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Global Cast MD, along with Cincinnati Children's Hospital,

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sharing knowledge to improve child health around the globe.

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Hello, Pediatric Surgery family.

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I'm Emgody, a research fellow from Cincinnati Children's Hospital Medical Center.

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Our 11th annual update course in pediatric surgery was held past August.

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In this video series, we'll recap the sessions and share the main highlights with you.

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Today, our topic is perineal body sparing peace arc.

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Joining the discussions are Dr. Stephen Lee,

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Kaitlyn Smith,

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and Julia Grabowski.

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Let's see our case.

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We have a one-month-old female seen in the doctor's office with a diagnosis of erecto-vestibular fistula.

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Bacterial workup is performed and there is no other significant anomalies.

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She has been suing well with dilations and parents are in the clinic to discuss operative repair.

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And what would you do as your repair?

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So this is a very relatively new thing.

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There's a couple of papers that have come out this year.

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There's two variations of something called a perineal body sparing piece arc that have come out in the last six months, one from Boston, one from D.C.

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One of the studies has six and the other one has four patients.

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They are similar but slightly different techniques.

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The one you see here is the Boston technique.

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It shows us there's a slight posterior sagittal extension of the incision.

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These techniques that are being described are all about sparing the perineal body and preserving long-term gynecologic function for our female patients.

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The perineal body is really important for sexual function and obstetric outcomes in the future.

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Especially as we see more of these patients as they age and they are telling us how their experiences are as adults.

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This one out of D.C. is just an incision just through the sphincter alone preserving the perineal body skin in its entirety.

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Obviously, do which technique you're comfortable with but it's important to think about for our patients as they age.

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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 post-op infection that is like the bane of our existence.

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So I think this is a really nice way to avoid that.

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In summary, according to the recent studies from Boston and Washington D.C. there are new surgical techniques that aim to spare the perineal body.

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Which is crucial for long-term gynecological function, sexual health and obstetric outcomes.

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Also preserving the perineal body can reduce post-op infection risks in patients undergoing dilations as well.

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Thank you for watching this video.