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Top Themes From The Stay Current App

Video Published 2020-09-14 Updated 2026-08-01

Timestops (10)

Introduction to the Stay Current App and user base.

Purpose of the video: highlighting top shared content.

Anorectal Malformation (Number 9)

Anorectal Malformation (Number 9): Key articles and techniques.

Congenital Diaphragmatic Hernia (Number 8)

Congenital Diaphragmatic Hernia (Number 8): International approach to laparoscopic treatment.

Esophageal Atresia (Number 7)

Esophageal Atresia (Number 7): Management, diagnosis, and follow up for long gap.

GERD (Number 6)

GERD (Number 6): Discussing management and surgical techniques like Nissan fundoplication.

Pyloric Stenosis (Number 5)

Pyloric Stenosis (Number 5): Importance of guidelines and pre/post operative treatment.

Perioperative Management (Number 4)

Perioperative Management (Number 4): Postoperative apnea monitoring, NPO guidelines, and antibiotic prophylaxis.

Hirschsprung's Disease (Number 3)

Hirschsprung's Disease (Number 3): Transition zone extent, lap assisted pull through, and enterocolitis management.

Intussusception (Number 2)

Intussusception (Number 2): Guidelines for OR, timing of repeats, and safe discharge criteria.

Topic Overview

A presentation reviewing the most-shared content from the Stay Current Pediatric Surgery app over the past year, as viewed by approximately 6,000 pediatric surgeons. The discussion covers the top nine clinical topics based on user engagement, including blunt trauma, intussusception, Hirschsprung's disease, perioperative management, pyloric stenosis, GERD, esophageal atresia, congenital diaphragmatic hernia, and anorectal malformations. Each topic is accompanied by specific guidelines, technique videos, or articles that were widely shared by the app's user base.

Key Takeaways

Ad lib feeds match or beat protocolized feeds for pyloric stenosis per multiple RCTs (6:00)
Intussusception: discharge after 4h observation post-reduction; OR if peritoneal signs or 3 failed attempts (10:00)
Hirschsprung pull-through: resect >5cm proximal to normal biopsy to avoid transition zone (8:00)
Blunt solid organ injury: prioritize non-op management in stable patients; consider angioembolization before OR (12:00)
Perioperative: clears to 2h, breast milk to 4h preop; abx within 60min of incision, redose intraop (7:00)

Inside this episode

Kai, the Library's AI content creator, listened to this episode and mapped who's speaking, the chapters, key claims, and cases. Every item links to the exact moment in the recording.

AI-enriched

Who's speaking

Speaker 1 — host
Speaker 2 — host
Speaker 3 — guest
Speaker 4 — guest

Chapters

0:00Introduction to Stay Current App Review — Introduction explaining that last year's fellows created a video reviewing the most popular content shared on the Stay Current app, which is viewed by 6,000 pediatric surgeons and sponsored by Cincinnati and Kansas City.
1:08Number 9: Anorectal Malformation — Review of shared content on anorectal malformations, including a lap-assisted pull-through technique video and an article on digital anal dilation for preventing strictures.
2:30Number 8: Congenital Diaphragmatic Hernia — Discussion of international content on laparoscopic CDH treatment, including techniques for bowel decompression, pneumothorax creation, and use of laparoscopic detectable magnets.
4:00Number 7: Esophageal Atresia — Review of content on long gap esophageal atresia management and thoracoscopic repair techniques.
5:00Number 6: GERD — Discussion of GERD management debate and Nissen fundoplication technique recommendations.
6:00Number 5: Pyloric Stenosis — Review of guidelines for pre- and postoperative management of pyloric stenosis, including resuscitation protocols and ad lib feeding approaches.
7:00Number 4: Perioperative Management — Guidelines on postoperative apnea monitoring, NPO/fasting guidelines, and antibiotic prophylaxis dosing.
8:00Number 3: Hirschsprung's Disease — Most-searched topic on the app, covering transition zone extent, lap-assisted pull-through technique, and Hirschsprung's-associated enterocolitis management.
10:00Number 2: Intussusception — Guidelines for operative indications, reduction attempts, and safe discharge criteria after successful reduction.
12:00Number 1: Blunt Trauma — Most-shared topic covering non-operative management of blunt solid organ injuries and indications for angioembolization.

