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Pediatric Surgery Essentials
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
By classification of the International esophageal atresia Group, a gap must be at least 4 centimeters to be considered a long gap. — Steven Rothenberg, Update Course Rewind: Magnet Therapy for Esophageal Atresia · 6:54
Esophageal Atresia3 items
Update Course Rewind: Magnet Therapy for Esophageal Atresia
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At Pediactric Surgery Update Course 2021, Dr. Bethany Slater from UChicago Comer Children's Hospital and Dr. Steven Rothenberg from Rocky Mountain Hospital for Children sharing their cases on using magnet therapy as an alternative treatment
podcast10:25 · Dec 2021
Internal traction as an effective bridge to successful anastomosis in complex esophageal atresia
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Internal traction is an evolving strategy for patients with long-gap esophageal atresia (LGEA) and esophageal atresia (EA) patients with a distal tracheo-esophageal fistula in whom primary anastomosis cannot be achieved. This study aimed to
article · Aug 2025
Thoracoscopic Mobilization and Intraoperative Internal Traction—A Novel Approach for Treatment of Long-gap Type C Esophageal Atresia with Distal Carinal Fistula
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Long-gap esophageal atresia (LGEA) is challenging due to the substantial distance between the proximal and distal esophageal pouches. Traditionally, it includes Gross types A and B, while inclusion of long-gap type C cases remains debated.
article · May 2026
Anorectal Malformations3 items
Can Complex Surgical Interventions Be Standardized? Reaching International Consensus on Posterior Sagittal Anorectoplasty Using a Modified-Delphi Method
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AbstractBackground/PurposeIn an effort to standardize educational experience, address future physician shortages, and improve quality of care to patients, many surgical specialties are discussing how to maximize exposure to index cases. One
article · Jan 2021
Translation and validation of the Hirschsprung and anorectal malformation quality of life (HAQL) questionnaire in a Danish Hirschsprung population
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Abstract Background Hirschsprung’s disease (HD) may result in an impaired quality of life (QoL) due to bowel problems, postoperative complications and other health-related issues. The Hirschsprung and Anorectal Malformation Quality of Life
article · Feb 2024
Rethinking Fistula Preservation in Anorectal Malformation Surgery: A Histopathological Perspective
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Objective This study aims to assess the histopathological characteristics of the fistulous tissue in males with anorectal malformation (ARM) to determine its suitability for use in constructing a neoanus. Methods This prospective observatio
article · Sep 2024
Pyloric Stenosis1 item
Are we performing ultrasound measurements of the wall thickness in hypertrophic pyloric stenosis studies the same way?
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Abstract Purpose To retrospectively review imaging planes, number of visible pyloric layers and location of measurements, in infants with suspected (HPS). Methods 103 pyloric ultrasound studies for suspected HPS were included. For each s
article · Nov 2019
Constipation & Sphincter Disorders1 item
Thickening of the Internal Anal Sphincter: Primary Cause or Secondary Effect of Constipation
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Constipation is one of the most common abdominal symptoms in childhood. In many cases, no primary cause is found and the condition may be labelled as “idiopathic constipation”. Fortunately, most of these cases respond well to dietary manipu
article · Mar 2024
Gastrostomy Management1 item
The “cut and push” method of removing percutaneous endoscopic gastrostomy tube is not safe in paediatric patients
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Abstract Purpose A “cut and push” (CP) approach has been described in the literature for removal of percutaneous endoscopic gastrostomy (PEG) tubes. The aim of this study is to investigate the safety profile of this method in children. M
article · Nov 2023
Laparoscopic Techniques1 item
A Single Institution Experience with Laparoscopic Hernia Repair in 791 Children
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AbstractIntroductionThere are many described technique to performing laparoscopic inguinal hernia repair in children. We describe our outcomes using a percutaneous internal ring suturing technique.MethodsA retrospective review of patients u
article · Feb 2021
IDRFs are imaging findings on CT or MRI that predict when neuroblastoma may be difficult or dangerous to remove surgically — Sophia Schermerhorn, The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report · 0:14
Neuroblastoma2 items
A Novel Standard for Systematic Reporting of Neuroblastoma Surgery: The International Neuroblastoma Surgical Report Form (INSRF): A Joint Initiative by the Pediatric Oncological Cooperative Groups SIOPEN∗, COG∗∗, and GPOH∗∗∗
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Objective: To create the first structured surgical report form for NBL with international consensus, to permit standardized documentation of all NBL-related surgical procedures and their outcomes.Summary of background data: NBL, the most co
article · Oct 2020
The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report
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Tom Monclair, Garrett M Brodeur, Peter F Ambros, Hervé J Brisse, Giovanni Cecchetto, Keith Holmes, Michio Kaneko, Wendy B London, Katherine K Matthay, Jed G Nuchtern, Dietrich von Schweinitz, Thorsten Simon, Susan L Cohn, Andrew D J Pearson
video0:59 · Mar 2026
Wilms Tumor2 items
The SIOP-Renal Tumour Study Group consensus statement on flank target volume delineation for highly conformal radiotherapy
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For decades, radiotherapy with two opposing photon beams has been the standard technique used to cover the flank target volume in paediatric patients with renal tumours. Nowadays, many institutes are implementing advanced radiotherapy techn
article · Jan 2021
Bilateral Wilms’ Tumour: An International Comparison of Treatments and Outcomes
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AbstractIntroduction:Wilms' tumour is the most common childhood renal malignancy, with 5–10% of cases presenting bilaterally 1. However, there is currently no consensus between centres on optimal management of bilateral Wilms' tumours. This
article · Jan 2021
Central Venous Catheters3 items
Totally implantable venous access ports: A prospective randomized study comparing subclavian and internal jugular vein punctures in children
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AbstractBackground and objectivesTotally implantable venous access ports (TIVAPs) are essential in children who require long-term intermittent intravenous therapy.MethodsPatients who needed to undergo TIVAP implantation were randomly assign
article · May 2020
The Use of the Internal Mammary Vein for Central Venous Access
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AbstractPurpose: To describe the use of the internal mammary vein as an alternative access for central venous catheters.Methods: We performed a retrospective review of patients who underwent placement of central venous catheters via the int
article · Dec 2020
Open CVP Catheter Insertion Internal jugular vein Cutdown By Dr. Tamer Ashraf...
