Alex Gibbons

47 timestamped statements across 12 topics — auto-found in recorded discussions, each timestamp jumps to the exact moment. Summaries Alex gave as host are listed separately below.

Abdominal Wall Defects · guest expert Etiologies (Gastroschisis/NEC/Atresia/Volvulus) · guest expert Intestinal Rehab · guest expert

Featured statements

▶ Ep 1 · 1:30
the main drawback to poem would be that unlike in a Heller myotomy, you don't have any kind of anti-reflux procedure with it.
quote · Achalasia
▶ Ep 2 · 12:45
There is potential benefit with thoracoscopic approach in time to extubation, time to first oral feeding, overall hospital length of stay, and musculoskeletal sequelae.
opinion · Esophageal Atresia
▶ Ep 2 · 13:00
The chief limitation of thoracoscopic TEF repair is the technical demand, specifically the challenge of the anastomosis done in situ.
opinion · Esophageal Atresia
▶ Ep 3 · 12:30
The retrospective data suggest no difference in leak rate or stricture rate between thoracoscopic and open TEF repair.
clinical · Esophageal Atresia
▶ Ep 1 · 0:24
POEM in children achieved about 91% clinical efficacy in terms of significant decrease in the Eckardt score
clinical · Achalasia
▶ Ep 1 · 1:42
Saline enemas under ultrasound avoid fluoroscopy exposure
clinical · Intussusception

Nothing matches these filters — clear the search or widen the filters.

Alex's statements about Achalasia 10 statements

Open the Achalasia collection →

How effective is POEM in children?

▶ Ep 1 · 0:24
quote So Todd, your dad is basically one of the fathers of surgical endoscopy, right? He did a lot of surgical endoscopy, yeah. So like you and surgical endoscopy are basically siblings. ↗
▶ Ep 1 · 0:24
epidemiological The study examined 117 patients across 14 different hospitals on three different continents ↗
▶ Ep 1 · 0:24
clinical POEM in children achieved about 91% clinical efficacy in terms of significant decrease in the Eckardt score ↗
▶ Ep 1 · 0:24
clinical The Eckardt score is a score used to measure achalasia symptoms ↗
▶ Ep 1 · 0:24
clinical POEM had about a 15% postoperative reflux incidence in children ↗
▶ Ep 1 · 0:24
clinical Unlike Heller myotomy, POEM does not include any kind of anti-reflux procedure ↗
▶ Ep 1 · 0:24
clinical The 90% efficacy and 15% reflux rate after POEM in children are pretty similar to what is seen in adults ↗
▶ Ep 1 · 0:24
clinical The study showed that POEM is effective and safe in children ↗
▶ Ep 1 · 0:50
quote What do you know about poem in children? Not much. There's only a few centers that have been doing it. I think the data is pretty early and preliminary at this point. ↗
▶ Ep 1 · 1:30
quote the main drawback to poem would be that unlike in a Heller myotomy, you don't have any kind of anti-reflux procedure with it. ↗
Alex's statements about Appendicitis 1 statement

Open the Appendicitis collection →

Update Course Rewind: Perforated Appendicitis 2019

▶ Ep 13 · 9:22
quote Yeah, more just um for, uh, in general, I think one of the issues is that no matter how good your data are, you can't beat a good rhyme. ↗
Alex's statements about Appendicitis 1 statement

Open the Appendicitis collection →

Update Course Rewind: Perforated Appendicitis 2019

▶ Ep 8 · 9:22
quote Yeah, more just um for, uh, in general, I think one of the issues is that no matter how good your data are, you can't beat a good rhyme. ↗
Alex's statements about DVT 5 statements

Open the DVT collection →

APSA 2018 Practice Gaps

▶ Ep 4 · 3:48
quote I would wait until their symptoms were improving. I I wasn't following lipase and amalyse, but I was waiting for their symptoms to improve. And now you don't have to do that. You just feed feed right away if they can tolerate it. ↗
▶ Ep 4 · 11:00
quote So I don't get where where we fall into the politics arena. Um, I have never talked to a patient about firearms ever. And I so I'm the one that needs to get into that mode, but I am I don't know how this works. ↗
▶ Ep 4 · 14:08
quote I have always go, okay, first day, resuscitate them. The next day, put them on maintenance fluid at a hypotonic solution. I said, oh my God. Okay, now I need to keep everybody on isotonic and I can't do it. A lot of it's because of our epic, um, Protocols? What? Order sets. Order sets that I'd have to go change the whole epic order set. ↗
▶ Ep 4 · 23:29
quote I don't know if any surgeon would look at that and go 41% failure rate is a success. ↗

7th Annual Pediatric Surgery Update Course 2019 - FULL SHOW

▶ Ep 2 · 0:26
clinical Restrictive transfusion protocols using a target hemoglobin of 7 instead of 8, 9, or 10 showed no difference in mortality ↗
Alex's statements about Early Assessment and Management of Trauma 1 statement

Open the Early Assessment and Management of Trauma collection →

JPS Journal Club: July 2019 Part 1

▶ Ep 3 · 3:14
epidemiological The issue of physician rights to ask about firearms in the home was battled at the Supreme Court level. ↗
Alex's statements about Esophageal Atresia 5 statements

Open the Esophageal Atresia collection →

Thoracoscopic TEF Repair, Is It Really Better Than Open? Update Course 2018

▶ Ep 2 · 12:25
quote I think the data would suggest a qualified yes. ↗
▶ Ep 2 · 12:30
clinical The retrospective data suggest no difference in leak rate or stricture rate between thoracoscopic and open TEF repair. ↗
▶ Ep 2 · 12:45
opinion There is potential benefit with thoracoscopic approach in time to extubation, time to first oral feeding, overall hospital length of stay, and musculoskeletal sequelae. ↗
▶ Ep 2 · 13:00
opinion The chief limitation of thoracoscopic TEF repair is the technical demand, specifically the challenge of the anastomosis done in situ. ↗
▶ Ep 2 · 13:15
opinion There remains a need for a powered randomized controlled trial comparing thoracoscopic and open TEF repair. ↗
Alex's statements about Esophageal Atresia 5 statements

