# Lectures, Courses and Honors — GCMD Library living collection

Updated: n/a · 13 episodes · 57 cited statements

## Episodes
### Named lectures and honors
- [Ladd Medal Award Presentation Honoring Dr. Steven Rothenberg's Pioneering Minimally Invasive Pediatric Surgery](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984) — video · 33:12 · [machine version](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984.md)
- [Storz Lecture IPEG](https://library.globalcastmd.com/watch/storz-lecture-ipeg-11965) — article · [machine version](https://library.globalcastmd.com/watch/storz-lecture-ipeg-11965.md)
- [Sybil Storz Lecture](https://library.globalcastmd.com/watch/sybil-storz-lecture-11966) — article · [machine version](https://library.globalcastmd.com/watch/sybil-storz-lecture-11966.md)

### Invited lectures
- [JRS surgeon presentation](https://library.globalcastmd.com/watch/jrs-surgeon-presentation-11924) — article · [machine version](https://library.globalcastmd.com/watch/jrs-surgeon-presentation-11924.md)
- [Rothenberg Vail](https://library.globalcastmd.com/watch/rothenberg-vail-11961) — article · [machine version](https://library.globalcastmd.com/watch/rothenberg-vail-11961.md)
- [SAGES Oncology talk](https://library.globalcastmd.com/watch/sages-oncology-talk-11962) — article · [machine version](https://library.globalcastmd.com/watch/sages-oncology-talk-11962.md)
- [TIF Vail](https://library.globalcastmd.com/watch/tif-vail-11970) — article · [machine version](https://library.globalcastmd.com/watch/tif-vail-11970.md)
- [WOFAPS 2016 Neo MIS](https://library.globalcastmd.com/watch/wofaps-2016-neo-mis-11981) — article · [machine version](https://library.globalcastmd.com/watch/wofaps-2016-neo-mis-11981.md)
- [World Vet Meeting 2021](https://library.globalcastmd.com/watch/world-vet-meeting-2021-11982) — article · [machine version](https://library.globalcastmd.com/watch/world-vet-meeting-2021-11982.md)
- [Yuri 2017](https://library.globalcastmd.com/watch/yuri-2017-11983) — article · [machine version](https://library.globalcastmd.com/watch/yuri-2017-11983.md)

### Course and meeting recaps
- [IPEG 2019 Highlights: From Virtual Reality and Magnets to Robots at the Bedside](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583) — video · [machine version](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583.md)
- [Update Course Rewind: 2021 Top Ten Key Takeaways](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578) — video · 16:02 · [machine version](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578.md)
- [Update Course Rewind: Pectus Excavatum 2021](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807) — video · 11:56 · [machine version](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807.md)

## Chapters
- [0:00](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=0) Virtual Reality for Sedation Reduction in Minor Procedures (Ep 11)
- [1:38](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=98) Robotic-Assisted Vascular Access Innovation (Ep 11)
- [3:45](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=225) Magnetic Compression Anastomosis for Esophageal Atresia (Ep 11)
- [5:07](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=307) Laparoscopic Pyeloplasty as Gold Standard (Ep 11)
- [5:53](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=353) Adolescent Bariatric Surgery Evidence and Outcomes (Ep 11)
- [7:54](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=474) Umbilical Vein Air Embolus Risk in Neonatal Access (Ep 11)
- [10:22](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=622) Manuscript Writing Tips for Surgical Authors (Ep 11)
- [0:12](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=12) Takeaway #10: Medical Management of Uncomplicated Appendicitis (Ep 12)
- [1:45](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=105) Takeaway #9: Surgical Approach to Osteosarcoma Lung Metastases (Ep 12)
- [3:08](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=188) Takeaway #8: Flourish Device for Esophageal Atresia (Ep 12)
- [4:43](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=283) Takeaway #7: Indocyanine Green Applications in Pediatric Surgery (Ep 12)
- [6:06](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=366) Takeaway #6: Timing of Colorectal Procedures (Ep 12)
- [7:42](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=462) Takeaway #5: Pain Management for Pectus Repair (Ep 12)
- [9:29](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=569) Takeaway #4: Button Battery Ingestion Management (Ep 12)
- [11:12](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=672) Takeaway #3: Updated ATLS Guidelines for Pediatric Hemorrhagic Shock (Ep 12)
- [12:21](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=741) Takeaway #2: Management of Primary Spontaneous Pneumothorax (Ep 12)
- [13:49](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=829) Takeaway #1: Diversity, Equity, and Inclusion in Pediatric Surgery (Ep 12)
