Pediatric Surgery

Outcomes of Colonic Pull-Through for Patients With Cloacal Exstrophy: Is it Really Helping Kids?
Outcomes of Colonic Pull-Through for Patients With Cloacal Exstrophy: Is it Really Helping Kids? 1024 683 Mary Bates, PhD

Collaborative study reveals infrequent utilization of the procedure and identifies factors correlated with success. Cloacal exstrophy is a rare grouping of congenital anorectal malformations. Although once nearly uniformly fatal, survival has increased significantly, and with it, the focus on long-term outcomes. In the last 15 years, a reconstructive surgery known as colonic pull-through has been…

Turning Complications into Fuel for a New Approach to Better Outcomes
Turning Complications into Fuel for a New Approach to Better Outcomes 1024 418 Alaina Doklovic

A new web application enhances Morbidity and Mortality data storage and actively improves patient care. Morbidity and Mortality (M&M) Conferences are mandated meetings that occur regularly at all academic medical centers and are powerful opportunities for learning and reflection. These conferences have been around for decades and provide opportunities to learn from medical errors, complications…

Transforming Treatment for Paratesticular Rhabdomyosarcoma in Adolescents through Robotics
Transforming Treatment for Paratesticular Rhabdomyosarcoma in Adolescents through Robotics 1024 683 Erin Gregory

Retroperitoneal lymph node dissection (RPLND) has been a crucial component of treating testicular and paratesticular cancers for over a century. Recent advancements in minimally invasive techniques, such as robotic-assisted methods, have expanded the applicability of RPLND, offering reduced morbidity and faster recovery. However, concerns persist regarding the equivalence of oncological outcomes compared to traditional open…

Treating Pediatric Melanoma: Ultrasound Surveillance vs. Completion Lymph Node Dissection for Sentinel Node Positive Patients
Treating Pediatric Melanoma: Ultrasound Surveillance vs. Completion Lymph Node Dissection for Sentinel Node Positive Patients 1024 683 Pam Georgiana

Treatments for pediatric melanoma are usually based on adult studies, but increasing recognition of the differences between pediatric and adult melanoma could change that. Pediatric melanoma is rare in the United States. The Skin Cancer Foundation reports that about 400 children under 20 years old are diagnosed with melanoma each year in the United States.…

Probiotics Delivered in Biofilm State Protect the Intestines and Brain in NEC Model
Probiotics Delivered in Biofilm State Protect the Intestines and Brain in NEC Model 898 504 Abbie Miller

Biofilm formulation of Limosilactobacillus reuteri protects against necrotizing enterocolitis in piglet model.  Necrotizing enterocolitis (NEC) is a debilitating and deadly condition affecting infants born preterm. In NEC cases, intestinal tissues become inflamed, and in severe cases, there is ischemia and death of the involved intestines. Treatment for NEC often involves surgery to remove the dying…

Straightforward Stitch Technique Dramatically Reduces Post-Operative Anorectoplasty Complications
Straightforward Stitch Technique Dramatically Reduces Post-Operative Anorectoplasty Complications 150 150 Katie Brind'Amour, PhD, MS, CHES

The novel para-U-stitch keeps post-operative wound dehiscence to a minimum, helping patients with anorectal malformations avoid readmission, reoperation and infection. After recognizing a pattern of wound dehiscence and postoperative complications in patients with anorectal malformations (ARMs) repaired without a colostomy bag — meaning they stool directly through the surgical site as it heals — surgeons…

Breast Surgery in Adolescents: When Should You Consider It?
Breast Surgery in Adolescents: When Should You Consider It? 150 150 Ibrahim Khansa, MD

Research shows that addressing macromastia, breast asymmetry and gynecomastia in adolescence can improve physical symptoms as well as quality of life and mental wellbeing. Breast disorders such as macromastia, breast asymmetry and gynecomastia are in adolescents.2 Those conditions can negatively impair quality-of-life, and their surgical treatment has been shown to improve self-esteem, as well as…

