All posts by Izabela Novacka

Published: Pancreatic Debridement via Sinus Tract Endoscopy

Pancreatic Debridement via Sinus Tract Endoscopy
Massachusetts General Hospital

Peter Fagenholz, MD
Assistant Professor of Surgery
Massachusetts General Hospital
Harvard Medical School

This patient is a 58-year-old male who was in a motor vehicle accident and developed a persistent necrotic collection adjacent to the pancreatic tail that did not improve with percutaneous drainage. Here, Dr. Peter Fagenholz at MGH performs a pancreatic debridement using sinus tract endoscopy (STE), a minimally-invasive technique for debridement of dead or infected tissue.

STE and other minimally-invasive techniques have significantly decreased morbidity and mortality for patients undergoing intervention for infected pancreatic necrosis. Common management principles include early non-interventional management to allow the necrosis to wall off, initial intervention with minimally-invasive drainage, and minimally-invasive necrosectomy addressing clearly demarcated necrosis.

STE involves the placement of a percutaneous drain followed by fluoroscopically-guided dilation of the drain tract to allow for placement of a working sheath, through which an endoscope can be introduced to debride the peripancreatic necrosis. After debridement, a drain is then replaced through the same tract.

PREPRINT RELEASE: Prophylactic Laparoscopic Bilateral Gonadectomy for Complete Androgen Insensitivity Syndrome

Prophylactic Laparoscopic Bilateral Gonadectomy for Complete Androgen Insensitivity Syndrome
University of Arkansas for Medical Sciences

J. Corbin Norton, MD
Department of Urology
University of Arkansas for Medical Sciences

Stephen J. Canon, MD
Department of Pediatric Urology
Arkansas Children’s Hospital

Amrit Singh, MD
Department of Pathology
University of Arkansas for Medical Sciences / Arkansas Children’s Hospital

Laura L. Hollenbach, MD
Department of Obstetrics and Gynecology
University of Arkansas for Medical Sciences

Georgia Gamble, MD
Department of Obstetrics and Gynecology
University of Arkansas for Medical Sciences

Laura A. Gonzalez-Krellwitz, MD
Department of Pathology
University of Arkansas for Medical Sciences / Arkansas Children’s Hospital

The patient, in this case, is a 15-year-old female who presented with primary amenorrhea and who on work-up was found to have complete androgen insensitivity syndrome. Here, Dr. Canon at the University of Arkansas for Medical Sciences performs a prophylactic laparoscopic bilateral gonadectomy to reduce her future risk for intra-abdominal testicular malignancies. Final pathology results showed a rare case of bilateral germ cell neoplasia in situ and bilateral paratesticular leiomyomas and reinforced the decision to intervene early allowing for the removal of the gonads prior to their conversion to formal germ cell tumors.

PUBLISHED: Less Invasive Stabilization System (LISS) for Distal Femur Fracture Repair

Less Invasive Stabilization System (LISS) for Distal Femur Fracture Repair
Brigham and Women’s Hospital

Michael J. Weaver, MD
Associate Orthopaedic Surgeon, Brigham and Women’s Hospital
Assistant Professor of Orthopedic Surgery, Harvard Medical School
Brigham and Women’s Hospital

The patient in this case is an 81-year-old male with dementia who sustained an unwitnessed fall that resulted in a displaced intra-articular distal femur fracture. Here, Dr. Weaver at Brigham and Women’s Hospital repairs the fracture by performing an open reduction and internal fixation with a LISS plate. An anterolateral approach was used to visualize the joint surface and obtain an anatomic reduction of the articular surface, and a percutaneously-placed lateral lock plate was used to bridge the area of comminution while restoring length, alignment, and rotation to hopefully allow for biologic fixation that permits the bone to heal well.

PUBLISHED: Creation Of A Radial-Cephalic Arteriovenous Fistula

Creation of a Radial-Cephalic Arteriovenous Fistula
Nahel Elias, MD FACS
Surgical Director
Kidney Transplantation
Massachusetts General Hospital

AV fistulas provide the crucial vascular access required for patients receiving hemodialysis, a life-saving procedure for end-stage renal disease. Such patients have irreversible kidney damage and must receive a new kidney. While waiting, patients rely on hemodialysis to filter their blood to stay alive, and AV fistulas provide the sustainable vascular access required for hemodialysis. 

Continue reading PUBLISHED: Creation Of A Radial-Cephalic Arteriovenous Fistula

OTO-Open: The Role of Video Atlases in Surgical Education

Surgical videos are a valuable resource in medical education – they help residents and students prepare for the operating room.


Dr. Scott Brown, the medical editor responsible for the creation of the Otolaryngology Section at JOMI, has published in OTO-Open an article “Development of a Surgical Video Atlas for Resident Education: 3-Year Experience“.  In this article, Dr. Brown discusses his journey, selection of cases, filming processes and challenges, and adoption of the content by residents and students.  Dr. Brown also discusses how surgical video atlases impact surgical training and the role they will play for ENT and other surgical residencies in the coming years.

https://doi.org/10.1177/2473974X20939067