Alessandro de Alarcon

104 statements · 4 topics

Aerodigestive / ENT · guest expert

Featured statements

▶ Ep 16 · 1:39
If we can, we like to use a NIM tube as part of trying to prevent potential injury to recurrent nerves or at least make you aware when you're Getting close to them.
quote · Aerodigestive / ENT
▶ Ep 16 · 3:15
We like to use 30 prolenes and we like to place all the stitches before we actually secure them down, and it's important to do this under spontaneous conditions.
quote · Aerodigestive / ENT
▶ Ep 49 · 2:54
We will sometimes place stitches in the trachea to pull it up and out of the way so you can visualize that posterior aspect of where you see the spine.
quote · Esophageal Atresia
▶ Ep 49 · 1:21
The flexible bronchoscopy is really key and Placing your endotracheal tube is really important so they can look as you were doing the operation.
quote · Esophageal Atresia
▶ Ep 26 · 1:15
You need a neck tray, and MLB tray, and Maloney dilators versus NG tubes in the operating room and you do it.
quote · Esophageal Atresia
▶ Ep 26 · 2:54
Stitches are sometimes placed in the trachea to pull it up and out of the way for visualization of the posterior aspect and spine.
clinical · Esophageal Atresia

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Alessandro's statements about Aerodigestive / ENT 26 statements

Open the Aerodigestive / ENT collection →

QUAD #1: Cervical Tracheopexy with Dr. Alessandro de Alarcon

▶ Ep 16 · 0:49
clinical Cincinnati Children's typically uses a combined cervical and thoracic approach for esophageal atresia cases. ↗
▶ Ep 16 · 0:49
quote In Cincinnati we typically use a combined approach looking at the thoracic approach as well as with the cervical approach. ↗
▶ Ep 16 · 1:15
quote You need a neck tray, and MLB tray, and Maloney dilators versus NG tubes in the operating room and you do it. ↗
▶ Ep 16 · 1:15
clinical Required intraoperative equipment includes a neck tray, MLB tray, and Maloney dilators or NG tubes. ↗
▶ Ep 16 · 1:21
quote The flexible bronchoscopy is really key and Placing your endotracheal tube is really important so they can look as you were doing the operation. ↗
▶ Ep 16 · 1:21
clinical Flexible bronchoscopy during the operation is key, and endotracheal tube placement must allow visualization during the procedure. ↗
▶ Ep 16 · 1:29
clinical Nasotracheal intubation is often used with the cuff positioned high, sometimes almost at the glottis. ↗
▶ Ep 16 · 1:33
quote And sometimes that means your cuff is super high and it's almost at the glottis. ↗
▶ Ep 16 · 1:39
quote If we can, we like to use a NIM tube as part of trying to prevent potential injury to recurrent nerves or at least make you aware when you're Getting close to them. ↗
▶ Ep 16 · 1:39
clinical A NIM tube is preferred when possible to prevent injury to recurrent nerves or provide awareness when approaching them. ↗
▶ Ep 16 · 1:55
clinical The surgical approach uses subplatysmal flaps and addresses anterior compression as needed. ↗
▶ Ep 16 · 2:09
clinical Aortopexy and innominate artery pexy can be added at the same time as the cervical procedure. ↗
▶ Ep 16 · 2:29
opinion The Cincinnati team has learned not to be afraid of mobilizing the esophagus, which is important for the procedure. ↗
▶ Ep 16 · 2:29
quote And then it's thinking about your approach to mobilize the esophagus and the experience of working with our team in Cincinnati, we have learned how to not be afraid of the esophagus. ↗
▶ Ep 16 · 2:54
clinical Stitches are sometimes placed in the trachea to pull it up and out of the way for visualization of the posterior aspect and spine. ↗
▶ Ep 16 · 2:54
quote We will sometimes place stitches in the trachea to pull it up and out of the way so you can visualize that posterior aspect of where you see the spine. ↗
▶ Ep 16 · 3:15
quote We like to use 30 prolenes and we like to place all the stitches before we actually secure them down, and it's important to do this under spontaneous conditions. ↗
▶ Ep 16 · 3:15
clinical Suture placement is performed under spontaneous ventilation conditions. ↗
▶ Ep 16 · 3:15
clinical The team uses 3-0 prolene sutures and places all stitches before securing them down. ↗
▶ Ep 16 · 3:33
clinical A patient who had prior thoracoscopic tracheopexy with dysphagia from torqued esophagus underwent the combined approach and became symptom-free. ↗
▶ Ep 16 · 4:00
clinical Outcome measures include follow-up endoscopy, pulmonary function tests when patients are old enough, and imaging. ↗
▶ Ep 16 · 4:09
quote And when you look 36 months later, it may still look like there's some malaysia, but symptomatically, they're better. ↗
▶ Ep 16 · 4:09
clinical At 36 months follow-up, imaging may still show tracheomalacia, but patients can be symptomatically better. ↗
▶ Ep 16 · 4:15
opinion The team is still learning what measures should define good versus bad outcomes. ↗
▶ Ep 16 · 4:15
quote So it's important to pair that piece and understand that we're still trying to learn exactly what are those measures that we want to use to be able to say that they are a good outcome versus a bad outcome. ↗
▶ Ep 16 · 4:26
clinical Managing complications including swallowing dysfunction and vocal fold paralysis is part of postoperative care. ↗
Alessandro's statements about Esophageal Atresia 26 statements

