All posts by Chris Boisvert

PUBLISHED: Female Foley Catheter Placement Preoperatively

Female Foley Catheter Placement Preoperatively
Linda J. Guan, MDJoseph Y. Clark, MD
Penn State Health Milton S. Hershey Medical Center

Urinary catheterization is a standard procedure performed in the perioperative setting. In this video, the procedure is initiated after the patient has been placed under anesthesia, and the lower extremities are positioned in a frog-leg configuration to provide optimal access to the perineum. A standard Foley catheter tray is utilized, which contains all necessary components for the procedure under sterile conditions. The placement of a Foley catheter in female patients preoperatively represents a fundamental yet critical procedure in perioperative care. Though technically straightforward, its proper execution demands meticulous attention to anatomical detail, strict sterile technique, and awareness of potential challenges. Furthermore, technical proficiency in catheter placement contributes to improved patient outcomes by reducing the risk of urethral trauma and catheter-associated infections.

PUBLISHED: Lateral Tarsal Strip Procedure for Right Lower Eyelid Entropion

Lateral Tarsal Strip Procedure for Right Lower Eyelid Entropion
John Lee, MD
Boston Vision

The lateral tarsal strip procedure offers several advantages, including addressing the fundamental underlying cause of involutional entropion, providing long-lasting correction, causing minimal postoperative discomfort, and having a low recurrence rate compared to other procedures. Additionally, it can be combined with other procedures when indicated. The accompanying video provides a detailed, comprehensive description of this surgical technique with visual demonstration of each step. This video will be particularly beneficial for ophthalmologists, oculoplastic surgeons, and trainees seeking to refine their understanding and surgical skills in the management of entropion.

PUBLISHED: Esophagogastroduodenoscopy (EGD) with Placement of a Bravo Probe for pH and GERD Symptom Monitoring

Esophagogastroduodenoscopy (EGD) with Placement of a Bravo Probe for pH and GERD Symptom Monitoring
Charu Paranjape, MD, FACS
Newton-Wellesley Hospital

Accurate diagnosis and monitoring of GERD are crucial for appropriate patient management and treatment selection. This demonstration highlights the advantages of the Bravo wireless system over traditional catheter-based methods for pH monitoring. The procedure proves particularly valuable in post-bariatric surgery patients, as illustrated in this case of a patient with previous sleeve gastrectomy, where GERD symptoms frequently require thorough evaluation. The extended 96-hour monitoring period provides comprehensive data regarding reflux patterns and symptom correlation, facilitating evidence-based decisions about medical or surgical management.

PUBLISHED: Open Incisional Hernia Repair with Mesh and Unilateral Posterior Component Separation with Excision of Unstable Scar

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.

PUBLISHED: Laparoscopic-Assisted Right Hemicolectomy

Laparoscopic-Assisted Right Hemicolectomy
Anthony D. Douglas II, MDDerrius Anderson, MDJelani Williams, MDRowan HusseinAshley RussellKonstantin 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.

PUBLISHED: Irrigation and pH Check for Unknown Substance in the Eye

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.

PUBLISHED: Carpal Tunnel Repair and Fasciectomy for Carpal Tunnel Syndrome and Dupuytren’s Disease

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.

PUBLISHED: Cystoscopy, Right Ureteroscopy, and Ureteral Stent Insertion with Aborted Biopsy and Potential Laser Ablation of a Right Renal Mass

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.

PUBLISHED: Open Total Thyroidectomy for Graves’ Disease

Open Total Thyroidectomy for Graves’ Disease
Allison S. Letica-Kriegel, MD, MScAntonia E. Stephen, MD
Massachusetts General Hospital

Graves’ disease is an autoimmune condition that causes hyperthyroidism. There are several options for management which include medications, radioactive iodine ablation, and surgery. Over time, total or near-total thyroidectomy has become the gold standard in surgical management of this disease. Although there is a slightly higher risk of complications following total thyroidectomy in patients with Graves’ disease as compared to their non-Graves’ counterparts undergoing thyroidectomy, the absolute risk remains low, especially for high-volume endocrine surgeons.

PUBLISHED: Open Onlay Hernia Repair for Recurrent Incisional Hernia

Open Onlay Hernia Repair for Recurrent Incisional Hernia
Samuel J. Zolin, MDEric M. Pauli, MD, FACS, FASGE
Penn State Health Milton S. Hershey Medical Center

An 80-year-old patient underwent an open onlay repair of a recurrent incisional hernia. This approach was chosen due to the patient’s prior retromuscular repair, age, history of adhesions, and religious preference against blood products. Following safe abdominal entry and adhesiolysis, a subcutaneous pocket extending 5 centimeters in all directions from the hernia was created. Fascia was closed using mesh-suture and a 12 x 12-centimeter macroporous, medium-weight polypropylene mesh was secured to the anterior fascia with staples and fibrin glue. A subcutaneous drain was placed. This case highlights the utility of an onlay approach for selected circumstances.