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Stay Current in Pediatric Surgery
This year was the 12th Annual Pediatric Surgery Update Course, where top hospital experts from around the world discussed this year’s changes in practices and innovation. Rewatch the event to learn more about the future of pediatric surgery and be at the forefront of medical excellence. In this clip, Drs. Em Gootee, Ramy Shaaban, Carlos Colunga, with Todd Ponsky as moderator, speaks on the top AI tools of 2024. Topics to be discussed: • AI: TOP 10 websites & tools for everyday usage…
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Stay Current in Pediatric Surgery
We are back with another episode of our Journal of Pediatric Surgery article review podcast. This time we have three publications from the first quarter of 2025, January, February and March issues. This time we're talking to editors Drs. Romeo Ignacio, Patrick Chung and Mark Davenport joined by authors Drs. Oluyinka Olutoye, Howard Jen, Jordan Rook and Liam McCarthy. Host: Em Gootee, MD Articles: Gadde R, Xia J, Hameedi S, Saulsbery A, Schafer C, Sbragia L, Olutoye OO. Remote Ischemic Conditioning (RIC) Decreases the Incidence and Severity of Necrotizing Enterocolitis (NEC) - Validation in a Large Animal Model. J Pediatr Surg. 2025 Jan;60(1):161957. doi: 10.1016/j.jpedsurg.2024.161957. Epub 2024 Sep 24. PMID: 39368858. https://pubmed.ncbi.nlm.nih.gov/39368858/ Rook JM, Lee LK, Wagner JP, Sullins VF, Lee SL, Shekherdimian S, DeUgarte DA, Dichter CE, Jen HC. Six Years of Quality Improvement in Pectus Excavatum Repair: Implementation of Intercostal Nerve Cryoablation and ERAS Protocols for Patients Undergoing Nuss Procedure. J Pediatr Surg. 2025 Feb;60(2):161634. doi: 10.1016/j.jpedsurg.2024.07.019. Epub 2024 Jul 20. PMID: 39117536. https://pubmed.ncbi.nlm.nih.gov/39117536/ Parkinson E, Robb A, McCarthy L. Long-term Survival of Bladder Augmentation is Influenced by its Shape and Mucosal Lining. J Pediatr Surg. 2025 Mar;60(3):162051. doi: 10.1016/j.jpedsurg.2024.162051. Epub 2024 Nov 1. PMID: 39572279. https://pubmed.ncbi.nlm.nih.gov/39572279/…
We’re back with nineteenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field. These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points. Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates". Host: Em Gootee https://pubmed.ncbi.nlm.nih.gov/38272766/ Fall F, Hu YY, Walker S, Baertschiger R, Gaffar I, Saltzman D, Stylianos S, Shapiro J, Wieck M, Buchmiller T, Brandt ML, Tracy T, Heiss K, Berman L. Peer Support to Promote Surgeon Well-being: The APSA Program Experience. J Pediatr Surg. 2024 Sep;59(9):1665-1671. doi: 10.1016/j.jpedsurg.2023.12.022. Epub 2024 Jan 6. PMID: 38272766. https://pubmed.ncbi.nlm.nih.gov/38914091/ Basurto D, Watananirun K, Cordier AG, Otaño J, Carriere D, Scuglia M, de Luna Freire Vargas AM, Prat J, Russo FM, Debeer A, Peralta CFA, De Coppi P, Gratacós E, Benachi A, Deprest J. Tracheomalacia and tracheomegaly in infants and children with congenital diaphragmatic hernia managed with and without fetoscopic endoluminal tracheal occlusion (FETO): a multicentre, retrospective cohort study. Lancet Child Adolesc Health. 2024 Aug;8(8):580-588. doi: 10.1016/S2352-4642(24)00109-3. Epub 2024 Jun 21. PMID: 38914091. https://pubmed.ncbi.nlm.nih.gov/38015091/ Pio L, Brisse HJ, Alaggio R, Zambaiti E, Stenman J, Giuliani S, Montano V, Hinojosa AS, Hoel AT, Pevere A, Abu-Zaid A, Franchi-Abella S, Abdelhafeez AH, Davidoff AM, Losty PD. Image-guided core-needle or surgical biopsy for neuroblastoma diagnosis in children: A systematic review and meta-analysis from the International Society of Pediatric Surgical Oncology (IPSO). Pediatr Blood Cancer. 2024 Feb;71(2):e30789. doi: 10.1002/pbc.30789. Epub 2023 Nov 27. PMID: 38015091.…
In this episode of the Colorectal Quiz, Drs. Marc Levitt, Jason Frischer, and special guests Dr. Chris Gayer and Dr. Sarah Ulrich tackle the complexities of managing megarectosigmoid in a 13-year-old patient with a history of cloaca. They explore the intricacies of diagnosis, anatomy, and long-term management for a child struggling with soiling despite a well-positioned rectum and no anatomical stricture. Key Highlights: Case Discussion: A deep dive into a patient with severe rectal dilation despite a perineal repair and normal bladder function. Diagnostic Strategy: The role of MRI, EUA, contrast enema, and sacral assessment to understand anatomy and guide treatment. Treatment Options: From Malone procedures to tapering and resection—what’s the right next step? Surgical Pearls: When to preserve the rectum and when to consider redoing the entire repair. This episode is packed with expert commentary, clinical pearls, and plenty of humor (including a colorectal-themed joke from a young patient).…
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Stay Current in Pediatric Surgery
