Colorectal and Urogenital Care Medical Education Videos

Obstructive problems after Hirschsprung pull-through

Babies born with Hirschsprung disease lack ganglion cells in certain parts of the large intestine, causing an inability to properly regulate bowel movements. Babies are treated with a pull-through surgery to remove the diseased section of the large intestine and pull the healthy section down to the rectum, but 30% of patients will still have flare-ups of colitis — even if performed correctly.

In this video, Luis De la Torre, MD, discusses the problematic obstructive symptoms experienced after a technically well-performed pull-through for Hirschsprung disease. Dr. De la Torre also explains the importance of preserving the anal canal, workup for recurrent enterocolitis, when redo pull-throughs are recommended and treatment for constipation after a pull-through procedure.

The Soave Procedure (Transanal approach) for Rectosigmoid Hirschsprung Disease

This video demonstrates the repair of rectosigmoid Hirschsprung disease via the Soave procedure, using the transanal approach.

The Swenson Procedure (Transanal approach) for Rectosigmoid Hirschsprung Disease

This video demonstrates the repair of rectosigmoid Hirschsprung disease via the Swenson procedure, using the transanal approach.

Transanal Repair of Idiopathic Rectal Prolapse

This video demonstrates the repair of idiopathic rectal prolapse via the transanal approach.

The De la Torre Procedure (Transanal Approach) for Megarectosigmoid associated with Idiopathic Constipation

This video demonstrates the De la Torre procedure: the transanal resection of megarectosigmoid in patients with idiopathic constipation.

In this video, internationally renowned pediatric colorectal surgeon Dr. Peña explains why the first 24 hours of life for a newborn with an anorectal malformation are critical.

Diagnostic information and associated medical management decisions made during this period can have significant health consequences and may greatly impact the baby's prognosis. Learn what the associated defects of anorectal malformations are and how they can be identified in the first day of life.

To support the medical education of colorectal and urogenital providers, Dr. Peña describes the now universally accepted surgical method for treating anorectal malformations that he developed. The posterior sagittal anorectoplasty (PSARP), also known as the Peña pull-through procedure, transformed the surgical treatment of anorectal malformations.

Learn about the meticulous surgical steps Dr. Peña takes while performing the PSARP to preserve bowel function and avoid damage to pelvic structures.

Prior to 1980, surgeons were performing colorectal malformation surgeries "blindly," according to Dr. Peña. The limited surgical approach used at the time led to poor bowel and urinary functional outcomes and other serious complications.

In this video, Dr. Peña shares how he developed the now widely accepted PSARP surgery. Also known as the "Peña Pull-Through Procedure," Dr. Peña's technique allows for direct visualization of the malformation and greatly improved the functional prognosis for children born with colorectal malformations.

Fecal incontinence is a devastating health problem that greatly impacts a patient's quality of life. Leading pediatric colorectal surgeon Dr. Bischoff describes the "A-B-C-D-Es" of effective fecal incontinence management used within the Bowel Management Program at the International Center for Colorectal and Urogenital Care at Children's Colorado.

Learn about the trial-and-error methods Dr. Bischoff uses over a one-week period to tailor bowel management programs to each child that have resulted in a 95% success rate.

Cloacal exstrophy represents a spectrum of rare anomalies that prevent normal development of a baby's lower abdominal wall. At Children's Colorado, we believe that executing a unified management plan from the first day of life is necessary to achieve the best possible outcomes.

In this video, Dr. Bischoff, along with pediatric urologist Duncan Wilcox, MD, and pediatric gynecologist Veronica Alaniz, MD, discuss their multidisciplinary approach to treating cloacal exstrophy.

Learn about the team-based approach they take in the operating room after the baby is born and how important their initial surgical approach is to future reconstructions that babies will need as they grow.

Cloaca is a condition in which the urethra, vagina and rectum are fused together as a common channel that opens as a single perineal orifice. Cloaca has a spectrum of anomalies, which are related to the length of the common channel.

In this medical education video, Dr. Bischoff describes the anatomic variations of cloaca and the different surgical strategies that are required for successful reconstruction of each type.