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This video demonstrates the open technique for central venous catheter insertion (Open CVP insetion) or also called Internal jugular vein cutdown. The demonstrated method uses a mini-cutdown to gain access to the internal jugular vein. Sild
video · Jul 2021
Sepsis Recognition & Management2 items
International Consensus Criteria for Pediatric Sepsis and Septic Shock
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New infographic by Dr. Jose Campos and the Chilean society of pediatric surgeons
"International Consensus Criteria for Pediatric Sepsis and Septic Shock"
Authors: Luregn J. Schlapbach, MD, PhD; R. Scott Watson, MD, MPH; Lauren R. Sorc
article · Mar 2024
International Consensus Criteria for Pediatric Sepsis and Septic Shock
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New article you should know selected by the Chilean Society of Pediatric Surgeons summarized by Dr. Cecilia Gigena
"International Consensus Criteria for Pediatric Sepsis and Septic Shock"
Authors: Luregn J. Schlapbach, MD, PhD; R. Sco
video1:21 · Mar 2024
Featured picks for families are being prepared — the summaries above are written for you.
Expert statements from the recordings in this collection.
The International Neuroblastoma Risk Group (INRG) staging system: an INRG Task Force report
IDRFs are necessary knowledge for clinicians treating neuroblastoma to determine safety of surgical intervention
Sophia Schermerhorn0:00
IDRFs are imaging findings on CT or MRI that predict when neuroblastoma may be difficult or dangerous to remove surgically
Sophia Schermerhorn0:14
The IDRF concept was first introduced in 2009 by the International Neuroblastoma Risk Group
The International Neuroblastoma Risk Group defined 20 specific imaging risk factors
Most IDRFs relate to how the tumor interacts with critical anatomy
Sophia Schermerhorn0:29
In the abdomen, a tumor that infiltrates the portahepati or hepatoduodenal ligament is considered to contain an IDRF
Sophia Schermerhorn0:34
The presence of an IDRF does not mean a tumor cannot be resected
Sophia Schermerhorn0:41
IDRF presence signals that surgery may be technically more complex
Sophia Schermerhorn0:41
Patients with IDRFs often receive neoadjuvant therapy first to try to shrink the tumor
Sophia Schermerhorn0:41
Surgeons use IDRFs to predict surgical risk and guide the safest treatment approach using imaging
Sophia Schermerhorn0:52
Update Course Rewind: Magnet Therapy for Esophageal Atresia
The Flourish device is an FDA approved commercially available catheter-based magnet system for esophageal atresia.
Bethany Slater1:54
Magnets placed in the proximal and distal ends of the esophagus attract one another and cause the esophagus to lengthen, then compression anastomosis happens as a result of ischemia in the tissue at the two ends.
Bethany Slater2:22
The Flourish device has both oesophageal and gastric catheters with inner bullet-shaped magnets on each end that taper down to a 10 French pumling surface.
Bethany Slater2:41
The proximal catheter has a suction port that can be used to suction saliva from the patient while being used.
Bethany Slater2:41
For magnet therapy eligibility, there needs to be a gap length of less than 4 centimeters because at lengths greater than that the magnets will not attract one another.
Bethany Slater3:11
There should be no fistula for magnet therapy, or if there is a fistula it must be repaired first.
Bethany Slater3:11
Patients require a gastrostomy that can accommodate an 18 French catheter because that is the diameter of the gastric portion of the catheter.
Bethany Slater3:11
Magnet therapy is not to replace esophageal atresia repair, it is another tool in the armamentarium particularly for patients who have cardiac disease or have had previous operations that might make them less of a candidate for reoperative surgery or at increased anesthetic risk.
Expert opinion3:39
One of the contraindications for using the flourish device is the presence of a fistula.
In the presented case, after magnet placement the patient had an acute decompensation 4 days later and was transferred to another institution.
Steven Rothenberg4:59
The case revealed an upper pouch fistula which had not previously been diagnosed, and when scoped it was determined to be a true upper pouch fistula rather than traumatic.
Steven Rothenberg4:59
Dr. Rothenberg ligates all upper pouch fistulas and H-type fistulas thoracoscopically because the view is excellent and provides good control.
In the complication case, after fistula repair the surgeon was able to mobilize the two ends together and achieve primary anastomosis.
Steven Rothenberg6:06
The patient developed a stricture post-operatively which is being dilated about once a month.
Steven Rothenberg6:44
By classification of the International esophageal atresia Group, a gap must be at least 4 centimeters to be considered a long gap.
The indications for the magnet require a gap of less than 4 centimeters, and there is an incredibly high stricture rate with multiple strictures.
Steven Rothenberg6:54
A patient with less than a 4 centimeter gap should be amenable to a primary anastomosis.
Magnets have been used sometimes for a staged repair rather than using internal traction sutures.
Bethany Slater7:51
There is a possibility of trying to get the two ends together closer surgically and then using a magnet just for the anastomosis portion.
Bethany Slater7:51
Just because you have experience with esophageal atresia doesn't mean you have experience with using the magnets.