Tag Archives: general surgery

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.

PREPRINT RELEASE: Intraperitoneal Mesh Repair for Incisional Hernia

Intraperitoneal Mesh Repair for Incisional Hernia
Hospital Leonardo Martinez, Honduras

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

Shabir Abadin, MD, MPH (Operating Surgeon)
Endocrine and General Surgeon
World Surgical Foundation

The patient in this case had an emergency exploratory laparotomy and diverting colostomy several years ago for a perforated colon. Following reversal of the colostomy, she developed an incisional hernia that also involved the stomal site. Here, Dr. Abadin performs an intraperitoneal mesh repair while on a surgical mission in Honduras with the World Surgical Foundation.

PREPRINT RELEASE: 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

In this video, Dr. Hafez discusses and demonstrates how to perform an EFAST exam.

PREPRINT RELEASE: Exploratory Laparotomy and Splenectomy for Ruptured Spleen Following Blunt Force Trauma


Exploratory Laparotomy and Splenectomy for Ruptured Spleen Following Blunt Force Trauma
UChicago Medicine

Brian Williams, MD
Associate Professor of Trauma and Acute Care Surgery
Co-Director, Surgical Intensive Care Unit

Ashley Suah, MD
Resident Physician
General Surgery

Daven Patel, MD, MPH
Resident Physician
Emergency Medicine

Nadim Michael Hafez, MD
Assistant Professor of Medicine
Emergency Medicine

The patient in this case was assaulted and sustained blunt force trauma to the abdomen. She was intermittently hypotensive, FAST exam revealed free fluid, and CT scan showed a grade IV splenic laceration. Here, Dr. Williams and Dr. Suah at UChicago Medicine perform an exploratory laparotomy and splenectomy.

PREPRINT RELEASE: Exploratory Laparotomy in a Hemodynamically Stable Patient for an Abdominal Gunshot Wound

Exploratory Laparotomy in a Hemodynamically Stable Patient for an Abdominal Gunshot Wound
UChicago Medicine

Brian Williams, MD
Associate Professor of Trauma and Acute Care Surgery
Co-Director, Surgical Intensive Care Unit

Ashley Suah, MD
Resident Physician
General Surgery

The patient in this case presented with an abdominal gunshot wound and peritonitis. Here, Dr. Williams and Dr. Suah perform an exploratory laparotomy and repair a through-and-through gunshot wound to the distal jejunum and a partial-thickness injury to the proximal cecum.

PREPRINT RELEASE: Ankle-Brachial Index, CT Angiography, and Proximal Tibial Traction for GSW Femoral Fracture

Ankle-Brachial Index, CT Angiography, and Proximal Tibial Traction for GSW Femoral Fracture
UChicago Medicine

Jack Kent, MD
Resident Physician
General Surgery

James Jeffries, MD
Resident Physician
Radiology

Andrew Straszewski, MD
Resident Physician
Orthopaedics

Kenneth Wilson, MD, FACS
Associate Professor of Surgery

In another trauma case with UChicago Medicine, Drs. Kent, Jeffries, Straszewski, and Wilson evaluate and treat a patient with a gunshot wound and femoral fracture. An ABI was obtained, CT angiography was evaluated, and proximal tibial traction was performed for pain management.