Key claims

0:00The Stay Current app is viewed by 6,000 pediatric surgeons — Speaker 1
0:00Stay Current is sponsored by Cincinnati and Kansas City — Speaker 1
0:43Stay Current Pediatric Surgery was released in February of 2019 — Speaker 2
1:08Users have shared over 450 pieces of content approximately 1400 times — Speaker 3
1:27Digital anal dilation is safe if the digits are appropriately sized and if the families follow a strict protocol of dilations — Speaker 4
2:30Techniques for laparoscopic CDH treatment include utilizing a needle to decompress bowel laparoscopically — Speaker 4
2:30Creating a pneumothorax allows easier retraction of the hernia sac in laparoscopic CDH repair — Speaker 4
2:30A laparoscopic detectable magnet can be utilized for greater maneuverability of the hernia sac — Speaker 4
4:00The evidence supporting best practices for long gap esophageal atresia is currently low quality — Speaker 4
4:00Patients with long gap esophageal atresia should receive appropriate long-term follow-up — Speaker 4
5:00Workup, diagnosis, and treatment of GERD patients is complex — Speaker 4
5:00The latest recommendation for Nissen fundoplication involves minimal dissection at the GE junction — Speaker 4
5:00The Nissen wrap should be performed above the left gastric artery — Speaker 4
6:00Multiple randomized control trials have shown that ad lib feeds are superior or equivalent to protocolized feeds for pyloric stenosis — Speaker 4
7:00All infants less than 50 weeks post-conceptual age at the time of surgery need some level of observation for apnea monitoring — Speaker 4
7:00NPO guidelines include clears up to two hours preop and breast milk up to four hours preop — Speaker 4
7:00Clinicians tend to be too restrictive with NPO guidelines — Speaker 4
7:00Pre-op antibiotic prophylaxis must be administered within 60 minutes before incision — Speaker 4
7:00Redosing of antibiotics is needed for the duration of the operation — Speaker 4
7:00Generally, antibiotics are not needed after surgery unless the case determines otherwise — Speaker 4
8:00Hirschsprung's disease is the number one search topic on the app overall — Speaker 4
8:00The transition zone can vary widely depending on the extent of disease with numbers as high as 22 centimeters for total colonic Hirschsprung's disease — Speaker 4
8:00Coyle et al recommend resecting greater than 5 cm proximally to the normal biopsy to avoid transition zone pull through — Speaker 4
8:00Management of suspected Hirschsprung's associated enterocolitis includes prompt evaluation of the patient, rectal irrigations with normal saline, NPO, IV fluids, antibiotics and continuous monitoring — Speaker 4
10:00Patients with intussusception should go to the operating room if they have peritoneal signs or if they fail reduction after three attempts — Speaker 4
10:00Patients can be safely discharged home after four hours of observation after a successful intussusception reduction — Speaker 4
10:00Patients with intussusception can have the air enema repeated every hour up to three times as long as there are no signs of peritonitis before operative exploration — Speaker 4
10:00Patients who are asymptomatic for four hours after a successful intussusception reduction can be discharged from the emergency department — Speaker 4
12:00Non-operative management should be primarily considered in hemodynamically stable patients with blunt solid organ injuries — Speaker 4
12:00Angioembolization should be considered for ongoing or delayed bleeding, high grade injuries and early hemodynamic compromise before proceeding to the operating room — Speaker 4

This episode was analyzed and enriched by Kai, the Library's AI content creator. Every item links to the moment it comes from — click a timestamp to listen in context.

Keywords

anorectal malformation anal strictures congenital diaphragmatic hernia esophageal atresia long gap esophageal atresia tracheoesophageal fistula gastroesophageal reflux disease GERD pyloric stenosis Hirschsprung's disease total colonic Hirschsprung's disease Hirschsprung's associated enterocolitis intussusception blunt solid organ injuries peritonitis

Hashtags

#StayCurrentApp #PediatricSurgery #AnorectalMalformation #CongenitalDiaphragmaticHernia #EsophagealAtresia #GERD #PyloricStenosis #StayCurrent #SurgicalEducation #MedEd