In this 2024 Update Course Rewind session, pediatric surgeons Dr. Justin Huntington and Dr. Ben Ham explore the emerging use of autofluorescence and ICG angiography during thyroid surgery. These imaging technologies are helping identify and assess parathyroid gland perfusion, with the goal of reducing hypocalcemia and improving long-term outcomes—especially in pediatric patients. Classified as a Black Diamond (early adopter practice), this approach is still gaining traction in pediatric centers, but adult trials are already showing promise. Key Highlights: What is Autofluorescence? A no-injection technique that uses natural gland fluorescence to locate parathyroids during surgery. ICG Angiography: Assessing real-time perfusion of glands to determine viability and reimplantation need. Clinical Impact: Reduced rates of post-op hypocalcemia, improved identification of glands in surgical specimens, and more targeted decision-making. Challenges in Practice: Equipment bulkiness, variable image quality, and limited adoption in lower-volume pediatric centers. While further pediatric data are needed, this episode shows how new technologies may shape the future of thyroid surgery—especially in safeguarding parathyroid function.…
In this 2024 Update Course Rewind, pediatric surgeons Drs. Regan Williams and Katie Russell share new updates on the management of thoracic aortic injuries. Classified as a “Black Diamond” practice—indicating unproven approaches for early adopters—this session reviews how Thoracic Endovascular Aortic Repair (TEVAR) is emerging as a less invasive and effective treatment option in pediatric patients, especially adolescents. Host: Lizzy Lee, PA-C Key Takeaways: Prioritize stabilization and life-threatening injuries before addressing thoracic aortic injury. Thoracic aortic injuries in children are rare and can be easily missed—maintain a high index of suspicion. A widened mediastinum on chest X-ray should prompt a CT chest to evaluate for vascular injury. Decisions should be guided by patient age, injury severity, and available expertise at your institution. Collaboration with vascular surgeons or interventional radiologists is essential for optimal care.…
In this episode of the Colorectal Quiz , Drs. Marc Levitt, Jason Frischer, Kristy Rialon, and Lily Cheng explore the diagnostic and surgical challenges of Hirschsprung disease , featuring a neonatal patient with Trisomy 21. Through a step-by-step case discussion, they highlight how early recognition, biopsy strategy, and patient-specific surgical planning can dramatically improve outcomes. Key Highlights: Patient Case Study: A newborn with Trisomy 21, bilious emesis, and delayed meconium passage sparks a thorough workup for Hirschsprung disease. Diagnosis: The team breaks down how rectal irrigations and full-thickness biopsies confirm aganglionosis and rule out other causes. Surgical Strategy: A discussion on when to perform a pull-through, mapping biopsies, and choosing between colostomy and ileostomy. Long-Term Management: Addressing the role of Botox for internal sphincter relaxation and educating families on home care and irrigations. This episode emphasizes the value of thoughtful, team-based decision-making and patient-tailored care in managing Hirschsprung disease. Don’t forget to download the StayCurrentMD app to view supporting visuals and expert resources—and subscribe for more pediatric surgery insights!…
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Stay Current in Pediatric Surgery
In this special episode from the QUAD Conference hosted by Cincinnati Children’s, Lizzy Lee takes us inside one of the world’s largest and most advanced multidisciplinary programs for children with complex airway and digestive conditions: the Aerodigestive and Esophageal Center (ADEC) . You'll hear from a diverse team of specialists—including speech-language pathologists, ENTs, GI, pulmonologists, and pediatric surgeons—who collaborate to manage complex conditions like esophageal atresia, TEF, chronic aspiration, GERD, and swallowing disorders. Key Highlights: Speech Pathology : VFSS, FEES, manometry, and innovative approaches to swallowing therapy Pulmonology : Airway clearance, aspiration management, bronchoscopy, and ventilator weaning ENT Perspective : Stratifying airway risk and managing vocal fold and structural anomalies Gastroenterology : Managing GERD, motility, EOE, and feeding disorders Surgical Insight : Feeding access, tracheopexy, and complex lung or airway repairs The episode is a masterclass in how cross-specialty teamwork leads to better diagnostics, better surgeries, and better long-term outcomes for children with aerodigestive disorders.…
