Curriculum
The goal of the Pediatric Colorectal and Pelvic Reconstruction Fellowship is to understand how to evaluate and treat patients with the spectrum of pediatric colorectal problems.
The fellow will learn to understand the newborn assessment of associated malformations and anorectal malformations:
- Urologic
- Spinal
- Sacral
- Gastrointestinal
- Gynecologic
The fellow will recognize the different types of anorectal malformations:
- Rectoperineal fistula
- Rectourethral fistula
- Rectovestibular fistula
- No fistula
- Cloacal malformation
The fellow will learn to understand the proper newborn radiologic evaluation for anorectal malformations:
- AP Spine
- Sacral x-rays
- Abdominal ultrasound
- Renal ultrasound
- Spinal ultrasound
- Cross-table lateral x-ray
The fellow will be able to determine the correct newborn surgical intervention in anorectal malformations:
- Anoplasty
- Colostomy
- Need for hydrocolpos drainage
The fellow will learn to understand the newborn assessment and treatment of Hirschsprung’s disease:
- Radiologic evaluation
- Irrigations
- Primary pull-through
- Colostomy
The fellow will develop expertise in the surgical management of index colorectal conditions:
- PSARP for male (rectobulbar, rectoprostatic and no fistula)
- PSAP for male (rectoperineal fistula)
- PSARP + laparoscopy/laparotomy for male with rectobladderneck fistula
- PSARP for female (rectovestibular fistula)
- PSAP for female (rectoperineal fistula)
- PSARVUP for cloacal malformations
- Pull-through for Hirschsprung’s (transanal techniques, laparoscopic techniques)
The fellow will gain understanding in multidisciplinary medical and surgical management for the variety of colorectal problems:
- Management of idiopathic constipation
- Management of constipation in anorectal malformation
- Management of constipation in Hirschsprung disease
- Management of hypermotility in anorectal malformations
- Management of hypermotility in Hirschsprung disease
- Management of enterocolitis
- Management of fecal incontinence
The fellow will gain understanding in surgical interventions for fecal incontinence:
- Sigmoid resection
- Malone procedure
The fellow will learn to understand the assessment of complex Hirschsprung’s disease with postoperative soiling or obstructive symptoms:
- Medical management
- Rectal biopsy
- Indications for re-operation
The fellow will gain understanding in the medical and surgical management of intractable idiopathic constipation:
- Laxative trial
- Colonic resection therapies
- Motility evaluation