So it's important to pair that piece and understand that we're still trying to learn exactly what are those measures that we want to use to be able to say that they are a good outcome versus a bad outcome.
So it's important to pair that piece and understand that we're still trying to learn exactly what are those measures that we want to use to be able to say that they are a good outcome versus a bad outcome.
So it's important to pair that piece and understand that we're still trying to learn exactly what are those measures that we want to use to be able to say that they are a good outcome versus a bad outcome.
And then it's thinking about your approach to mobilize the esophagus and the experience of working with our team in Cincinnati, we have learned how to not be afraid of the esophagus.
And then it's thinking about your approach to mobilize the esophagus and the experience of working with our team in Cincinnati, we have learned how to not be afraid of the esophagus.
And then it's thinking about your approach to mobilize the esophagus and the experience of working with our team in Cincinnati, we have learned how to not be afraid of the esophagus.
QUAD #1: Cervical Tracheopexy with Dr. Alessandro de Alarcon
▶Ep 16 · 0:49
clinicalCincinnati Children's typically uses a combined cervical and thoracic approach for esophageal atresia cases.↗
▶Ep 16 · 0:49
quoteIn Cincinnati we typically use a combined approach looking at the thoracic approach as well as with the cervical approach.↗
▶Ep 16 · 1:15
quoteYou need a neck tray, and MLB tray, and Maloney dilators versus NG tubes in the operating room and you do it.↗
▶Ep 16 · 1:15
clinicalRequired intraoperative equipment includes a neck tray, MLB tray, and Maloney dilators or NG tubes.↗
▶Ep 16 · 1:21
clinicalFlexible bronchoscopy during the operation is key, and endotracheal tube placement must allow visualization during the procedure.↗
▶Ep 16 · 1:21
quoteThe flexible bronchoscopy is really key and Placing your endotracheal tube is really important so they can look as you were doing the operation.↗
▶Ep 16 · 1:29
clinicalNasotracheal intubation is often used with the cuff positioned high, sometimes almost at the glottis.↗
▶Ep 16 · 1:33
quoteAnd sometimes that means your cuff is super high and it's almost at the glottis.↗
▶Ep 16 · 1:39
quoteIf we can, we like to use a NIM tube as part of trying to prevent potential injury to recurrent nerves or at least make you aware when you're Getting close to them.↗
▶Ep 16 · 1:39
clinicalA NIM tube is preferred when possible to prevent injury to recurrent nerves or provide awareness when approaching them.↗
▶Ep 16 · 1:55
clinicalThe surgical approach uses subplatysmal flaps and addresses anterior compression as needed.↗
▶Ep 16 · 2:09
clinicalAortopexy and innominate artery pexy can be added at the same time as the cervical procedure.↗
▶Ep 16 · 2:29
quoteAnd then it's thinking about your approach to mobilize the esophagus and the experience of working with our team in Cincinnati, we have learned how to not be afraid of the esophagus.↗
▶Ep 16 · 2:29
opinionThe Cincinnati team has learned not to be afraid of mobilizing the esophagus, which is important for the procedure.↗
▶Ep 16 · 2:54
quoteWe will sometimes place stitches in the trachea to pull it up and out of the way so you can visualize that posterior aspect of where you see the spine.↗
▶Ep 16 · 2:54
clinicalStitches are sometimes placed in the trachea to pull it up and out of the way for visualization of the posterior aspect and spine.↗
▶Ep 16 · 3:15
clinicalSuture placement is performed under spontaneous ventilation conditions.↗
▶Ep 16 · 3:15
clinicalThe team uses 3-0 prolene sutures and places all stitches before securing them down.↗
▶Ep 16 · 3:15
quoteWe like to use 30 prolenes and we like to place all the stitches before we actually secure them down, and it's important to do this under spontaneous conditions.↗
▶Ep 16 · 3:33
clinicalA patient who had prior thoracoscopic tracheopexy with dysphagia from torqued esophagus underwent the combined approach and became symptom-free.↗
▶Ep 16 · 4:00
