Past Events

Update on Cloaca and Complex Anorectal Malformations

Aired on 9.29.2015
Update on Cloaca and Complex Anorectal Malformations CME
Join the multidisciplinary team from Cincinnati Children’s Alberto Pena, MD, Colorectal Center as they discuss the current management and new innovations of complex malformation, particularly cloaca malformations. Topics covered will include the prenatal diagnosis, workup, collaborative management and long-term management. The symposium will be broadcast live to a virtual audience from Cincinnati, Ohio. This 4 hour symposium will be based on case presentation and faculty panel discussion. This will be an interactive and engaging seminar with audience polling, questions and debate.


Directors & Faculty


Belinda Hsi Dickie, MD, PhD

Belinda Hsi Dickie, MD, PhD, is the surgical director of the Hemangioma and Vascular Malformations Center since July 2013. She is also the director of the Vascular Anomalies Fellowship. Dr. Dickie is an assistant professor with the Division of Pediatric General and Thoracic Surgery at Cincinnati Children's Hospital Medical Center.

Todd Ponsky, MD

Todd Ponsky is currently Professor of Surgery at the University of Cincinnati and a pediatric surgeon at Cincinnati Children’s Hospital Medical Center and Akron Children’s Hospital. He is the Director of Clinical Growth and Transformation at Cincinnati Children’s Hospital. He attended medical school at Case Western Reserve University in Cleveland, Ohio from 1995-1999,Residency in General Surgery at The George Washington University in Washington, DC from 1999-2005, Pediatric Surgery Fellowship at Children's National Medical Center in Washington, DC from 2005-2007,and an Advanced Minimally Invasive Pediatric Surgery Fellowship at The Rocky Mountain Hospital for Children in Denver, CO from 2007-2008. Dr. Ponsky was the first to perform and report single port surgery in children and modernized the methods of the laparoscopic pediatric hernia repair. He has published over 125 manuscripts, edited 3 textbooks, and authored over 30 book chapters. He has directed over 50 national/international courses and has given over 200 visiting lectureships. He is the Associate Editor for The Journal of Pediatric Surgery, and serves on three editorial boards. He is the immediate past president of the International Pediatric Endosurgery Group (IPEG) and holds, or has held, leadership positions in the American College of Surgeons (ACS), the American Pediatric Surgical Association (APSA), the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) and the International Society for Pediatric Innovation (iSPI). He has won numerous faculty teaching awards. He is involved in both outcomes and animal research with a focus on inguinal hernia physiology, surgical telementoring, endoscopic repair techniques for pure esophageal atresia, and innovations in education. He founded GlobalcastMD and Stay Current in Surgery, both of which serve to democratize and internationalize medical knowledge and modernize the way we teach and learn surgery.

Additional Faculty

Shumyle Alam, MD

Dr. Shumyle Alam specializes in pediatric pelvic and urogenital reconstruction. He is sought for his special expertise in the management and treatment of complex urologic conditions. Patients come to see Dr. Alam from across the country and around the world for his experience in performing surgeries that restore form and function, improving quality of life for children. He is nationally and internationally known for his expertise in the treatment of anorectal malformations, disorders of sexual development, bladder disorders (such as neurogenic bladder and posterior urethral valves), complex and reoperative hypospadias, and patients with end-stage renal disease.

Andrea Bischoff, MD

Andrea Bischoff is a pediatric surgeon for the Colorectal Center at Cincinnati Children’s Hospital Medical Center. She earned her medical degree at University of Brasilia – Brasilia, Brazil. Her general surgery residency and pediatric surgical fellowship were completed at Brasilia University Hospital - Brasilia, Brazil.

Lesley Breech, MD


Maria A. Calvo-Garcia, MD

Maria A. Calvo-Garcia, MD, received her medical degree from the Autonomous University of Madrid, Spain. She completed her residency at Gregorio Maranon University General Hospital, University of Madrid, Spain. She was a staff radiologist at Ambulatorio Moratalaz, Virgen de la Torre Hospital, Madrid, Spain. In 1994 she served as staff radiologist at Badalona Hospital, Badalona, Barcelona, Spain until June 2001 with a six-month visiting fellowship at Dijkzigt Hospital, Erasmus Univ. of Rotterdam, The Netherlands (Feb 1998-July 1998). She came to Cincinnati Children’s Hospital Medical Center first as a research assistant in radiology and then as a clinical fellow until 2004, when she became staff.