Open the Esophageal Atresia collection →

QUAD #1: Cervical Tracheopexy with Dr. Alessandro de Alarcon

▶ Ep 49 · 0:49
quote In Cincinnati we typically use a combined approach looking at the thoracic approach as well as with the cervical approach. ↗
▶ Ep 49 · 0:49
clinical Cincinnati Children's typically uses a combined cervical and thoracic approach for esophageal atresia cases. ↗
▶ Ep 49 · 1:15
clinical Required intraoperative equipment includes a neck tray, MLB tray, and Maloney dilators or NG tubes. ↗
▶ Ep 49 · 1:15
quote You need a neck tray, and MLB tray, and Maloney dilators versus NG tubes in the operating room and you do it. ↗
▶ Ep 49 · 1:21
clinical Flexible bronchoscopy during the operation is key, and endotracheal tube placement must allow visualization during the procedure. ↗
▶ Ep 49 · 1:21
quote The flexible bronchoscopy is really key and Placing your endotracheal tube is really important so they can look as you were doing the operation. ↗
▶ Ep 49 · 1:29
clinical Nasotracheal intubation is often used with the cuff positioned high, sometimes almost at the glottis. ↗
▶ Ep 49 · 1:33
quote And sometimes that means your cuff is super high and it's almost at the glottis. ↗
▶ Ep 49 · 1:39
clinical A NIM tube is preferred when possible to prevent injury to recurrent nerves or provide awareness when approaching them. ↗
▶ Ep 49 · 1:39
quote If we can, we like to use a NIM tube as part of trying to prevent potential injury to recurrent nerves or at least make you aware when you're Getting close to them. ↗
▶ Ep 49 · 1:55
clinical The surgical approach uses subplatysmal flaps and addresses anterior compression as needed. ↗
▶ Ep 49 · 2:09
clinical Aortopexy and innominate artery pexy can be added at the same time as the cervical procedure. ↗
▶ Ep 49 · 2:29
opinion The Cincinnati team has learned not to be afraid of mobilizing the esophagus, which is important for the procedure. ↗
▶ Ep 49 · 2:29
quote And then it's thinking about your approach to mobilize the esophagus and the experience of working with our team in Cincinnati, we have learned how to not be afraid of the esophagus. ↗
▶ Ep 49 · 2:54
quote We will sometimes place stitches in the trachea to pull it up and out of the way so you can visualize that posterior aspect of where you see the spine. ↗
▶ Ep 49 · 2:54
clinical Stitches are sometimes placed in the trachea to pull it up and out of the way for visualization of the posterior aspect and spine. ↗
▶ Ep 49 · 3:15
clinical Suture placement is performed under spontaneous ventilation conditions. ↗
▶ Ep 49 · 3:15
quote We like to use 30 prolenes and we like to place all the stitches before we actually secure them down, and it's important to do this under spontaneous conditions. ↗
▶ Ep 49 · 3:15
clinical The team uses 3-0 prolene sutures and places all stitches before securing them down. ↗
▶ Ep 49 · 3:33
clinical A patient who had prior thoracoscopic tracheopexy with dysphagia from torqued esophagus underwent the combined approach and became symptom-free. ↗
▶ Ep 49 · 4:00
clinical Outcome measures include follow-up endoscopy, pulmonary function tests when patients are old enough, and imaging. ↗
▶ Ep 49 · 4:09
quote And when you look 36 months later, it may still look like there's some malaysia, but symptomatically, they're better. ↗
▶ Ep 49 · 4:09
clinical At 36 months follow-up, imaging may still show tracheomalacia, but patients can be symptomatically better. ↗
▶ Ep 49 · 4:15
opinion The team is still learning what measures should define good versus bad outcomes. ↗
▶ Ep 49 · 4:15
quote So it's important to pair that piece and understand that we're still trying to learn exactly what are those measures that we want to use to be able to say that they are a good outcome versus a bad outcome. ↗
▶ Ep 49 · 4:26
clinical Managing complications including swallowing dysfunction and vocal fold paralysis is part of postoperative care. ↗
Alessandro's statements about Esophageal Atresia 26 statements