Dr. José Campos is back, this time helping us review some of the latest literature on the management of Inguinal Hernia in children. In this podcast, we're reviewing a hernia case with Dr. Todd Ponsky and incorporating literature from the last few years. Host: Em Gootee Articles in the order we mentioned if you want to follow along: https://pubmed.ncbi.nlm.nih.gov/38530261/ HIP Trial Investigators; Blakely ML, Krzyzaniak A, Dassinger MS, Pedroza C, Weitkamp JH, Gosain A, Cotten M, Hintz SR, Rice H, Courtney SE, Lally KP, Ambalavanan N, Bendel CM, Bui KCT, Calkins C, Chandler NM, Dasgupta R, Davis JM, Deans K, DeUgarte DA, Gander J, Jackson CA, Keszler M, Kling K, Fenton SJ, Fisher KA, Hartman T, Huang EY, Islam S, Koch F, Lainwala S, Lesher A, Lopez M, Misra M, Overbey J, Poindexter B, Russell R, Stylianos S, Tamura DY, Yoder BA, Lucas D, Shaul D, Ham PB 3rd, Fitzpatrick C, Calkins K, Garrison A, de la Cruz D, Abdessalam S, Kvasnovsky C, Segura BJ, Shilyansky J, Smith LM, Tyson JE. Effect of Early vs Late Inguinal Hernia Repair on Serious Adverse Event Rates in Preterm Infants: A Randomized Clinical Trial. JAMA. 2024 Mar 26;331(12):1035-1044. doi: 10.1001/jama.2024.2302. PMID: 38530261; PMCID: PMC10966421. https://pubmed.ncbi.nlm.nih.gov/34856625/ Dreuning KMA, Derikx JPM, Ouali A, Janssen LMJ, Tulder MWV, Twisk JWR, Haverman L, van Heurn LWE. One-Stop Surgery: An Innovation to Limit Hospital Visits in Children. Eur J Pediatr Surg. 2022 Oct;32(5):435-442. doi: 10.1055/s-0041-1740158. Epub 2021 Dec 2. PMID: 34856625; PMCID: PMC9481276. https://pubmed.ncbi.nlm.nih.gov/36307301/ Fraser JD, Duran YK, Deans KJ, Downard CD, Fallat ME, Gadepalli SK, Hirschl RB, Lal DR, Landman MP, Leys CM, Mak GZ, Markel TA, Minneci PC, Sato TT, St Peter SD; Midwest Pediatric Surgery Consortium. Natural history and consequence of patent processus vaginalis: An interim analysis from a multi-institutional prospective observational study. J Pediatr Surg. 2023 Jan;58(1):142-145. doi: 10.1016/j.jpedsurg.2022.09.012. Epub 2022 Oct 3. PMID: 36307301. https://pubmed.ncbi.nlm.nih.gov/21259030/ Zendejas B, Onkendi EO, Brahmbhatt RD, Greenlee SM, Lohse CM, Farley DR. Contralateral metachronous inguinal hernias in adults: role for prophylaxis during the TEP repair. Hernia. 2011 Aug;15(4):403-8. doi: 10.1007/s10029-011-0784-2. Epub 2011 Jan 23. PMID: 21259030.…
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Stay Current in Pediatric Surgery
1 Update Course Rewind: Highlighting Collaboration from Surgery & Interventional Radiology in the OR 2024 10:20
In this Update Course Rewind, Drs. Dan von Allmen, John Racadio, and Timothy Lautz, alongside IR technologist Amanda Wallingford, discuss how strong collaboration between surgery and interventional radiology is transforming patient care at Cincinnati Children’s and beyond. From ultrasound-guided lymph node localization to cone beam CT in a hybrid OR, this session highlights the power of shared expertise and image-guided surgery. Key Highlights: Use of cone beam CT, ultrasound, and fluoroscopy to improve surgical precision Hybrid OR vs. traditional OR: benefits and workarounds Real-life examples: neuroblastoma surgery, vascular malformations, pulmonary nodule localization Preview of emerging tech like augmented reality and holographic overlays for surgical planning This session is marked as a “Blue Square”—a promising newer practice that’s showing significant results and potential. Watch to learn how breaking down silos between teams can elevate outcomes across specialties.…
We’re back with eighteenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field. These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points. Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates". Host: Em Gootee https://pubmed.ncbi.nlm.nih.gov/39083294/ Pilkington M, Nelson G, Pentz B, Marchand T, Lloyd E, Chiu PPL, de Beer D, de Silva N, Else S, Fecteau A, Giuliani S, Hannam S, Howlett A, Lee KS, Levin D, O'Rourke L, Stephen L, Wilson L, Brindle ME. Enhanced Recovery After Surgery (ERAS) Society Recommendations for Neonatal Perioperative Care. JAMA Surg. 2024 Sep 1;159(9):1071-1078. doi: 10.1001/jamasurg.2024.2044. PMID: 39083294. https://pubmed.ncbi.nlm.nih.gov/38493027/ Moore EJ, Sawyer SM, King SK, Tien MY, Trajanovska M. Transition From Pediatric to Adult Healthcare for Colorectal Conditions: A Systematic Review. J Pediatr Surg. 2024 Jun;59(6):1028-1036. doi: 10.1016/j.jpedsurg.2024.02.012. Epub 2024 Feb 23. PMID: 38493027. https://pubmed.ncbi.nlm.nih.gov/36658074/ Zeng G, Zhang Q, Song B, Feng X, Sun J, Mo X, Wu KH. Clinical Symptoms Affect Treatment and Prognosis in Pediatric Patients with Congenital Pulmonary Airway Malformation: A Propensity Score Matching Retrospective Cohort Study. J Pediatr Surg. 2023 Oct;58(10):1963-1968. doi: 10.1016/j.jpedsurg.2022.11.013. Epub 2022 Nov 29. PMID: 36658074. Don't forget to like and subscribe to see more entertaining medical educational videos! See more lectures, articles, and more on the Stay Current app: https://www.globalcastmd.com/stay-current-app-download…
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Stay Current in Pediatric Surgery
In this episode of the Pediatric Surgery Update Course Rewind, Dr. Nelson Rosen and Dr. Whit Holcomb discuss advancements in the surgical management of pilonidal disease, emphasizing minimally invasive techniques like the GIPS procedure. Learn how these methods offer faster recovery, fewer complications, and better outcomes for patients. Key Highlights: Minimally Invasive Techniques: The GIPS procedure and hybrid approaches that maximize skin preservation and minimize recovery time. EPSIT Technique: A global perspective on endoscopic management, including its benefits and challenges. Recurrence Prevention: The importance of ongoing hair removal strategies, including laser treatments, to prevent recurrence and improve long-term outcomes. When to Escalate: For cases where minimally invasive approaches fail, off-midline closure options like the Bascom cleft lift offer effective solutions. This video is essential for understanding the evolving management of pilonidal disease and the role of patient-centered care in achieving lasting results. Host: Em Gootee, MD…
