PUBLISHED: Subtotal Parotidectomy and Unilateral Lateral Neck Dissection (Levels II, III, and IV) for Right Parotid Mucoepidermoid Carcinoma Involving the Deep and Superficial Lobes and Extending into Parapharyngeal Space

Subtotal Parotidectomy and Unilateral Lateral Neck Dissection (Levels II, III, and IV) for Right Parotid Mucoepidermoid Carcinoma Involving the Deep and Superficial Lobes and Extending into Parapharyngeal Space
Veenadhari Kollipara, BA1,2Kunal A. Koka, BS1,2Quentin C. Durfee, BS1Emily K. Funk, MD1,2Neerav Goyal, MD, MPH, FACS1,2Guy Slonimsky, MD1,2
1Penn State College of Medicine
2Penn State Health Milton S. Hershey Medical Center

Mucoepidermoid carcinoma (MEC) is the most common malignant tumor of the salivary glands, predominantly affecting the parotid gland. It commonly presents as a painless neck mass. Diagnostic workup includes physical examination, imaging, and fine needle aspiration biopsy. Superficial, subtotal, or total parotidectomy, with or without neck dissection and possible adjuvant radiation therapy, is recommended in most cases according to tumor stage, grade, and adverse pathological features. In the case presented here, subtotal parotidectomy with facial nerve preservation and neck dissection followed by adjuvant radiation therapy was elected. Post-treatment imaging at three-month intervals showed no evidence of persistent disease. The attached video demonstrates subtotal right parotidectomy via combined anterograde and retrograde nerve dissection and right selective neck dissection of levels IIa, IIb, III, and IV.

PUBLISHED: Anterolateral Thigh Free Flap Reconstruction of Parotidectomy Defect

Anterolateral Thigh Free Flap Reconstruction of Parotidectomy Defect
Kunal A. Koka, BS1,2Quentin C. Durfee, BS1Veenadhari Kollipara, BA1,2Emily K. Funk, MD2Guy Slonimsky, MD2Neerav Goyal, MD, MPH, FACS2
1Penn State College of Medicine
2Penn State Health Milton S. Hershey Medical Center

Anterolateral Thigh (ALT) free flap is a widely utilized technique for the reconstruction of head and neck soft tissue defects. Key steps of this procedure include flap design for reconstruction of surgical defect, identification and dissection of perforator vessels and vascular pedicle for harvest of the anterolateral thigh free flap, microvascular anastomosis of the pedicle to head and neck vessels, and flap inset for reconstruction at recipient site. The ALT free flap is a versatile tool that can be utilized for reconstruction throughout the body but is very frequently utilized for reconstruction in oncologic resections of the head and neck. In this case, it was utilized for reconstruction of a soft tissue defect resulting from a parotidectomy with resulting skin and soft tissue defect, performed for removal of a mucoepidermoid carcinoma.

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

Setup for a Laparoscopic Appendectomy (Kingsborough Community College, Brooklyn, NY)
Roxanne West, BS, CST
Kingsborough Community College, Brooklyn, NY

Correct preoperative setup of the sterile field, including surgical instrumentation, is critical to ensure patient safety and optimize surgical outcomes. Educational videos such as this provide important resources for surgical technology students and other healthcare professionals who are learning how to master these foundational skills. This video demonstrates a complete setup of the back table and Mayo stand for a laparoscopic appendectomy, during which all instruments are identified and counted in accordance with established safety protocols. The setup process includes verification of sterile indicators to confirm sterility, followed by a systematic count of soft goods and sharps and identification of specialized laparoscopic instrumentation.

PUBLISHED: Setup for an Open Pancreatectomy (Kingsborough Community College, Brooklyn, NY)

Setup for an Open Pancreatectomy (Kingsborough Community College, Brooklyn, NY)
Gina Forsythe, CST
Kingsborough Community College, Brooklyn, NY

Open pancreatectomy is a complex abdominal procedure requiring detailed preoperative preparation by the surgical technologist. An efficient sterile back table and Mayo stand setup is important for patient safety and operative workflow. In this educational video, the setup sequence demonstrates sterility verification, instrument organization, the initial surgical count, and medication labeling. All steps were conducted in accordance with perioperative safety standards.

PUBLISHED: Endobronchial Ultrasound Bronchoscopy-Guided Biopsy for Lymphoma

Endobronchial Ultrasound Bronchoscopy-Guided Biopsy for Lymphoma
Don Kim, MD1Vigen Janoyan, MD2Yu 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.

PUBLISHED: Setup for an Open Cholecystectomy (Kingsborough Community College, Brooklyn, NY)

Setup for an Open Cholecystectomy (Kingsborough Community College, Brooklyn, NY)
Dana Donovan, BA, CST
Kingsborough Community College, Brooklyn, NY

This instructional video shows how to prepare a back table, Mayo stand, and ring stand for an open cholecystectomy. Surgical instrumentation, radiopaque sponges, sutures, and blades are organized carefully prior to an initial count with a circulating nurse or other licensed professional.