Category Archives: Fundamentals

Fundamentals, Global Surgery, Print Release

PUBLISHED: Lipoma Excision

Lipoma Excision
John Grove1; Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES2
1Lincoln Memorial University – DeBusk College of Osteopathic Medicine
2Philippine Children’s Medical Center

Lipomas are slow-growing lumps that occur as a result of overgrowth of fat cells. They present as doughy, moveable, and non-tender lumps usually found underneath the skin; however, they may occasionally be deeper. Lipomas occur in 1 in every 1,000 people and commonly grow on the upper back, shoulders, and abdomen. In most cases, lipomas are painless unless they affect joints, nerves, or blood vessels. A physical examination is the easiest way to diagnose a lipoma; however, imaging studies and biopsy may aid in the diagnosis when they are large, have unusual features, or appear deep.

No treatment is usually necessary for a lipoma; however, if a lipoma is painful or growing, removal may be recommended by excision or liposuction. Here, we present a 35-year-old male who has a large and deep 8-year-old lipoma on his upper back. The lipoma was excised and sent for biopsy.

Fundamentals, Global Surgery, Print Release

PUBLISHED: Sebaceous Cyst Excision

Sebaceous Cyst Excision
Casey L. Meier, RN¹; Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES²
¹Lincoln Memorial University, DeBusk College of Osteopathic Medicine
²Philippine Children’s Medical Center

Sebaceous cysts are closed sacs filled with foul-smelling, cheese-like material found underneath the skin. They form when a gland or hair follicle becomes blocked and are commonly found on the scalp, face, neck, or torso. Sebaceous cysts are non-cancerous and usually present as painless lumps, but can become tender when infected.

In most cases, smaller sebaceous cysts may be ignored as they do not cause any symptoms; however, larger cysts may need to be removed with complete excision recommended to prevent recurrence. Oral antibiotics may be required when a sebaceous cyst becomes infected. Here is the case of a 33-year-old male patient who underwent complete resection of a 2-year-old cyst.

Fundamentals, Hand Surgery, Orthopedics, Print Release

PUBLISHED: Ulnar Nerve Transposition (Cadaver)

Ulnar Nerve Transposition (Cadaver)
Irene Kalbian; Asif M. Ilyas, MD, MBA, FACS
Rothman Institute

Ulnar nerve transposition is a surgical procedure performed to treat ulnar nerve compression of the elbow, also known as cubital tunnel syndrome. This procedure is utilized after both non-operative management and in situ decompression fails, or if these procedures are deemed inappropriate based on patient pathology or ulnar nerve instability.

Transposition of the ulnar nerve involves not only decompression of the nerve but also its anterior repositioning to reduce compression and irritation while maintaining nerve integrity. This video demonstrates, on a cadaver arm, the operative technique for performing an ulnar nerve transposition using either a subcutaneous or a submuscular technique.

Fundamentals, Global Surgery, Print Release

PUBLISHED: Excision of Epidermal Inclusion Cyst

Excision of Epidermal Inclusion Cyst

John Grove
Lincoln Memorial University – DeBusk College of Osteopathic Medicine

Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES
Philippine Children’s Medical Center

Epidermal inclusion cysts, also called keratin or epithelial cysts, are benign lumps that develop beneath the skin. They present as a slow-growing, painless lumps, usually with a punctum in the middle that represents the blockage of keratin excretion. Here, Dr. Lester Suntay with the World Surgical Foundation presents the case of a 64-year-old male with a mass on his upper back. It was noted to be gradually enlarging, and thus excision was performed in order to prevent further growth and infection.

Fundamentals, Hand Surgery, Orthopedics, Print Release

PUBLISHED: Cubital Tunnel Release (Cadaver)

Cubital Tunnel Release

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.

Fundamentals, Hand Surgery, Orthopedics, Print Release

PUBLISHED: Carpal Tunnel Release (Cadaver)

Carpal Tunnel Release (Cadaver)

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.


Announcement, Fundamentals, Global Surgery, Preprint Release

PREPRINT RELEASE: Sebaceous Cyst Excision


Sebaceous Cyst Excision
Romblon Provincial Hospital

Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES
World Surgical Foundation, Philippines
Training Officer of the Division of Pediatric Surgery
Philippine Children’s Medical Center

In this case, Dr. Lester Suntay performs an excision of a 2-year-old sebaceous cyst from the face of an adult male.

Announcement, Fundamentals, Global Surgery, Preprint Release

PREPRINT RELEASE: Lipoma Excision


Lipoma Excision
Romblon Provincial Hospital

Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES
World Surgical Foundation, Philippines
Training Officer of the Division of Pediatric Surgery
Philippine Children’s Medical Center

In this case, Dr. Lester Suntay excises an 8-year-old lipoma from the upper back of an adult male.

Announcement, Fundamentals, Global Surgery, Preprint Release

PREPRINT RELEASE: Aspiration of Ganglion Cyst on Right Wrist


Aspiration of Ganglion Cyst on Right Wrist
Romblon Provincial Hospital

Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES
World Surgical Foundation, Philippines
Training Officer of the Division of Pediatric Surgery
Philippine Children’s Medical Center

This case centers around a 51-year-old female with a ganglion cyst on her right wrist. Here, Dr. Lester Suntay performs an aspiration of the cyst while on a surgical mission with the World Surgical Foundation.

Announcement, Fundamentals, Preprint Release

PREPRINT RELEASE: Excision of Epidermal Inclusion Cyst


Excision of Epidermal Inclusion Cyst
Romblon Provincial Hospital

Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES
World Surgical Foundation, Philippines
Training Officer of the Division of Pediatric Surgery
Philippine Children’s Medical Center

Here, Dr. Lester Suntay with the World Surgical Foundation performs an excision of an epidermal inclusion cyst on the upper back of a 64-year-old male.