From 1 to 1,000: How Robotic Technology Has Brought Surgeons Together at Nationwide Children’s Hospital
From 1 to 1,000: How Robotic Technology Has Brought Surgeons Together at Nationwide Children’s Hospital 1024 683 Marc Michalsky, MD, MBA, Karen Diefenbach, MD, Molly Fuchs, MD and Daniel DaJusta, MD

This month marks an important milestone for patients receiving care at Nationwide Children’s Hospital in Columbus, Ohio: the completion of our 1,000th minimally invasive case using the DaVinci Robotic System. Nationwide Children’s was one of the first large children’s hospitals in the country to acquire a robotic system (2013) and like many, the decision was…

The Impact of Genomic Medicine: Carter’s Story
The Impact of Genomic Medicine: Carter’s Story 1024 685 Natalie Wilson

In 2013, at just 1 year old, Carter Daggett was diagnosed with a rare brain tumor. Now, in 2021, at 8 years old, he celebrated three years cancer free — thanks to his clinical teams and cutting-edge research by the team at the Steve and Cindy Rasmussen Institute for Genomic Medicine at Nationwide Children’s Hospital.…

Probiotic Treatment Promotes Neurodevelopment After Experimental Necrotizing Enterocolitis
Probiotic Treatment Promotes Neurodevelopment After Experimental Necrotizing Enterocolitis 777 640 Lauren Dembeck
B&W image of Dr. Gail Besner posing for a photo in her lab coat

A single dose of a novel live probiotic therapeutic protects the rodent brain during early development and the effects persist into adolescence. Researchers at Nationwide Children’s Hospital have demonstrated that when given in a biofilm state, probiotic Lactobacillus reuteri prevents the detrimental neurodevelopmental sequalae of experimental necrotizing enterocolitis (NEC).1 The findings, published in Brain, Behavior…

Postoperative Care for Benign Ovarian Neoplasms
Postoperative Care for Benign Ovarian Neoplasms 150 150 Mary Bates, PhD

Study suggests no benefit from routine imaging and supports symptomatic imaging for postoperative management of benign ovarian neoplasms. In a new study, researchers at Nationwide Children’s Hospital led a collaboration with eight children’s hospitals examining the follow-up care and subsequent outcomes of pediatric patients after surgery for a benign ovarian neoplasm to develop evidence-based recommendations…

Robotic Surgery Is Here to Stay
Robotic Surgery Is Here to Stay 150 150 Abbie Miller

A recent publication describes increases in the use of robotic surgery in children’s hospitals across the country.  The use of robotic surgery in tertiary children’s hospitals has been on the rise since the 2000s. In a recent publication, researchers from Nationwide Children’s Hospital sought to characterize the use and growth in acceptance of robotic surgeries…

5 Things to Know About Vertebral Body Tethering for Scoliosis
5 Things to Know About Vertebral Body Tethering for Scoliosis 150 150 Allan C. Beebe, MD and Crystal D. Seilhamer, FNP

As the surgical approach to scoliosis grows in popularity, understanding the pros, cons and contraindications becomes increasingly important. At the Center for Comprehensive Spine Care in the Department of Orthopedics at Nationwide Children’s Hospital, patients and providers are increasingly asking about vertebral body tethering for scoliosis. Traditionally, scoliosis is treated with a variety of modalities…

Do Surgical Outcomes Differ Between Minimally Invasive Pyeloplasty Procedures in Treating Ureteropelvic Junction Obstruction?
Do Surgical Outcomes Differ Between Minimally Invasive Pyeloplasty Procedures in Treating Ureteropelvic Junction Obstruction? 1024 575 JoAnna Pendergrass, DVM
Dr. Jayanthi standing in OR

Minimally invasive pyeloplasty has become increasingly popular over open dismembered pyeloplasty, the traditional treatment for ureteropelvic junction obstruction. Robotic-assisted pyeloplasty (RALP) and laparoscopic pyeloplasty (LP) are minimally invasive procedures that produce smaller scars and less postoperative pain. These are advantages that appeal to parents of patients undergoing these procedures. In a recent Journal of Pediatric Urology publication, Rama…

How Do Parents and Surgeons Evaluate Treatment Options for Uncomplicated Appendicitis?
How Do Parents and Surgeons Evaluate Treatment Options for Uncomplicated Appendicitis? 1024 575 Natalie Wilson
Parent and provider at child's hospital bed