Open the Esophageal Atresia collection →

Thoracoscopic TEF Repair, Is It Really Better Than Open? Update Course 2018

▶ Ep 3 · 12:25
quote I think the data would suggest a qualified yes. ↗
▶ Ep 3 · 12:30
clinical The retrospective data suggest no difference in leak rate or stricture rate between thoracoscopic and open TEF repair. ↗
▶ Ep 3 · 12:45
opinion There is potential benefit with thoracoscopic approach in time to extubation, time to first oral feeding, overall hospital length of stay, and musculoskeletal sequelae. ↗
▶ Ep 3 · 13:00
opinion The chief limitation of thoracoscopic TEF repair is the technical demand, specifically the challenge of the anastomosis done in situ. ↗
▶ Ep 3 · 13:15
opinion There remains a need for a powered randomized controlled trial comparing thoracoscopic and open TEF repair. ↗
Alex's statements about Hyponatremia 4 statements

Open the Hyponatremia collection →

APSA 2018 Practice Gaps

▶ Ep 3 · 3:48
quote I would wait until their symptoms were improving. I I wasn't following lipase and amalyse, but I was waiting for their symptoms to improve. And now you don't have to do that. You just feed feed right away if they can tolerate it. ↗
▶ Ep 3 · 11:00
quote So I don't get where where we fall into the politics arena. Um, I have never talked to a patient about firearms ever. And I so I'm the one that needs to get into that mode, but I am I don't know how this works. ↗
▶ Ep 3 · 14:08
quote I have always go, okay, first day, resuscitate them. The next day, put them on maintenance fluid at a hypotonic solution. I said, oh my God. Okay, now I need to keep everybody on isotonic and I can't do it. A lot of it's because of our epic, um, Protocols? What? Order sets. Order sets that I'd have to go change the whole epic order set. ↗
▶ Ep 3 · 23:29
quote I don't know if any surgeon would look at that and go 41% failure rate is a success. ↗
Alex's statements about Intussusception 1 statement

Open the Intussusception collection →

Reduction of intussusception with saline enema superior to air enema

▶ Ep 1 · 1:42
clinical Saline enemas under ultrasound avoid fluoroscopy exposure ↗
Alex's statements about Pediatric Oncology 4 statements

Open the Pediatric Oncology collection →

APSA 2018 Practice Gaps

▶ Ep 155 · 3:48
quote I would wait until their symptoms were improving. I I wasn't following lipase and amalyse, but I was waiting for their symptoms to improve. And now you don't have to do that. You just feed feed right away if they can tolerate it. ↗
▶ Ep 155 · 11:00
quote So I don't get where where we fall into the politics arena. Um, I have never talked to a patient about firearms ever. And I so I'm the one that needs to get into that mode, but I am I don't know how this works. ↗
▶ Ep 155 · 14:08
quote I have always go, okay, first day, resuscitate them. The next day, put them on maintenance fluid at a hypotonic solution. I said, oh my God. Okay, now I need to keep everybody on isotonic and I can't do it. A lot of it's because of our epic, um, Protocols? What? Order sets. Order sets that I'd have to go change the whole epic order set. ↗
▶ Ep 155 · 23:29
quote I don't know if any surgeon would look at that and go 41% failure rate is a success. ↗
Alex's statements about Tracheoesophageal Fistula 5 statements

Open the Tracheoesophageal Fistula collection →

Thoracoscopic TEF Repair, Is It Really Better Than Open? Update Course 2018

▶ Ep 1 · 12:25
quote I think the data would suggest a qualified yes. ↗
▶ Ep 1 · 12:30
clinical The retrospective data suggest no difference in leak rate or stricture rate between thoracoscopic and open TEF repair. ↗
▶ Ep 1 · 12:45
opinion There is potential benefit with thoracoscopic approach in time to extubation, time to first oral feeding, overall hospital length of stay, and musculoskeletal sequelae. ↗
▶ Ep 1 · 13:00
opinion The chief limitation of thoracoscopic TEF repair is the technical demand, specifically the challenge of the anastomosis done in situ. ↗
▶ Ep 1 · 13:15
opinion There remains a need for a powered randomized controlled trial comparing thoracoscopic and open TEF repair. ↗
Alex's statements about Tracheoesophageal Fistula 5 statements

Open the Tracheoesophageal Fistula collection →

Thoracoscopic TEF Repair, Is It Really Better Than Open? Update Course 2018

▶ Ep 1 · 12:25
quote I think the data would suggest a qualified yes. ↗
▶ Ep 1 · 12:30
clinical The retrospective data suggest no difference in leak rate or stricture rate between thoracoscopic and open TEF repair. ↗
▶ Ep 1 · 12:45
opinion There is potential benefit with thoracoscopic approach in time to extubation, time to first oral feeding, overall hospital length of stay, and musculoskeletal sequelae. ↗
▶ Ep 1 · 13:00
opinion The chief limitation of thoracoscopic TEF repair is the technical demand, specifically the challenge of the anastomosis done in situ. ↗
▶ Ep 1 · 13:15
opinion There remains a need for a powered randomized controlled trial comparing thoracoscopic and open TEF repair. ↗

Summaries Alex gave as host · 164 summaries

Recaps of what the experts said, with Alex as narrator — not Alex's own clinical position, and never cited in answers.