- [0:00](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=0) Introduction and Case Presentation (Ep 13)
- [1:57](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=117) Cryoanalgesia for Pain Management (Ep 13)
- [3:55](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=235) Alternative Pain Management Strategies (Ep 13)
- [7:04](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=424) Surgical Technique Variations for Nuss Procedure (Ep 13)
- [10:28](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=628) Summary and Closing (Ep 13)
- [0:00](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=0) Introduction and Award Presentation (Ep 1)
- [8:49](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=529) Early Career and Training Influences (Ep 1)
- [15:00](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=900) Muscle-Sparing Thoracotomy and Early Innovation (Ep 1)
- [20:00](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=1200) Thoracoscopic Surgery Development and Morbidity Reduction (Ep 1)
- [25:00](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=1500) First Thoracoscopic TEF Repairs (Ep 1)
- [30:00](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=1800) Current State and Call to Action (Ep 1)

## Statements
Every statement is attributed, typed, and timestamped; the link is the citation.
- Cryoanalgesia technique involves counting down to the 4th rib and freezing underneath it for 2 minutes per rib, treating ribs 4 through 7. (clinical) [Ep 13 · 2:19](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=139)
- Cryoanalgesia should not be performed on rib 8 or below because it can cause abdominal wall paralysis. (clinical) [Ep 13 · 2:29](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=149)
- With cryoanalgesia, length of stay decreased from 4 days to 1 day. (clinical) [Ep 13 · 2:37](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=157)
- Cryoanalgesia dramatically reduced median morphine equivalents compared to previous pain management methods. (clinical) [Ep 13 · 2:46](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=166)
- There are no long-term studies on cryoanalgesia outcomes. — Victor Garcia (clinical) [Ep 13 · 3:04](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=184)
- Medical devices and implants are not required to undergo clinical trials before being introduced to market, unlike drugs. — Victor Garcia (guideline) [Ep 13 · 3:24](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=204)
- Erector spinal catheters are placed by the pain team with ultrasound guidance, positioned juxtaposed to but not in the vertebral space. — Victor Garcia (clinical) [Ep 13 · 4:09](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=249)
- With erector spinal catheters, hospital stay is 2 days, catheters stay in for 5 days, and are pulled out by the family on day 3 while the patient is at home. — Victor Garcia (clinical) [Ep 13 · 4:19](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=259)
- Erector spinal catheters reduced opioid requirements both in the hospital and outside the hospital. — Victor Garcia (clinical) [Ep 13 · 4:33](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=273)
- With erector spinal catheters, hospital stays are 2 days, which is much less than the 4-5 days seen with epidurals. — Victor Garcia (clinical) [Ep 13 · 4:45](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=285)
- With cryoanalgesia, it is not just when patients go home but how they feel when they go home that has changed dramatically. — Steven Rothenberg (opinion) [Ep 13 · 5:08](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=308)
- For multimodal pain therapy, the best treatments are preoperative counseling, gabapentin both pre and postoperatively, and then methadone, clonidine, bowel regimen medications, and anti-emetics. — Justin Wagner (clinical) [Ep 13 · 6:02](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=362)
- If bars are going to flip, they flip early because they were sitting in a funky inner space, in a bad spot, the bar wasn't wrapped tight enough, or it wasn't secured well. (clinical) [Ep 13 · 6:39](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=399)
- The bar must sit in a comfortable position before securing it or it probably will not stay there. (clinical) [Ep 13 · 6:54](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=414)
- Bar flippage is completely a surgical issue. — Steven Rothenberg (opinion) [Ep 13 · 6:59](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=419)
- A sternal elevator is used in about 10% of cases, primarily in really deep stiff pectuses where it allows less tissue damage and a better repair. — Steven Rothenberg (clinical) [Ep 13 · 8:19](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=499)
- In the average younger patient, thoracoscopy provides adequate visualization without needing a sternal elevator. — Steven Rothenberg (clinical) [Ep 13 · 8:22](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=502)
