Category Archives: Announcement

Print Release, Urology

PUBLISHED: Spermatocelectomy and Partial Epididymectomy for a Large Multilocular Spermatocele and Epididymal Head Cyst

Spermatocelectomy and Partial Epididymectomy for a Large Multilocular Spermatocele and Epididymal Head Cyst
Linda J. Guan, MD; Joseph Y. Clark, MD
Penn State Health Milton S. Hershey Medical Center

Spermatocelectomy is a surgical procedure used to treat spermatoceles, which are cystic structures that arise from the epididymis that contain spermatozoa and proteinaceous fluid. In cases of symptomatic spermatoceles, such as in the setting of pain or discomfort, spermatocelectomy may be offered. The general approach to a spermatocelectomy is via a scrotal incision to deliver the testis. The spermatocele is then dissected from the epididymis and divided to complete the procedure. In cases of large and broad-based spermatoceles where complete dissection of the spermatocele off the epididymis is not possible, an epididymectomy can be carried out for complete removal. The tunica vaginalis, dartos fascia, and scrotal skin are reapproximated in separate layers. In this video, we present a patient electing to undergo spermatocelectomy secondary to pain and discomfort.

Print Release, Surgical Technology

PUBLISHED: Setup for an Open Reduction and Internal Fixation (ORIF) of the Tibia (South College, Knoxville, TN)

Setup for an Open Reduction and Internal Fixation (ORIF) of the Tibia (South College, Knoxville, TN)
Madison Campbell, AS-Ed, AS-ST, CST
South College, Knoxville, TN

This educational video demonstrates how to set up for an open reduction and internal fixation (ORIF) of tibial fractures. A comprehensive, detailed protocol for sterile field preparation, instrument organization, and supply arrangement is outlined, emphasizing the double-draping technique, strategic placement of orthopaedic instruments, and essential safety checks. The setup also covers the preparation of power drill systems, fixation hardware, irrigation equipment, and tourniquet supplies. This video serves as a practical and easy-to-follow guide for surgical technology students, new operating room personnel, and healthcare facilities working to develop consistent and safe orthopaedic trauma protocols.

Print Release, Surgical Technology

PUBLISHED: Setup for an Open Reduction and Internal Fixation (ORIF) of the Tibia (Ivy Tech Community College, Indianapolis, IN)

Setup for an Open Reduction and Internal Fixation (ORIF) of the Tibia (Ivy Tech Community College, Indianapolis, IN)
Aaron Smith, AAS, CST
Ivy Tech Community College, Indianapolis, IN

Open reduction and internal fixation (ORIF) of tibial fractures is one of the most common orthopaedic trauma procedures. This video provides a comprehensive back table and Mayo stand setup for an ORIF including instrumentation arrangement, integration of fluoroscopic imaging equipment, and preparation for the initial count with a circulator or other licensed professional. This setup enhances surgical efficiency, minimizes contamination risk, and promotes patient safety.

Cardiac Surgery, Print Release

PUBLISHED: Aortic Hemiarch and Valve Replacement for Severe Aortic Stenosis with Ascending Aortic Ectasia

Aortic Hemiarch and Valve Replacement for Severe Aortic Stenosis with Ascending Aortic Ectasia
Adeel Ahmad, MD; Peter A. Collings, MD; Kirill Zakharov, DO
University of Michigan Health-Sparrow

Severe aortic valvular stenosis is a prevalent condition with potentially fatal consequences. Presenting symptoms may include dyspnea with angina/chest pains that can be significantly lifestyle limiting. Early detection and treatment are paramount to effective management, as untreated severe aortic stenosis has a five-year mortality of 50–70%. Treatment options range from the minimally invasive transcatheter approach to open heart surgery. Each strategy is tailored to the respective patient’s presentation, with considerations for cardiac anatomy, comorbidities, and patient frailty. When concomitant aortopathy is present, an open approach allows for definitive management of both conditions.

Aortic ectasia is an abnormal dilation of the ascending aorta that, while itself is not as serious, can be a precursor to aortic aneurysm or dissection. In patients undergoing surgical aortic valve replacement, a composite replacement strategy can also address concomitant aortic ectasia by incorporating the new valve into an aortic graft segment as a single implant.

General Surgery, Pediatrics, Print Release

PUBLISHED: Laparoscopic Percutaneous Extraperitoneal Closure (LPEC) for an Inguinal Hernia in a Pediatric Female

Laparoscopic Percutaneous Extraperitoneal Closure (LPEC) for an Inguinal Hernia in a Pediatric Female
Yuki Noguchi, MD, PhD; Shogo Saito, MD; Shohei Hiwatashi, MD, PhD; Satoshi Umeda, MD, PhD; Masahiro Zenitani, MD, PhD; Keigo Nara, MD, PhD
Osaka Women’s and Children’s Hospital

Pediatric inguinal hernias are indirect, resulting from a persistent patent processus vaginalis (PPV). These hernias will not spontaneously heal and carry a serious, persistent risk of incarceration. Consequently, surgical repair is typically advised soon after diagnosis to minimize the risk of incarceration.

This report details a 4-year-old girl with a reducible left inguinal hernia containing the greater omentum undergoing minimally invasive laparoscopic percutaneous extraperitoneal closure (LPEC). LPEC offers improved visualization, superior cosmetic results, and the ability to identify and repair contralateral PPV during the same procedure, which reduces the risk of metachronous hernia—particularly in girls, where the technique is technically straightforward.

