Category Archives: Announcement

Print Release, Vascular Surgery

PUBLISHED: Supraceliac Aorta-to-SMA Bypass with Ileocecectomy for Acute-on-Chronic Mesenteric Ischemia Complicated by Bowel Necrosis and Perforation

Supraceliac Aorta-to-SMA Bypass with Ileocecectomy for Acute-on-Chronic Mesenteric Ischemia Complicated by Bowel Necrosis and Perforation
Benjamin J. Pearce, MD
UAB Hospital

This case involved a 63-year-old female with a history of chronic tobacco use, hypertension, and hyperlipidemia, who had undergone aortobifemoral bypass several months earlier at an outside institution. Shortly afterward, she developed progressive postprandial abdominal pain, alternating constipation and diarrhea, unintentional weight loss, and food fear. During a prolonged hospital admission, she underwent upper and lower endoscopy and autoimmune evaluation, none of which yielded a definitive diagnosis. She was dependent on total parenteral nutrition due to intolerance of enteral intake.

On transfer to our facility, she was found to have a high-grade occlusion of the superior mesenteric artery (SMA), beginning approximately 3–4 cm distal to the ostium, caused by a bulky, calcified atherosclerotic plaque. The SMA origin was patent but significantly narrowed, correlating with her chronic symptoms. Given her worsening condition, surgical exploration was undertaken and revealed necrotic terminal ileum, a contained perforation, and localized peritonitis. A supraceliac aorta-to-SMA bypass was performed using a cryopreserved superficial femoral artery (SFA) graft routed through a retropancreatic tunnel, followed by ileocecal resection.

This surgical video demonstrates critical aspects of complex mesenteric revascularization. The technical elements of supraceliac aortic exposure, retropancreatic tunnel creation, and management of bowel complications provide valuable insights for surgeons encountering similar challenging scenarios. This case demonstrates the continued importance of open surgical expertise alongside endovascular techniques.

General Surgery, Print Release

PUBLISHED: Partial Mastectomy (Lumpectomy) Utilizing Savi Scout for a Nonpalpable Papilloma

Partial Mastectomy (Lumpectomy) Utilizing Savi Scout for a Nonpalpable Papilloma
Olivia D. Flessland, DO; Libby A. Moberg, MD; Thais A. Fortes, MD
University of Michigan Health – Sparrow

Partial mastectomy of the breast, also known as lumpectomy, is a breast-conserving procedure performed to remove many different types of masses and irregularities in the breast tissue. This involves a small incision concealed at the nipple borders or along the natural breast contours, followed by dissection of the area of concern. The excised tissue is then sent to pathology for final tissue diagnosis and, if applicable, to determine if appropriate margins have been achieved. Furthermore, Savi Scout utilization may help to localize the mass when it otherwise would be difficult to identify or locate. Many different breast pathologies can be removed in this fashion, both benign and malignant, depending on both biological and patient-specific details. In the case presented, a nonpalpable papilloma—typically found to be a benign breast lesion with an increased risk of harboring occult premalignant ductal carcinoma in situ (DCIS)—is surgically excised due to the presence of associated concerning symptoms in the patient.

Print Release, Thoracic Surgery

PUBLISHED: Robotic Right Middle Lobectomy and Mediastinal Lymph Node Dissection for Adenocarcinoma

Robotic Right Middle Lobectomy and Mediastinal Lymph Node Dissection for Adenocarcinoma
Hugh G. Auchincloss, MD, MPH
Massachusetts General Hospital

This surgical video provides a comprehensive demonstration of advanced robotic-assisted thoracic surgical techniques, focusing specifically on right middle lobectomy for adenocarcinoma. It documents the strategic decision-making processes involved in complex thoracic interventions. It highlights how technological advancements can enhance patient outcomes. As an educational resource, the video bridges theoretical knowledge with practical application, providing surgeons and medical professionals with a nuanced understanding of advanced surgical techniques. It exemplifies how robotic assistance can enhance surgical precision, reduce invasiveness, and enable more comprehensive tissue management, ultimately representing a significant advancement in the field of oncological surgery.