- Using a sternal elevator in every case eliminates guesswork and allows entry and exit at the same interspace. — Victor Garcia (clinical) [Ep 13 · 8:35](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=515)
- Techniques to avoid cardiac injury include thoracoscopy, sternal elevator, vacuum bell in the operating room, or subxiphoid incision. (clinical) [Ep 13 · 8:59](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=539)
- Passing the bar from left chest to right chest is preferred by some because going right to left means the instrument points directly at the ventricle. (clinical) [Ep 13 · 9:31](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=571)
- Bar passage direction (left-to-right versus right-to-left) is surgeon preference and probably does not make much difference as long as the substernal space is well dissected and everything is clear. (opinion) [Ep 13 · 10:12](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=612)
- 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. — Steven Rothenberg (clinical) [Ep 1 · 25:00](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=1500)
- 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. — Steven Rothenberg (clinical) [Ep 1 · 27:30](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=1650)
- Rothenberg's initial thoracoscopic TEF series of approximately 15 cases was rejected by ABSA but published in JPS through Jay Grosfeld's support. — Steven Rothenberg (clinical) [Ep 1 · 28:20](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=1700)
- 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. — Steven Rothenberg (clinical) [Ep 1 · 29:10](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=1750)
- At Rothenberg's hospital, no open thoracic procedures have been performed in 20 years; all partners perform thoracoscopic repairs. — Steven Rothenberg (clinical) [Ep 1 · 32:30](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=1950)
- Rothenberg performed the first laparoscopic Nissen fundoplication at Texas Children's Hospital in 1990. — Steven Rothenberg (clinical) [Ep 1 · 15:00](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=900)
- 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. — Steven Rothenberg (clinical) [Ep 1 · 11:40](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=700)
- 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. — Steven Rothenberg (clinical) [Ep 1 · 15:50](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=950)
- 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. — Steven Rothenberg (clinical) [Ep 1 · 20:50](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=1250)
- Rothenberg's 25-year thoracoscopic TEF series was submitted to ABSA and rejected as single-surgeon experience. — Steven Rothenberg (clinical) [Ep 1 · 31:20](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=1880)
- The morbidity of thoracotomy is significant and should drive broader adoption of thoracoscopic approaches for TEF and CPAM resections. — Steven Rothenberg (opinion) [Ep 1 · 32:30](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=1950)
- Virtual reality headsets have been used to completely eliminate the need for IV or sedating medications in 19 patients during minor surgical procedures over about a year. — Alex Kasar (clinical) [Ep 11 · 0:26](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=26)
- All enrolled patients using VR have recommended it for future use, both if they were going to have the surgery again and if other kids were going to have it. — Alex Kasar (clinical) [Ep 11 · 0:26](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=26)
- VR has been used primarily for minor procedures requiring just a little bit of sedation medication, specifically hormone implant exchanges and cystostomy tube exchanges. — Alex Kasar (clinical) [Ep 11 · 0:26](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=26)
- Imaging combined with robotics can improve the insertion of needles into specific places, whether vessels, lesions, or other targets. — Daniel von Allmen (clinical) [Ep 11 · 2:00](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=120)
- The addition of robotics provides precision and accuracy that allows people who don't necessarily have the experience or training to do advanced vascular access to perform it in settings like the ICU, emergency department, or operating room. — Daniel von Allmen (clinical) [Ep 11 · 2:00](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=120)
- The robotic vascular access device is designed as an assistant device at the bedside to help clinicians be better clinicians, positioned between telemanipulators like Da Vinci and fully autonomous industrial robots. — Daniel von Allmen (clinical) [Ep 11 · 2:00](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=120)
- In a retrospective study of 13 patients across six institutions with long gap esophageal atresia treated with catheter-based magnet devices, all patients achieved anastomosis in an average of 6.3 days. — Bethany Slater (clinical) [Ep 11 · 3:45](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=225)