Summaries Alex gave as host · Abdominal Wall Defects 1 summary

Open the Abdominal Wall Defects collection →

7th Annual Pediatric Surgery Update Course 2019 - FULL SHOW

▶ Ep 15 · 0:26
host summary Alex Gibbons summarizing the discussion: Restrictive transfusion protocols using a target hemoglobin of 7 instead of 8, 9, or 10 showed no difference in mortality ↗
Summaries Alex gave as host · Appendicitis 10 summaries

Open the Appendicitis collection →

Too Much Variability in Opioid Prescriptions for Pediatric Operations

▶ Ep 2 · 0:00
host summary Alex Gibbons summarizing a resource: The study was a retrospective chart review of all patients who had an appendectomy for simple appendicitis between October 2016 and January 2018. ↗
▶ Ep 2 · 0:00
host summary Alex Gibbons summarizing a resource: There are currently no recommendations for opioid prescriptions for post-surgical patients in the pediatric population. ↗
▶ Ep 2 · 0:00
host summary Alex Gibbons summarizing a resource: Of adolescents who use opioid prescriptions recreationally, 80% have their source from leftover medications. ↗
▶ Ep 2 · 3:00
host summary Alex Gibbons summarizing a resource: There was wide variability in oral morphine equivalents per kilogram per day prescribed. ↗
▶ Ep 2 · 3:00
host summary Alex Gibbons summarizing a resource: There was no difference in narcotic prescribing based on race, sex, age, or insurance status. ↗
▶ Ep 2 · 3:00
host summary Alex Gibbons summarizing a resource: 62.5% of patients received narcotics after an appendectomy for simple appendicitis. ↗
▶ Ep 2 · 3:00
host summary Alex Gibbons summarizing a resource: Patients who received a prescription for opioids came to the emergency department over three times more often than those who did not. ↗
▶ Ep 2 · 3:00
host summary Alex Gibbons summarizing a resource: Some surgeons gave only 6% of their patients a narcotic prescription, while others gave nearly 70% of their patients a prescription. ↗
▶ Ep 2 · 3:00
host summary Alex Gibbons summarizing a resource: Prescription duration varied widely, with some patients receiving prescriptions for only one day while others received prescriptions for up to a month. ↗
▶ Ep 2 · 5:00
host summary Alex Gibbons summarizing a resource: The variability in opioid prescribing is evidence for the need for a standardized protocol for prescriptions after pediatric operations. ↗
Summaries Alex gave as host · DVT 8 summaries

Open the DVT collection →

APSA 2018 Practice Gaps

▶ Ep 4 · 0:27
host summary Alex Gibbons summarizing the discussion: Restrictive transfusion protocols using target hemoglobin of 7 instead of 8, 9, or 10 show no difference in mortality ↗
▶ Ep 4 · 2:27
host summary Alex Gibbons summarizing the discussion: Early enteral feeding in pancreatitis decreases morbidity, infectious complications, and overall mortality ↗
▶ Ep 4 · 2:27
host summary Alex Gibbons summarizing the discussion: Nasogastric feeding is equal to nasojejunal feeding in pancreatitis and equally tolerated ↗
▶ Ep 4 · 13:13
host summary Alex Gibbons summarizing the discussion: Current strategy should be to continue isotonic fluids throughout hospitalization rather than switching to hypotonic maintenance fluids ↗
▶ Ep 4 · 13:13
host summary Alex Gibbons summarizing the discussion: Continuing isotonic fluids decreases the risk of hyponatremia and had similar mortality otherwise ↗
▶ Ep 4 · 17:10
host summary Alex Gibbons summarizing the discussion: In Wilms tumor surgery, failing to take lymph nodes automatically upstages the patient ↗
▶ Ep 4 · 17:10
host summary Alex Gibbons summarizing the discussion: Pulmonary metastasis in Wilms tumor does not preclude doing a primary nephrectomy ↗
▶ Ep 4 · 22:45
host summary Alex Gibbons summarizing the discussion: In the adult IMPACT trial from Finland at 5 years, 41% of the non-operative appendicitis management group underwent appendectomy ↗
Summaries Alex gave as host · Early Assessment and Management of Trauma 13 summaries

Open the Early Assessment and Management of Trauma collection →

JPS Journal Club: July 2019 Part 1

▶ Ep 3 · 0:24
host summary Alex Gibbons summarizing a resource: firearm injury is trauma and should be evaluated by the trauma system and that injury prevention should be considered part of that trauma system as well ↗
▶ Ep 3 · 0:24
host summary Alex Gibbons summarizing a resource: APSA position statement recommends that firearm injury is trauma and should be evaluated by the trauma system, with injury prevention considered part of that trauma system. ↗
▶ Ep 3 · 1:12
host summary Alex Gibbons summarizing a resource: APSA recommends better access to mental health services for both children and adults in the context of firearm injury prevention. ↗
▶ Ep 3 · 1:12
host summary Alex Gibbons summarizing a resource: we should make have better access for mental health services to both children and adults ↗
▶ Ep 3 · 1:42
host summary Alex Gibbons summarizing a resource: The belief underlying APSA's background check recommendation is that background checks would decrease the number of childhood injuries related to guns. ↗
▶ Ep 3 · 2:21
host summary Alex Gibbons summarizing a resource: APSA supports banning of assault weapons and high capacity magazines. ↗
▶ Ep 3 · 2:21
host summary Alex Gibbons summarizing a resource: APSA strongly supports the use of child access prevention laws and safe storage of guns to prevent access to firearms by children. ↗
▶ Ep 3 · 2:21
host summary Alex Gibbons summarizing a resource: APPSA supports uh banning of assault weapons and high capacity magazines ↗
▶ Ep 3 · 2:21
host summary Alex Gibbons summarizing a resource: APPSA strongly supporting the use of child access prevention laws and making sure that guns are safely stored to prevent access to firearms to children ↗
▶ Ep 3 · 3:14
host summary Alex Gibbons summarizing a resource: supporting uh readiness for school shooter situations, making sure that schools are prepared ↗
▶ Ep 3 · 3:14
host summary Alex Gibbons summarizing a resource: APSA supports readiness for school shooter situations, ensuring schools are prepared. ↗
▶ Ep 3 · 3:57
host summary Alex Gibbons summarizing a resource: APPSA supports uh research in the second victim syndrome for both survivors and for healthcare uh providers in these situations ↗
▶ Ep 3 · 3:57
host summary Alex Gibbons summarizing a resource: APSA supports research in second victim syndrome for both survivors and healthcare providers in firearm injury situations. ↗
Summaries Alex gave as host · Esophageal Atresia 27 summaries

