Stay Current in Pediatric Surgery

StayCurrent: Pediatric Surgery

Through GlobalCastMD’s world-class network of physicians and technology, any health system can provide their doctors access to ongoing mentoring and education. Companies can leverage this same network to more effectively train physicians on products and use it to help train their own sales force. Our educational materials aim to provide entertaining, interactive education for anyone, regardless of geography. We truly are: Dedicated to the rapid advancement of care. Everywhere.

  1. Update Course Rewind 2025: Botox for Hirschsprung’s: Where, When, and Why

    May 19

    Update Course Rewind 2025: Botox for Hirschsprung’s: Where, When, and Why

    This video from GlobalCast MD, featuring Cincinnati Children's, recaps key insights from the 13th Annual Pediatric Surgery Update Course on the use of Botox in Hirschsprung's Disease. It discusses current practices, poll results among pediatric surgeons regarding intrasphincteric botox injection during pull-through procedures, and findings from studies on its efficacy in reducing enterocolitis risk. Experts also delve into the challenges of dosing and the role of ultrasound guidance in these injections.

    2 min
  2. Update Course Rewind 2025: Hirschsprung’s Pull-Through: Why Family Training May Save Lives

    May 14

    Update Course Rewind 2025: Hirschsprung’s Pull-Through: Why Family Training May Save Lives

    In this Update Course Rewind from the 13th Annual Update Course in Pediatric Surgery, Drs. Annie Le-Nguyen, Jamie Harris, and Elizabeth Speck discuss one of the most debated questions in Hirschsprung disease management: when is the best time to perform a pull-through procedure? Key Highlights: Neonatal vs Delayed Pull-Through: Audience opinions were widely split, reflecting the lack of consensus in the field. Some surgeons favor neonatal repair before NICU discharge, while others prefer waiting several months. What the Literature Shows: A 2021 PCPLC retrospective study comparing neonatal versus delayed primary pull-through procedures found no significant difference in enterocolitis rates, postoperative complications, or long-term fecal continence outcomes. Timing Isn’t the Only Factor: The neonatal cohort underwent surgery at a median age of 11 days, while delayed repairs occurred closer to 98 days—yet outcomes remained comparable. The Importance of Home Irrigations: Panelists emphasized that a family’s ability to safely perform rectal irrigations at home may be more important than patient age when deciding surgical timing. Preventing Serious Complications: Inadequate decompression at home can increase the risk of enterocolitis or perforation, making caregiver education and confidence a critical component of successful Hirschsprung management. Individualized Decision-Making: Surgeons should consider family readiness, follow-up access, and irrigation competency when determining the timing of pull-through surgery. This session highlights that while surgical timing remains flexible, empowering families with proper bowel management skills is essential to achieving safe outcomes in Hirschsprung disease.

    2 min
  3. Update Course Rewind 2025: Do We Still Need Routine Anal Dilations After PSARP?

    May 14

    Update Course Rewind 2025: Do We Still Need Routine Anal Dilations After PSARP?

    In this Update Course Rewind from the 13th Annual Update Course in Pediatric Surgery, Drs. Jamie Harris, Elizabeth Speck, Aaron Garrison, and Annie Le-Nguyen revisit a long-standing postoperative practice in colorectal surgery: are routine anal dilations after PSARP truly necessary? Key Highlights: Questioning a Surgical Tradition: For decades, postoperative anal dilations have been considered standard after PSARP—but emerging studies and clinician experience are challenging whether they should be universally required. Emotional Impact on Families: Panelists discussed the significant anxiety and stress dilations can create for caregivers, including concerns about harming the repair and reports of PTSD-like experiences for both families and patients. What the Data Shows: Recent institutional reviews comparing dilation protocols versus no dilations found similar rates of neoanal stricture and reoperation, suggesting mandatory dilations may not always improve outcomes. Alternative Approaches: Heineke-Mikulicz anoplasty (HMA) was highlighted as a safe, minimally invasive outpatient option for managing strictures instead of prolonged dilation regimens. Why Some Surgeons Still Dilate: Many surgeons continue postoperative dilations in neonates, particularly in healthcare systems where rapid access to elective revision procedures may be limited. Individualized Decision-Making: Patient age, anatomy, caregiver comfort, access to follow-up care, and institutional resources all play a role in deciding whether postoperative dilations are appropriate. This session emphasizes that postoperative care after PSARP may not need a one-size-fits-all approach—and that family-centered decision-making is becoming increasingly important in colorectal surgery.

    3 min
  4. Update Course Rewind 2025: Perineal Body–Preserving PSARP: The New Standard?