- All patients treated with magnetic compression anastomosis for esophageal atresia had stenosis afterwards requiring dilation. — Bethany Slater (clinical) [Ep 11 · 3:45](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=225)
- Six of 13 patients treated with magnetic compression anastomosis required stent placements and two underwent surgery. — Bethany Slater (clinical) [Ep 11 · 3:45](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=225)
- 92% of patients treated with magnetic compression anastomosis for esophageal atresia had full feeds at time of follow up, which was about 9.3 years. — Bethany Slater (clinical) [Ep 11 · 3:45](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=225)
- The magnetic compression anastomosis study was retrospective over 17 years, and a prospective FDA-approved observational study using the Flourish device is underway aiming to enroll 20 patients over two years. — Bethany Slater (clinical) [Ep 11 · 3:45](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=225)
- Pyeloplasty has evolved to become the gold standard for taking care of UPJO obstruction. — Philip Savive (opinion) [Ep 11 · 5:07](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=307)
- Bariatric surgery in children and adolescents can be performed at any age as long as there are comorbidities and it is proven safe and effective. — Ayed Al-Qahtani (clinical) [Ep 11 · 5:53](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=353)
- Obese children and adolescents with type 2 diabetes should go for bariatric surgery because it cured diabetes and the cure lasts for up to 10 years in studies. — Ayed Al-Qahtani (clinical) [Ep 11 · 5:53](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=353)
- Bariatric surgery does not affect growth in children and adolescents; in fact, it improved growth by almost 10cm in height in those who are from five to nine years of age. — Ayed Al-Qahtani (clinical) [Ep 11 · 5:53](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=353)
- When children and adolescents lose weight through bariatric surgery at an early age, they can maintain their weight loss for almost up to 10 years. — Ayed Al-Qahtani (clinical) [Ep 11 · 5:53](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=353)
- There are reported cases where surgeons gained access directly through the umbilicus in newborns and babies four to six weeks of age, and patients got air embolus because of unrecognized injury to the umbilical vein. — Steven Rothenberg (clinical) [Ep 11 · 7:54](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=474)
- Direct access through the center of the umbilicus should not be performed in anyone under six to eight weeks of age due to risk of umbilical vein patency and injury, regardless of technique used. — Steven Rothenberg (clinical) [Ep 11 · 7:54](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=474)
- The only safe way to gain abdominal access in infants under 6-8 weeks is through an infraumbilical ring incision, below the vein and between the umbilical arteries. — Steven Rothenberg (clinical) [Ep 11 · 7:54](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=474)
- The risk of umbilical vein injury exists whether using blunt dissection, inserting a trocar, putting a trocar in, or putting a scope in to look. — Steven Rothenberg (clinical) [Ep 11 · 7:54](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=474)
- Most people do not realize that air embolus from umbilical vein injury is a potential complication of direct umbilical access in young infants. — Steven Rothenberg (opinion) [Ep 11 · 7:54](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=474)
- The best advice for getting started writing a manuscript is to either create an outline or write the abstract first, then lock yourself in your office and dictate something that can be edited multiple times. — Holcomb (opinion) [Ep 11 · 10:22](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=622)
- Authors often don't read the instructions to authors, and there are subtle differences from one journal to another that affect what is expected for publication. — Holcomb (opinion) [Ep 11 · 10:22](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=622)
- The biggest mistake in manuscript submissions is in the references, because electronic reference manager software is often not in the same format that the Journal of Pediatric Surgery uses. — Holcomb (opinion) [Ep 11 · 10:22](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=622)
- Authors should ensure the paper has good English grammar and syntax and that the data is the same in the abstract and the paper. — Holcomb (opinion) [Ep 11 · 10:22](https://library.globalcastmd.com/watch/ipeg-2019-highlights-from-virtual-reality-and-magnets-to-robots-at-the-bedside-3583?t=622)

## Host summaries
Recaps by a host of what the experts said — not the host's own clinical position.
