In this long and complicated case, Dr. Marco Zenati performs a full, biatrial Cox-MAZE IV procedure with coronary artery bypass grafting (CABG) and a mitral valve replacement (MVR), moving between the three procedures as necessary to minimize time on the ischemic heart. The patient suffers from congestive heart failure that recently escalated from class II to class III.
Distal Gastrectomy (Open) John T. Mullen, MD Director, General Surgery Resident Program
Massachusetts General Hospital
An 80-year-old patient with anemia undergoes an upper endoscopy that reveals inflammation in the distal stomach. Biopsies identify it as an early intramucosal adenocarcinoma while an endoscopic ultrasound shows the tumor invading the muscle of the stomach. Given that there are no signs of metastasis, the patient presents for a potentially curative gastrectomy where Dr. John Mullen removes the distal two-thirds of the stomach, performs a D1 lymph node dissection and a partial D2 lymph node dissection, and reconstructs in a Billroth II fashion.
Abstract: Total knee arthroplasty has evolved into a very successful procedure to relieve pain and restore function in the arthritic knee with advanced structural damage. Optimal results are dependent on the restoration of alignment and ligament stability. Operative techniques involve either preservation of the posterior cruciate ligament or substitution of its function through increased prosthetic constraint. The vast majority of knees do not require cruciate substitution to establish appropriate stability and function. This video outlines the operative technique used by the author for posterior cruciate-retaining total knee arthroplasty in a patient with a preoperative varus deformity.
Laser Stapedotomy for Otosclerosis Duke University Medical Center Calhoun D. Cunningham III, MD
C. Scott Brown, MD Department of Surgery
Division of Head and Neck Surgery & Communication Sciences
In a staple surgery for conductive hearing loss, Dr. Calhoun Cunningham III performs a laser stapedotomy and prosthesis placement via transcanal approach. A thickened footplate does not preclude its success in alleviating the patient's longstanding hearing loss.
Visiting Surgeon, MGH & Associate Professor of Surgery, Harvard Medical School
Fellow in Thoracic Surgery, MGH
A patient with myasthenia gravis undergoes a procedure meant to originally be a lobectomy and thymectomy. Henning Gaissert, MD decides to do a lobe wedge resection instead given the tumor’s positioning and carcinoid nature before proceeding with the thymectomy. Please note that the patient had to return to the OR the following day due to bleeding near the internal mammary vein.
Dr. Calhoun Cunningham III performs a repair of a cerebrospinal fluid leak into the mastoid cavity by way of a middle fossa craniotomy. His novel use of bone and fascia grafts allows for autologous closure.
Laparoscopic Adrenalectomy Massachusetts General Hospital Richard Hodin, M.D.
Professor of Surgery, Harvard Medical School
After visiting an endocrinologist who diagnosed her with aldosteronism, the patient takes a CT scan that reveals a 8mm nodule in the left adrenal gland. Dr. Hodin performs a laparoscopic adrenalectomy to remove it.
After a patient is found to have a gastrointestinal stromal tumor (GIST), David Rattner, MD performs a laparoscopic resection, carefully avoiding the nerves of Latarjet. He then confirms the success of the procedure with an upper GI endoscopy.
Minimally Invasive Ivor Lewis Esophagectomy Massachusetts General Hospital Christopher R. Morse, M.D. Assistant Professor of Surgery, Harvard Medical School
Co-Director, Gastroesophageal Surgery Program
A patient presents with dysphagia and is found to have a locally advanced distal esophageal adenocarcinoma. She is treated with neoadjuvant chemoradiotherapy and Christopher R. Morse MD performs a minimally invasive Ivor Lewis esophagectomy.
Extraction of donor kidneys is transitioning from an open to a laparoscopic procedure. Professor of Surgery Dr. Tatsuo Kawai walks us through this minimally invasive technique.
Cox-MAZE IV with Coronary Artery Bypass Graft and Mitral Valve Replacement
