Print Release, Surgical Technology

PUBLISHED: Setup for a Breast Biopsy (Kingsborough Community College, Brooklyn, NY)

Setup for a Breast Biopsy (Kingsborough Community College, Brooklyn, NY)
Dana Donovan, BA, CST
Kingsborough Community College, Brooklyn, NY

Proper preparation of the operative field is essential for safe and efficient breast biopsy procedures. This instructional video was recorded at Kingsborough Community College and illustrates a setup performed by a certified surgical technologist. This demonstration includes preparation of the Mayo stand, back table, and ring stand; verification of medications on the sterile field; instrument organization; and performance of the initial count with the circulating nurse. This setup aligns with established best practices for a breast biopsy, which is a diagnostic technique used to examine suspicious breast lesions discovered through histologic examination. This demonstration aims to reinforce standardized preparation practices that support patient safety and efficient surgical workflow.

Anesthesiology, Print Release

PUBLISHED: Spinal Anesthesia for Ambulatory Hip and Knee Arthroplasty Procedures

Spinal Anesthesia for Ambulatory Hip and Knee Arthroplasty Procedures
Bruna Castro de Oliveira, MD
Massachusetts General Hospital

This educational video article details the technique of spinal anesthesia administration for total hip and knee arthroplasty. The presentation details key procedural elements, including anatomical landmarks, midline and paramedian techniques for spinal placement, equipment for spinal anesthesia, patient positioning and preparation, and local anesthetic selection. Spinal anesthesia offers distinct advantages for outpatient arthroplasty, including rapid onset, favorable operative conditions, and facilitation of same-day discharge. The video serves as a practical educational tool that reinforces evidence-based anesthetic practice and supports the continued advancement of safe, efficient care in ambulatory joint replacement surgery.

Print Release, Surgical Technology

PUBLISHED: Setup for a Laparoscopic Appendectomy (Eastwick College, Ramsey, NJ)

Setup for a Laparoscopic Appendectomy (Eastwick College, Ramsey, NJ)
Hansel Samson Perez, AAS, CST; Karen L. Chambers, MHA/Ed, CST, FAST
Eastwick College, Ramsey, NJ

Laparoscopic appendectomy has become the standard surgical approach for acute appendicitis. Organization and maintenance of the sterile field are necessary in order to protect the patient’s safety and ensure an efficient surgical workflow. This educational video demonstrates how to prepare a back table, Mayo stand, and ring basin for a laparoscopic appendectomy using an efficient method that promotes patient safety.

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.

Print Release, Surgical Technology

PUBLISHED: Setup for a Laparoscopic Hemicolectomy (Eastwick College, Ramsey, NJ)

Setup for a Laparoscopic Hemicolectomy (Eastwick College, Ramsey, NJ)
Ana M. Anilmis, AAS, CST; Karen L. Chambers, MHA/Ed, CST, FAST
Eastwick College, Ramsey, NJ

Laparoscopic hemicolectomy is a minimally invasive surgical intervention requiring careful organization and clear setup procedures. A systematic approach to this setup ensures all necessary equipment is available, and it supports optimal surgical outcomes and patient safety. This educational video provides a demonstration of a setup for a laparoscopic hemicolectomy including back table organization, Mayo stand preparation, instrument arrangement, and the initial count with a circulator.

Print Release, Vascular Surgery

PUBLISHED: Fistulogram for a Cephalic Arch Aneurysm

Fistulogram for a Cephalic Arch Aneurysm
Tiffany R. Bellomo, MD1,2; Brett J. Salomon, MD1,2; Jonah Thomas, MD2; Anahita Dua, MD, MS, MBA, FACS1
1Massachusetts General Hospital
2Mass General Brigham

More than 100,000 arteriovenous fistulas (AVFs) are created annually in the United States, but are frequently complicated by venous outflow stenosis, aneurysm formation, and aneurysms that often require angiographic evaluation and intervention. Cephalic arch stenosis is a particularly common cause of dysfunction in brachiocephalic fistulas due to high flow. This is typically managed with fistulogram-guided angioplasty, although repeated interventions are associated with restenosis and access-related complications.

