Update Course Rewind: Perineal Body Sparing PSARP 2023

Global Cast MD, along with Cincinnati Children's Hospital, sharing knowledge to improve child health around the globe. Hello pediatric surgery family. I'm M. Godi, a research fellow from Cincinnati Children's Hospital Medical Center. Our 11th annual update course in pediatric surgery was held past August. In this video series, we'll recap the sessions and share the main highlights with you. Today, our topic is perineal body sparing psarp. Joining the discussions are Dr. Steven Lee, Catly Smith, and Julia Grabowski. Let's see our case. We have a one-month-old female seen in the doctor's office with a diagnosis of recto vestibular fistula. Rectal workup is performed and there is no other significant anomalies. She has been stuling well with dilations and parents are in the clinic to discuss operative repair. And what would you do as your repair? So, this is a very relatively new thing. There's a couple of papers that have come out this year. There's two variations of something called the perineal body sparing uh psarp that have come out in the last uh six months, one from Boston, one from DC. One of the studies has six and the other one has four patients. They're similar but slightly different techniques. The one you see here is the Boston technique. It shows us there's a slight posterior sagittal extension of the incision. These techniques that are being described are all about sparing the perineal body and preserving long-term gynecologic function for our female patients. The perineal body is really important for sexual function and obstetrical outcomes in the future. Especially as we see more of these patients as they age and they are telling us how their experiences are as adults. This one out of DC is just an incision just through the sphincter alone, preserving the perineal body skin in its entirety. Obviously, do which technique you're comfortable with, but it's important to think about for our patients as they age. I think one thing that's nice is for the patient who is undergoing dilations and isn't diverted, that perineal body seeing stool right away is such a setup for post-op infection that is like the bane of our existence. So, I think this is a really nice way to avoid that. In summary, according to the recent studies from Boston and Washington DC, there are new surgical techniques that aim to spare the perineal body, which is crucial for long-term gynecological function, sexual health, and obstetrical outcomes. Also, preserving the perineal body can reduce post-op infection risks in patients undergoing dilations as well. Thank you for watching this video. Don't forget to subscribe to the Stay Current MD YouTube channel. Follow our social media channels and download the Stay Current MD app for tons of content in pediatric surgery. Global Cast MD, along with Cincinnati Children's Hospital, sharing knowledge to improve child health around the globe.