Tag Archives: mgh

PREPRINT RELEASE: Pancreatic Debridement via Sinus Tract Endoscopy


Pancreatic Debridement via Sinus Tract Endoscopy
Massachusetts General Hospital

Peter Fagenholz, MD
Assistant Professor of Surgery
Harvard Medical School

A patient who was involved in a motor vehicle accident developed large peripancreatic fluid collections and eventually had percutaneous drainage of those collections. In this video, Dr. Peter Fagenholz at MGH performs a pancreatic debridement utilizing sinus tract endoscopy after this patient’s necrotic collection had persisted for weeks.

PUBLISHED: Whipple Procedure for Multiple Endocrine Neoplasia of the Pancreas

Whipple Procedure for Multiple Endocrine Neoplasia of the Pancreas
Keith Lillemoe, MD
Surgeon in Chief
Massachusetts General Hospital
Harvard Medical School

Participate in a masterclass with MGH Chief of Surgery, Dr. Keith Lillemoe, as he performs and narrates a complete Whipple procedure in the latest video-article published by JOMI.

The Whipple procedure, or pancreaticoduodenectomy, is most notably known for its use in the treatment of cancer that is confined to the head of the pancreas. Because of the intricate blood supply between the pancreas, duodenum, gallbladder, and common bile duct, these structures must be resected along with the head of the pancreas. The remaining structures must then be carefully and precisely anastomosed in order to preserve digestive functioning.

This procedure is a complex and difficult operation that can have serious risks; however, it is responsible for saving countless lives.

 

PREPRINT RELEASE: Laparoscopic Cholecystectomy

Laparoscopic Cholecystectomy
Massachusetts General Hospital

Denise W. Gee, MD
Assistant Professor of Surgery
Harvard Medical School

A female patient presented with a few months of abdominal pain following the eating of fatty foods. Imaging showed gallbladder sludge, small stones, or potentially a polyp. Here, Dr. Denise W. Gee performs a laparoscopic cholecystectomy to alleviate these symptoms. #MGH #generalsurgery #gallbladder #cholecystectomy

PREPRINT RELEASE: Right Laparoscopic Adrenalectomy

Right Laparoscopic Adrenalectomy
Massachusetts General Hospital

Richard Hodin, MD
Professor of Surgery
Harvard Medical School

In this case, a 58-year-old female was found to have hyperaldosteronism, and a CT scan revealed bilateral cortical adenomas. Here, Dr. Richard Hodin, MD, walks the viewer through the analysis of adrenal vein sampling and performs a right laparoscopic adrenalectomy at MGH.

PREPRINT RELEASE: Leiomyosarcoma of the Inferior Vena Cava: Resection and Reconstruction

Leiomyosarcoma of the Inferior Vena Cava: Resection and Reconstruction
Massachusetts General Hospital
Madhukar S. Patel, MD, MBA, ScM

Department of Surgery, MGH
Jahan Mohebali, MD, MPH
Department of Surgery, Division of Vascular and Endovascular Surgery, MGH
Parsia A. Vagefi, MD, FACS
Department of Surgery, Division of Transplant Surgery, MGH
Alex B. Haynes, MD, MPH, FACS
Department of Surgery, Division of Surgical Oncology, MGH

A woman presented with back pain, and when biopsied, she was found to have an inferior vena cava leiomyosarcoma - specifically involving the infrahepatic vena cava, the origin of the left renal vein, and the hilum of the right kidney. After undergoing preoperative proton beam radiation, the patient has her tumor resected en bloc by Dr. Vagefi and Dr. Haynes. They will also reconstruct the vena cava with a ringed synthetic graft covered by an omental pedicle flap.

PREPRINT RELEASE: Open Lobectomy

Open Lobectomy
Massachusetts General Hospital
Christopher R. Morse, M.D.
Assistant Professor of Surgery, Harvard Medical School
Co-Director, Gastroesophageal Surgery Program

An adult male with cystic fibrosis (CF) presents with a chronically damaged left upper lung lobe that Dr. Christopher Morse decides to treat with an open lobectomy given that the patient was not going to heal from antibiotic therapy and still had mild preserved pulmonary function. Two unusual things in this procedure are the dense inflammatory changes at the hilum and the use of muscle from chest wall to reinforce the bronchial closure because of the patient’s recurrent and chronic pulmonary infections due to CF.

PREPRINT RELEASE: Distal Gastrectomy (Open)

Distal Gastrectomy (Open)
John T. Mullen, MD
Director, General Surgery Resident Program
Massachusetts General Hospital

 

An 80-year-old patient with anemia undergoes an upper endoscopy that reveals inflammation in the distal stomach. Biopsies identify it as an early intramucosal adenocarcinoma while an endoscopic ultrasound shows the tumor invading the muscle of the stomach. Given that there are no signs of metastasis, the patient presents for a potentially curative gastrectomy where Dr. John Mullen removes the distal two-thirds of the stomach, performs a D1 lymph node dissection and a partial D2 lymph node dissection, and reconstructs in a Billroth II fashion.

PREPRINT RELEASE: Wedge Resection of the Lung and Thymectomy by Thoracoscopy

Wedge Resection of the Lung and Thymectomy by Thoracoscopy
Massachusetts General Hospital
Henning A. Gaissert, MD
Lucia Madariaga, MD

Visiting Surgeon, MGH & Associate Professor of Surgery, Harvard Medical School
Fellow in Thoracic Surgery, MGH

A patient with myasthenia gravis undergoes a procedure meant to originally be a lobectomy and thymectomy. Henning Gaissert, MD decides to do a lobe wedge resection instead given the tumor’s positioning and carcinoid nature before proceeding with the thymectomy. Please note that the patient had to return to the OR the following day due to bleeding near the internal mammary vein. 

PREPRINT RELEASE: Laparoscopic Adrenalectomy

Laparoscopic Adrenalectomy
Massachusetts General Hospital
Richard Hodin, M.D.
Professor of Surgery, Harvard Medical School

After visiting an endocrinologist who diagnosed her with aldosteronism, the patient takes a CT scan that reveals a 8mm nodule in the left adrenal gland. Dr. Hodin performs a laparoscopic adrenalectomy to remove it.