The most recent in a series of publications on management of uncomplicated appendicitis showed patients and families cited the same concerns when electing either surgery or nonoperative treatment. Antibiotics alone have been shown to successfully treat uncomplicated appendicitis in children. But patients, families and surgeons may differently evaluate risks and benefits of this treatment option.…

Midwest Pediatric Surgery Consortium Finds Antibiotics Alone Successfully Treat Uncomplicated Appendicitis in Children
Midwest Pediatric Surgery Consortium Finds Antibiotics Alone Successfully Treat Uncomplicated Appendicitis in Children 1024 822 Natalie Wilson

New research expands on a 2015 pilot study to demonstrate that nonoperative management of uncomplicated appendicitis is a safe and effective option in a variety of healthcare systems. Appendicitis is the most common cause for emergency abdominal surgery in childhood, affecting 80,000 children in the United States each year, but nonoperative treatment options are viable.…

Race Is a Risk Factor for Postoperative Death in Apparently Healthy Children in United States
Race Is a Risk Factor for Postoperative Death in Apparently Healthy Children in United States 1024 683 Abbie Miller

African American children were nearly 3.5 times more likely to die within 30 days after surgery, compared to white peers. In a new study, published in Pediatrics, researchers have shown that being African American was strongly associated with a higher risk of postoperative complications and mortality among apparently healthy children. In fact, compared to their white peers,…

Meet Oluyinka Olutoye, MD, PhD
Meet Oluyinka Olutoye, MD, PhD 1024 575 Abbie Miller

In August 2019, Nationwide Children’s welcomed Oluyinka Olutoye, MD, PhD, as surgeon-in-chief. In a Q&A, the internationally renowned fetal surgeon shares his thoughts about the past, present and future of fetal surgery and the challenges and opportunities facing pediatric surgeons today.   Q: What brought you to Nationwide Children’s Hospital? I was initially attracted to…

A New Therapeutic Era in Pediatric Functional and Motility Disorders
A New Therapeutic Era in Pediatric Functional and Motility Disorders 150 150 Katie Brind'Amour, PhD, MS, CHES

20 years ago, treatment options were limited for children with functional gastrointestinal (GI) and motility disorders. Now, a growing list of drugs, behavioral and dietary care plans, and an advanced, forward-looking technique – neuromodulation – are transforming pediatric GI care. Gastrointestinal (GI) disorders are notoriously difficult to diagnose. Virtually all functional and motility-related GI problems…

Skin-to-Skin Care Safe for Infants After Surgery
Skin-to-Skin Care Safe for Infants After Surgery 150 150 Mary Bates, PhD

A quality improvement project shows that skin-to-skin care can be safely integrated into the treatment of infants who require surgery. Multiple barriers prevent routine skin-to-skin care for infants in the neonatal intensive care unit (NICU), particularly for infants requiring surgical consultation. A recent quality improvement project, published in the Journal of Pediatric Surgery, shows that routine…

Stopping Progression of Tissue Injury after Button Battery Ingestion
Stopping Progression of Tissue Injury after Button Battery Ingestion 150 150 Abbie Miller

Irrigation with acetic acid neutralizes tissue and prevents delayed esophageal complications. Button battery injuries in children have been increasingly severe – resulting in devastating injuries and even death. Button batteries damage esophageal tissue through isothermic hydrolysis reactions, resulting in alkaline caustic injury, which leads to tissue necrosis. Prompt removal of the battery is critical to…

Free Disposal Bags Increase Rate of Proper Opioid Disposal
Free Disposal Bags Increase Rate of Proper Opioid Disposal 150 150 Kevin Mayhood

With or without the bags, families of young children prescribed opioids after surgery properly discard drugs at more than double the rate of adults prescribed post-operative opioids. Handing parents a free drug-disposal bag and discussing its usage significantly increases the rate of proper disposal of unused opioid pain medication leftover after surgery, a study at…

