Ladd Medal Award Presentation Honoring Dr. Steven Rothenberg's Pioneering Minimally Invasive Pediatric Surgery

During thoracic fellowship in Liverpool, Rothenberg developed muscle-sparing thoracotomy technique and observed improved recovery in patients who received bilateral procedures with this approach compared to traditional thoracotomy.

Rothenberg performed the first laparoscopic Nissen fundoplication at Texas Children's Hospital in 1990.

Rothenberg collaborated on one of the first successful gene therapy projects, performing 80% hepatectomy in factor VIII deficient dogs using only eye cautery, which cured factor VIII deficiency and was published in Science.

Rothenberg pioneered thoracoscopic lung biopsies in children with interstitial lung disease, changing care by making tissue diagnosis accessible when previously the morbidity of open biopsy prevented diagnosis.

Rothenberg performed the first thoracoscopic TEF repair in Berlin in 1999 during the IPEG meeting, operating live in front of 100 people on a patient with pure esophageal atresia whose ends had been brought together by metal bougie dilation.

Almost a year after the Berlin case, Rothenberg performed the first thoracoscopic type C esophageal atresia repair in a healthy large baby (Connor) who is now a chemist.

Rothenberg's initial thoracoscopic TEF series of approximately 15 cases was rejected by ABSA but published in JPS through Jay Grosfeld's support.

Rothenberg presented a series of 220 consecutive thoracoscopic TEF repairs, after which the nature of audience questions shifted from critiquing the technique to asking why more surgeons were not adopting it.

Rothenberg's 25-year thoracoscopic TEF series was submitted to ABSA and rejected as single-surgeon experience.

At Rothenberg's hospital, no open thoracic procedures have been performed in 20 years; all partners perform thoracoscopic repairs.

The morbidity of thoracotomy is significant and should drive broader adoption of thoracoscopic approaches for TEF and CPAM resections.