Tag Archives: ultrasound

Print Release, Pulmonology

PUBLISHED: Endobronchial Ultrasound Bronchoscopy-Guided Biopsy for Lymphoma

Endobronchial Ultrasound Bronchoscopy-Guided Biopsy for Lymphoma
Don Kim, MD1; Vigen Janoyan, MD2; Yu Maw Htwe, MD1
1RWJBarnabas-Rutgers Medical Group
2Institute of Surgery after A. Mikaelyan, RA

Endobronchial ultrasound bronchoscopy (EBUS) is a minimally invasive and widely utilized endoscopic technique that enables real-time ultrasound visualization of mediastinal and hilar lymph nodes adjacent to the tracheobronchial tree, allowing tissue sampling under direct sonographic guidance. Accessible nodal stations include 1, 2R/L, 3P, 4R/L, 7, 10R/L, and 11R/L; however, stations 5 and 6 are technically more challenging and associated with a higher risk of complications due to their proximity to the aorta and pulmonary vessels.

EBUS can be used for diagnostic, staging, and restaging purposes, particularly in conditions such as lymphoma and sarcoidosis, as demonstrated in the accompanying video. Its diagnostic yield varies according to the underlying pathology and nodal characteristics, and the diagnostic sensitivity for specific diseases is outlined below.

General Surgery, Print Release

PUBLISHED: Robotic Hepatectomy for a Segment V/VI Suspected HCC Lesion with Cholecystectomy and Evaluation by Ultrasound and Excisional Biopsy of a Segment IVb Lesion

Robotic Hepatectomy for a Segment V/VI Suspected HCC Lesion with Cholecystectomy and Evaluation by Ultrasound and Excisional Biopsy of a Segment IVb Lesion
Ji Ho Park, MD; Corbin S. Morris, MD; Kelsey L. Fletcher, MD; Charles C. Vining, MD, FACS, FSSO; Lawrence M. Knab, MD, FACS, FSSO; Rushin D. Brahmbhatt, MD, FACS
Penn State Health Milton S. Hershey Medical Center

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and is associated with high morbidity and mortality. In this case, the patient was incidentally found to have a segment V/VI lesion consistent with HCC and a IVb lesion indeterminate probability of malignancy. He underwent a robotic-assisted hepatectomy for a segment V/VI lesion with cholecystectomy and evaluation by ultrasound and excisional biopsy of a segment IVb lesion. His postoperative course was unremarkable, and he was discharged on postoperative day four. The pathology demonstrated well-differentiated HCC with resection margins negative for carcinoma. This video demonstrates an experienced surgeon’s technique for performing a robotic hepatectomy for a segment V/VI lesion with cholecystectomy and evaluation by ultrasound and excisional biopsy of a segment IVb lesion. It also highlights effective management of bleeding during hepatic parenchymal transection.

Anesthesiology, Print Release

PUBLISHED: Neuraxial Ultrasound and Spinal Anesthesia for Cesarean Delivery

Neuraxial Ultrasound and Spinal Anesthesia for Cesarean Delivery
Fatine Karkri, MD; Lauren Blake, MD; Brendan Carvalho, MBBCh, FRCA, MDCH, FASA
Stanford University School of Medicine

This video provides a step-by-step demonstration of preprocedural neuraxial ultrasound for lumbar neuraxial procedures. The film shows probe selection and orientation, sonoanatomy landmarks (sagittal and transverse views), measurement of skin-to-posterior complex depth, and skin marking. Indications and evidence for improved procedural accuracy and reduced needle passes are discussed. The technique is applicable to routine obstetric neuraxial procedures and is especially useful in patients with challenging surface landmarks or a history of difficult neuraxial placement.

General Surgery, Print Release, Trauma

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.

General Surgery, Preprint Release, Trauma

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.

Announcement, General Surgery, Preprint Release

PREPRINT RELEASE: Distal Gastrectomy (Open)

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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.