BOB in Ped Surg 2023 - PAPSA Winner - Mohamad Mahmoud Qinawy, MD

OK, so that was really interesting. It's time to move on to our next heat, and for this heat, we have PAPSA. PAPSA is the Pan-African Pediatric Surgical Association, is another new society that's joining us, and we have these 3 presentations that were the best presented last year in the annual, um, meeting. So, first, we have Doctor. Doctor Basma Magdi, a doctor from Cairo University Pediatric Hospital, and she brought thoracoscopic posterior trachypexy in esophageal attricia patients single institute experience. This is a prospective study from 2019 to 2022. And their aim was to evaluate the benefits of the trachyopexy in patients with esophageal atricia and tracheomalacia. OK, so posterior tracheopexy, yeah, OK, perfect. So second, we have Doctor Mohammad Mahmoud Kinawi. He's also from Cairo University Specialist Children's Hospital, and he's presenting comparative study of. Laparoscopic needing fun duplications versus heal no procedure for treatment of gastroesophageal reflux disease in children. So this is a prospective single-blinded randomized study from October 2018 to April 2020, and their aim was to compare the outcomes between these two procedures for treating GEERD. So here we go. That's perfect. And third, we have Doctor Ismael Eladi. He's an assistant lecturer pediatric surgery in the faculty of medicine in Tane University, and he's presenting thoracoscopic T2, T3 versus T4 sympathectomy for primary palmar hyperoidrosis in children's and adolescents. And this is a perspective randomized study done in Egypt between January 2019 and January 2020 and compares these two types of sympathectomy for treating hyperandrosis. So here you have it. These are the three best presentations from PAPSA, and it's time for you to decide which one you want to hear in full. And remember, we will. Make all these videos available on the Stay Current app and also through social media throughout the year. But today, we have to pick one. So, uh, let's vote and uh we'll see you in a minute. A lot can happen in just one day. A mother can check into the hospital and her family can be assured they won't miss a single update. A nurse can harness the power of a visual dashboard to set up an entire operating room with the touch of a button. A surgeon can see with greater clarity than ever before with everything at the touch of a finger. And a resident can gain the knowledge she needs even when she is not scrubbed in. With full 4K, a surgeon can operate around vessels in near 3D with precision. And an instant visual connection to pathology can help determine the path forward. A family can be messaged signaling a close. And can exhale with a smile as they prepare to see the surgeon. And OR transforms to visually drive efficiency and turnover. And self alerts if there's a problem. A surgeon can visually share the successes of the day, bringing peace and comfort to a family. Not just a patient. Not just a family. Not just a nurse Not just a surgeon. Not just the biomed. Not just an OR. OK, so we're back and this was very tight. We had, so yeah, it was changing all the time. It was super excited, but we have one presentation that we are going to show, and this is Doctor Mohammad Mahmoud Kinawi with the comparative study of laparoscopic mis and fanlications versus heals no procedure for treatment of gastroesophageal reflux disease in children. So here we go. And yeah Professors and colleagues, I'm Mohammed Neu, lecturer of pediatric surgery, Cairo University, Egypt. It's my honor to participate in this great international best of the best event. Today I present a comparative study between laparoscopicness and foundation versus Heli no procedure for treatment of gastroesocular reflux disease in children. All of us know that this fundation is the most commonly adopted procedure all over the world. However, the post-operative phia and the bloating frequently encountered creates the necessity for a more facilitative design. The current GERD represents a significant clinical problem. It has been reported, reported to occur in up to 15% of children requiring re-operation. Our study is a prospective single blinded randomized comparative study that was conducted in the time period from October 2018 to February 2020. The study included 40 patients, which were divided into two groups. They listen and then is. Regarding the operative setup, it will, it is, it is similar between the two operations like the, the conventional anti-reflux nascent thunder medication as we can see. The steps of the new procedure. will be shown in this video. The early steps of dissection. It The similar between between two operations between the two operations. Till we do Approximation of the. Cruel. With non-absorbed structures, the, the first step of health new is excision of the this abdominal esophagus. To the pleurtic decision. It's not absorbable suture. 2022. 