Open the Esophageal Atresia collection →

Thoracoscopic TEF Repair, Is It Really Better Than Open? Update Course 2018

▶ Ep 3 · 1:24
host summary Alex Gibbons summarizing the discussion: The first successful open repair of tracheoesophageal fistula was performed in 1941 by Dr. Cameron Haight. ↗
▶ Ep 3 · 1:46
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: In the year 2000, Dr. Steven Rothenberg performed the first successful repair of a tracheoesophageal fistula with a minimally invasive approach (esophageal atresia had been the year before). ↗
▶ Ep 3 · 2:10
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: In Rothenberg's first decade of experience with 62 patients, he reported that thoracoscopic approach offered better visualization of the anatomy. ↗
▶ Ep 3 · 2:40
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: Rothenberg reported that performing the operation entirely in situ reduced manipulation of the trachea and therefore potentially reduced risk for tracheomalacia. ↗
▶ Ep 3 · 3:00
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: Rothenberg reported decreased tension on the esophageal anastomosis with thoracoscopic approach. ↗
▶ Ep 3 · 3:10
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: Rothenberg reported that smaller incisions would result in fewer musculoskeletal deformities such as scapular winging, chest wall asymmetry, and scoliosis. ↗
▶ Ep 3 · 4:00
host summary Alex Gibbons summarizing the discussion: The Tübingen Germany single-center study found the minimally invasive group was slightly larger at about 2,700g compared to 2,100g in the open group. ↗
▶ Ep 3 · 4:30
host summary Alex Gibbons summarizing the discussion: The Tübingen study found slightly more associated anomalies in the minimally invasive group at about 40% compared to 31% in the open group. ↗
▶ Ep 3 · 5:00
host summary Alex Gibbons summarizing the discussion: The Tübingen study found no statistically significant difference between groups in complication rate or time to postoperative extubation. ↗
▶ Ep 3 · 5:15
host summary Alex Gibbons summarizing the discussion: The Tübingen study found operative time was slightly longer at about half an hour longer in the minimally invasive group than in the open group. ↗
▶ Ep 3 · 5:30
host summary Alex Gibbons summarizing the discussion: The Tübingen study found higher intraoperative PaCO2 in the MIS group, but postoperatively there was no statistically significant difference. ↗
▶ Ep 3 · 5:50
host summary Alex Gibbons summarizing the discussion: The Holcomb multi-center study included 6 hospitals (Stanford California, Kansas City Missouri, Denver Colorado, Buenos Aires Argentina, Utrecht Netherlands, and Hong Kong China) with 104 total patients. ↗
▶ Ep 3 · 6:30
host summary Alex Gibbons summarizing the discussion: The Holcomb study found results equivalent to historical open controls in mortality rate and need for postoperative fundoplication. ↗
▶ Ep 3 · 6:45
host summary Alex Gibbons summarizing the discussion: The Holcomb study found results compared favorably to historical controls in terms of leak and recurrence. ↗
▶ Ep 3 · 7:30
host summary Alex Gibbons summarizing the discussion: The Japanese multi-center study of 7 hospitals with 58 patients found equivalence in mortality, leak rate, and recurrence between MIS and open approaches. ↗
▶ Ep 3 · 7:50
host summary Alex Gibbons summarizing the discussion: The Japanese study found a higher stricture rate in the minimally invasive group at about 48% compared to 17% in the open group. ↗
▶ Ep 3 · 9:00
host summary Alex Gibbons summarizing the discussion: The Hanover Germany study of patients who had minimally invasive or open thoracic procedures for benign conditions found improved rate of mild scoliosis in MIS group: over 50% in thoracotomy group compared to less than 10% in minimally invasive group. ↗
▶ Ep 3 · 9:30
host summary Alex Gibbons summarizing the discussion: The Hanover study found patients were more satisfied with scarring in the MIS group based on Manchester scarring criteria. ↗
▶ Ep 3 · 9:40
host summary Alex Gibbons summarizing the discussion: The Hanover study found chest wall asymmetry was improved in the minimally invasive group, specifically in chest wall diameter and distance of nipple to xiphoid. ↗
▶ Ep 3 · 9:55
host summary Alex Gibbons summarizing the discussion: The Hanover study found no difference in shoulder range of motion between MIS and open groups. ↗
▶ Ep 3 · 10:10
host summary Alex Gibbons summarizing the discussion: A 2012 meta-analysis of 4 articles representing 166 patients (69 MIS, 97 open) found no statistically significant difference in stricture rate, leak rate, operative time, or time to postoperative extubation. ↗
▶ Ep 3 · 10:35
host summary Alex Gibbons summarizing the discussion: A 2016 meta-analysis of 8 articles with 452 patients (221 MIS, 231 open) found no difference in stricture rate or leak rate. ↗
▶ Ep 3 · 10:50
host summary Alex Gibbons summarizing the discussion: The 2016 meta-analysis found operative time was about 20 minutes longer in the minimally invasive group. ↗
▶ Ep 3 · 11:00
host summary Alex Gibbons summarizing the discussion: The 2016 meta-analysis found time to postoperative extubation and first postoperative feeding were about 2.5 days sooner in the MIS group. ↗
▶ Ep 3 · 11:15
host summary Alex Gibbons summarizing the discussion: The 2016 meta-analysis found hospital length of stay was almost 11 days shorter in the MIS group. ↗
▶ Ep 3 · 11:30
host summary Alex Gibbons summarizing the discussion: A pilot randomized controlled trial at Children's Hospital London with 10 patients (randomized to MIS or open) found no difference in intraoperative PaCO2, pH, time in OR, peak inspiratory pressure, or length of ICU stay. ↗
▶ Ep 3 · 12:00
host summary Alex Gibbons summarizing the discussion: The London pilot RCT found 1 stricture in the open group compared to 3 strictures in the thoracoscopic group, and 1 leak in the thoracoscopic group compared to none in the open group. ↗
Summaries Alex gave as host · Esophageal Atresia 27 summaries