In this engaging episode of the Colorectal Quiz, Drs. Marc Levitt, Jason Frischer, and Erin Teeple dive into the complexities of pelvic floor dyssynergia, an often under-recognized condition impacting bowel and urinary function. Dr. Teeple, the only U.S. surgeon dually trained in pediatric and adult colorectal surgery, shares invaluable insights on diagnosis, treatment, and management strategies. Key Highlights: Patient Case Study: A 17-year-old with unexplained urinary retention and testicular pain leads to a detailed exploration of pelvic floor dysfunction. Diagnostic Tools: The role of SITZ marker studies, defecography, and manual assessments in identifying pelvic floor tightness. Treatment Approaches: From pelvic floor physical therapy to Botox injections for puborectalis relaxation. Collaboration Matters: How pediatric and adult colorectal care intersect for comprehensive management. This episode underscores the importance of a multidisciplinary approach and innovative techniques for treating pelvic floor dysfunction. Don’t forget to download the Stay Current app to access related images and resources, and subscribe for more pediatric surgery content!…
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In this Update Course Rewind session, Dr. Greg Tiao, Surgical Director of the Liver Transplantation Program at Cincinnati Children’s, discusses the critical role of MMP-7 as a biomarker in the early diagnosis of biliary atresia. With data showing that every 10-day delay in treatment worsens outcomes by 20% , early detection is essential for improving native liver survival. Key Highlights: Importance of Early Diagnosis: Performing a Kasai procedure before 45 days significantly improves patient outcomes. MMP-7 as a Biomarker: Validated in international studies, MMP-7 is proving to be a powerful diagnostic tool. Challenges in Diagnosis: Distinguishing BA from other neonatal cholestasis conditions remains complex. Global Impact: Lessons from high-incidence regions like China are helping shape best practices in North America. With the integration of MMP-7 testing, pediatric surgery is moving towards earlier diagnosis and intervention, improving the chances of avoiding liver transplant in affected infants. Don’t forget to like, comment, and subscribe for more updates!…
Pediatric empyema pneumonia is a lung infection that occurs when pus collects in the pleural space, the area between the lungs and chest wall. In this video, we cover the management of pediatric empyema, including diagnosis, treatment algorithms, imaging, and surgical versus non-surgical approaches with Dr. Aaron Garrison, a pediatric surgeon at Cincinnati Children’s. Host: Brittany Levy Key Takeaways: • Pediatric empyema pneumonia requires a combination of medical and surgical management, but decision-making can be complex. • Community-acquired pneumonia is a leading cause of hospitalization in children, yet bacterial pathogens are detected in only 15% of cases. • Empyema progresses in three stages: exudative, fibrinopurulent, and organizing. The fibrinopurulent stage is when surgical intervention is often needed. • Ultrasound is more sensitive than CT in detecting septations in pleural effusions and avoids radiation exposure. • Chest tube drainage with fibrinolytics (such as TPA) has been shown to be a viable alternative to VATS, reducing hospital stays and costs. • Some children with effusions may not require TPA—clinical improvement within 24 hours of drainage can indicate that it’s unnecessary. • Inhaled foreign bodies, particularly peanuts, can mimic pneumonia and require a high index of suspicion for proper diagnosis. • CT scans are now being used to diagnose airway foreign bodies with high reliability, reducing unnecessary bronchoscopies. Further reading: https://api.semanticscholar.org/CorpusID:53467976 Module 2 . Hemodynamic Disorders, 2015 https://thoracickey.com/nonmalignant-pleural-effusions/ Nonmalignant Pleural Effusions by John E. Heffner https://www.ctsnet.org/article/thoracoscopic-decortication Thoracoscopic Decortication by Christopher Komanapalli https://publications.aap.org/neoreviews/article-abstract/18/9/e564/91880/A-Newborn-with-a-Cyst-in-the-Lung?redirectedFrom=fulltext A Newborn with a Cyst in the Lung by Shabih Manzar, MD; Liaqat H. Khan, MD https://journals.lww.com/ascp/fulltext/2019/07020/management_of_parapneumonic_effusion_and_empyema.1.aspx Singh, S et.al. Management of parapneumonic effusion and empyema. The Journal of Association of Chest Physicians https://pubmed.ncbi.nlm.nih.gov/23164006/ Islam S et.al. The diagnosis and management of empyema in children: a comprehensive review from the APSA Outcomes and Clinical Trials Committee https://pubmed.ncbi.nlm.nih.gov/31973927/ Derderian SC et.al. Pediatric empyemas - Has the pendulum swung too far? https://pubmed.ncbi.nlm.nih.gov/26382287/ Long AM et.al. 'Less may be best'-Pediatric parapneumonic effusion and empyema management: Lessons from a UK center…