Development of a Patient Reported Experience and Outcomes Measure in Pediatric Patients
Development of a Patient Reported Experience and Outcomes Measure in Pediatric Patients 150 150 Lauren Dembeck

Researchers develop a questionnaire that enables them to assess the burden of treatment compared to the burden of the disease. Researchers have developed a rigorous, patient reported experience and outcomes questionnaire for pediatric patients undergoing an intensive bowel management program (BMP). The report was published online in the Journal of Pediatric Gastroenterology and Nutrition. “Often physicians…

Pushing the Boundaries of Regional Anesthesia for Complex Urological Surgery
Pushing the Boundaries of Regional Anesthesia for Complex Urological Surgery 150 150 Katie Brind'Amour, PhD, MS, CHES

Physician-researchers extend the possibilities for regional anesthesia using combined spinal/caudal catheter anesthesia, allowing even complex, time-consuming pediatric urological surgeries to be completed without general anesthesia. In an effort to extend more regional anesthetic options to children undergoing urological procedures — and to obviate concerns about airway safety and theoretical neurocognitive effects of general anesthesia (GA)…

Weight-Loss Surgery in Teens with Severe Obesity Offers Greater Benefits Than Waiting Until Adulthood
Weight-Loss Surgery in Teens with Severe Obesity Offers Greater Benefits Than Waiting Until Adulthood 1024 575 Katie Brind'Amour, PhD, MS, CHES
scale

Research reveals that gastric bypass surgery during the teen years offers a greater chance of reversal of type 2 diabetes and high blood pressure than when the surgery is delayed until adulthood.

Worth It: Why Wrestling Through the Logistical Challenges of a Multidisciplinary Colorectal Center Matters
Worth It: Why Wrestling Through the Logistical Challenges of a Multidisciplinary Colorectal Center Matters 150 150 Jeb Phillips

Consider the complex case of a girl born with rectal, vaginal and urinary tracts fused into a common channel – a cloacal malformation. The child needs reconstructive procedures across three different organ systems and three different surgical specialties. It could take months or years to manage the surgeries needed for the colorectal portion, then the…

A High Risk of Urological Diagnosis in Anorectal Malformations
A High Risk of Urological Diagnosis in Anorectal Malformations 150 150 Jeb Phillips

Treating Pilonidal Disease with Laser Hair Depilation
Treating Pilonidal Disease with Laser Hair Depilation 150 150 Mary Bates, PhD

Lymphocyte Response After a Burn Predicts Infection
Lymphocyte Response After a Burn Predicts Infection 150 150 Mary Bates, PhD

A Better Way to Administer Probiotics?
A Better Way to Administer Probiotics? 150 150 Abbie Miller

Researchers have designed a delivery system to treat premature infants with necrotizing enterocolitis that may have applications beyond the NICU. Most of the time, we think biofilms are bad news. And when pathogenic microbes form biofilms, they are. The biofilms created by pathogenic microbes create fortresses that make them resistant to attack by the immune…

Reducing Radiation Exposure and Imaging Costs for Children With Appendicitis
Reducing Radiation Exposure and Imaging Costs for Children With Appendicitis 1024 575 Rachael Hardison
Black and white photo of boy sitting up on hospital bed

Appendicitis is one of the most common indications for abdominal surgery in children. Accurate, efficient diagnosis is critical for initiating timely treatment. Current imaging options for diagnosing appendicitis include ultrasound and computed tomography (CT). CT scans, while readily available and highly sensitive, require radiation exposure that can increase the risk of malignancy over the child’s…

Growing Tissue to Help Children With Short Bowel Syndrome
Growing Tissue to Help Children With Short Bowel Syndrome 1024 575 Kevin Mayhood

Research using a small animal model shows that it matters where in the body the cultured intestine is grown. Researchers at Nationwide Children’s Hospital are hoping to use short bowel syndrome patients’ own cells to grow extra tissue needed for their small intestine to function properly. Using rat models, the team of physician-scientists found that…

Combining Quality Measures to Improve Surgical Outcomes
Combining Quality Measures to Improve Surgical Outcomes 150 150 Kevin Mayhood