Jason Frischer, MD

Director, Colorectal Center

Jacob Langer, MD, FRCSC

Robert M. Filler Chair and Chief, Pediatric General and Thoracic Surgery, The Hospital for Sick Children; Professor of Surgery, University of Toronto, Toronto, ON

Manish N. Patel, DO

Medical Director, Vascular Access Team Co-Director, Hereditary Hemorrhagic Telangiectasia (HHT) Center Interventional Radiologist, Department of Radiology and Medical Imaging Dr. Manish Patel, DO, has helped to expand the treatment options for high flow vascular malformations. Dr. Patel is a pediatric interventional radiologist and anassociate professor of radiology. Additionally, he works as d irector of daily operations in the Interventional Radiology team and as the associate fellowship director of the Pediatric Radiology Fellowship Program. Dr. Patel obtained his DO degree from the University of Health Sciences – College of Osteopathic Medicine, completed his residency at University of Missouri Kansas City, and completed his fellowship at Cincinnati Children’s Hospital Medical Center. His key interests are pediatric interventional radiology, vascular access, and v ascular malformations. He is currently working on research of the effects of rapamycin on VMs as well as treatment options for high flow lesions.

Alberto Peña, MD

Founding Director, Colorectal Center Professor, Division of Pediatric Surgery. Since 1982 until the present, Dr. Peña has been traveling all over the world, lecturing and operating on children affected by this particular malformation. At the present time, Dr. Peña dedicates 80 percent of his time to the treatment of anorectal problems in children. Seventy percent of the patients operated on by Dr. Peña at Cincinnati Children's come from other states and from all over the world.

Brian A. VanderBrink, MD

Dr. VanderBrink is a pediatric urologist at Cincinnati Children’s Hospital. His career goal is to help children with congenital conditions that affect the urinary tract to achieve the best possible outcomes. This can mean different things to different families and he takes pride in listening to each individual family’s concerns while formulating a treatment plan. His main goals are to preserve kidney function, work towards urinary control and provide opportunities to become independent for their chronic condition. Dr. VanderBrink’s specialties include reconstructive lower urinary tract surgery; neurogenic bladder; and spina bifida.

Richard Wood, MD

Richard Wood is a Pediatric Surgeon and Assistant Professor of Surgery at Nationwide Children’s Hospital in the Center for Colorectal and Pelvic Reconstruction in Columbus, OH. He trained General Surgery in the United Kingdom and South Africa and completed Pediatric Surgery training at the Red Cross War Memorial Children’s Hospital in Cape Town. He subsequently completed a Pediatric Colorectal Fellowship at Nationwide Children’s Hospital. His areas of interest are complex pelvic reconstructive surgery and outcomes research in colorectal surgery.


1:00 pm - 1:15 pm
Introduction of Panelists

1:15 pm - 1:45 pm
Prenatal imaging and diagnosis, Prenatal counseling topics
1:45 pm - 2:15 pm
Radiology- Ultrasound, Cloacagram, Endoscopy- Cystoscopy/Vaginoscopy
2:15 pm - 3:00 pm
Urologic Concerns

3:00 pm - 3:15 pm
3:15 pm - 3:45 pm
Gynecologic Concerns
3:45 pm - 4:30 pm
Surgical Management and Techniques
--- Techniques: Short common Channel, Intermediate common Channel, Long Common Channel, Vaginal replacement (Lesley Breech), Role of laparoscopy

4:30 pm - 5:00 pm
Postoperative Management
also includes long term follow up needs

Topics Covered

1) Prenatal diagnosis
2) Workup
3) Urologic concerns
4) Gynecology concerns
5) Surgical management
6) New innovations (minimally invasive)
7) Postoperative management
​8) Long-term follow-up needs.


  • Describe current management of cloaca and other complex malformations.
  • Review recent innovations in the care management of  cloaca and other complex malformations.
  • Discuss cases related to cloaca and other complex malformations.
  • Apply new knowledge to current practice management with cloaca and other complex malformations.

Disclosures and Accreditation Statement

Medical Education to provide continuing medical education for physicians.  Cincinnati Children’s designates this live activity for a maximum of 3.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity
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