Category Archives: General Surgery

Announcement, General Surgery, Preprint Release

PREPRINT RELEASE: Minimally Invasive Parathyroidectomy under Local Cervical Block

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Minimally Invasive Parathyroidectomy under Local Cervical Block
Yale School of Medicine
Tobias Carling, MD, PhD, FACS
Associate Professor of Surgery

A 60-year-old female’s biochemical workup concluded she had primary hyperparathyroidism, and preoperative images suggested a left lower parathyroid lesion. Consequently, Dr. Tobias Carling performed a minimally invasive parathyroidectomy under local cervical anesthesia while preserving the esophagus and recurrent laryngeal nerve. Intraoperative PTH proved complete resection.
Announcement, General Surgery, Preprint Release

PREPRINT RELEASE: Revision Bascom Cleft Lift Pilonidal Cystectomy

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Revision Bascom Cleft Lift Pilonidal Cystectomy
Tufts University School of Medicine
Michael Reinhorn, MD, MBA, FACS
Associate Clinical Professor of Surgery

Dr. Michael Reinhorn performs a pilonidal cleft lift procedure, thoroughly describing the pre-op, post-op, and intraoperative steps, on a young man who previously had surgery but experienced recurrence.
Announcement, General Surgery, Preprint Release

PREPRINT RELEASE: Laparoscopic Nissen Fundoplication

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Laparoscopic Nissen Fundoplication
VA Boston Healthcare System
Marco Fisichella, MD, MBA, FACS
Assistant Professor of Surgery, Harvard Medical School
Associate Chief of Surgery, VA Boston Healthcare System

After medical management with high dose proton pump inhibitors proves to be refractory, a 63-year-old man with gastroesophageal reflux disease (GERD) presents for surgical management. Consequently, Dr. Marco Fisichella conducts a laparoscopic Nissen fundoplication.
Announcement, General Surgery, Preprint Release

PREPRINT RELEASE: Laparoscopic Appendectomy

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Laparoscopic Appendectomy
VA Boston Healthcare System
Marco Fisichella, MD, MBA, FACS
Assistant Professor of Surgery, Harvard Medical School
Associate Chief of Surgery, VA Boston Healthcare System

A 66-year-old man with a history of polyps has undergone colonoscopic surveillance every 3 years. After the recent discovery of an adenoma at the patient’s appendiceal orifice, Dr. Marco Fisichella performs a laparoscopic appendectomy.
Announcement, General Surgery, Preprint Release, Vascular Surgery

PREPRINT RELEASE: Leiomyosarcoma of the Inferior Vena Cava: Resection and Reconstruction

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Leiomyosarcoma of the Inferior Vena Cava: Resection and Reconstruction
Massachusetts General Hospital
Madhukar S. Patel, MD, MBA, ScM
Department of Surgery, MGH
Jahan Mohebali, MD, MPH
Department of Surgery, Division of Vascular and Endovascular Surgery, MGH
Parsia A. Vagefi, MD, FACS
Department of Surgery, Division of Transplant Surgery, MGH
Alex B. Haynes, MD, MPH, FACS
Department of Surgery, Division of Surgical Oncology, MGH

A woman presented with back pain, and when biopsied, she was found to have an inferior vena cava leiomyosarcoma - specifically involving the infrahepatic vena cava, the origin of the left renal vein, and the hilum of the right kidney. After undergoing preoperative proton beam radiation, the patient has her tumor resected en bloc by Dr. Vagefi and Dr. Haynes. They will also reconstruct the vena cava with a ringed synthetic graft covered by an omental pedicle flap.
Announcement, General Surgery, Preprint Release

PREPRINT RELEASE: Open Lobectomy

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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.
Announcement, General Surgery, Preprint Release

PREPRINT RELEASE: Distal Gastrectomy (Open)

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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.
Announcement, General Surgery, Preprint Release

PREPRINT RELEASE: Wedge Resection of the Lung and Thymectomy by Thoracoscopy

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Wedge Resection of the Lung and Thymectomy by Thoracoscopy
Massachusetts General Hospital
Henning A. Gaissert, MD
Lucia Madariaga, MD

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.
General Surgery, Preprint Release

PREPRINT RELEASE: Laparoscopic Adrenalectomy

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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.