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.

In this educational video, experts from Cincinnati Children’s Pancreas Care Center discuss the complexities of diagnosing and managing chronic pancreatitis. Dr. Maisam Abu-El-Haija and Dr. Andrew Trout cover the condition’s impact on pancreatic function, imaging techniques, genetic testing, and treatment options.

Key Topics:

• What is Chronic Pancreatitis? A progressive inflammatory condition leading to fibrosis, loss of pancreatic function, and complications like diabetes and malnutrition.
• Diagnosis: The role of imaging (MRI, CT) and genetic testing in identifying and understanding the disease.
• Treatment Strategies: From nutritional management and pancreatic enzyme replacement to endoscopic therapy and a multidisciplinary approach to pain management.
• Pain Management: A stepwise approach involving pain specialists, psychologists, and physical therapists to address both the physical and emotional aspects of chronic pain.

Learn how the team at Cincinnati Children’s is transforming care for patients with chronic pancreatitis through innovative techniques and a comprehensive, patient-centered approach.

In this insightful podcast, Drs. Marc Levitt, Jason Frischer, and Chris Westgarth-Taylor discuss the challenging anatomy and surgical strategies for complex female anorectal malformations. They walk us through a unique case involving a cloacal malformation with a high blind-ending rectum, highlighting the importance of detailed preoperative planning, multidisciplinary collaboration, and a tailored surgical approach.

Key Topics Covered:

• Case Presentation: A young patient with a rare cloacal anomaly presenting with a single perineal orifice and absent Mullerian structures.
• Surgical Strategy: Using laparoscopic-assisted PSARP, considerations for colostomy, and preserving future options for gynecological reconstruction.
• Anatomy & Vascular Concerns: Managing unexpected vascular anomalies and protecting critical structures.
• Future Planning: Long-term follow-up for continence, bladder function, and possible tissue engineering solutions for gynecologic needs.

Join us for a fascinating discussion on managing rare anorectal malformations and the careful planning that goes into achieving successful outcomes.

In this video, Dr. Charlie Myer IV from Cincinnati Children's Hospital explores the role of laryngeal sensory reinnervation in children with swallowing and aspiration issues, particularly those with nerve injuries impacting both motor and sensory functions. He reviews the significance of combining motor function restoration with sensory reinnervation to improve swallowing and reduce the risk of aspiration.

Key Points Covered:

• Sensory & Motor Balance in Swallowing: Understanding that swallowing involves both motor control and sensory input, and why both are essential for safe swallowing.
• Innovative Reinnervation Technique: Connecting the great auricular nerve to the superior laryngeal nerve to enhance sensation and improve swallowing function.
• Case Study: A 12-year-old patient with high vagal injury, severe aspiration, and lung complications who experienced remarkable improvement after laryngeal sensory reinnervation.
• Results and Challenges: Promising outcomes seen in initial cases, though more research is needed to determine the best timing and long-term effects of this emerging technique.

Join us to learn more about this exciting approach to laryngeal sensory reinnervation and its potential to transform care for children with complex swallowing disorders.

In this recap from our 12th Annual Update Course in Pediatric Surgery, Lizzy Lee introduces a thought-provoking session on Resuscitative Endovascular Balloon Aortic Occlusion (REBOA) for pediatric trauma patients, featuring Drs. Regan Williams and Katie Russell. This emerging technique is categorized as both a Black Diamond (unproven) and Blue Square (newer) practice, sparking valuable discussion among trauma surgeons.

Key Points Discussed:

• What is REBOA? A life-saving procedure used to control bleeding by inflating a balloon in the aorta, buying time for surgical intervention.
• Pediatric Use Challenges: REBOA is rarely performed in pediatric hospitals, making rapid application difficult, and there is no clear survival advantage in pediatric cases.
• Clinical Debate: A case study of a 16-year-old trauma patient illustrates the decision-making process, with most surgeons opting for laparotomy over REBOA.
• Algorithm Comparison: When to use REBOA versus resuscitative thoracotomy, based on guidelines from the Western Trauma Association.

Learn more about this complex and evolving topic in pediatric trauma care. Don’t forget to like, comment, and subscribe for more updates from our 12th Annual Pediatric Surgery Update Course!

In this video, Dr. Carl Backer, renowned pediatric surgeon, shares insights on vascular rings and aortic uncrossing at Cincinnati Children's Hospital. Discover the history, diagnosis, and surgical approaches to these complex congenital anomalies that compress the trachea and esophagus, impacting respiratory and digestive health.

Key Points Covered:

• History of Vascular Rings: From Dr. Robert Gross's first case in 1945 to the techniques established today.
• Diagnostic Process: Importance of chest X-rays, bronchoscopy, CT scans, and echocardiograms in identifying vascular ring anomalies.
• Surgical Techniques: How procedures like dividing double aortic arches or addressing Kommerell's diverticulum relieve pressure on vital structures.
• Fetal Diagnosis Benefits: Early detection has reduced surgery age, hospital stay, and respiratory complications for newborns.

Tune in to learn how Cincinnati Children’s continues to lead in the treatment of vascular rings and congenital airway anomalies. Don’t forget to like, comment, and subscribe for more pediatric surgical content!

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 through the importance of fetal surgery, the role of advanced prenatal diagnostics, and groundbreaking techniques like fetoscopy, open fetal surgery, and the EXIT procedure.

Key Topics Covered:

• Prenatal Diagnosis: Utilizing ultrasounds, Doppler, and MRI to detect and evaluate fetal malformations early in gestation.
• Fetal Surgery Techniques: The evolution from open fetal surgery to minimally invasive options like fetoscopy to treat conditions such as Twin to Twin Transfusion Syndrome (TTTS), spina bifida, and congenital diaphragmatic hernia (CDH).
• EXIT Procedure: A life-saving technique performed at birth to ensure a safe airway for babies with obstructions.
• Innovative Outcomes: How fetal surgery has significantly improved survival rates and postnatal outcomes for babies with severe conditions.

Discover how the team at Cincinnati Children’s is pushing the boundaries of fetal care and saving lives before birth. Don't forget to like, comment, and subscribe for more groundbreaking medical content!