clinicalOutcome measures include follow-up endoscopy, pulmonary function tests when patients are old enough, and imaging.↗
▶Ep 16 · 4:09
clinicalAt 36 months follow-up, imaging may still show tracheomalacia, but patients can be symptomatically better.↗
▶Ep 16 · 4:09
quoteAnd when you look 36 months later, it may still look like there's some malaysia, but symptomatically, they're better.↗
▶Ep 16 · 4:15
opinionThe team is still learning what measures should define good versus bad outcomes.↗
▶Ep 16 · 4:15
quoteSo it's important to pair that piece and understand that we're still trying to learn exactly what are those measures that we want to use to be able to say that they are a good outcome versus a bad outcome.↗
▶Ep 16 · 4:26
clinicalManaging complications including swallowing dysfunction and vocal fold paralysis is part of postoperative care.↗
QUAD #1: Cervical Tracheopexy with Dr. Alessandro de Alarcon
▶Ep 7 · 0:49
quoteIn Cincinnati we typically use a combined approach looking at the thoracic approach as well as with the cervical approach.↗
▶Ep 7 · 0:49
clinicalCincinnati Children's typically uses a combined cervical and thoracic approach for esophageal atresia cases.↗
▶Ep 7 · 1:15
clinicalRequired intraoperative equipment includes a neck tray, MLB tray, and Maloney dilators or NG tubes.↗
▶Ep 7 · 1:15
quoteYou need a neck tray, and MLB tray, and Maloney dilators versus NG tubes in the operating room and you do it.↗
▶Ep 7 · 1:21
quoteThe flexible bronchoscopy is really key and Placing your endotracheal tube is really important so they can look as you were doing the operation.↗
▶Ep 7 · 1:21
clinicalFlexible bronchoscopy during the operation is key, and endotracheal tube placement must allow visualization during the procedure.↗
▶Ep 7 · 1:29
clinicalNasotracheal intubation is often used with the cuff positioned high, sometimes almost at the glottis.↗
▶Ep 7 · 1:33
quoteAnd sometimes that means your cuff is super high and it's almost at the glottis.↗
▶Ep 7 · 1:39
clinicalA NIM tube is preferred when possible to prevent injury to recurrent nerves or provide awareness when approaching them.↗
▶Ep 7 · 1:39
quoteIf we can, we like to use a NIM tube as part of trying to prevent potential injury to recurrent nerves or at least make you aware when you're Getting close to them.↗
▶Ep 7 · 1:55
clinicalThe surgical approach uses subplatysmal flaps and addresses anterior compression as needed.↗
▶Ep 7 · 2:09
clinicalAortopexy and innominate artery pexy can be added at the same time as the cervical procedure.↗
▶Ep 7 · 2:29
quoteAnd then it's thinking about your approach to mobilize the esophagus and the experience of working with our team in Cincinnati, we have learned how to not be afraid of the esophagus.↗
▶Ep 7 · 2:29
opinionThe Cincinnati team has learned not to be afraid of mobilizing the esophagus, which is important for the procedure.↗
▶Ep 7 · 2:54
quoteWe will sometimes place stitches in the trachea to pull it up and out of the way so you can visualize that posterior aspect of where you see the spine.↗
▶Ep 7 · 2:54
clinicalStitches are sometimes placed in the trachea to pull it up and out of the way for visualization of the posterior aspect and spine.↗
▶Ep 7 · 3:15
clinicalThe team uses 3-0 prolene sutures and places all stitches before securing them down.↗
▶Ep 7 · 3:15
clinicalSuture placement is performed under spontaneous ventilation conditions.↗
▶Ep 7 · 3:15
quoteWe like to use 30 prolenes and we like to place all the stitches before we actually secure them down, and it's important to do this under spontaneous conditions.↗
▶Ep 7 · 3:33
clinicalA patient who had prior thoracoscopic tracheopexy with dysphagia from torqued esophagus underwent the combined approach and became symptom-free.↗
▶Ep 7 · 4:00
clinicalOutcome measures include follow-up endoscopy, pulmonary function tests when patients are old enough, and imaging.↗
▶Ep 7 · 4:09
clinicalAt 36 months follow-up, imaging may still show tracheomalacia, but patients can be symptomatically better.↗
▶Ep 7 · 4:09
quoteAnd when you look 36 months later, it may still look like there's some malaysia, but symptomatically, they're better.↗
▶Ep 7 · 4:15