Open the Esophageal Atresia collection →

Thoracoscopic TEF Repair, Is It Really Better Than Open? Update Course 2018

▶ Ep 2 · 1:24
host summary Alex Gibbons summarizing the discussion: The first successful open repair of tracheoesophageal fistula was performed in 1941 by Dr. Cameron Haight. ↗
▶ Ep 2 · 1:46
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: In the year 2000, Dr. Steven Rothenberg performed the first successful repair of a tracheoesophageal fistula with a minimally invasive approach (esophageal atresia had been the year before). ↗
▶ Ep 2 · 2:10
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: In Rothenberg's first decade of experience with 62 patients, he reported that thoracoscopic approach offered better visualization of the anatomy. ↗
▶ Ep 2 · 2:40
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: Rothenberg reported that performing the operation entirely in situ reduced manipulation of the trachea and therefore potentially reduced risk for tracheomalacia. ↗
▶ Ep 2 · 3:00
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: Rothenberg reported decreased tension on the esophageal anastomosis with thoracoscopic approach. ↗
▶ Ep 2 · 3:10
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: Rothenberg reported that smaller incisions would result in fewer musculoskeletal deformities such as scapular winging, chest wall asymmetry, and scoliosis. ↗
▶ Ep 2 · 4:00
host summary Alex Gibbons summarizing the discussion: The Tübingen Germany single-center study found the minimally invasive group was slightly larger at about 2,700g compared to 2,100g in the open group. ↗
▶ Ep 2 · 4:30
host summary Alex Gibbons summarizing the discussion: The Tübingen study found slightly more associated anomalies in the minimally invasive group at about 40% compared to 31% in the open group. ↗
▶ Ep 2 · 5:00
host summary Alex Gibbons summarizing the discussion: The Tübingen study found no statistically significant difference between groups in complication rate or time to postoperative extubation. ↗
▶ Ep 2 · 5:15
host summary Alex Gibbons summarizing the discussion: The Tübingen study found operative time was slightly longer at about half an hour longer in the minimally invasive group than in the open group. ↗
▶ Ep 2 · 5:30
host summary Alex Gibbons summarizing the discussion: The Tübingen study found higher intraoperative PaCO2 in the MIS group, but postoperatively there was no statistically significant difference. ↗
▶ Ep 2 · 5:50
host summary Alex Gibbons summarizing the discussion: The Holcomb multi-center study included 6 hospitals (Stanford California, Kansas City Missouri, Denver Colorado, Buenos Aires Argentina, Utrecht Netherlands, and Hong Kong China) with 104 total patients. ↗
▶ Ep 2 · 6:30
host summary Alex Gibbons summarizing the discussion: The Holcomb study found results equivalent to historical open controls in mortality rate and need for postoperative fundoplication. ↗
▶ Ep 2 · 6:45
host summary Alex Gibbons summarizing the discussion: The Holcomb study found results compared favorably to historical controls in terms of leak and recurrence. ↗
▶ Ep 2 · 7:30
host summary Alex Gibbons summarizing the discussion: The Japanese multi-center study of 7 hospitals with 58 patients found equivalence in mortality, leak rate, and recurrence between MIS and open approaches. ↗
▶ Ep 2 · 7:50
host summary Alex Gibbons summarizing the discussion: The Japanese study found a higher stricture rate in the minimally invasive group at about 48% compared to 17% in the open group. ↗
▶ Ep 2 · 9:00
host summary Alex Gibbons summarizing the discussion: The Hanover Germany study of patients who had minimally invasive or open thoracic procedures for benign conditions found improved rate of mild scoliosis in MIS group: over 50% in thoracotomy group compared to less than 10% in minimally invasive group. ↗
▶ Ep 2 · 9:30
host summary Alex Gibbons summarizing the discussion: The Hanover study found patients were more satisfied with scarring in the MIS group based on Manchester scarring criteria. ↗
▶ Ep 2 · 9:40
host summary Alex Gibbons summarizing the discussion: The Hanover study found chest wall asymmetry was improved in the minimally invasive group, specifically in chest wall diameter and distance of nipple to xiphoid. ↗
▶ Ep 2 · 9:55
host summary Alex Gibbons summarizing the discussion: The Hanover study found no difference in shoulder range of motion between MIS and open groups. ↗
▶ Ep 2 · 10:10
host summary Alex Gibbons summarizing the discussion: A 2012 meta-analysis of 4 articles representing 166 patients (69 MIS, 97 open) found no statistically significant difference in stricture rate, leak rate, operative time, or time to postoperative extubation. ↗
▶ Ep 2 · 10:35
host summary Alex Gibbons summarizing the discussion: A 2016 meta-analysis of 8 articles with 452 patients (221 MIS, 231 open) found no difference in stricture rate or leak rate. ↗
▶ Ep 2 · 10:50
host summary Alex Gibbons summarizing the discussion: The 2016 meta-analysis found operative time was about 20 minutes longer in the minimally invasive group. ↗
▶ Ep 2 · 11:00
host summary Alex Gibbons summarizing the discussion: The 2016 meta-analysis found time to postoperative extubation and first postoperative feeding were about 2.5 days sooner in the MIS group. ↗
▶ Ep 2 · 11:15
host summary Alex Gibbons summarizing the discussion: The 2016 meta-analysis found hospital length of stay was almost 11 days shorter in the MIS group. ↗
▶ Ep 2 · 11:30
host summary Alex Gibbons summarizing the discussion: A pilot randomized controlled trial at Children's Hospital London with 10 patients (randomized to MIS or open) found no difference in intraoperative PaCO2, pH, time in OR, peak inspiratory pressure, or length of ICU stay. ↗
▶ Ep 2 · 12:00
host summary Alex Gibbons summarizing the discussion: The London pilot RCT found 1 stricture in the open group compared to 3 strictures in the thoracoscopic group, and 1 leak in the thoracoscopic group compared to none in the open group. ↗
Summaries Alex gave as host · Etiologies (Gastroschisis/NEC/Atresia/Volvulus) 1 summary

