# Update Course Rewind: Perineal Body Sparing PSARP 2023 — GCMD Library

<p> </p>

<p>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, we'll talk about "Perineal Body Sparing PSARP". Joining the discussion are Drs. Steven Lee, Caitlin Smith and Julia Grabowski.</p>

<p>Host: Em Gootee, MD</p>

<p>References:</p>

<p><a href="https://pubmed.ncbi.nlm.nih.gov/36356590/">https://pubmed.ncbi.nlm.nih.gov/36356590/</a></p>

<p>Badillo A, Tiusaba L, Jacobs SE, Al-Shamaileh T, Feng C, Russell TL, Bokova E, Sandler A, Levitt MA. Sparing the Perineal Body: A Modification of the Posterior Sagittal Anorectoplasty for Anorectal Malformations with Rectovestibular Fistulae. Eur J Pediatr Surg. 2023 Dec;33(6):463-468. doi: 10.1055/a-1976-3611. Epub 2022 Nov 10. PMID: 36356590.</p>

<p><a href="https://pubmed.ncbi.nlm.nih.gov/36592252/">https://pubmed.ncbi.nlm.nih.gov/36592252/</a></p>

<p>Ostertag-Hill CA, Nandivada P, Dickie BH. Saving the perineal body-A modification of the posterior sagittal anorectoplasty. Pediatr Surg Int. 2023 Jan 2;39(1):71. doi: 10.1007/s00383-022-05350-5. PMID: 36592252.<br />
 </p>


Type: video · 2 min · posted 2023-12-29
Canonical: https://library.globalcastmd.com/watch/update-course-rewind-perineal-body-sparing-psarp-2023-7857

## Chapters
- [0:00](https://library.globalcastmd.com/watch/update-course-rewind-perineal-body-sparing-psarp-2023-7857?t=0) Introduction
- [0:45](https://library.globalcastmd.com/watch/update-course-rewind-perineal-body-sparing-psarp-2023-7857?t=45) Case Presentation
- [1:03](https://library.globalcastmd.com/watch/update-course-rewind-perineal-body-sparing-psarp-2023-7857?t=63) Perineal Body-Sparing Techniques
- [2:00](https://library.globalcastmd.com/watch/update-course-rewind-perineal-body-sparing-psarp-2023-7857?t=120) Clinical Benefits and Summary
- [2:35](https://library.globalcastmd.com/watch/update-course-rewind-perineal-body-sparing-psarp-2023-7857?t=155) Closing

## Statements
- "Two variations of perineal body-sparing PSARP have been published in the last 6 months, one from Boston and one from DC." — Steven Lee (clinical) [1:08](https://library.globalcastmd.com/watch/update-course-rewind-perineal-body-sparing-psarp-2023-7857?t=68)
- "One study has 6 patients and the other has 4 patients." — Em Gootee (epidemiological) [1:17](https://library.globalcastmd.com/watch/update-course-rewind-perineal-body-sparing-psarp-2023-7857?t=77)
- "The techniques are similar but slightly different." — Em Gootee (clinical) [1:20](https://library.globalcastmd.com/watch/update-course-rewind-perineal-body-sparing-psarp-2023-7857?t=80)
- "The Boston technique includes a slight posterior sagittal extension of the incision." — Steven Lee (clinical) [1:26](https://library.globalcastmd.com/watch/update-course-rewind-perineal-body-sparing-psarp-2023-7857?t=86)
- "These techniques aim to spare the perineal body and preserve long-term gynecologic function for female patients." — Steven Lee (clinical) [1:30](https://library.globalcastmd.com/watch/update-course-rewind-perineal-body-sparing-psarp-2023-7857?t=90)
- "The perineal body is important for sexual function and obstetric outcomes in the future." (clinical) [1:38](https://library.globalcastmd.com/watch/update-course-rewind-perineal-body-sparing-psarp-2023-7857?t=98)
- "The DC technique uses an incision just through the sphincter alone, preserving the perineal body skin in its entirety." — Steven Lee (clinical) [1:49](https://library.globalcastmd.com/watch/update-course-rewind-perineal-body-sparing-psarp-2023-7857?t=109)
- "For non-diverted patients undergoing dilations, the perineal body seeing stool right away creates a setup for postoperative infection." (clinical) [2:00](https://library.globalcastmd.com/watch/update-course-rewind-perineal-body-sparing-psarp-2023-7857?t=120)
- "Perineal body-sparing techniques can reduce postoperative infection risks in patients undergoing dilations." — Em Gootee (clinical) [2:29](https://library.globalcastmd.com/watch/update-course-rewind-perineal-body-sparing-psarp-2023-7857?t=149)

## Transcript
Global Cat MD along with Cincinnati Children's Hospital, sharing knowledge to improve child health around the globe. Hello pediatric surgery family. I'm I'm Goddy, 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 peace art. Joining the discussions are Doctor Steven Lee. Caitlin 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 a recto vestibular fistula. Rectal workup is performed, and there is no other significant anomalies. She has been stooling 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 a perineal body sparing a PSARP that have come out in the last 6 months, one from Boston, one from DC. One of the studies has 6 and the other one has 4 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 obstetric outcomes in the future, especially as we see more of these patients as they age, and they are telling us how they're. 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 you do which technique you're comfortable with, but it's important to think about for our patients as they age. And 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 a post-op infection that is like the bane of our. 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 obstetric 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 Cat MD along with Cincinnati Children's Hospital, sharing knowledge to improve child health around the globe.

---
Not medical advice · citation policy: https://library.globalcastmd.com/ai