Open the Esophageal Atresia collection →

QUAD #1: Cervical Tracheopexy with Dr. Alessandro de Alarcon

▶ Ep 26 · 0:49
quote In Cincinnati we typically use a combined approach looking at the thoracic approach as well as with the cervical approach. ↗
▶ Ep 26 · 0:49
clinical Cincinnati Children's typically uses a combined cervical and thoracic approach for esophageal atresia cases. ↗
▶ Ep 26 · 1:15
quote You need a neck tray, and MLB tray, and Maloney dilators versus NG tubes in the operating room and you do it. ↗
▶ Ep 26 · 1:15
clinical Required intraoperative equipment includes a neck tray, MLB tray, and Maloney dilators or NG tubes. ↗
▶ Ep 26 · 1:21
quote The flexible bronchoscopy is really key and Placing your endotracheal tube is really important so they can look as you were doing the operation. ↗
▶ Ep 26 · 1:21
clinical Flexible bronchoscopy during the operation is key, and endotracheal tube placement must allow visualization during the procedure. ↗
▶ Ep 26 · 1:29
clinical Nasotracheal intubation is often used with the cuff positioned high, sometimes almost at the glottis. ↗
▶ Ep 26 · 1:33
quote And sometimes that means your cuff is super high and it's almost at the glottis. ↗
▶ Ep 26 · 1:39
quote If we can, we like to use a NIM tube as part of trying to prevent potential injury to recurrent nerves or at least make you aware when you're Getting close to them. ↗
▶ Ep 26 · 1:39
clinical A NIM tube is preferred when possible to prevent injury to recurrent nerves or provide awareness when approaching them. ↗
▶ Ep 26 · 1:55
clinical The surgical approach uses subplatysmal flaps and addresses anterior compression as needed. ↗
▶ Ep 26 · 2:09
clinical Aortopexy and innominate artery pexy can be added at the same time as the cervical procedure. ↗
▶ Ep 26 · 2:29
quote And then it's thinking about your approach to mobilize the esophagus and the experience of working with our team in Cincinnati, we have learned how to not be afraid of the esophagus. ↗
▶ Ep 26 · 2:29
opinion The Cincinnati team has learned not to be afraid of mobilizing the esophagus, which is important for the procedure. ↗
▶ Ep 26 · 2:54
quote We will sometimes place stitches in the trachea to pull it up and out of the way so you can visualize that posterior aspect of where you see the spine. ↗
▶ Ep 26 · 2:54
clinical Stitches are sometimes placed in the trachea to pull it up and out of the way for visualization of the posterior aspect and spine. ↗
▶ Ep 26 · 3:15
clinical The team uses 3-0 prolene sutures and places all stitches before securing them down. ↗
▶ Ep 26 · 3:15
quote We like to use 30 prolenes and we like to place all the stitches before we actually secure them down, and it's important to do this under spontaneous conditions. ↗
▶ Ep 26 · 3:15
clinical Suture placement is performed under spontaneous ventilation conditions. ↗
▶ Ep 26 · 3:33
clinical A patient who had prior thoracoscopic tracheopexy with dysphagia from torqued esophagus underwent the combined approach and became symptom-free. ↗
▶ Ep 26 · 4:00
clinical Outcome measures include follow-up endoscopy, pulmonary function tests when patients are old enough, and imaging. ↗
▶ Ep 26 · 4:09
clinical At 36 months follow-up, imaging may still show tracheomalacia, but patients can be symptomatically better. ↗
▶ Ep 26 · 4:09
quote And when you look 36 months later, it may still look like there's some malaysia, but symptomatically, they're better. ↗
▶ Ep 26 · 4:15
opinion The team is still learning what measures should define good versus bad outcomes. ↗
▶ Ep 26 · 4:15
quote So it's important to pair that piece and understand that we're still trying to learn exactly what are those measures that we want to use to be able to say that they are a good outcome versus a bad outcome. ↗
▶ Ep 26 · 4:26
clinical Managing complications including swallowing dysfunction and vocal fold paralysis is part of postoperative care. ↗
Alessandro's statements about Tracheomalacia 26 statements