When misdiagnosed, Hirschsprung disease can lead to serious medical conditions. Luis De La Torre, MD, explains how to provide a comprehensive and accurate diagnosis of Hirschsprung disease in newborns and babies. As the Assistant Director of the International Center for Colorectal and Urogenital Care at Children’s Hospital Colorado, Dr. De La Torre emphasizes how important it is to avoid misdiagnosis. It is not uncommon to misdiagnose Hirschsprung disease as idiopathic constipation; this error can translate to significant complications and sequelae.

Many advances have been made in treating Hirschsprung disease since Dr. Orvar Swenson performed the first pull-through procedure in 1948. The International Center for Colorectal and Urogenital Care continues to work hard to advance the treatment for children with Hirschsprung disease.

In this video, Dr. Peña discusses how even after surgery to treat Hirschsprung disease, 30% of patients still experience enterocolitis. This inflammation of the digestive tract, enteritis of the small intestine and colitis of the colon can still be fatal to children recovering from Hirschsprung disease treatment. Watch to learn what treatments must be done to prevent enterocolitis.

After the surgical treatment for Hirschsprung disease, long-term follow-up care is often necessary. In this video, Andrea Bischoff, MD, Assistant Director of the International Center for Colorectal and Urogenital Care, explains the team’s approach to bowel management in patients that have been treated for Hirschsprung disease. Watch to learn how the center tests for the potential of natural bowel movements and ensures proper bowel management for those suffering from fecal incontinence.

At the International Center for Colorectal and Urogenital Care, we believe that the correct bowel management regiment can greatly improve the quality of life for those who have gone through treatment for Hirschsprung disease. Learn about the bowel management training the center offers.

Children with spina bifida can experience abnormal bladder and bowel function resulting from neurogenic bladder and bowels. In this video, Andrea Bischoff, MD, Assistant Director of the International Center for Colorectal and Urogenital Care, discusses the options for bowel management in patients with spina bifida.

At the International Center for Colorectal and Urogenital Care, we believe that the correct bowel management regiment can greatly improve the quality of life for those living with spina bifida. Learn about the bowel management training the center offers.

Anorectal malformations affect the lives of children and their families in many ways. However, the mental health of a child with an anorectal malformation is not always the first thing we think about when considering treatment. As more and more hospitals accept that idea that being healthy means examining mental health as well as physical health, we are constantly looking for new ways to offer more holistic treatment.

Laura Judd-Glossy, PhD, is a psychologist with our International Center for Colorectal and Urogenital Care. In this video, she describes strategies to promote healthy psychosocial functioning for children with colorectal conditions and their families. It includes helpful tips and ideas that are tailored to children and adolescents of various ages and developmental levels. Watch the video to learn how to help children better deal with the anxiety and depression that can be brought on by such things as fecal incontinence.

When treating children with fecal incontinence or severe constipation, using daily abdominal radiographs to evaluate the efficacy of treatment can greatly improve results. When done correctly, daily radiographs provide important details to inform treatment changes for pediatric bowel management. Andrea Bischoff, MD, Co-Director of the International Center for Colorectal and Urogenital Care at Children’s Hospital Colorado, explains the approach her team uses.

Hirschsprung disease is a congenital condition that causes intestinal obstruction in the first days or weeks of life. Surgical treatment known as a pull-through procedure can connect the healthy part of the intestine to the rectum. While it is critically important to identify the histological transition zone of ganglion cells — where the aganglionic cells stop and the normoganglionic cells start — in the intestine before performing the procedure, it is also important to understand how they appear after the procedure.

In this video, Luis De la Torre, MD, Assistant Director of the International Center for Colorectal and Urogenital Care, explains the importance of understanding the histological transition zone after surgery. Not fully understanding how these areas look and test after surgery can lead to unnecessary reoperations and fetal incontinence. Watch the video to hear Dr. De la Torre explain his studies on postoperative functional results following a pull-through procedure and his current recommendations for re-doing a pull-through procedure for children with Hirschsprung disease.