Open the Etiologies (Gastroschisis/NEC/Atresia/Volvulus) collection →

7th Annual Pediatric Surgery Update Course 2019 - FULL SHOW

▶ Ep 21 · 0:26
host summary Alex Gibbons summarizing the discussion: Restrictive transfusion protocols using a target hemoglobin of 7 instead of 8, 9, or 10 showed no difference in mortality ↗
Summaries Alex gave as host · Hyponatremia 8 summaries

Open the Hyponatremia collection →

APSA 2018 Practice Gaps

▶ Ep 3 · 0:27
host summary Alex Gibbons summarizing the discussion: Restrictive transfusion protocols using target hemoglobin of 7 instead of 8, 9, or 10 show no difference in mortality ↗
▶ Ep 3 · 2:27
host summary Alex Gibbons summarizing the discussion: Nasogastric feeding is equal to nasojejunal feeding in pancreatitis and equally tolerated ↗
▶ Ep 3 · 2:27
host summary Alex Gibbons summarizing the discussion: Early enteral feeding in pancreatitis decreases morbidity, infectious complications, and overall mortality ↗
▶ Ep 3 · 13:13
host summary Alex Gibbons summarizing the discussion: Continuing isotonic fluids decreases the risk of hyponatremia and had similar mortality otherwise ↗
▶ Ep 3 · 13:13
host summary Alex Gibbons summarizing the discussion: Current strategy should be to continue isotonic fluids throughout hospitalization rather than switching to hypotonic maintenance fluids ↗
▶ Ep 3 · 17:10
host summary Alex Gibbons summarizing the discussion: In Wilms tumor surgery, failing to take lymph nodes automatically upstages the patient ↗
▶ Ep 3 · 17:10
host summary Alex Gibbons summarizing the discussion: Pulmonary metastasis in Wilms tumor does not preclude doing a primary nephrectomy ↗
▶ Ep 3 · 22:45
host summary Alex Gibbons summarizing the discussion: In the adult IMPACT trial from Finland at 5 years, 41% of the non-operative appendicitis management group underwent appendectomy ↗
Summaries Alex gave as host · Intestinal Rehab 1 summary

Open the Intestinal Rehab collection →

7th Annual Pediatric Surgery Update Course 2019 - FULL SHOW

▶ Ep 30 · 0:26
host summary Alex Gibbons summarizing the discussion: Restrictive transfusion protocols using a target hemoglobin of 7 instead of 8, 9, or 10 showed no difference in mortality ↗
Summaries Alex gave as host · Intussusception 5 summaries

Open the Intussusception collection →

Reduction of intussusception with saline enema superior to air enema

▶ Ep 1 · 0:16
host summary Alex Gibbons summarizing a resource: The study randomized 124 patients to either air contrast enema or hydrostatic enema under ultrasound guidance ↗
▶ Ep 1 · 0:16
host summary Alex Gibbons summarizing a resource: A Randomized Trial of Pneumatic Reduction versus Hydrostatic Reduction for Intussusception in Pediatric Patients ↗
▶ Ep 1 · 0:16
host summary Alex Gibbons summarizing a resource: The primary outcome was success of non-operative management confirmed with post-procedure ultrasound ↗
▶ Ep 1 · 0:16
host summary Alex Gibbons summarizing a resource: Baseline characteristics were the same between groups except for shorter procedure time in the hydrostatic group ↗
▶ Ep 1 · 1:42
host summary Alex Gibbons summarizing a resource: Under all measured parameters, ultrasound-guided saline enema was superior to traditional air enemas under fluoroscopy ↗
Summaries Alex gave as host · Pediatric Oncology 9 summaries

Open the Pediatric Oncology collection →

APSA 2018 Practice Gaps

▶ Ep 155 · 0:27
host summary Alex Gibbons summarizing the discussion: Restrictive transfusion protocols using target hemoglobin of 7 instead of 8, 9, or 10 show no difference in mortality ↗
▶ Ep 155 · 2:27
host summary Alex Gibbons summarizing the discussion: Early enteral feeding in pancreatitis decreases morbidity, infectious complications, and overall mortality ↗
▶ Ep 155 · 2:27
host summary Alex Gibbons summarizing the discussion: Nasogastric feeding is equal to nasojejunal feeding in pancreatitis and equally tolerated ↗
▶ Ep 155 · 13:13
host summary Alex Gibbons summarizing the discussion: Current strategy should be to continue isotonic fluids throughout hospitalization rather than switching to hypotonic maintenance fluids ↗
▶ Ep 155 · 13:13
host summary Alex Gibbons summarizing the discussion: Continuing isotonic fluids decreases the risk of hyponatremia and had similar mortality otherwise ↗
▶ Ep 155 · 17:10
host summary Alex Gibbons summarizing the discussion: In Wilms tumor surgery, failing to take lymph nodes automatically upstages the patient ↗
▶ Ep 155 · 17:10
host summary Alex Gibbons summarizing the discussion: Pulmonary metastasis in Wilms tumor does not preclude doing a primary nephrectomy ↗
▶ Ep 155 · 22:45
host summary Alex Gibbons summarizing the discussion: In the adult IMPACT trial from Finland at 5 years, 41% of the non-operative appendicitis management group underwent appendectomy ↗

7th Annual Pediatric Surgery Update Course 2019 - FULL SHOW

▶ Ep 210 · 0:26
host summary Alex Gibbons summarizing the discussion: Restrictive transfusion protocols using a target hemoglobin of 7 instead of 8, 9, or 10 showed no difference in mortality ↗
Summaries Alex gave as host · Tracheoesophageal Fistula 27 summaries

