An interactive discussion about pediatric lung lesions between Todd Ponsky, MD and Steve Rothenberg, MD.
Dr. Rothenberg is Chief of Pediatric Surgery and the Chairman of the Department of Pediatrics at the Rocky Mountain Hospital for Children in Denver, CO. He is also faculty at Columbia University, College of Physicians and Surgeons in the Division of Pediatric Surgery as a Senior Consultant in Pediatric Minimal Access Surgery.
Table of Contents
00:00 Introduction
02:46 Prenatal evaluation
04:11 Role of fetal MRI
04:30 Fetal imaging features
05:11 Choice of delivery location
06:01 Role of fetal intervention
07:09 Administration of corticosteroids
07:49 Cyst volume ratio
08:32 Spectrum of CPAM
11:16 Routine neonatal care
13:45 Role of neonatal MRI
15:15 Institutional variations in management
17:41 Decision to operate
20:10 Too small for thoracoscopic surgery?
21:59 Preoperative preparation
23:31 Anesthetic considerations
25:15 Avoidance of over-ventilation
26:36 Avoidance of high peak ventilator pressures
28:28 Patient positioning
30:02 Port placement
32:56 Instrument selection
35:17 Technique for vessel sealing
35:51 Vascular control
37:12 Vessel sealing devices
41:28 Left lower lobe technique
42:01 LLL-Take down inferior pulmonary ligament
42:31 LLL-Exposure of inferior pulmonary vein
42:44 LLL-Major fissure
43:46 LLL-Exposure of pulmonary artery
44:53 LLL-Dissection of superior segmental branch
45:11 LLL-Dissection of trunk to basal segments
45:33 LLL-Division of trunk
47:26 LLL-Division of the bronchus
49:33 LLL-Dissection of the pulmonary vein
50:33 Key point-Do not divide the trunk near the pericardium
51:02 Right lower lobe technique
51:46 Left upper lobe technique
52:17 LUL-Retraction
52:48 LUL-Identification of the pulmonary trunk
53:23 LUL- Exposure of the superior pulmonary vein
53:59 LUL- Isolation of venous supply to the lingula
54:25 LUL-Attention to the fissure
54:33 LUL-Lingular artery
54:54 LUL-Bronchus
55:12 LUL-Overview
55:40 Right middle lobe technique
56:43 RML-Pulmonary artery
57:05 Lobectomy technical pearls
57:38 Popping of lung cysts
58:33 Extralobar sequestration technique
59:48 Never use vessel sealer and clips on the same vessel
01:01:01 Alternative to resection of extralobar pulmonary sequestration
01:02:33 Role of segmental resection
01:04:41 Lobectomy post-operative course
01:05:50 Conclusion
Intro track is adapted from "I dunno" by grapes, featuring J Lang, Morusque.
Artist URL: ccmixter.org/files/grapes/16626
License: creativecommons.org/licenses/by/3.0/