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1 QUAD #26 - Use of Ultrashort Echo-Time MRI to Measure Tracheomalacia in Neonates with Esophageal Atresia with Dr. Doug von Allmen 5:51
In this QUAD Conference presentation, Dr. Doug von Allmen from Cincinnati Children’s shares groundbreaking research on using ultrashort echo-time MRI to evaluate tracheomalacia in neonates with esophageal atresia (EA). This innovative imaging technique offers a non-invasive, sedation-free, and radiation-free way to assess airway weakness and create detailed 3D models for better surgical planning. Key Highlights: New Diagnostic Tool: Ultrashort echo-time MRI offers high-resolution imaging without the need for sedation or radiation. Study Findings: Patients with long gap esophageal atresia showed more severe tracheomalacia than those with short gap EA. Pre- and Post-Surgical Analysis: Repair improves upper trachea eccentricity but may worsen the distal trachea postoperatively. Clinical Implications: Long gap EA patients are at higher risk for respiratory complications and require close post-operative monitoring. This research sheds light on how advanced imaging can lead to better diagnosis, treatment, and follow-up care for infants with esophageal atresia and tracheoesophageal fistula (TEF).…
In this recap from the 12th Annual Pediatric Surgery Update Course, Dr. Carlos Colunga highlights the potential of CO2 lasers in pediatric surgery. From circumcisions to frenulectomies and pilonidal cyst ablations, CO2 lasers are gaining traction for their precision, reduced pain, and shorter operating times. Key Highlights: Clinical Applications: Successfully used for circumcision, frenulectomy, perianal fistulas, pilonidal cysts, and more. Benefits of CO2 Lasers: Reduced bleeding, lower complication rates, shorter operative times, and improved cosmetic outcomes. Evidence-Based Insights: Meta-analyses show CO2 laser-assisted surgeries have better results than traditional techniques in specific cases. Challenges: High equipment cost, steep learning curve, and the need for specialized training remain barriers to adoption. Join us to explore how CO2 lasers are transforming pediatric surgery and learn about the exciting possibilities for the future! Host: Lizzy Lee, PA-C…
We’re back with seventeenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field. These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points. Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates". Host: Em Gootee https://pubmed.ncbi.nlm.nih.gov/37983822/ Zhang M, Huang J, Jin Z, Zhang X, Zhou Y, Chi S, Rong L, Zhang Y, Cao G, Li S, Tang ST. Comparison of robotic versus thoracoscopic repair for congenital esophageal atresia: a propensity score matching analysis. Int J Surg. 2024 Feb 1;110(2):891-901. doi: 10.1097/JS9.0000000000000889. PMID: 37983822; PMCID: PMC10871573. https://pubmed.ncbi.nlm.nih.gov/38677965/ Ullrich S, Austin K, Avansino JR, Badillo A, Calkins CM, Crady RC, Durham MM, Fuller MK, Rana A, Reeder RW, Rentea RM, Rollins MD, Saadai P, Speck KE, Wood RJ, van Leeuwen K, Frischer JS; Pediatric Colorectal and Pelvic Learning Consortium. Does Delayed Diagnosis of Hirschsprung Disease Impact Post-operative and Functional Outcomes? A Multi-Center Review From the Pediatric Colorectal and Pelvic Learning Consortium. J Pediatr Surg. 2024 Jul;59(7):1250-1255. doi: 10.1016/j.jpedsurg.2024.03.034. Epub 2024 Mar 18. PMID: 38677965. https://pubmed.ncbi.nlm.nih.gov/37978002/ Ameer A, Mirza MB, Talat N. The Outcome of Purse-string Versus Conventional Wound Closure Techniques in Patients Undergoing Stoma Reversal: A Randomized Controlled Trial. J Pediatr Surg. 2024 Jun;59(6):1186-1189. doi: 10.1016/j.jpedsurg.2023.10.062. Epub 2023 Oct 30. PMID: 37978002.…
In this episode of the Colorectal Quiz, Drs. Marc Levitt, Jason Frischer, and Martin Lacher dive into the intricacies of frozen sections and reoperative strategies in Hirschsprung disease. Using a fascinating case of a late-diagnosed Hirschsprung patient, they explore critical decision-making in staged repairs and reoperative pull-through surgeries. Key Highlights: Frozen Section Techniques: Best practices for biopsy marking and pathology review to confirm ganglion cells. Staged Repairs: Why ileostomy followed by a laparoscopic-assisted Swenson pull-through was chosen for this case. Reoperative Strategies: Managing transition zone pull-throughs, early reoperations, and avoiding long-term complications. Surgical Pearls: Insights into laparoscopic port placement, anastomotic site preparation, and collaboration with pathologists for accurate diagnoses. Whether you're a seasoned colorectal surgeon or new to the field, this episode is packed with practical tips and lessons learned. Download the Stay Current app to view related images, X-rays, and resources discussed in the episode.…
