Open Incisional Hernia Repair with Mesh and Unilateral Posterior Component Separation with Excision of Unstable Scar
Hany M. Takla, MD, FACS, FASMBS, DABS-FPMBS
Wentworth-Douglass Hospital
Yuri Novitsky’s description of the posterior component separation in 2012 has revolutionized the world of ventral hernia repairs. While large hernia defects above 10 to 12 centimeters seemed impossible to close primarily without tension, the technique of transversus abdominis release as described helped achieve posture as well as anterior abdominal wall closure without tension in addition to providing a highly vascularized medium for mesh integration in between these layers. Not only does the posterior component separation allow for medialization of the posterior rectus sheath to be closed in the midline, but it also gives a release to the anterior components of the abdominal wall to allow for recreation of the linea alba without tension.
Laparoscopic-Assisted Right Hemicolectomy
Anthony D. Douglas II, MD; Derrius Anderson, MD; Jelani Williams, MD; Rowan Hussein; Ashley Russell; Konstantin Umanskiy, MD
UChicago Medicine
The patient-centered environment of the operating room often precludes extensive intraoperative discussions or detailed explanations between a resident and the attending surgeon. This constraint in real-time feedback poses a challenge for surgical residents to refine their surgical skills. Implementation of a structured case review between attendings and senior residents at interval timepoints of their rotations could support addressing this gap. This case presents a laparoscopic right hemicolectomy. This procedure removes a portion of the colon and is commonly indicated for colon cancer. In this video article, a senior general surgery resident participates in the procedure and then engages in a structured case review with their attending, analyzing the fundamental steps of the procedure as well as identifying opportunities for technical improvement and enhancement of intraoperative decision-making.
Irrigation and pH Check for Unknown Substance in the Eye
Alexander Martin, OD
Boston Vision
When an unknown substance has entered the eye, diagnostic measurement of ocular surface pH and therapeutic irrigation of the eye are essential steps to minimize the risk of long term consequences. These procedures are demonstrated here and represent critical interventions in emergency eye care. When properly executed, they serve as both diagnostic and therapeutic measures. Their simplicity and effectiveness make them essential skills in emergency and primary care settings, where rapid intervention can prevent permanent ocular damage. Time to irrigation is the most critical factor in determining outcomes, with each minute of delay potentially increasing the risk of permanent visual impairment as this can lead to permanent scarring.
Carpal Tunnel Repair and Fasciectomy for Carpal Tunnel Syndrome and Dupuytren’s Disease
Sudhir B. Rao, MD
Munson Healthcare Cadillac Hospital
Carpal Tunnel Syndrome (CTS) and Dupuytren’s disease (DD) are two common hand conditions that can significantly impact a patient’s quality of life and hand function. In cases where both conditions coexist, as demonstrated in this video, a combined surgical approach is adopted in suitable candidates. Combining carpal tunnel release and fasciectomy in a single surgical setting is safe, cost-effective, and efficient, reducing recovery time and healthcare costs while achieving functional outcomes comparable to staged interventions. This video demonstration is particularly valuable for practicing hand surgeons and surgical trainees, offering detailed insights into technical challenges such as neurovascular bundle protection, management of retrovascular cord components, and the precise balance between complete disease excision and preservation of vital structures. The demonstrated solutions, including the use of vessel loops for nerve protection, staged fascia removal, and careful hemostasis management, provide practical guidance for similar cases.
Cystoscopy, Right Ureteroscopy, and Ureteral Stent Insertion with Aborted Biopsy and Potential Laser Ablation of a Right Renal Mass
Ryan A. Hankins, MD
MedStar Georgetown University Hospital
This article describes a case of a 58-year-old male patient with a renal mass, which was incidentally discovered on an imaging of chest CT scan, without any signs and symptoms indicative for renal masses. The patient has no history of ureteroscopy before, and no prior history of urolithiasis. The multiphasic, contrast-enhanced abdominal CT scan shows 2.5-cm hyperattenuating enhancing mass in the upper pole of the right kidney. Transverse unenhanced CT image shows hyperattenuating mass with no evidence of fat. Transverse CT image shows enhancement of the mass from 60 HU to 116 HU. The chest CT scan showed no abnormalities. This video describes a complex urological procedure that initially aimed to perform diagnostic and potentially therapeutic intervention but was modified due to anatomical constraints. The procedure demonstrates the importance of surgical adaptability and the role of staged approaches in urological surgery.
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