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  1. Admin

    a clinical pearl Operative indications in VUR

    Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "According to recommendations from the European Association of Urology and the American Urological Association, we decided to operate on children with VUR grade...
  2. Admin

    weekly question 20/4/2025

    A 5-year-old child is undergoing umbilical hernia repair. Which of the following would you expect to be most successful in limiting perioperative opioid administration? A Transversus abdominus plane block prior to the incision B Rectus sheath block prior to the incision C Rectus sheath block...
  3. Admin

    a clinical pearl Management of blocked PD cath

    Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns - "Catheter occlusions secondary to fibrin or blood clot can be managed with tissue plasminogen activator (TPA). Two milligrams of TPA reconstituted in 40 cc of normal...
  4. Admin

    interesting case consequence of magnet ingestion

    another case of multiple Magnets ingestions (case of dr Abdullah Alsheri, associate professor and consultant pediatric surgeon king Saud university medical city, Riyadh, Saudi Arabia)
  5. Admin

    weekly question 13/4/2025

    A 3-day-old, full-term boy is POD 2 from duodenoduodenostomy for annular pancreas and duodenal atresia. He has a history of truncus arteriosus on preoperative echocardiogram. He has worsening acidemia, requires epinephrine and dopamine, and a distended abdomen. Abdominal x-rays show free air...
  6. Admin

    a clinical pearl Tip during vascular control in laparoscopy

    Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "It is important to remember that if you use clips to close vessels, it is forbidden to use monopolar scissors or sealing devices to cut between clips, because...
  7. Admin

    a clinical pearl Laparoscopic vs Retroperitonscopic nephrectomy

    Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "The main disadvantage of retroperitoneoscopy is that it is not possible to isolate the ureter arriving near the bladder as in laparoscopy. This is a problem...
  8. Admin

    weekly question 6/4/2025

    Correct answer B Excision of the entire lesion This patient presents with a first branchial cleft lesion. First branchial cleft anomalies can occur anywhere along the course of the first branchial arch tract. This area extends from a cutaneous opening in the submandibular triangle...
  9. Admin

    a clinical pearl Technical details during bariatric operations

    Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns - "The assistant should grasp and laterally retract the posterior wall of the stomach near the greater curvature to ensure no wall of the stomach is folded on itself...
  10. Admin

    a clinical pearl Sleeve vs bypass

    Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns - "The advantages of this technique are preservation of the pylorus, which prevents the dumping syndrome prevalent in bypass, reduced malabsorption (although nutritional...
  11. Admin

    weekly question 6/4/2025

    A 1-year old girl presents with intermittent drainage near the angle of the mandible. She also has a history of intermittent otorrhea. On exam, there is a small opening near the angle of her mandible and mucus expressed with manual pressure. The rest of her exam is normal. What is the best next...
  12. Admin

    weekly question 30/3/2025

    A 4-month-old infant presents to clinic with a swollen, red left fourth toe (see images below). In addition to the swelling, the toe has an area of circumferential indentation (marked by arrow). His parents state that his toe was minimally swollen at birth, but it has continued to gradually...
  13. Admin

    weekly question 23/3/2025

    Correct answer a Type I achalasia Achalasia has been classically defined by conventional manometry as the absence of esophageal peristalsis and incomplete LES relaxation with pressures greater than 10 mm Hg. Using findings from high resolution manometry and esophageal topography, the Chicago...
  14. Admin

    a clinical pearl During Ventriculoperitonal shunt placement

    Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns - "A technique to prevent distal obstructions where the distal catheter is passed through the falciform and positioned above the liver with the tip pointed at the...
  15. Admin

    weekly question 23/3/2025

    An eleven year old girl presents with difficulty swallowing. An esophagram shows a distended esophagus and “beaking” at the gastroesophageal junction. Upper endoscopy demonstrates dilated esophageal body and puckering at the LES and retained saliva in the esophagus. The treating...
  16. Admin

    a clinical pearl Reduceing rectal prolapse after laparoscopic-assisted anorectal pull-through for ARM

    Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "Numerous technical tricks have been advocated to reduce RP after laparoscopic-assisted anorectal pull-through (LAARP): colic washout of the distal loop to...
  17. Admin

    a clinical pearl Regarding management of rectal prolapse

    Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "Children presenting RP and older than 4 years usually have a predisposing condition. These older patients usually present recurrent or persistent RP and tend...
  18. Admin

    video torsion of left testicular appendix

    see video link in second post
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