This article present the case of a 63-year-old, right-hand dominant male with end-stage renal disease secondary to glomerulonephritis on dialysis through a left upper extremity brachiocephalic AVF that was complicated by recurrent cephalic arch stenosis requiring multiple angioplasties, which ultimately resulted in the development of a cephalic arch aneurysm. Subsequent fistulograms demonstrated a high-grade stenosis that could not be traversed despite multiple attempts.

Comprehensive preoperative evaluation included focused history, physical examination, duplex ultrasound, and computed tomography venography. The fistulogram described in this article demonstrated a patent, high-flow AVF with a saccular aneurysm of the proximal cephalic vein measuring up to 28 mm without thrombus and no hemodynamically significant flow-limiting stenosis. Given the absence of flow limitation and the risk of compromising future access, stent placement was deferred.

This case highlights the importance of individualized decision-making in the management of complex AVF complications. Fistulograms serve as a critical diagnostic and therapeutic tool, allowing real-time assessment of anatomy and flow to guide intervention. In select patients, conservative endovascular management with surveillance may preserve access durability and delay the need for more invasive procedures.

General Surgery, Print Release

PUBLISHED: Robotic Preperitoneal eTEP Repair for Umbilical Hernia and Diastasis

Robotic Preperitoneal eTEP Repair for Umbilical Hernia and Diastasis
Hector A. Valenzuela Alpuche, MD; Juan P. Saucedo Gonzalez, MD; Roland K. Cethorth Fonseca, MD
Hospital Angeles del Carmen, Guadalajara, Mexico

Robotic extraperitoneal approaches have expanded the possibilities of minimally invasive abdominal wall reconstruction. The suprapubic preperitoneal eTEP (PeTEP) technique offers an alternative for selected patients with small-to-medium midline hernias, with or without rectus diastasis, in whom preservation of the retrorectus plane is desirable. This article describes the application of PeTEP in a 58-year-old male with a 3-cm primary umbilical hernia and a 5-cm rectus diastasis, using a suprapubic robotic extraperitoneal approach to achieve functional midline reconstruction while maintaining the integrity of the retrorectus space. The procedure includes pretransversalis access, development of the preperitoneal and pretransversalis planes, midline restoration, and placement of a preperitoneal polypropylene mesh. This technique avoids posterior sheath division, neurovascular bundle manipulation, and retromuscular dissection, thereby reducing potential morbidity in selected patients. This case illustrates the feasibility of PeTEP in a carefully selected patient. The authors do not propose this approach as a replacement for open or transabdominal techniques, but rather as an additional option within a broader reconstructive spectrum.

Print Release, Surgical Technology

PUBLISHED: Setup for a Laparoscopic Hemicolectomy (Kingsborough Community College, Brooklyn, NY)

Setup for a Laparoscopic Hemicolectomy (Kingsborough Community College, Brooklyn, NY)
Gina Forsythe, CST
Kingsborough Community College, Brooklyn, NY

Laparoscopic hemicolectomy has become the standard of care for the surgical management of various colonic pathologies. Proper instrument setup and systematic counting protocols are essential components of surgical safety and procedural efficiency. The setup protocol for laparoscopic hemicolectomy shown in this video is based on established guidelines for sterile technique and encompasses instrument arrangement, the initial count, and discussion of fluid management on the sterile field. The setup includes organized placement of laparoscopic instruments, trocars, sponges, sharps, and essential equipment. This setup promotes surgical safety, reduces procedural delays, and minimizes the risk of retained surgical items.

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

PUBLISHED: Robotic-Assisted Transabdominal Preperitoneal (rTAPP) Repair for Ventral Hernias

Robotic-Assisted Transabdominal Preperitoneal (rTAPP) Repair for Ventral Hernias
Daphne Y. Lu, MD, MPH, MBA; Olivia Ziegler, MD; Saamia Shaikh, DO, JD; Jerome R. Lyn-Sue, MD, FACS
Penn State Health Milton S. Hershey Medical Center

This case describes a 58-year-old man who developed a symptomatic incisional ventral hernia following a trauma laparotomy and left nephrectomy after a motor vehicle collision. The patient presented with multiple midline hernia defects associated with bulging and discomfort. This video demonstrates a robotic transabdominal preperitoneal (rTAPP) repair with mesh. The case highlights practical strategies for managing intra-abdominal adhesions and a prior gastrostomy site, while outlining alternative operative approaches for cases in which preperitoneal flap development is technically challenging.

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