12 statements
· 1 topic
· summaries given as host listed separately
Featured statements
▶Ep 7 · 14:37
if you go in back early, you just release the stitches, and you arrive there in the same plane again and can do a re-anastomosis to the anal canal exactly in the same plane where you went in initially. And that's why I think we did not face any dehiscence here.
The beauty of laparoscopy is always that you can take, take the, the IMA for example, and preserve the colonic arcade without stretching, without overstretching the anus, and you have a beautiful, well-perfused, pull through, tension free.
quoteThe frozen can be really misleading, uh, but if you mark those biopsy sites and come back at a later time, that's actually, actually a good thing.↗
▶Ep 7 · 4:08
clinicalFrozen section pathology for Hirschsprung disease can be misleading; marking biopsy sites with prolene stitches allows for reliable permanent pathology before pull-through↗
▶Ep 7 · 4:51
clinicalLaparoscopic approach allows preservation of the colonic arcade without overstretching the anus and provides a well-perfused, tension-free pull-through↗
▶Ep 7 · 4:51
quoteThe beauty of laparoscopy is always that you can take, take the, the IMA for example, and preserve the colonic arcade without stretching, without overstretching the anus, and you have a beautiful, well-perfused, pull through, tension free.↗
▶Ep 7 · 7:23
clinicalTaking biopsies at the time of ileostomy can result in adhesions of former biopsy sites with the lateral abdominal wall, which is a disadvantage↗
▶Ep 7 · 7:53
clinicalThe anastomotic donut should be cut into 4 quadrants to ensure ganglion cells are present in all quadrants, because the transition zone is sometimes like a lip and not circumferential↗
▶Ep 7 · 9:21
quoteif you're not happy with a permanent pathology. To go back in early is, is not so bad idea because then it's very easy to redissect around the pull through and it's like the adhesions are not so firm.↗
▶Ep 7 · 14:13
clinicalAfter a couple of weeks post-operatively, there is no chance to go back in again for re-operation, and results of reoperative transanal pull-throughs are not great with high rates of anastomotic dehiscence↗
▶Ep 7 · 14:37
clinicalOne reason for high dehiscence rates in delayed reoperative surgery is that you can never re-enter the anal canal in the same plane↗
▶Ep 7 · 14:37
clinicalIf you go back early, you can release the stitches and arrive in the same plane again to do re-anastomosis to the anal canal exactly in the same plane where you went in initially, which is why this case did not face any dehiscence↗
▶Ep 7 · 14:37
quoteif you go in back early, you just release the stitches, and you arrive there in the same plane again and can do a re-anastomosis to the anal canal exactly in the same plane where you went in initially. And that's why I think we did not face any dehiscence here.↗
▶Ep 7 · 15:07
clinicalReoperative Hirschsprung transanal surgery is not as complicated if you go back in early↗
Summaries Martin gave as host
· 1 summary
Recaps of other experts' statements, not Martin's own clinical position.
Summaries Martin gave as host · Hirschsprung Disease: Diagnosis to Long-Term Management1 summary
host summaryMartin Latcher summarizing the discussion: According to Dane Teitelbaum's paper, if you are not happy with permanent pathology, going back in early is not a bad idea because adhesions are not so firm and it is easy to redissect around the pull-through↗
