C. Scott Brown, MD Neurotology & Lateral Skull Base Surgery Fellow University of Miami Miller School of Medicine
Cadaveric dissections of the temporal bone are a critical part of learning otologic surgery in residency. Dr. Scott Brown, neurotology fellow at the University of Miami, performs a step-by-step dissection of the temporal bone. He outlines key anatomical structures and describes safe and efficient techniques for these procedures.
Asif M. Ilyas, MD Professor of Orthopaedic Surgery Program Director of Hand Surgery Rothman Institute, Thomas Jefferson University
Cubital tunnel syndrome is a condition that affects the ulnar nerve as it crosses the medial elbow through the retrocondylar groove. It is the second most common compressive neuropathy, causing tingling and numbness in the ring and small fingers. In advanced cases of symptomatic cubital tunnel syndrome, weakness, altered dexterity, and atrophy of the intrinsic muscles of the hand may develop. Cubital tunnel syndrome can be treated with either a cubital tunnel release or an ulnar transposition. In this case, the former is demonstrated on a cadaveric arm using the mini-open technique.
Asif M. Ilyas, MD Professor of Orthopaedic Surgery Program Director of Hand Surgery Rothman Institute, Thomas Jefferson University
Carpal tunnel syndrome (CTS) is the most common peripheral compression neuropathy and results in symptoms of numbness and paresthesia in the thumb, index finger, middle finger, and half of the ring finger. When CTS symptoms progress and can no longer be managed with nonoperative measures, carpal tunnel release (CTR) surgery is indicated.
In this case, Dr. Asif Ilyas at the Rothman Institute performs CTR surgery on a cadaveric arm via the mini-open CTR technique. A 2-cm longitudinal incision was placed directly over the carpal tunnel, the transverse carpal ligament was exposed and then released, and the wound was closed. Patients are typically sent home with instructions to use their hand immediately postoperatively, while avoiding strenuous use until the incision has healed. Splinting and therapy are not required postoperatively.
Rockson C. Liu, MD, FACS General Surgery, Epic Care, Alta Bates Summit Medical Center
In this case, Dr. Rockson Liu performs a robotic eTEP retrorectus Rives-Stoppa repair of an upper midline primary ventral hernia that was partially reducible but mostly incarcerated, and greater than 6 cm in a 63-year-old female. Robotic ports were placed directly into the retrorectus space. Using the crossover technique, the retrorectus spaces were combined with a preperitoneal bridge of the peritoneum. The defects were closed robotically, and a medium-weight, macroporous polypropylene mesh was placed within the retrorectus space.
Laura Celmins, PharmD, BCPS, BCCCP Clinical Pharmacy Specialist Emergency Medicine
In this video, Laura Celmins, a clinical pharmacist in the emergency department at UChicago Medicine, discusses rapid sequence intubation (RSI) medications as part of the airway management for trauma patients.
C. Scott Brown, MD Neurotology and Lateral Skull Base Surgery Fellow University of Miami Miller School of Medicine
Fred F. Telischi, MEE, MD, FACS James R. Chandler Chair in Otolaryngology Chairman of Otolaryngology and Professor, Neurological Surgery and Biomedical Engineering University of Miami Miller School of Medicine
During the COVID-19 pandemic, viral transmission via aerosolized particles poses the risk of infecting operating room staff. In this video, Dr. Telischi at the University of Miami demonstrates one of several techniques for draping the microscope during cochlear implant surgery.
Peter Fagenholz, MD Assistant Professor of Surgery Massachusetts General Hospital Harvard Medical School
This patient is a 58-year-old male who was in a motor vehicle accident and developed a persistent necrotic collection adjacent to the pancreatic tail that did not improve with percutaneous drainage. Here, Dr. Peter Fagenholz at MGH performs a pancreatic debridement using sinus tract endoscopy (STE), a minimally-invasive technique for debridement of dead or infected tissue.
STE and other minimally-invasive techniques have significantly decreased morbidity and mortality for patients undergoing intervention for infected pancreatic necrosis. Common management principles include early non-interventional management to allow the necrosis to wall off, initial intervention with minimally-invasive drainage, and minimally-invasive necrosectomy addressing clearly demarcated necrosis.
STE involves the placement of a percutaneous drain followed by fluoroscopically-guided dilation of the drain tract to allow for placement of a working sheath, through which an endoscope can be introduced to debride the peripancreatic necrosis. After debridement, a drain is then replaced through the same tract.
InciSioN is a nonprofit organization representing over 5000 students, trainees, and early career physicians around the world, who are passionate about Global Surgery. We work towards the common goal of access to safe, timely and affordable surgical healthcare for all. Our work rests on three pillars of Advocacy, Education, and Research.
