PUBLISHED: Myringoplasty and Tympanostomy Tube Placement

Myringoplasty and Tympanostomy Tube Placement
C. Scott Brown, MD; David M. Kaylie, MD, MS
Duke University Medical Center

Eustachian tube dysfunction can often cause otitis media, tympanic membrane perforation, or conductive hearing loss. In this video article, myringoplasty was performed using a CO2 laser that provided reorganization of collagen fibers and improved compliance of the tympanic membrane. Given the ongoing eustachian tube dysfunction, a pressure equalization tube was placed to prevent recurrent retraction and atelectasis of the eardrum.

PUBLISHED: Robotic Low Anterior Resection with Diverting Loop Ileostomy for Locally Advanced Rectal Cancertapedectomy

Robotic Low Anterior Resection with Diverting Loop Ileostomy for Locally Advanced Rectal Cancer

Todd Francone, MD
Massachusetts General Hospital, Newton-Wellesley Hospital

Jon Harrison, MD
Massachusetts General Hospital

In this video article, Dr. Todd Francone at Newton-Wellesley Hospital demonstrates and narrates a robotic low anterior resection for locally advanced rectal cancer after neoadjuvant FOLFOX-based chemoradiation treatment. Low anterior resection is recommended for rectal tumors in which a 1-cm distal margin is achievable without sphincter encroachment. A key component of this operation is a complete mesorectal dissection, which is highlighted with the robotic technique. In this case, the patient had a 2.6-cm tumor located 6 cm above the anal verge, which was treated with 8 cycles of FOLFOX followed by consolidative radiation therapy. A robotic low anterior resection was performed, and the final pathology revealed a complete pathologic response.

PUBLISHED: Open Distal Pancreatectomy for Pancreatic Cancer

 

Open Distal Pancreatectomy for Pancreatic Cancer

Carlos Fernandez-del Castillo, MD
Massachusetts General Hospital

Morgan L. Hennessy, MD, PhD
Massachusetts General Hospital

In this case, Dr. Carlos Fernandez-del Castillo at MGH performs and narrates an open distal pancreatectomy with splenectomy in a patient who has undergone neoadjuvant treatment for pancreatic adenocarcinoma. This is a unique case of a patient undergoing surgical resection after initial diagnosis of metastatic disease. The patient is a 69-year-old woman who initially presented with abdominal pain and bloating, and was found to have a 2-cm suspicious tumor in the body of her pancreas and biopsy-proven single liver metastasis. She was treated with an extended course of neoadjuvant chemotherapy, and re-staging scans showed significant response. Chemoradiation was completed, and the liver metastasis was no longer visible on imaging. 27 months after diagnosis she was taken to the operating room for distal pancreatectomy and splenectomy; no liver or peritoneal metastases were seen. Her postoperative course was overall uneventful, and she recovered well. Final surgical pathology demonstrated complete pathological response with no evidence of disease seen and 0/11 lymph nodes positive for malignancy.

 

PUBLISHED: Endoscopic Stapedectomy

 

 

Endoscopic Stapedectomy

Scott Brown, MD, FACS
University of Miami Miller School of Medicine

Michael E. Hoffer, MD
University of Miami Miller School of Medicine

Benjamin Park
Vanderbilt University School of Medicine

In this video, Dr. Scott Brown performs an endoscopic stapedectomy for the treatment of conductive hearing loss. He explains his technique and the advantages afforded by adoption of the endoscope in ear surgery.