General Surgery, Print Release

PUBLISHED: Bilateral Laparoscopic Inguinal Hernia Repair with Mesh Using the Totally Extraperitoneal (TEP) Technique

Bilateral Laparoscopic Inguinal Hernia Repair with Mesh Using the Totally Extraperitoneal (TEP) Technique
Shirin Towfigh, MD
Beverly Hills Hernia Center

This video is a comprehensive step-by-step demonstration of laparoscopic inguinal hernia repair using the TEP method. It features a middle-aged male with bilateral inguinal hernias who has experienced left groin pain for several years. This case is significant as it showcases the efficiency of laparoscopic techniques in addressing bilateral hernias, which are relatively common, through a single surgical procedure. The detailed description of the procedure provides valuable insights for surgeons at various stages of their careers. For novice surgeons, it offers a step-by-step guide to the TEP technique, highlighting critical anatomical landmarks and potential pitfalls. Experienced surgeons may benefit from the nuanced discussions on tissue handling, dissection techniques, and mesh placement.

Ophthalmology, Print Release

PUBLISHED: Internal Ptosis Repair by Muller’s Muscle Resection

Internal Ptosis Repair by Muller’s Muscle Resection
John Lee, MD
Boston Vision

This instructional video on internal ptosis repair through Müller’s muscle resection demonstrates a refined surgical technique for correcting mild to moderate ptosis in patients with good Müller’s muscle function. It is particularly valuable for ophthalmology residents, oculoplastic surgery fellows, and practicing surgeons. By clearly illustrating the key steps—eyelid eversion with a precisely placed traction suture, careful isolation of the Müller’s muscle, precise shortening of the muscle by a measured amount, and closure of the conjunctival defect—the video provides a comprehensive educational resource.

General Surgery, Print Release

PUBLISHED: Open Total Thyroidectomy and Central Neck Dissection for Papillary Thyroid Cancer in the Setting of Hashimoto’s Thyroiditis

Open Total Thyroidectomy and Central Neck Dissection for Papillary Thyroid Cancer in the Setting of Hashimoto’s Thyroiditis
Allison S. Letica-Kriegel, MD, MSc; Antonia E. Stephen, MD
Massachusetts General Hospital

Papillary thyroid cancer is the most common type of thyroid malignancy. While prognosis is overall favorable, many patients present with clinically positive lymph nodes, most commonly in the central neck compartment. Total thyroidectomy with central lymph node dissection is the treatment of choice in these patients.

General Surgery, Print Release

PUBLISHED: Robotic Paraesophageal Hernia Repair with Magnetic Sphincter Augmentation Using the LINX Device

Robotic Paraesophageal Hernia Repair with Magnetic Sphincter Augmentation Using the LINX Device
Jonathan A. Levy, MD
University of Michigan Health-Sparrow

Robotic paraesophageal hernia repair with concurrent LINX device placement represents an evolutionary step in the surgical management of complex hiatal pathology. When performed with appropriate patient selection and attention to technical detail, the procedure offers excellent outcomes with acceptable morbidity. This instructional video will be particularly beneficial for surgeons, surgical trainees, and advanced practice providers seeking to enhance their understanding of the technical aspects of robotic paraesophageal hernia repair with LINX placement, as well as for medical educators teaching complex, minimally-invasive upper gastrointestinal procedures.

Ophthalmology, Print Release

PUBLISHED: Lower Eyelid Full-Thickness Lid Margin Repair for 8-mm Defect Following Mohs Surgery for Basal Cell Carcinoma

Lower Eyelid Full-Thickness Lid Margin Repair for 8-mm Defect Following Mohs Surgery for Basal Cell Carcinoma
John Lee, MD
Boston Vision

Surgical management of periocular basal cell carcinomas (BCCs) presents unique challenges due to the anatomical complexity and functional significance of the eyelid. This video illustrates the nuanced approach required in periocular reconstructive surgery following skin cancer excision. When choosing the best repair method, surgeons should assess each patient’s unique factors, including skin elasticity, defect size, and eye protection needs. This careful approach to lower eyelid reconstruction can deliver good functional results while maintaining appearance and improving patient outcomes and satisfaction.

Basic Skills for the OR, Print Release, Urology

PUBLISHED: Female Foley Catheter Placement Preoperatively

Female Foley Catheter Placement Preoperatively
Linda J. Guan, MD; Joseph 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.

Ophthalmology, Print Release

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.