    May 14

    Update Course Rewind 2025: Perineal Body–Preserving PSARP: The New Standard?

    In this Update Course Rewind from the 13th Annual Update Course in Pediatric Surgery, Drs. Nelson Rosen, Elizabeth Speck, Aaron Garrison, and Jamie Harris explore a key surgical debate: classic PSARP vs. the perineal body–preserving approach for anorectal malformations. Key Highlights: Technique Comparison: The perineal body–preserving PSARP is gaining traction, with many surgeons adopting it as an alternative to the traditional approach, while classic PSARP remains widely used. Early Outcomes Data: Recent studies (2023) show promising results for the perineal body–preserving technique, including no dehiscence, no prolapse, and relatively low rates of anal stricture requiring revision. Postoperative Recovery: Patients undergoing the perineal body–preserving approach may benefit from shorter hospital stays, with many discharged as early as postoperative day one. Technical Considerations: While effective, the approach can be technically more challenging, particularly when identifying anterior anatomy and protecting the posterior vaginal wall. Flexibility in Approach: Surgeons emphasized that conversion to a standard PSARP is always appropriate if there is any uncertainty about anatomy or safety during the procedure. This session highlights that while newer techniques show promise, surgeon judgment and adaptability remain critical to achieving safe and effective outcomes.

    2 min
  5. Update Course Rewind 2025: Timing of PSARP: Early vs. Delayed—Does It Really Matter?

    May 14

    Update Course Rewind 2025: Timing of PSARP: Early vs. Delayed—Does It Really Matter?

    In this Update Course Rewind from the 13th Annual Update Course in Pediatric Surgery, Dr. Jamie Harris—joined by Drs. Nelson Rosen, Annie Le-Nguyen, Aaron Garrison, and Elizabeth Speck—explores one of the most debated questions in colorectal surgery: when is the optimal timing for PSARP in patients with rectovestibular fistula? Key Highlights: Early vs. Delayed PSARP: Both early repair (during the newborn admission) and delayed repair (1–3 months of age) are shown to be equally safe, with no significant differences in complications, reoperations, or readmissions. What the Data Shows: Recent multi-institutional studies (NSQIP and PCPLC) found no difference in 30-day outcomes between early and delayed repairs, reinforcing that timing alone does not determine success. Role of Dilations: Initial dilations can help decompress the bowel, but should be limited (e.g., up to 7 Hegar) to avoid fibrosis and preserve optimal conditions for future repair. Clinical Tradeoffs: Delayed repair: May increase technical difficulty due to fibrosis or rectal distention if not well managedEarly repair: Avoids additional hospitalizations and reduces burden on families, especially those facing access or financial barriersWhat Really Matters: Decision-making should be individualized—taking into account patient size, comorbidities, surgeon experience, and family logistics, rather than a strict timeline. This session highlights that while timing remains flexible, thoughtful, patient-centered decision-making is key to achieving the best outcomes.

    4 min
  6. Pediatric Obesity Is a Disease: Treatment, Medications, Surgery & Equity in Care w/ Dr. Justin Ryder

    Mar 18

    Pediatric Obesity Is a Disease: Treatment, Medications, Surgery & Equity in Care w/ Dr. Justin Ryder

    In this segment from Lurie Children’s Hospital, Dr. Justin Ryder breaks down the evolving science and treatment paradigm of pediatric obesity—highlighting why it must be approached as a chronic, biologically driven disease rather than a lifestyle issue. Key Highlights: Obesity Is a Disease: Pediatric obesity is multifactorial, shaped by genetics, epigenetics, hormones, environment, stress, and socioeconomic factors. The newest AAP guidelines formally recognize obesity as a disease and recommend active treatment—not watchful waiting. Shift in Clinical Practice: Treatment should be offered to children above the 85th percentile BMI. The model has shifted from prevention-only efforts to a proactive, continuum-based care strategy. Continuum of Care: Management includes Intensive Health Behavior and Lifestyle Treatment (26+ contact hours), FDA-approved pharmacotherapy for adolescents, and bariatric surgery for select patients—each playing a role depending on severity and response. Efficacy & Challenges: GLP-1 medications demonstrate meaningful weight loss, and bariatric surgery shows durable BMI reduction and improvement in comorbidities. However, weight regain remains a significant biological challenge. MASLD & Long-Term Risk: Obesity is strongly linked to metabolic dysfunction–associated steatotic liver disease (MASLD), affecting millions of youth and placing many at risk for cirrhosis, transplant, or hepatocellular carcinoma. Equity & Advocacy: Obesity disproportionately impacts children of color and those in under-resourced communities. Access to effective treatment—including medications—is a health equity issue that demands advocacy. This session reinforces that pediatric obesity requires early, evidence-based intervention, multidisciplinary care, and systemic advocacy to improve lifelong health outcomes.