Open the Tracheoesophageal Fistula collection →

Thoracoscopic TEF Repair, Is It Really Better Than Open? Update Course 2018

▶ Ep 1 · 1:24
host summary Alex Gibbons summarizing the discussion: The first successful open repair of tracheoesophageal fistula was performed in 1941 by Dr. Cameron Haight. ↗
▶ Ep 1 · 1:46
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: In the year 2000, Dr. Steven Rothenberg performed the first successful repair of a tracheoesophageal fistula with a minimally invasive approach (esophageal atresia had been the year before). ↗
▶ Ep 1 · 2:10
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: In Rothenberg's first decade of experience with 62 patients, he reported that thoracoscopic approach offered better visualization of the anatomy. ↗
▶ Ep 1 · 2:40
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: Rothenberg reported that performing the operation entirely in situ reduced manipulation of the trachea and therefore potentially reduced risk for tracheomalacia. ↗
▶ Ep 1 · 3:00
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: Rothenberg reported decreased tension on the esophageal anastomosis with thoracoscopic approach. ↗
▶ Ep 1 · 3:10
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: Rothenberg reported that smaller incisions would result in fewer musculoskeletal deformities such as scapular winging, chest wall asymmetry, and scoliosis. ↗
▶ Ep 1 · 4:00
host summary Alex Gibbons summarizing the discussion: The Tübingen Germany single-center study found the minimally invasive group was slightly larger at about 2,700g compared to 2,100g in the open group. ↗
▶ Ep 1 · 4:30
host summary Alex Gibbons summarizing the discussion: The Tübingen study found slightly more associated anomalies in the minimally invasive group at about 40% compared to 31% in the open group. ↗
▶ Ep 1 · 5:00
host summary Alex Gibbons summarizing the discussion: The Tübingen study found no statistically significant difference between groups in complication rate or time to postoperative extubation. ↗
▶ Ep 1 · 5:15
host summary Alex Gibbons summarizing the discussion: The Tübingen study found operative time was slightly longer at about half an hour longer in the minimally invasive group than in the open group. ↗
▶ Ep 1 · 5:30
host summary Alex Gibbons summarizing the discussion: The Tübingen study found higher intraoperative PaCO2 in the MIS group, but postoperatively there was no statistically significant difference. ↗
▶ Ep 1 · 5:50
host summary Alex Gibbons summarizing the discussion: The Holcomb multi-center study included 6 hospitals (Stanford California, Kansas City Missouri, Denver Colorado, Buenos Aires Argentina, Utrecht Netherlands, and Hong Kong China) with 104 total patients. ↗
▶ Ep 1 · 6:30
host summary Alex Gibbons summarizing the discussion: The Holcomb study found results equivalent to historical open controls in mortality rate and need for postoperative fundoplication. ↗
▶ Ep 1 · 6:45
host summary Alex Gibbons summarizing the discussion: The Holcomb study found results compared favorably to historical controls in terms of leak and recurrence. ↗
▶ Ep 1 · 7:30
host summary Alex Gibbons summarizing the discussion: The Japanese multi-center study of 7 hospitals with 58 patients found equivalence in mortality, leak rate, and recurrence between MIS and open approaches. ↗
▶ Ep 1 · 7:50
host summary Alex Gibbons summarizing the discussion: The Japanese study found a higher stricture rate in the minimally invasive group at about 48% compared to 17% in the open group. ↗
▶ Ep 1 · 9:00
host summary Alex Gibbons summarizing the discussion: The Hanover Germany study of patients who had minimally invasive or open thoracic procedures for benign conditions found improved rate of mild scoliosis in MIS group: over 50% in thoracotomy group compared to less than 10% in minimally invasive group. ↗
▶ Ep 1 · 9:30
host summary Alex Gibbons summarizing the discussion: The Hanover study found patients were more satisfied with scarring in the MIS group based on Manchester scarring criteria. ↗
▶ Ep 1 · 9:40
host summary Alex Gibbons summarizing the discussion: The Hanover study found chest wall asymmetry was improved in the minimally invasive group, specifically in chest wall diameter and distance of nipple to xiphoid. ↗
▶ Ep 1 · 9:55
host summary Alex Gibbons summarizing the discussion: The Hanover study found no difference in shoulder range of motion between MIS and open groups. ↗
▶ Ep 1 · 10:10
host summary Alex Gibbons summarizing the discussion: A 2012 meta-analysis of 4 articles representing 166 patients (69 MIS, 97 open) found no statistically significant difference in stricture rate, leak rate, operative time, or time to postoperative extubation. ↗
▶ Ep 1 · 10:35
host summary Alex Gibbons summarizing the discussion: A 2016 meta-analysis of 8 articles with 452 patients (221 MIS, 231 open) found no difference in stricture rate or leak rate. ↗
▶ Ep 1 · 10:50
host summary Alex Gibbons summarizing the discussion: The 2016 meta-analysis found operative time was about 20 minutes longer in the minimally invasive group. ↗
▶ Ep 1 · 11:00
host summary Alex Gibbons summarizing the discussion: The 2016 meta-analysis found time to postoperative extubation and first postoperative feeding were about 2.5 days sooner in the MIS group. ↗
▶ Ep 1 · 11:15
host summary Alex Gibbons summarizing the discussion: The 2016 meta-analysis found hospital length of stay was almost 11 days shorter in the MIS group. ↗
▶ Ep 1 · 11:30
host summary Alex Gibbons summarizing the discussion: A pilot randomized controlled trial at Children's Hospital London with 10 patients (randomized to MIS or open) found no difference in intraoperative PaCO2, pH, time in OR, peak inspiratory pressure, or length of ICU stay. ↗
▶ Ep 1 · 12:00
host summary Alex Gibbons summarizing the discussion: The London pilot RCT found 1 stricture in the open group compared to 3 strictures in the thoracoscopic group, and 1 leak in the thoracoscopic group compared to none in the open group. ↗
Summaries Alex gave as host · Tracheoesophageal Fistula 27 summaries