1 or 2 sutures. To maintain The Emperor Abdulmini Esophagus inside the abdomen. After the change of the intraabdominal. And We Situation of the anglo fist. We established the anglo fist by suturing the fundus of the stomach. To the third lens of the esophagus. With running to 0 suture. Not Use a tapbo or silk suture. It's gonna Till we reach the best frame. Uh, give me which is the pain? The next to last suture incorporates the stomach. The the ligament, the cooler. And approximate part of the abdominal esophagus. Then he takes the fundus of the stomach to the frame with 1 or 2 sutures. And It takes the. To the hiatus To thin the esophagus, fix it inside the abdomen. Take care here not to injure the hero. And finally, we do air insufflation to test for cardia confidence. The study included patients suffering from GERD, with failure of medical treatment. Patients with symptomatic hiatus hernia, patients presenting with ostriction. Patients presenting with life-threatening symptoms like happening. We execluded recurrent cases, joint hiatus hernia and hernia. Regarding the interrupted interoperative data, the operative time was significantly longer in the Helles new group when compared to the missing group. According to the early post-traumatic assessment, bloating was found to be lower in the hell no. 3 cases versus 15 cases in the nation. The Asia was found to be lower in the new group, 2 cases versus 7 cases from the group. Also, early vomiting was encountered. More in the Helln Group, 6 cases versus 2 cases in the race. The instance of decision. was found to be insignificant in both groups regarding late postop assessment. But it was a short duration in the ethnic group. No bloating was found in any snow brook. While 11 cases from Tennessee suffered from bloating. Recurrent vomiting and need for drugs. It was found in 8 cases and there is no versus 6 cases in missing. There were 3 recurrent hell no cases versus 2 recent cases. The recurrent cases of Hell no. We found in the 1st 10 cases, which was attributed to the learning curve, which increased gradually. To conclude, there is no procedure offers an effective alternative to nasal ligation with no bloating and much less prophia, and so early return to the normal eating pattern. Further studies with larger sample size, longer follow-up was needed for a more validated results. Thank you for your attention. Great. So we are back and we have Doctor Mohammad Kinawi. Hello. Welcome to the Best of the best live event. How are you? Thank you for your presentation. Hello. Hi, thanks for congratulations. Uh, thank you so much. So let me open it up to Tony, Brittany, Ellen, or Cecilia. Anyone have any questions? Um, go ahead, go ahead a comment. Thank you for that presentation. I'm not familiar with the Hill Snow procedure. Um, but having said that, uh, I think when you look at a reflux disease, you really need to differentiate neurologically normal versus neurologically abnormal. Because their responses to surgery are very different. And I think you only had a very small group that were neurologically abnormal. Is that correct? I think if going forward, uh, you should probably evaluate it under that context as well. Any thoughts on that? Of course, uh, the study, uh. Members, our, our view on this study. We need a more uh uh population for uh a more valid validated results regarding the neurological impaired patients. So OK, um, I just have a Basically, I'm not familiar with the hill snow either, but it looks like it's a posterior PExi. So you do your, your Nissan but you Pxi posteriorly. Um, interestingly, uh, I don't know if it was the Midwest Pediatric Surgery Consortium or if it was just the Kansas City Group, but I know that there was a recent study. In fact, Tony, I learned this at your annual fellows course where I was, uh, schooled up by uh Michael Petrojan and Tim Kaine because I still do anterior PEI, where I stitch the, uh, esophagus to the curra anteriorly, and the data clearly shows, at least I learned at your course, that that is ineffective and actually worse outcomes by doing an anterior PEI. So, Mohammad, your data It flies in the face of a different study, uh, out of Kansas City showing that anterior Py does not work. Uh, you think there's a difference? Uh, uh, our, uh, study, uh, revealed that there is no difference, uh, or, uh, no importance of fixation of the esophagus to the pleura. Uh, like the most recent literature regarding this topic. So, uh, usually, and after this, after this study, we don't use or, or, uh, we don't take structures between the esophagus and the crust. OK. OK. Uh, Cecilia, you were gonna ask something. Oh, no, it's, it's OK. I think that that was super interesting that, um. It says you talk about dysphagia and bloating. Oh, OK. All right, we'll have to end it here. Mohammed, thank you so much. Congratulations, and hopefully we'll see you in the final round. Have a good day. Thank you.