Stay Current in Pediatric Surgery

In this episode of the Colorectal Quiz, Drs. Mark Levitt, Jason Frischer, and Chris Gayer discuss a complex case of persistent constipation in a patient with a history of Hirschsprung’s disease. Despite a successful pull-through surgery in infancy, the patient continued to experience significant symptoms into adulthood, highlighting the importance of long-term management. Key Points Covered: * Challenges Post-Surgery: Why constipation persists in some Hirschsprung’s patients despite anatomically successful surgeries. * Diagnostic Approach: The use of exams under anesthesia, rectal biopsies, contrast enemas, and motility testing to evaluate potential causes. * Segmental Dysmotility Management: How a Malone procedure can provide a minimally invasive solution for improved colon emptying. * Multidisciplinary Care: Collaboration between surgeons, gastroenterologists, and therapists to address motility disorders, pelvic floor dysfunction, and behavioral factors. This case highlights the importance of moving beyond the initial diagnosis and surgery to focus on the patient’s current symptoms for better quality of life. Don’t forget to like, comment, and subscribe for more insights into colorectal surgery!

In this insightful session from the QUAD Conference, Dr. David Lehenbauer, a cardiothoracic surgeon at Cincinnati Children’s, discusses the management of concurrent cardiac pathology in patients undergoing slide tracheoplasty. Learn about the role of ECMO vs. cardiopulmonary bypass, timing of cardiac and tracheal repairs, and the challenges of addressing complex cases with multiple comorbidities. Key Points Covered: * Slide Tracheoplasty: A transformative surgical technique for congenital tracheal stenosis. * ECMO vs. Cardiopulmonary Bypass: Benefits of ECMO, including reduced inflammation, lower heparin requirements, and better post-op outcomes. * Concurrent Cardiac Pathologies: Common conditions such as PA sling, ASDs, VSDs, and Tetralogy of Fallot, often repaired simultaneously with tracheoplasty. * Timing of Repairs: Exploring when to combine vs. stage cardiac and tracheal interventions, with insights from recent studies and case reviews. Join us for an in-depth look at how a multidisciplinary approach is transforming care for children with complex cardiac and airway conditions. Don’t forget to like, comment, and subscribe for more expert insights!

In this recap from the 12th Annual Pediatric Surgery Update Course, Drs. Regan Williams and Katie Russell delve into the latest approaches to deep vein thrombosis (DVT) prophylaxis in pediatric trauma patients. Learn when to start chemical prophylaxis, how to balance bleeding risks, and the best options for discharge medication. Key Points Covered: * Timing is Critical: Start chemical DVT prophylaxis within 24 hours of admission for stable trauma patients to reduce the risk of venous thromboembolism (VTE). * Guideline Recommendations: Follow EAST guidelines and assess factors like Injury Severity Score (ISS) to determine risk levels. * Discharge Medications: Recent studies show aspirin is as effective as Lovenox for DVT prevention and offers easier compliance for pediatric patients at home. Join us as we explore how new evidence is shaping DVT prevention strategies in pediatric trauma care. Don’t forget to like, comment, and subscribe for more updates from the Pediatric Surgery Update Course!

In this episode of the Colorectal Quiz, research fellow Filipa Jalles from Children's National Hospital is joined by Dr. Marc Levitt, Dr. Jason Frisher, and Dr. Paola Midrio to discuss a challenging case involving perineal hypospadias and anorectal malformation. Together, they explore the intricacies of diagnosis, the emotional impact on families, and the detailed surgical approach required for successful outcomes. Key Topics Covered: * Prenatal Diagnosis: How advancements in imaging are reshaping prenatal counseling for conditions like hypospadias. * Surgical Strategy: The decision-making process around colostomy, PSARP, and collaboration with pediatric urologists. * Anoplasty Techniques: Detailed discussion on the mobilization of the rectum and management of the fistula in these rare and complex cases. * Multidisciplinary Collaboration: The importance of teamwork between pediatric surgeons and urologists to ensure optimal care. Join us for an in-depth look at this fascinating case and learn from the expertise of a world-class surgical team. Like, comment, and subscribe for more pediatric surgery insights!

In this video, Dr. Catherine Hart, ENT surgeon at Cincinnati Children’s, discusses the endoscopic repair of minor laryngeal clefts, highlighting key surgical techniques and considerations. She explains the importance of accurately diagnosing these subtle clefts using combined evaluations and the criteria for deciding when surgery is necessary. Key Points Covered: * When to Operate: Indications include persistent respiratory symptoms, aspiration, or recurrent infections in children. * Surgical Technique: The procedure involves removing the interarytenoid mucosa, using precise suturing to prevent issues like inverted edges, and ensuring complete demucosalization at the apex. * Postoperative Care: Patients are monitored overnight and follow a preoperative diet until a follow-up evaluation 6-8 weeks later, which includes a video swallow study and endoscopy. * Outcomes and Complications: While endoscopic repair shows a high success rate, Dr. Hart discusses the potential risks, including scarring and supraglottic infections, and emphasizes the importance of technique to minimize these complications. Learn how Cincinnati Children's ENT team ensures successful outcomes for kids with minor laryngeal clefts and why endoscopic repair is often preferred.