General Surgery, Pediatrics, Print Release

PUBLISHED: Pediatric Laparoscopic Splenectomy for Splenomegaly due to Hereditary Spherocytosis

Pediatric Laparoscopic Splenectomy for Splenomegaly due to Hereditary Spherocytosis
Swetha Jayavelu, MD; Marc Mankarious, MD; Bryanna M. Emr, MD
Penn State Health Milton S. Hershey Medical Center

Hereditary spherocytosis (HS) is a form of inherited hemolytic anemia seen in children. HS is characterized by anemia, jaundice, splenomegaly, and complications such as gallstone formation or growth delay. While mild cases may be managed conservatively, splenectomy remains the definitive treatment for patients with severe symptoms or complications. This case presents a 10-year-old male with HS who presented with anemia, fatigue, abdominal pain, and palpable splenomegaly. He was found to have splenomegaly with a splenic length of 19.6 cm. He ultimately underwent a laparoscopic total splenectomy after receiving appropriate preoperative vaccinations. The procedure was completed successfully without complications, and the patient was discharged on post-op day 3. At follow-up, he demonstrated improved hemoglobin levels, resolution of abdominal pain, and no early complications. This case highlights the role of laparoscopic total splenectomy as a safe and effective treatment for pediatric patients with hereditary spherocytosis and massive splenomegaly, offering durable hematologic improvement with the benefits of a minimally invasive approach.

Print Release, Surgical Technology

PUBLISHED: Setup for an Open Total Thyroidectomy (South College, Knoxville, TN)

Setup for an Open Total Thyroidectomy (South College, Knoxville, TN)
Melissa Yearwood, AS-ST, CST
South College, Knoxville, TN

For every surgical procedure, a sterile, well-organized back table setup is needed to provide surgical efficiency and patient safety. This educational video demonstrates a setup for an open total thyroidectomy. This surgical procedure is performed to treat various conditions. The setup protocol provided here shows how to create the sterile field and position instruments and supplies to allow for quick access while maintaining sterility throughout the procedure.

General Surgery, Print Release

PUBLISHED: Robotic Whipple Procedure for an Ampullary Intramucosal Carcinoma

Robotic Whipple Procedure for an Ampullary Intramucosal Carcinoma
Charles C. Vining, MD, FACS, FSSO; Rushin D. Brahmbhatt, MD, FACS; Lawrence M. Knab, MD, FACS, FSSO
Penn State Health Milton S. Hershey Medical Center

A 76-year-old man presented to the emergency department with fatigue and chest pain. Initial laboratory evaluation revealed significant anemia with a hemoglobin level of 7.4 g/dL. He was transfused one unit of packed red blood cells and discharged with plans for outpatient gastroenterology follow-up. Upper endoscopy performed shortly thereafter demonstrated a tubulovillous adenoma without high-grade dysplasia at the level of the ampulla. Subsequent cross-sectional imaging with CT of the abdomen and pelvis identified an area of mass-like thickening in the descending duodenum as well as two suspicious peripancreatic lymph nodes. Endoscopic ultrasound with biopsy confirmed the presence of a uT3N1 duodenal mass. Histopathologic analysis revealed at least intramucosal adenocarcinoma arising within an adenoma.

The case was reviewed at a multidisciplinary tumor board, where consensus recommendation was for surgical resection. The patient subsequently underwent diagnostic laparoscopy, laparoscopic liver biopsy, robotic pancreaticoduodenectomy (Whipple procedure), and falciform ligament flap. Pathologic examination of the resected specimen revealed an 8.2-cm, grade 2, moderately differentiated invasive adenocarcinoma of intestinal type, arising from a duodenal adenoma. The tumor demonstrated direct invasion into the pancreas, peripancreatic soft tissues, and periduodenal tissue. All surgical resection margins were negative for carcinoma. A total of 22 lymph nodes were examined, of which 6 were positive for metastatic adenocarcinoma, consistent with a final pathologic stage of pT3b pN2 duodenal adenocarcinoma.

This case highlights the diagnostic and therapeutic challenges associated with duodenal adenocarcinoma, a rare and often late-presenting malignancy. It further demonstrates the role of a multidisciplinary approach in guiding management, as well as the feasibility of a minimally invasive robotic pancreaticoduodenectomy in selected patients.

Print Release, Surgical Technology

PUBLISHED: Setup for an Exploratory Laparotomy with Possible Splenectomy (South College, Knoxville, TN)

Setup for an Exploratory Laparotomy with Possible Splenectomy (South College, Knoxville, TN)
Chris Blevins, BS, AAS-ST, CST, FAST
South College, Knoxville, TN

The combination of an exploratory laparotomy with a possible splenectomy demands a quick and efficient back table and Mayo stand setup. This video demonstrates an efficient setup that includes placement of surgical instruments, sponges, hemostatic agents, and vascular clamps. The demonstrated setup techniques shown here provide surgical technologists with useful strategies to prepare for complex trauma cases.

General Surgery, Print Release

PUBLISHED: Parathyroidectomy and Four-Gland Exploration for Hyperparathyroidism

Parathyroidectomy and Four-Gland Exploration for Hyperparathyroidism
Allison S. Letica-Kriegel, MD, MSc; Antonia E. Stephen, MD
Massachusetts General Hospital

Primary hyperparathyroidism is a common endocrinopathy. Surgery is the mainstay of treatment. Preoperative imaging is useful in localization of diseased glands and can allow for focal rather than four-gland exploration. Intraoperative adjuncts such as intraoperative parathyroid hormone (ioPTH) monitoring can be useful in select cases in determining the extent of parathyroid resection.