Open Lobectomy Massachusetts General Hospital Christopher R. Morse, M.D. Assistant Professor of Surgery, Harvard Medical School
Co-Director, Gastroesophageal Surgery Program
An adult male with cystic fibrosis (CF) presents with a chronically damaged left upper lung lobe that Dr. Christopher Morse decides to treat with an open lobectomy given that the patient was not going to heal from antibiotic therapy and still had mild preserved pulmonary function. Two unusual things in this procedure are the dense inflammatory changes at the hilum and the use of muscle from chest wall to reinforce the bronchial closure because of the patient’s recurrent and chronic pulmonary infections due to CF.
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.
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.
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.
Dr. Meireles expertly conducts the world’s most commonly performed bariatric surgery for weight loss in this JoMI production on textbook sleeve gastrectomies.
Per-Oral Endoscopic Myotomy (POEM) Massachusetts General Hospital David Rattner, MD
Chief of General and Gastrointestinal Surgery Ozanan R Meireles, MD
General and Gastrointestinal Surgery
Dr. Rattner and Dr. Meireles endoscopically generate a submucosal tunnel to reach and release the circular muscles of the lower esophageal sphincter to help alleviate a patient’s achalasia.
Dr. Rattner tackles a problematic paraesophageal hernia, systematically retracting the stomach into the abdominal cavity. He finishes the procedure by performing both a toupet fundoplication and gastropexy.
Open Lobectomy
Laparoscopic Paraesophageal Hernia Repair