- In the Petcova et al. study published in Annals of Surgery 2020, children with uncomplicated appendicitis were randomized to medical management with antibiotics or surgery, with 5-year follow-up. — Ellen Encisco summarizing the discussion [Ep 12 · 0:43](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=43)
- In the Petcova et al. appendicitis study, the surgery group had no complications, while 46% of patients in the non-surgical management group required appendectomy during follow-up. — The host summarizing the discussion [Ep 12 · 1:11](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=71)
- Medical management of acute uncomplicated appendicitis may be safe but is associated with a high failure rate, with many children ultimately requiring laparoscopic appendectomy. — Ellen Encisco summarizing the discussion [Ep 12 · 1:22](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=82)
- Metastectomy for osteosarcoma lung metastases improves survival and can make patients long-term survivors. — The host summarizing the discussion [Ep 12 · 2:15](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=135)
- Approximately 10% of 1 millimeter lung nodules in osteosarcoma patients contain malignant disease. — The host summarizing the discussion [Ep 12 · 2:24](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=144)
- The Children's Oncology Group is starting a study to determine whether thoracotomy or thoracoscopy is superior for resection of pulmonary metastases in osteosarcoma, with enrollment expected late 2021 or early 2022. — The host summarizing the discussion [Ep 12 · 2:40](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=160)
- The Flourish device is a catheter-based device that places magnets in proximal and distal esophageal pouches to create a compression anastomosis by causing ischemia of tissue between the magnets, which then sloughs off. — The host summarizing the discussion [Ep 12 · 3:16](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=196)
- Inclusion criteria for the Flourish device are: atretic gap less than 4 centimeters long, fistula repaired or absent, and G-tube able to accommodate an 18 French catheter. — The host summarizing the discussion [Ep 12 · 3:39](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=219)
- The Flourish device is associated with a high stricture rate and known serious life-threatening complications, and should only be used by centers with capabilities to treat the many issues associated with esophageal atresia. — The host summarizing the discussion [Ep 12 · 3:57](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=237)
- Indocyanine green (ICG) has become a topic of interest in the last few years for use in pediatric surgery, especially in minimally invasive procedures to improve visualization of structures. — Ellen Encisco summarizing the discussion [Ep 12 · 4:43](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=283)
- For laparoscopic cholecystectomy, ICG must be administered intravenously 12 to 18 hours prior to surgery to allow time for accumulation in the extrahepatic ducts, or can be injected directly into the gallbladder during surgery. — Ellen Encisco summarizing the discussion [Ep 12 · 5:32](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=332)
- ICG applications in pediatric surgery include laparoscopic cholecystectomies, varicocele repairs, partial nephrectomies, and tumor excisions. — Ellen Encisco summarizing the discussion [Ep 12 · 5:48](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=348)
- For anorectal malformations with rectal-perineal or rectal-vestibular fistula, outcomes including complications are similar whether the procedure is done before or after 14 days of life. — The host summarizing the discussion [Ep 12 · 6:37](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=397)
- A PCPLC consortium study comparing endorectal pull-through for Hirschsprung disease at less than 31 days versus greater than 31 days found that preoperative enterocolitis, postoperative enterocolitis, constipation, and incontinence were the same between both groups. — The host summarizing the discussion [Ep 12 · 6:54](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=414)
- Delayed pull-through with irrigations is a safe alternative to an operation in the neonatal period for Hirschsprung disease. — The host summarizing the discussion [Ep 12 · 7:14](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=434)
- Cryoanalgesia is probably effective at improving post-operative pain and decreasing length of stay for pectus patients, with length of stay reduced from 4 days to 1 day. — The host summarizing the discussion [Ep 12 · 8:11](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=491)
- There are no long-term studies on the effects of cryoanalgesia for pectus repair. — The host summarizing the discussion [Ep 12 · 8:34](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=514)
- The double rim sign or halo sign on X-ray indicates a child has swallowed a button battery rather than a coin. — Ellen Encisco summarizing the discussion [Ep 12 · 9:48](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=588)
- The main goal of button battery ingestion treatment is to remove the battery within 2 hours of ingestion. — Ellen Encisco summarizing the discussion [Ep 12 · 10:13](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=613)
- Sucralfate or honey can help reduce damage from button batteries on the child's esophagus as temporizing measures. — Ellen Encisco summarizing the discussion [Ep 12 · 10:20](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=620)