Open the Tracheomalacia collection →

QUAD #1: Cervical Tracheopexy with Dr. Alessandro de Alarcon

▶ Ep 4 · 0:49
quote In Cincinnati we typically use a combined approach looking at the thoracic approach as well as with the cervical approach. ↗
▶ Ep 4 · 0:49
clinical Cincinnati Children's typically uses a combined cervical and thoracic approach for esophageal atresia cases. ↗
▶ Ep 4 · 1:15
quote You need a neck tray, and MLB tray, and Maloney dilators versus NG tubes in the operating room and you do it. ↗
▶ Ep 4 · 1:15
clinical Required intraoperative equipment includes a neck tray, MLB tray, and Maloney dilators or NG tubes. ↗
▶ Ep 4 · 1:21
clinical Flexible bronchoscopy during the operation is key, and endotracheal tube placement must allow visualization during the procedure. ↗
▶ Ep 4 · 1:21
quote The flexible bronchoscopy is really key and Placing your endotracheal tube is really important so they can look as you were doing the operation. ↗
▶ Ep 4 · 1:29
clinical Nasotracheal intubation is often used with the cuff positioned high, sometimes almost at the glottis. ↗
▶ Ep 4 · 1:33
quote And sometimes that means your cuff is super high and it's almost at the glottis. ↗
▶ Ep 4 · 1:39
quote If we can, we like to use a NIM tube as part of trying to prevent potential injury to recurrent nerves or at least make you aware when you're Getting close to them. ↗
▶ Ep 4 · 1:39
clinical A NIM tube is preferred when possible to prevent injury to recurrent nerves or provide awareness when approaching them. ↗
▶ Ep 4 · 1:55
clinical The surgical approach uses subplatysmal flaps and addresses anterior compression as needed. ↗
▶ Ep 4 · 2:09
clinical Aortopexy and innominate artery pexy can be added at the same time as the cervical procedure. ↗
▶ Ep 4 · 2:29
quote And then it's thinking about your approach to mobilize the esophagus and the experience of working with our team in Cincinnati, we have learned how to not be afraid of the esophagus. ↗
▶ Ep 4 · 2:29
opinion The Cincinnati team has learned not to be afraid of mobilizing the esophagus, which is important for the procedure. ↗
▶ Ep 4 · 2:54
clinical Stitches are sometimes placed in the trachea to pull it up and out of the way for visualization of the posterior aspect and spine. ↗
▶ Ep 4 · 2:54
quote We will sometimes place stitches in the trachea to pull it up and out of the way so you can visualize that posterior aspect of where you see the spine. ↗
▶ Ep 4 · 3:15
quote We like to use 30 prolenes and we like to place all the stitches before we actually secure them down, and it's important to do this under spontaneous conditions. ↗
▶ Ep 4 · 3:15
clinical Suture placement is performed under spontaneous ventilation conditions. ↗
▶ Ep 4 · 3:15
clinical The team uses 3-0 prolene sutures and places all stitches before securing them down. ↗
▶ Ep 4 · 3:33
clinical A patient who had prior thoracoscopic tracheopexy with dysphagia from torqued esophagus underwent the combined approach and became symptom-free. ↗
▶ Ep 4 · 4:00
clinical Outcome measures include follow-up endoscopy, pulmonary function tests when patients are old enough, and imaging. ↗
▶ Ep 4 · 4:09
quote And when you look 36 months later, it may still look like there's some malaysia, but symptomatically, they're better. ↗
▶ Ep 4 · 4:09
clinical At 36 months follow-up, imaging may still show tracheomalacia, but patients can be symptomatically better. ↗
▶ Ep 4 · 4:15
opinion The team is still learning what measures should define good versus bad outcomes. ↗
▶ Ep 4 · 4:15
quote So it's important to pair that piece and understand that we're still trying to learn exactly what are those measures that we want to use to be able to say that they are a good outcome versus a bad outcome. ↗
▶ Ep 4 · 4:26
clinical Managing complications including swallowing dysfunction and vocal fold paralysis is part of postoperative care. ↗