Use a refined morbidity and mortality conference with a national database, a new study suggests. A pediatric surgery morbidity and mortality (M&M) conference that applies quality improvement practices borrowed from industry can be a significantly more effective tool for learning from mistakes and making corrections, researchers from Nationwide Children’s Hospital show in a new study.…

Specialists Collaborate to Improve Ovary Preservation
Specialists Collaborate to Improve Ovary Preservation 150 150 Brianne Moore

A weekend case inspires an investigation into how pediatric surgeons and gynecologists treat the same patient differently. When lesions persist on a patient’s ovary, there are two options for treatment: oophorectomy, which removes the entire ovary, and ovarian sparing surgery (OSS). Depending on referral patterns and access to specialists, either a pediatric surgeon or a…

In Sight: Three Procedures, One Surgery
In Sight: Three Procedures, One Surgery 388 320 Jeb Phillips

Colorectal Surgery, Urology and Gynecology coordinate to save tissue and time. A child with a complex colorectal and pelvic condition may require several surgeries over months or years before they are able to successfully manage their urine and stool. With advance planning and coordination it can be possible to treat many issues at once and…

One Dose Probiotic Biofilm Protects Against NEC
One Dose Probiotic Biofilm Protects Against NEC 150 150 Kevin Mayhood

Probiotic biofilm enables the beneficial bacteria to withstand stomach acid, promote microbial activity and decrease intestinal inflammation. A single dose of a probiotic biofilm grown on microspheres prevented or significantly reduced the severity of necrotizing enterocolitis (NEC) in animal models of the disease, researchers show. This delivery method not only appears to protect against NEC…

Planning, Teamwork and Technology Essential to Conjoined Twins’ Separation
Planning, Teamwork and Technology Essential to Conjoined Twins’ Separation 150 150 Abbie Miller

In a meticulously planned 16-hour operation, a 30-person team from four specialties successfully separated 11-month-old twins conjoined at the buttocks and lower spine. Specialists from General Pediatric Surgery, Plastic and Reconstructive Surgery, Neurosurgery and Colorectal Surgery worked together to plan and execute a successful separation of conjoined twin girls, Acen and Apio, earlier this month. “In surgery,…

Fighting Fibrosis
Fighting Fibrosis 1024 575 Katie Brind'Amour, PhD, MS, CHES
Colorful illustration showing how fibrosis, or a spiky lumpy mass of scar tissue, forms over healthy liver tissue when the liver attempts to repair and replace damaged cells

Fibrosis is an unmet medical challenge with no satisfactory test and insufficient therapy. Now, one naturally occurring cellular component could simultaneously diagnose and heal patients. It’s much more than a million-dollar idea. The person who invents a simple blood or urine test that can accurately measure the severity of scarring in internal organs will have…

Getting to the Point: Are Safety Needles Really Safe?
Getting to the Point: Are Safety Needles Really Safe? 150 150 Kelli Whitlock Burton

Sharp hypodermic needles are, as the name implies, sharp. Just ask the nearly 400,000 U.S. health care workers who are accidentally pricked each year. Most needle sticks aren’t serious, but the potential for exposure to bloodborne diseases has led many hospitals to discontinue the use of sharp needles in certain areas, including the operating room.…

InSight: Working Up the Nerve
InSight: Working Up the Nerve 150 150 Katie Brind'Amour, PhD, MS, CHES

Using regional anesthesia to numb nerves reduces pain and speeds recovery in pediatric orthopedic surgery. Ultrasound-guided regional anesthesia has been used in adult patients for more than a decade but is now being used more regularly in pediatric patients, especially for orthopedic procedures. Femoral nerve block, in which the femoral nerve is numbed, is among…

Antibiotics Alone are a Successful Treatment for Uncomplicated Acute Appendicitis in Children
Antibiotics Alone are a Successful Treatment for Uncomplicated Acute Appendicitis in Children 150 150 Kelli Whitlock Burton

Using antibiotics alone to treat children with uncomplicated acute appendicitis is a reasonable alternative to surgery that leads to less pain and fewer missed school days, according to a pilot study. The research, led by a team at Nationwide Children’s Hospital and published online April 12 in the Journal of the American College of Surgeons, is…