- Children less than 1 year old should not receive honey due to risk of botulism and should instead receive 10 mL of sucralfate every 10 minutes for up to 3 doses for button battery ingestion. — Ellen Encisco summarizing the discussion [Ep 12 · 10:35](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=635)
- Children over age 1 with button battery ingestion should receive honey 10 mL every 10 minutes for up to 6 doses. — Ellen Encisco summarizing the discussion [Ep 12 · 10:51](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=651)
- New ATLS recommendations for pediatric trauma patients in hemorrhagic shock call for earlier transfusion: after 1 bolus of 20 cc per kilogram of crystalloid fluid, blood should be given. — The host summarizing the discussion [Ep 12 · 11:28](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=688)
- Balanced transfusion protocol for pediatric hemorrhagic shock typically includes 10 to 20 mLs per kilogram of packed red blood cells, plus inclusion of FFP and platelets. — The host summarizing the discussion [Ep 12 · 11:38](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=698)
- Earlier transfusion in pediatric trauma was associated with shorter median time to transfusion and a decrease in total fluid volume administered. — The host summarizing the discussion [Ep 12 · 11:46](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=706)
- Whole blood in trauma patients requires less volume compared to component therapy. — The host summarizing the discussion [Ep 12 · 11:59](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=719)
- Research shows that observation of spontaneous pneumothorax in adults is non-inferior to immediate intervention with tube thoracostomy. — The host summarizing the discussion [Ep 12 · 12:42](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=762)
- The Midwest Pediatric Surgery Consortium study on spontaneous pneumothorax management with simple aspiration showed 48% success rate, but 44% of patients in the simple aspiration group recurred. — The host summarizing the discussion [Ep 12 · 12:53](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=773)
- 83% of patients who failed simple aspiration for spontaneous pneumothorax ultimately ended up with VATS or blebectomy. — The host summarizing the discussion [Ep 12 · 13:16](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=796)
- Greenwood et al. showed that mortality amongst black newborns is 3 times that of white newborns. — Ellen Encisco summarizing the discussion [Ep 12 · 14:10](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=850)
- When black newborns are treated by black physicians, their mortality is reduced by 58% compared to black newborns treated by white physicians. — Ellen Encisco summarizing the discussion [Ep 12 · 14:19](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=859)
- Bias exists within medicine and can change outcomes; representation matters and can make a difference. — Ellen Encisco summarizing the discussion [Ep 12 · 14:30](https://library.globalcastmd.com/watch/update-course-rewind-2021-top-ten-key-takeaways-4578?t=870)
- Cryoanalgesia uses cold temperatures to cause a conduction block, interrupting pain impulses to the brain. — Cecilia Gigena summarizing the discussion [Ep 13 · 1:57](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=117)
- The FDA requires clinical trials with long-term results for medications before approval, but not for medical devices and techniques. — Cecilia Gigena summarizing the discussion [Ep 13 · 3:36](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=216)
- In Nebraska, where Steve Rayner practices, length of stay is under 2 days and patients are off opioids by 1 week. — Justin Wagner summarizing the discussion [Ep 13 · 6:19](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=379)
- Computational modeling showed that shorter flat bars have different stress points compared to traditionally U-shaped bars, with shorter bars having more pressure on the sternum and therefore being more stable. — Justin Wagner summarizing the discussion [Ep 13 · 7:40](https://library.globalcastmd.com/watch/update-course-rewind-pectus-excavatum-2021-5807?t=460)
- Dr. Rothenberg performed the first laparoscopic repair for TEF, the first thoracoscopic lobectomy in a child, and the first laparoscopic repair of duodenal atresia in the United States. — The host summarizes what Dr. Steven Rothenberg said [Ep 1 · 0:00](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=0)
- Martin Larker's study demonstrated that even muscle-sparing thoracotomy results in significant diminished chest wall movement and chest wall asymmetry with smaller lung volumes compared to thoracoscopy. — Steven Rothenberg summarizing a resource [Ep 1 · 23:20](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=1400)
- A mother reported that her son who underwent muscle-sparing thoracotomy for esophageal atresia developed noticeable chest asymmetry and spinal curve. — Steven Rothenberg summarizing a resource [Ep 1 · 22:30](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=1350)
- According to the newest consortium data, less than 11% of 500 TEF repairs are performed thoracoscopically and less than 50% of CPAM resections are performed thoracoscopically. — Steven Rothenberg summarizing a resource [Ep 1 · 31:40](https://library.globalcastmd.com/watch/ladd-medal-award-presentation-honoring-dr-steven-rothenberg-s-pioneering-minimal-11984?t=1900)

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Educational content from recorded physician discussions — not medical advice. Cite the canonical URL or the ?t= deep link. Policy: https://library.globalcastmd.com/ai