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Stay Current in Pediatric Surgery
In this episode, Dr. Greg Burg, a pulmonologist at Cincinnati Children’s, discusses the medical management of minor laryngeal clefts, highlighting a comprehensive approach that includes swallow assessments, pulmonary therapies, and long-term monitoring. Learn how a combination of safe swallowing strategies, dietary modifications, and reactive therapies can help manage aspiration risks in pediatric patients. Key Takeaways: Diagnostic Approach: Importance of bronchoscopy, swallow studies, and chest CT scans in identifying aspiration-related issues. Medical Management: Use of inhaled steroids, macrolide therapy, and saline treatments to reduce inflammation and improve airway clearance. Swallowing & Nutrition: Thickened feeds, pacing, and feeding tube strategies to prevent aspiration. Long-Term Monitoring: Vaccination recommendations, environmental risk reduction, and periodic reassessments to guide further intervention. This discussion provides valuable insights into how a multidisciplinary approach can improve outcomes for children with minor laryngeal clefts. Don’t forget to like, comment, and subscribe for more expert discussions!…
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We are back with another episode of our Journal of Pediatric Surgery article review podcast. This time we have three publications from the fourth quarter of 2024, October, November and December issues. This time we're talking to editors Drs. Mauricio "Tony" Escobar, Mikko Pakarinen, and Pablo Laje joined by authors Drs. Aodhnait Fahy, Anne-Fleur van Hal, John M. Woodward and Ben Ham III. Host: Em Gootee Articles: Fahy AS, Klima DA, Gillam MM, Aprahamian CJ, Kim SS, Kokoska ER, Teeple EA, Weiss RG, Escobar MA Jr. Locum Tenens and Pediatric Surgery: A Position Statement and Practice Guidelines From the American Pediatric Surgical Association (APSA). J Pediatr Surg. 2024 Oct;59(10):161567. doi: 10.1016/j.jpedsurg.2024.04.021. Epub 2024 May 8. PMID: 38806318. https://pubmed.ncbi.nlm.nih.gov/38806318/ van Hal ARL, Aanen IP, Wijnen RMH, Pullens B, Vlot J. The Value of Preoperative Rigid Tracheobronchoscopy for the Diagnosis of Tracheomalacia in Oesophageal Atresia Patients. J Pediatr Surg. 2024 Nov;59(11):161620. doi: 10.1016/j.jpedsurg.2024.07.005. Epub 2024 Jul 14. PMID: 39089893. https://pubmed.ncbi.nlm.nih.gov/39089893/ Woodward JM, Chunco C, Brierley SF, Bittner K, Osei H, Harmon CM, Ham PB 3rd. Same-Day Discharge for Elective Pediatric Laparoscopic Gastrostomy Tube Insertion is Safe and Increasing in Frequency; A NSQIP Pediatric Retrospective Review 2017 to 2021. J Pediatr Surg. 2024 Dec;59(12):161665. doi: 10.1016/j.jpedsurg.2024.08.005. Epub 2024 Aug 6. PMID: 39261186. https://pubmed.ncbi.nlm.nih.gov/39261186/…
We’re back with sixteenth episode of "Quick Literature Updates" the podcast series that delivers the latest updates in pediatric surgery literature in a quick and digestible format. In each episode, we review articles covering the most interesting and relevant topics in the field. These articles are either chosen by JPS editors or our collaborators. We present these reviews as short news pieces with a summarization of key points. Whether you're a trainee, attending, or an advanced medical professional, tune in to our podcast for a dose of medical knowledge in every episode. Stay up to date on the latest trends and advancements in pediatric surgery with "Quick Literature Updates". Host: Em Gootee https://pubmed.ncbi.nlm.nih.gov/36805142/ Brandt K, Dukleska K, McKeown M, Brancato J, Grossi V, Schoem S, Sacco T, D'Amato J, Bourque MD, Campbell BT. Utilizing a critical airway response team expedites esophageal button battery removal. J Pediatr Surg. 2023 May;58(5):810-813. doi: 10.1016/j.jpedsurg.2023.01.037. Epub 2023 Jan 19. PMID: 36805142. https://pubmed.ncbi.nlm.nih.gov/38413262/ Hodgson E, Briatico D, Klapman S, Skarsgard E, Beltempo M, Shah PS, Huisman E, Walton JM, Livingston MH; Canadian Association of Pediatric Surgeons Network (CAPSNet) and Canadian Neonatal Network (CNN) investigators. Association of Exclusive Breast Milk Intake and Outcomes in Infants With Uncomplicated Gastroschisis: A National Cohort Study. J Pediatr Surg. 2024 May;59(5):863-868. doi: 10.1016/j.jpedsurg.2024.01.045. Epub 2024 Feb 3. PMID: 38413262. https://pubmed.ncbi.nlm.nih.gov/36494205/ Lai K, Notrica DM, McMahon LE, Kang P, Molitor MS, Egan JC, Bae JO, Hunteman ZM, Ostlie DJ, Lee JH, Padilla BE. Cryoablation in 350 Nuss Procedures: Evolution of Hospital Length of Stay and Opioid Use. J Pediatr Surg. 2023 Aug;58(8):1435-1439. doi: 10.1016/j.jpedsurg.2022.10.051. Epub 2022 Nov 7. PMID: 36494205.…
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1 Update Course Rewind: Patient Education and Non-Surgical Management of Pilonidal Disease 2024 6:13
