast12:23 · Apr 2022
Clinical Symptoms Affect Treatment and Prognosis in Pediatric Patients with Congenital Pulmonary Airway Malformation
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New article you should know by Dr. Cecilia Gigena
"Clinical Symptoms Affect Treatment and Prognosis in Pediatric Patients with Congenital Pulmonary Airway Malformation: A Propensity Score Matching Retrospective Cohort Study"
Authors: Guow
video0:55 · Dec 2023
In Germany, the standard practice is to operate on any cystic lung lesion at 3-6 months of age because of potential malignancy risk later in life. — Benno, Congenital Cystic Lung Lesions: Update Course 2014 · 17:46
Congenital Cystic Lung Lesions: Update Course 2014
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Dr. Steve Rothenberg, Chief of Pediatric Surgery at Rocky Mountain Hospital for Children, Denver, Colorado, presents the topic of congenital cystic lung lesions. His discussion includes various case presentations and comprehensive panel dis
video24:39 · Nov 2018
Panel Discussion: Pediatric Thoracic Surgery Part 1-Lung Lesions 2012
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The internationalfaculty debate and discuss management of difficult cases, includinglower lobe cystic lesion, spontaneous pneumothorax and unilateral bleb disease, and right pulmonary cyst.
video1:01:56 · Jan 2019
Thoracoscopic resection of intradiaphragmatic bronchopulmonary sequestration
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This video, presented at IPEG 2019 in Santiago, Chile by Alexander Gibbons, demonstrates a thoracoscopic resection of an intradiaphragmatic bronchopulmonary sequestration. This congenital anomaly is exceedingly rare, with only 17 previously
video3:59 · Mar 2019
Open fetal surgery is the gold standard for spina bifida, though other innovations are in development. — Jose Peiro, Open Fetal Surgery & EXIT Procedure with Dr. Jose Peiro · 5:51
The Full Story on CPAMs
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Here we cover Congenital Pulmonary Airway Malformations (CPAMs) through a story with the help of Dr. Todd Ponsky, Dr. Pam Choi, Dr. Beth Rymeski, Dr. Jacob Langer, and Dr. Steven Rothenberg. Hosts: Ellen Encisco & Rod GerardoChapter 1: Pren
podcast56:08 · Sep 2021
Open Fetal Surgery & EXIT Procedure with Dr. Jose Peiro
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Join us for an insightful discussion with Dr. Jose Peiro, pediatric surgeon and director of endoscopic fetal surgery at Cincinnati Children’s Fetal Care Center, which is the highest-volume fetoscopic center in the nation. Dr. Peiro walks us
video10:23 · Oct 2024
Expert statements from the recordings in this collection.
Thoracoscopic Left Lower Lobectomy for Congenital Pulmonary Airway Malformation
The malformation was a hybrid congenital pulmonary airway malformation diagnosed prenatally.
The patient was asymptomatic at birth and remained asymptomatic through 9 months of age.
CT scan at 4 months showed a left lower lobe CPAM with systemic blood supply arising from the sub-diaphragmatic aorta.
The operation was performed at 9 months of age.
The left lung is isolated by right main stem intubation.
The patient is placed in the right lateral decubitus position with surgeon and assistant operating facing the patient.
A large arterial vessel coming through the diaphragm medial to the inferior pulmonary ligament and entering the left lower lobe confirms a hybrid lesion.
The inferior pulmonary ligament is divided all the way to the border of the inferior pulmonary vein to mobilize the left lower lobe off the diaphragm.
Division of the inferior pulmonary ligament allows stretching of the systemic arterial vessel for skeletonization with hook cautery.
The systemic arterial vessel is double-clipped proximally and divided distally with a ligature device.
The approach of proximal clipping and distal ligature division is used repeatedly for control of several major vessels.
The fissure is completed using ligature and sharp dissection.
Division of pulmonary parenchyma in the fissure allows visualization of pulmonary artery branches to the lower lobe.
The dissection should be kept as bloodless as possible, with any bleeding from divided parenchyma controlled early with ligature.
Expert opinion2:50
Excellent visualization is essential for adequate vascular control.
Expert opinion3:13
A right angle dissector is extremely useful in skeletonizing vessels and gaining adequate distance for safe ligation.
Expert opinion3:41
Dissection in the fissure always proceeds from medial to lateral.
While ligature can be used as the sole method of vessel control, the surgeon prefers to apply clips proximally if adequate vessel length has been achieved.
Expert opinion4:54
Once the pulmonary artery and all pulmonary parenchyma in the fissure is divided, the bronchus comes into view.
The inferior pulmonary vein is skeletonized using a right angle dissector.
The junction of the inferior pulmonary vein and the left atrium can be clearly seen after adequate dissection.
It is quite common for the inferior pulmonary vein to consist of two major tributaries that join as they approach the left atrium, in addition to one or more small tributaries.
When the inferior pulmonary vein has two major tributaries, it is best to dissect each tributary separately.
Expert opinion8:31
Each pulmonary vein tributary is controlled by clipping on the cardiac side and applying ligature on the pulmonary side.
Hook cautery is used to clean the bronchus of surrounding lymphatic and adventitial tissue.
An endo-GIA device is introduced directly through the chest wall and used to staple and divide the bronchus.
The specimen is extracted by slightly enlarging the posteriormost port site.
A chest tube is placed at the end of the operation.
The patient was extubated at the end of the procedure.
The patient was discharged on the 2nd postoperative day with excellent recovery.