Category Archives: General Surgery

PUBLISHED: Extended Focused Assessment with Sonography for Trauma (EFAST) Exam

Extended Focused Assessment with Sonography for Trauma (EFAST) Exam
UChicago Medicine

Daven Patel, MD, MPH
Resident Physician
Emergency Medicine

Kristin Lewis, MD, MA
Resident Physician
Emergency Medicine

Allyson Peterson, MD
Resident Physician
Emergency Medicine

Nadim Michael Hafez, MD
Assistant Professor of Medicine
Emergency Medicine

This video covers information related to the FAST exam, which evaluates the pericardial, hepatorenal, splenorenal, and suprapubic regions for free fluid in a trauma patient as well as the extended version, which includes an additional evaluation of the pleural spaces for a pneumothorax. It goes through probe selection, probe placement and image acquisition, image optimization, and pitfalls and pearls for the subxiphoid/subcostal, right upper quadrant, left upper quadrant, suprapubic, and pleural views.

PREPRINT RELEASE: Airway Equipment

Airway Equipment

Nicholas Ludmer, MD
Assistant Professor of Emergency Medicine
UChicago Medicine

Abdullah Hasan Pratt, MD
Assistant Professor of Emergency Medicine
UChicago Medicine

Stephen Estime, MD
Assistant Professor of Anesthesia and Trauma Critical Care
UChicago Medicine

In this video, Dr. Ludmer at UChicago Medicine describes the airway equipment that they have available for when a patient has an airway problem.

PREPRINT RELEASE: Airway Assessment for Trauma Patient

Airway Assessment for Trauma Patient

Nicholas Ludmer, MD
Assistant Professor of Emergency Medicine
UChicago Medicine

Abdullah Hasan Pratt, MD
Assistant Professor of Emergency Medicine
UChicago Medicine

Stephen Estime, MD
Assistant Professor of Anesthesia and Trauma Critical Care
UChicago Medicine

In this video, Dr. Ludmer at UChicago Medicine describes the airway assessment for a trauma patient.

PREPRINT RELEASE: Robotic eTEP Retrorectus Rives-Stoppa Repair for Ventral Hernia

Robotic eTEP Retrorectus Rives-Stoppa Repair for Ventral Hernia
Alta Bates Summit Medical Center

Rockson C. Liu, MD, FACS
General Surgery, Epic Care, Alta Bates Summit Medical Center

In this case, Dr. Rockson Liu performs a robotic eTEP retrorectus Rives-Stoppa repair of an upper midline primary ventral hernia that was partially reducible but mostly incarcerated, and greater than 6 cm in a 63-year-old female. Robotic ports were placed directly into the retrorectus space. Using the crossover technique, the retrorectus spaces were combined with a preperitoneal bridge of the peritoneum. The defects were closed robotically, and a medium-weight, macroporous polypropylene mesh was placed within the retrorectus space.

PREPRINT RELEASE: Pharmacology for Rapid Sequence Intubation (RSI) Airway Management in Trauma Patients

Pharmacology for Rapid Sequence Intubation (RSI) Airway Management in Trauma Patients
UChicago Medicine

Laura Celmins, PharmD, BCPS, BCCCP
Clinical Pharmacy Specialist
Emergency Medicine

In this video, Laura Celmins, a clinical pharmacist in the emergency department at UChicago Medicine, discusses rapid sequence intubation (RSI) medications as part of the airway management for trauma patients.

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: Trauma Resuscitation Demonstration in a Stable Patient with a Minor Perforating Wound

Trauma Resuscitation Demonstration in a Stable Patient with a Minor Perforating Wound
UChicago Medicine

Priya Prakash, MD
Assistant Professor of Surgery
Trauma, Critical Care, and Emergency Surgery
UChicago Medicine

The patient in this case is a 17-year-old male who presented in stable condition with a minor, superficial, perforating saber wound. In this video article, Dr. Priya Prakash at UChicago Medicine demonstrates a trauma resuscitation and removes the saber.

PREPRINT RELEASE: Colonic Interposition for Esophageal Atresia

Colonic Interposition for Esophageal Atresia
Mario Catarino Rivas Hospital, Honduras

Yoko Young Sang, MD
Resident Physician
General Surgery
Louisiana State University Shreveport

Caroll Alvarado Lemus, MD
Pediatric Surgery, Mario Catarino Rivas Hospital, Honduras
San Pedro Sula, Honduras

Domingo Alvear, MD
Founder
World Surgical Foundation

The patient in this case is a 6-year-old boy who was born with Down syndrome and esophageal atresia. In this video article, Dr. Alvear performs a colonic interposition to replace the absent esophagus with part of the patient’s colon. This was performed during a global surgical mission in Honduras with the World Surgical Foundation.

PREPRINT RELEASE: Left Mastectomy Wound Closure with Left Latissimus Dorsi Musculocutaneous Local Flap

Left Mastectomy Wound Closure with Left Latissimus Dorsi Musculocutaneous Local Flap
Hospital Leonardo Martinez, Honduras

Geoffrey G. Hallock, MD
Plastic Surgery Consultant
Sacred Heart Campus, St. Luke’s Hospital
Allentown, Pennsylvania

Yoko Young Sang, MD
Resident Physician
General Surgery
Louisiana State University Shreveport

In this case, Dr. Hallock closes the wound that was left behind following a mastectomy using a latissimus dorsi musculocutaneous local flap. This was performed during a surgical mission in Honduras with the World Surgical Foundation.

PREPRINT RELEASE: Abdominal Hysterectomy for Uterine Fibroids

Abdominal Hysterectomy for Uterine Fibroids
Hospital Leonardo Martinez, Honduras

Col. Arthur C. Wittich, DO
Fort Belvoir Community Hospital (Retired)
World Surgical Foundation

In this case, Dr. Wittich performs an abdominal hysterectomy on a 45-year-old female with symptomatic uterine fibroids. This was performed during a surgical mission in Honduras with the World Surgical Foundation.