In this episode from the 12th Annual Update Course in Pediatric Surgery, Dr. Nelson Rosen discusses non-surgical approaches to managing pilonidal disease, emphasizing the importance of patient education and hygiene. Learn how techniques like hair removal, meticulous hygiene, and lifestyle adjustments can significantly reduce the need for invasive procedures. Key Highlights: Non-Surgical Success Rates: Up to 60-70% of patients experience improvement with non-surgical interventions alone. Hair Removal Techniques: Options include weekly clipping, waxing, Nair-type agents, and even laser removal for long-term maintenance. Hygiene Best Practices: Showering regularly, using washlets, and debunking myths about bathing restrictions for faster healing. Setting Expectations: How to guide patients and families through treatment while balancing realistic outcomes. Join us to explore how non-surgical management can transform the care and recovery of patients with pilonidal disease. Don’t forget to like, comment, and subscribe for more pediatric surgery updates! Host: Em Gootee, MD…
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In this episode, pulmonologist Dr. Cherie Torres-Silva from Cincinnati Children's shares insights on managing pulmonary challenges in patients with CHARGE syndrome. Through a detailed case study, she explores strategies to address chronic aspiration, airway clearance limitations, and recurrent infections. Key Highlights: Challenges in CHARGE Syndrome: Understanding how aspiration, obstructive sleep apnea (OSA), and recurrent infections intersect in CHARGE patients. Management Strategies: Improving airway clearance with therapies like intrapulmonary percussion and thinning secretions using hypertonic saline. Infection Prevention: The role of dental hygiene, prophylactic antibiotics (e.g., inhaled tobramycin), and balancing the risks of antibiotic resistance. Individualized Care: Tailoring treatments based on respiratory cultures and underlying comorbidities such as hypotonia and restrictive lung disease. Learn how a multidisciplinary approach can improve outcomes for CHARGE patients with complex pulmonary issues. Don’t forget to like, comment, and subscribe for more insights! Host: Em Gootee, MD…
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In this educational video, Dr. Robin Bowman from Lurie Children’s Hospital in Chicago demonstrates the surgical release of a fatty filum terminale in a patient with tethered cord syndrome. Tethered cord syndrome is a stretch-induced condition that can cause progressive neurological deficits, including gait abnormalities, loss of bladder control, and chronic pain. Key Highlights: Understanding Tethered Cord Syndrome: How abnormal attachment of the filum terminale stretches the spinal cord and impacts function. Preoperative Imaging: The use of spinal MRI to identify the location of the conus, tethering lesions, and spina bifida occulta. Surgical Technique: A step-by-step overview of the untethering procedure, including laminotomy, nerve root stimulation, and filum transection. Postoperative Closure: Ensuring a watertight dura closure and layered wound repair to optimize healing and outcomes. Learn about this critical surgical procedure designed to relieve symptoms and prevent further neurological deterioration in children with tethered cord syndrome.…
In this episode of the Colorectal Quiz, Drs. Marc Levitt and Jason Frischer are joined by Drs. Jeffrey Avansino and Hira Ahmad to discuss the nuances of the Malone procedure, used for managing fecal incontinence and constipation in pediatric patients. From patient selection to managing complications, this in-depth conversation highlights the importance of collaboration between urology and surgery for optimal outcomes. Key Topics: Understanding the Malone Procedure: Creating a channel to administer enemas for patients with continence challenges. Technical Considerations: When to use a shared appendix, manage leakage, and troubleshoot complex cases. Complication Management: Addressing stenosis, leakage, and rare issues like appendiceal prolapse. Future Approaches: Exploring the importance of teamwork and innovative solutions in colorectal surgery. Whether you're a pediatric surgeon or someone interested in advancing your understanding of colorectal care, this episode is packed with practical tips and insights. Don't forget to download the Stay Current app for related images and resources, and subscribe for more episodes of the Colorectal Quiz!…