quoteSo it's important to pair that piece and understand that we're still trying to learn exactly what are those measures that we want to use to be able to say that they are a good outcome versus a bad outcome.↗
▶Ep 7 · 4:15
opinionThe team is still learning what measures should define good versus bad outcomes.↗
▶Ep 7 · 4:26
clinicalManaging complications including swallowing dysfunction and vocal fold paralysis is part of postoperative care.↗
QUAD #1: Cervical Tracheopexy with Dr. Alessandro de Alarcon
▶Ep 3 · 0:49
clinicalCincinnati Children's typically uses a combined cervical and thoracic approach for esophageal atresia cases.↗
▶Ep 3 · 0:49
quoteIn Cincinnati we typically use a combined approach looking at the thoracic approach as well as with the cervical approach.↗
▶Ep 3 · 1:15
clinicalRequired intraoperative equipment includes a neck tray, MLB tray, and Maloney dilators or NG tubes.↗
▶Ep 3 · 1:15
quoteYou need a neck tray, and MLB tray, and Maloney dilators versus NG tubes in the operating room and you do it.↗
▶Ep 3 · 1:21
clinicalFlexible bronchoscopy during the operation is key, and endotracheal tube placement must allow visualization during the procedure.↗
▶Ep 3 · 1:21
quoteThe flexible bronchoscopy is really key and Placing your endotracheal tube is really important so they can look as you were doing the operation.↗
▶Ep 3 · 1:29
clinicalNasotracheal intubation is often used with the cuff positioned high, sometimes almost at the glottis.↗
▶Ep 3 · 1:33
quoteAnd sometimes that means your cuff is super high and it's almost at the glottis.↗
▶Ep 3 · 1:39
clinicalA NIM tube is preferred when possible to prevent injury to recurrent nerves or provide awareness when approaching them.↗
▶Ep 3 · 1:39
quoteIf we can, we like to use a NIM tube as part of trying to prevent potential injury to recurrent nerves or at least make you aware when you're Getting close to them.↗
▶Ep 3 · 1:55
clinicalThe surgical approach uses subplatysmal flaps and addresses anterior compression as needed.↗
▶Ep 3 · 2:09
clinicalAortopexy and innominate artery pexy can be added at the same time as the cervical procedure.↗
▶Ep 3 · 2:29
opinionThe Cincinnati team has learned not to be afraid of mobilizing the esophagus, which is important for the procedure.↗
▶Ep 3 · 2:29
quoteAnd then it's thinking about your approach to mobilize the esophagus and the experience of working with our team in Cincinnati, we have learned how to not be afraid of the esophagus.↗
▶Ep 3 · 2:54
quoteWe will sometimes place stitches in the trachea to pull it up and out of the way so you can visualize that posterior aspect of where you see the spine.↗
▶Ep 3 · 2:54
clinicalStitches are sometimes placed in the trachea to pull it up and out of the way for visualization of the posterior aspect and spine.↗
▶Ep 3 · 3:15
clinicalThe team uses 3-0 prolene sutures and places all stitches before securing them down.↗
▶Ep 3 · 3:15
quoteWe like to use 30 prolenes and we like to place all the stitches before we actually secure them down, and it's important to do this under spontaneous conditions.↗
▶Ep 3 · 3:15
clinicalSuture placement is performed under spontaneous ventilation conditions.↗
▶Ep 3 · 3:33
clinicalA patient who had prior thoracoscopic tracheopexy with dysphagia from torqued esophagus underwent the combined approach and became symptom-free.↗
▶Ep 3 · 4:00
clinicalOutcome measures include follow-up endoscopy, pulmonary function tests when patients are old enough, and imaging.↗
▶Ep 3 · 4:09
clinicalAt 36 months follow-up, imaging may still show tracheomalacia, but patients can be symptomatically better.↗
▶Ep 3 · 4:09
quoteAnd when you look 36 months later, it may still look like there's some malaysia, but symptomatically, they're better.↗
▶Ep 3 · 4:15
quoteSo it's important to pair that piece and understand that we're still trying to learn exactly what are those measures that we want to use to be able to say that they are a good outcome versus a bad outcome.↗
▶Ep 3 · 4:15
opinionThe team is still learning what measures should define good versus bad outcomes.↗
▶Ep 3 · 4:26
clinicalManaging complications including swallowing dysfunction and vocal fold paralysis is part of postoperative care.↗