Transcript

Yeah, so here's the deal. Uh, last year's fellows, you guys probably all heard their names, um Alex Kassar, Ray Hnky and Alexander Gibbons. Uh, they're back in residency, uh, and uh weren't able to come for this course physically, so they made a video. Now, this is a cool video they made. For those of you who've downloaded the app, the Stay Current app, who also helps to support this event, Stay Current, um, is sponsored by um Cincinnati and Kansas City. So thank you both for for making that happen. This app, um, um is viewed by uh 6,000 people, 6,000 pediatric surgeons, and we went through and looked at the most popular content shared. So what is it that people care about? So they go through and they review in the last year, what were the most pop and it's a random array of things, you'll see. It's pretty interesting. So let's roll the tape. As many of you know, the Stay Current team in partnership with Cincinnati Children's, Children's Mercy, Kansas City, and the Journal of Pediatric Surgery released Stay Current Pediatric Surgery in February of 2019. Since that time, our users have shared over 450 pieces of content, approximately 1400 times. Today, we're going to highlight the top items our users felt were worth sharing. Feel free to scan the QR codes to find each item in the Stay Current app. Starting us off at number nine is anorectal malformation. First in this category was the lap assisted pull through technique video for imperferate anus by Dr. Stephen Rothenberg. Next was the article effectiveness of digital anal dilation in preventing anal strictures after anorectal malformation repair published in JPS. Authors found that digital anal dilation is safe if the digits are appropriately sized and if the families follow a strict protocol of dilations. At number eight, the topic is congenital diaphragmatic hernia. One of the highlights of the app is its international user base. And this doesn't refer only to the people who are sharing the content, but those who created it as well. This video was created by Dr. Marcelo Martinez Ferro and Dr. Carolina Millan, both from Argentina and highlights techniques that they find helpful for the laparoscopic treatment of congenital diaphragmatic hernia. Some of the highlights from the video include utilizing a needle to decompress bowel that's in the way laparoscopically. Creating a pneumothorax in order to allow easier retraction of the hernia sac. And utilizing a laparoscopic detectable magnet in order to have greater maneuverability of the hernia sac. At number seven, the topic was esophageal atresia. Here, we highlighted an A review on the management of long gap esophageal atresia, focus on the diagnosis, management and follow up of these patients. We also highlighted a technical video from Dr. Sri Ramiel where he highlights thoscopic repair of esophageal atresia with distal tracheoesophageal fistula. In summary, the evidence supporting best practices for long gap esophageal atresia is currently low quality. Further research is needed. However, we should ensure patients receive appropriate long-term follow-up. Watch Dr. Emil's video for technical pearls for thoscopic repair. Coming in at number six was gastroesophageal reflux disease or GERD. Dr. Witt Holkham and Dr. Rachel Rosen, a pediatric gastroenterologist at Boston Children's, joined our fearless leader, Dr. Todd Ponsky to debate the appropriate management of patients with suspected GERD. The big takeaway here is that workup, diagnosis, and treatment of these patients is complex. And for those surgeons out there striving to perform the perfect Nissan, the latest and greatest recommendation involves minimal dissection at the GE junction, but also be sure you're still performing your wrap above the left gastric artery. Check out the audio chapter for some great discussion. At number five, the topic is pyloric stenosis. Guidelines are one of the most commonly shared pieces of content on our app and that makes sense because guidelines allow us to have a protocolized treatment for problems that we see frequently in pediatric surgery. This first guideline, referring to pyloric stenosis, was put together by Dr. Amir Kogel from Cincinnati Children's Hospital and it refers to both pre and postoperative treatment of patients with pyloric stenosis. In terms of the preoperative component, this is based off of an article by Dalton at all that highlighted how to properly resuscitate patients based only off of their lab values coming in in order to minimize future lab draws. In terms of the postoperative treatment, the highlight for this protocol is in terms of the feeding and is based off of multiple randomized control trials that have shown that adlib feeds are superior or equivalent to uh protocolized feeds. At number four, the topic was perioperative management. Here, we highlighted guidelines on postoperative apnea monitoring for infants, an infographic on fasting and NPO guidelines before surgery, and the guideline on preoperative and perioperative antibiotic prophylaxis dosing. In summary, all infants less than 50 weeks post-conceptual age at the time of surgery need some level of observation for apnea monitoring. NPO guidelines include clears up to two hours preop and breast milk up to four hours preop, and we tend to be too restrictive with these. And pre-op antibiotic prophylaxis must be administered within 60 minutes before incision and redoses needed for the duration of the operation. Generally, antibiotics are not needed after surgery unless the case determines otherwise. Coming in at number three and also the number one search topic on the app overall is Hirschsprung's disease. The article, the extent of the transition zone in Hirschsprung's disease caught many people's eye. So much so that Dr. Bazan Garwu of our idea team created a metabite. Next is another technique video from Dr. Stephen Rothenberg, but this time he's demonstrating the lap assisted pull through for Hirschsprung's disease. Finally, we have the evidence-based Cincinnati Children's video guideline for suspected Hirschsprung's associated enterocolitis. Your highlights here are that the transition zone can vary widely depending on the extent of disease with numbers as high as 22 centimeters for total colonic Hirschsprung's disease. Coyle at all recommend resecting greater than 5 cm proximately to the normal biopsy to avoid transition zone pull through. If you're wondering what that pull through might look like with a lap assisted approach, check out Dr. Rothenberg's video. And finally, remember in suspected Hirschsprung's associated enterocolitis, management includes prompt evaluation of the patient, rectal irrigations with lifesaving salt water, NPO, IV fluids, antibiotics and continuous monitoring. At number two, the topic is intussusception. We had two pieces of content that were widely shared for this. The first one was a guideline, again by Dr. Amir Kogel from Cincinnati Children's Hospital. And this guideline highlighted when patients should go to the operating room, specifically if they haveal signs or if they fail reduction after three attempts. And when patients can be safely discharged after reduction. One of the articles in which that protocol was based was the other piece of content that was widely shared and this was a video review highlighting article that showed that patients can be safely discharged home after four hours of observation after a successful reduction. Therefore, the highlights for interception would be that patients can have the air enema repeated every hour up to three times as long as there are no signs of peritonitis before operative aspiration and that patients who are asymptomatic for four hours after a successful reduction can be discharged from the emergency department. And lastly, the number one topic for content shared was blunt trauma. Here, we highlighted an infographic based on our ABS systematic review for blunt solid organ injuries in children. We also highlighted a podcast by PTS or the Pediatric Trauma Society that expands this guidelines to include renal and pancreas injuries. In summary, we should primarily consider non-operative management in hemodynamically stable patients. We should also consider angioembolization for ongoing or delayed bleeding, high grade injuries and early hemodynamic compromise before proceeding to the operating room. And that's the top shared content from State Current Pediatric Surgery for the year. Be sure to check out the app for this great content and more.

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