In this podcast, we explore the anatomy, conditions, and treatment strategies related to umbilical disorders in newborns and young children with Dr. Rebeccah Brown from Cincinnati Children's. From umbilical cord anatomy and infections like omphalitis to congenital abnormalities like gastroschisis and umbilical hernias, this comprehensive discussion covers key diagnostic and management approaches. We also highlight treatment guidelines for umbilical granulomas and practical tips for avoiding complications with silver nitrate applications. Host: Em Gootee, MD 0:00 Introduction 0:59 Omphalitis 2:00 Umbilical Hernia 6:55 Proboscoid Hernia 8:48 Umbilical Granuloma 10:18 Summary Zens TJ, Rogers A, Cartmill R, Ostlie D, Muldowney BL, Nichol P, Kohler JE. Age-dependent outcomes in asymptomatic umbilical hernia repair. Pediatr Surg Int. 2019 Apr;35(4):463-468. doi: 10.1007/s00383-018-4413-3. Epub 2018 Nov 14. PMID: 30430281. https://pubmed.ncbi.nlm.nih.gov/30430281/ Zens T, Nichol PF, Cartmill R, Kohler JE. Management of asymptomatic pediatric umbilical hernias: a systematic review. J Pediatr Surg. 2017 Nov;52(11):1723-1731. doi: 10.1016/j.jpedsurg.2017.07.016. Epub 2017 Jul 24. PMID: 28778691. https://pubmed.ncbi.nlm.nih.gov/28778691/ Halleran DR, Minneci PC, Cooper JN. Association between Age and Umbilical Hernia Repair Outcomes in Children: A Multistate Population-Based Cohort Study. J Pediatr. 2020 Feb;217:125-130.e4. doi: 10.1016/j.jpeds.2019.10.035. Epub 2019 Nov 8. PMID: 31711762. https://pubmed.ncbi.nlm.nih.gov/31711762/ He K, Graham DA, Vernacchio L, Hatoun J, Patane L, Cramm SL, Rangel SJ. Age and Probability of Spontaneous Umbilical Hernia Closure. JAMA Pediatr. 2024 May 1;178(5):497-498. doi: 10.1001/jamapediatrics.2024.0087. PMID: 38466296; PMCID: PMC10928535. https://pubmed.ncbi.nlm.nih.gov/38466296/…
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In this video, Dr. Catherine Hart, ENT surgeon at Cincinnati Children’s, discusses the unique airway and aspiration challenges faced by children with CHARGE syndrome. From structural abnormalities like anteriorly positioned arytenoids to feeding difficulties due to cranial nerve impairments, Dr. Hart explores the multidisciplinary approaches required to provide optimal care. Key Highlights: CHARGE Larynx Features: Structural differences leading to upper airway obstruction, foreshortened vocal folds, and difficult intubation. Feeding Challenges: Aspiration risks due to absent cough reflex, high rates of reflux, and swallowing dysfunction in over 60% of CHARGE patients. Medical and Surgical Management: Options including Robinul, Botox, duct ligation, submandibular gland excision, and tympanic neurectomy to reduce aspiration risks. Tracheotomy and Beyond: When tracheotomy or laryngotracheal separation becomes necessary for severe cases with chronic lung impact. Learn how the team at Cincinnati Children’s combines innovative treatments and surgical expertise to improve the quality of life for children with CHARGE syndrome. Don’t forget to like, comment, and subscribe for more expert insights!…
In this educational video, Dr. Catherine Hart, ENT surgeon at Cincinnati Children’s, provides an overview of CHARGE syndrome, a rare genetic disorder that affects multiple organ systems. Learn about its diagnosis, clinical features, and the comprehensive care required for patients with this condition. Key Highlights: What is CHARGE Syndrome? The acronym stands for coloboma, heart defects, atresia of the choanae, retardation of growth and development, genital/urinary anomalies, and ear malformations. Causes and Diagnosis: CHARGE is typically caused by a CHD7 mutation on chromosome 8 but can also be diagnosed clinically with specific major and minor criteria. Multisystem Impact: The syndrome’s highly variable expression means it can affect almost every organ system, requiring coordinated care. Care through an Aerodigestive Center: The Aerodigestive Center at Cincinnati Children’s ensures comprehensive management of airway, feeding, and developmental challenges. Learn how Cincinnati Children’s provides expert care for patients with CHARGE syndrome, helping them overcome complex challenges and improve quality of life. Don’t forget to like, comment, and subscribe for more pediatric insights!…
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Stay Current in Pediatric Surgery
1 Total Pancreatectomy with Islet Autotransplantation (TPIAT) - Cincinnati Children's Pancreas Care Center 10:21
In this video, we take you through a Total Pancreatectomy with Islet Autotransplantation (TPIAT)—one of the most complex abdominal surgeries performed in children. Learn about who qualifies for TPIAT, the surgical process, and the critical role of the lab team in isolating islet cells for infusion. From patient evaluation to the OR, lab preparation, and postoperative care, you’ll see how multiple specialists—surgeons, lab physicians, GI experts, and critical care teams—work together to ensure successful outcomes.Join Dr. Juan Gurria for a behind-the-scenes look at TPIAT, brought to you by the Pancreas Care Center at Cincinnati Children’s Hospital. Main Takeaways TPIAT is a complex procedure for patients with chronic or acute recurrent pancreatitis who have failed all medical and endoscopic therapies. It involves pancreas removal, islet cell processing, and infusion into the liver. A multidisciplinary approach is key to success, involving extensive preoperative planning, precision surgery, lab-based islet cell isolation, and meticulous postoperative care. 0:08 Introduction 0:49 What is Total Pancreatectomy with Islet Autotransplantation? 1:02 Who are the candidates for TPIAT? 1:23 Pre-op evaluation 2:13 Step-by-step overview of TPIAT surgery 7:42 Post-op Care 9:07 Summary Host: Cecilia Gigena, MD…
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