Open the Tracheoesophageal Fistula collection →

Thoracoscopic TEF Repair, Is It Really Better Than Open? Update Course 2018

▶ Ep 1 · 1:24
host summary Alex Gibbons summarizing the discussion: The first successful open repair of tracheoesophageal fistula was performed in 1941 by Dr. Cameron Haight. ↗
▶ Ep 1 · 1:46
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: In the year 2000, Dr. Steven Rothenberg performed the first successful repair of a tracheoesophageal fistula with a minimally invasive approach (esophageal atresia had been the year before). ↗
▶ Ep 1 · 2:10
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: In Rothenberg's first decade of experience with 62 patients, he reported that thoracoscopic approach offered better visualization of the anatomy. ↗
▶ Ep 1 · 2:40
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: Rothenberg reported that performing the operation entirely in situ reduced manipulation of the trachea and therefore potentially reduced risk for tracheomalacia. ↗
▶ Ep 1 · 3:00
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: Rothenberg reported decreased tension on the esophageal anastomosis with thoracoscopic approach. ↗
▶ Ep 1 · 3:10
host summary Alex Gibbons summarizes what Dr. Steven Rothenberg said: Rothenberg reported that smaller incisions would result in fewer musculoskeletal deformities such as scapular winging, chest wall asymmetry, and scoliosis. ↗
▶ Ep 1 · 4:00
host summary Alex Gibbons summarizing the discussion: The Tübingen Germany single-center study found the minimally invasive group was slightly larger at about 2,700g compared to 2,100g in the open group. ↗
▶ Ep 1 · 4:30
host summary Alex Gibbons summarizing the discussion: The Tübingen study found slightly more associated anomalies in the minimally invasive group at about 40% compared to 31% in the open group. ↗
▶ Ep 1 · 5:00
host summary Alex Gibbons summarizing the discussion: The Tübingen study found no statistically significant difference between groups in complication rate or time to postoperative extubation. ↗
▶ Ep 1 · 5:15
host summary Alex Gibbons summarizing the discussion: The Tübingen study found operative time was slightly longer at about half an hour longer in the minimally invasive group than in the open group. ↗
▶ Ep 1 · 5:30
host summary Alex Gibbons summarizing the discussion: The Tübingen study found higher intraoperative PaCO2 in the MIS group, but postoperatively there was no statistically significant difference. ↗
▶ Ep 1 · 5:50
host summary Alex Gibbons summarizing the discussion: The Holcomb multi-center study included 6 hospitals (Stanford California, Kansas City Missouri, Denver Colorado, Buenos Aires Argentina, Utrecht Netherlands, and Hong Kong China) with 104 total patients. ↗
▶ Ep 1 · 6:30
host summary Alex Gibbons summarizing the discussion: The Holcomb study found results equivalent to historical open controls in mortality rate and need for postoperative fundoplication. ↗
▶ Ep 1 · 6:45
host summary Alex Gibbons summarizing the discussion: The Holcomb study found results compared favorably to historical controls in terms of leak and recurrence. ↗
▶ Ep 1 · 7:30
host summary Alex Gibbons summarizing the discussion: The Japanese multi-center study of 7 hospitals with 58 patients found equivalence in mortality, leak rate, and recurrence between MIS and open approaches. ↗
▶ Ep 1 · 7:50
host summary Alex Gibbons summarizing the discussion: The Japanese study found a higher stricture rate in the minimally invasive group at about 48% compared to 17% in the open group. ↗
▶ Ep 1 · 9:00
host summary Alex Gibbons summarizing the discussion: The Hanover Germany study of patients who had minimally invasive or open thoracic procedures for benign conditions found improved rate of mild scoliosis in MIS group: over 50% in thoracotomy group compared to less than 10% in minimally invasive group. ↗
▶ Ep 1 · 9:30
host summary Alex Gibbons summarizing the discussion: The Hanover study found patients were more satisfied with scarring in the MIS group based on Manchester scarring criteria. ↗
▶ Ep 1 · 9:40
host summary Alex Gibbons summarizing the discussion: The Hanover study found chest wall asymmetry was improved in the minimally invasive group, specifically in chest wall diameter and distance of nipple to xiphoid. ↗
▶ Ep 1 · 9:55
host summary Alex Gibbons summarizing the discussion: The Hanover study found no difference in shoulder range of motion between MIS and open groups. ↗
▶ Ep 1 · 10:10
host summary Alex Gibbons summarizing the discussion: A 2012 meta-analysis of 4 articles representing 166 patients (69 MIS, 97 open) found no statistically significant difference in stricture rate, leak rate, operative time, or time to postoperative extubation. ↗
▶ Ep 1 · 10:35
host summary Alex Gibbons summarizing the discussion: A 2016 meta-analysis of 8 articles with 452 patients (221 MIS, 231 open) found no difference in stricture rate or leak rate. ↗
▶ Ep 1 · 10:50
host summary Alex Gibbons summarizing the discussion: The 2016 meta-analysis found operative time was about 20 minutes longer in the minimally invasive group. ↗
▶ Ep 1 · 11:00
host summary Alex Gibbons summarizing the discussion: The 2016 meta-analysis found time to postoperative extubation and first postoperative feeding were about 2.5 days sooner in the MIS group. ↗
▶ Ep 1 · 11:15
host summary Alex Gibbons summarizing the discussion: The 2016 meta-analysis found hospital length of stay was almost 11 days shorter in the MIS group. ↗
▶ Ep 1 · 11:30
host summary Alex Gibbons summarizing the discussion: A pilot randomized controlled trial at Children's Hospital London with 10 patients (randomized to MIS or open) found no difference in intraoperative PaCO2, pH, time in OR, peak inspiratory pressure, or length of ICU stay. ↗
▶ Ep 1 · 12:00
host summary Alex Gibbons summarizing the discussion: The London pilot RCT found 1 stricture in the open group compared to 3 strictures in the thoracoscopic group, and 1 leak in the thoracoscopic group compared to none in the open group. ↗