    7 min
  7. Pediatric Oncofertility: From Cryopreservation to Future Fertility Solutions

    Mar 18

    Pediatric Oncofertility: From Cryopreservation to Future Fertility Solutions

    In this educational video from Ann & Robert H. Lurie Children’s Hospital of Chicago, Dr. Monica Laronda explores the rapidly evolving field of pediatric oncofertility—highlighting how fertility preservation is becoming an essential part of care for children at risk of treatment-related infertility. Key Highlights: Why Fertility Preservation Matters: Cancer therapies and certain genetic conditions can lead to premature gonadal failure, significantly impacting future reproductive potential and long-term quality of life. Who Should Be Considered: Fertility preservation extends beyond oncology to include patients with conditions like Turner syndrome and gonadal dysgenesis—emphasizing early counseling regardless of risk level or prognosis. Current Clinical Options: Post-pubertal patients may undergo oocyte or sperm banking, while ovarian and testicular tissue cryopreservation offer options for younger patients who are not yet producing mature gametes. Risk Stratification: Fertility risk is assessed using treatment exposure (e.g., alkylating agents, radiation) and cumulative dosing, helping guide decision-making and timing of intervention. Program Growth & Outcomes: Lurie Children’s has performed hundreds of tissue cryopreservation procedures, demonstrating both feasibility and increasing national awareness of these options. Advances in Fertility Restoration: Ovarian tissue transplantation can restore hormone function and fertility, though risks—such as reintroducing malignant cells—remain a key limitation. Future Innovation: Cutting-edge research in ovarian tissue engineering, including 3D-printed bioprosthetic scaffolds, is paving the way for safer and more effective fertility restoration. This session highlights how multidisciplinary care, research innovation, and early intervention are reshaping the future of fertility preservation for pediatric patients.

    13 min
  8. Colorectal Quiz: Episode 50 16th Annual European Pediatric Colorectal and Pelvic Reconstruction Conference, Stockholm, Sweden, October 2025 - What did we learn?

    Mar 10

    Colorectal Quiz: Episode 50 16th Annual European Pediatric Colorectal and Pelvic Reconstruction Conference, Stockholm, Sweden, October 2025 - What did we learn?

    In this special 50th episode of the Colorectal Quiz Podcast, Dr. Marc Levitt and an international panel review key takeaways from the 16th European Pediatric Colorectal Reconstruction Meeting in Stockholm, highlighting emerging ideas, evolving surgical techniques, and global perspectives in the care of children with colorectal conditions. Key Highlights: Early Irrigation Training in Hirschsprung’s Disease: Some centers are beginning irrigation competency even before ostomy takedown, helping families and patients adapt earlier and potentially reducing post-operative enterocolitis risk. Advances in Surgical Technology: Innovations such as robotic-assisted surgery and ICG fluorescence imaging are improving visualization of blood supply during pull-through procedures, helping surgeons reduce complications like leaks and ischemia. New Diagnostic Concepts: High-frequency ultrasound may help measure bowel wall muscle thickness to identify aganglionic segments, potentially supporting or supplementing traditional biopsy-based diagnosis. Understanding Enterocolitis Risk: Emerging research suggests that reduced mucus protection in proximal bowel segments and mechanical stress on the bowel wall may contribute to microbial imbalance and breakdown of the intestinal barrier. The Power of Nursing and Multidisciplinary Care: Dedicated colorectal nursing programs and global case discussions highlighted how long-term outcomes depend not only on surgical technique but also on ongoing bowel management, education, and coordinated care. Evolving Techniques for Anorectal Malformations: New procedures such as perineal-preserving PSARP and posterior rectal advancement anoplasty (PRAA) aim to reduce complications while improving functional outcomes. Transition to Adult Care: Experts emphasized the need for stronger transition programs and multidisciplinary teams—including gynecology, urology, and sexual health specialists—to support patients with congenital colorectal conditions into adulthood. This episode offers a global snapshot of how pediatric colorectal care continues to evolve through collaboration, innovation, and shared clinical experience.

    25 min
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About

Through GlobalCastMD’s world-class network of physicians and technology, any health system can provide their doctors access to ongoing mentoring and education. Companies can leverage this same network to more effectively train physicians on products and use it to help train their own sales force. Our educational materials aim to provide entertaining, interactive education for anyone, regardless of geography. We truly are: Dedicated to the rapid advancement of care. Everywhere.

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