Tag Archives: tumor

General Surgery, Print Release

PUBLISHED: Laparoscopic Resection of Gastric GIST Tumor

Laparoscopic Resection of Gastric GIST Tumor
Daniel Rice1; David Rattner, MD2
1Lake Erie College of Osteopathic Medicine
2Massachusetts General Hospital

This case illustrates a laparoscopic resection of a gastrointestinal stromal tumor (GIST): the most common mesenchymal tumor found in the gastrointestinal tract. GISTs can be found anywhere along the gastrointestinal tract; however, they are most commonly found in the stomach and small intestine. These tumors are often associated with mutations in the KIT (receptor tyrosine kinase) and PDGFRA (platelet-derived growth factor receptor alpha) genes. Because it is difficult to achieve a permanent cure using protein tyrosine kinase inhibitors, such as imatinib, surgical resection is the recommended therapy in most cases. While the surgical approach may vary on tumor characteristics, the laparoscopic approach is associated with low perioperative morbidity and mortality.

Neurosurgery, Otolaryngology, Print Release

PUBLISHED: Anterior Skull Base Resection of Esthesioneuroblastoma (Endoscopic)

Anterior Skull Base Resection of Esthesioneuroblastoma (Endoscopic)
David W. Jang, MD¹; Ali R. Zomorodi, MD¹; Feras Ackall, MD¹; Josef Madrigal, BS²; C. Scott Brown, MD¹
¹Duke University Medical Center
²David Geffen School of Medicine at the University of California, Los Angeles

First described by Berger in 1924, esthesioneuroblastoma (ENB) remains a rare sinonasal tumor believed to originate from specialized sensory olfactory cells. To date, the literature includes 1,000 recorded cases of ENB. Patients with ENB often present with non-specific symptoms, most often chronic nasal obstruction or epistaxis. Careful examination may reveal a pink or brown polyploid mass in the nasal cavity. Overall, ENB may demonstrate various growth patterns ranging from slow, indolent progression to aggressive invasion with widespread metastasis.

Current literature indicates that ENB should be treated with a combination of surgical resection and postoperative radiation therapy with or without chemotherapy. However, significant controversy remains regarding the appropriate surgical approach. This video demonstrates a transnasal endoscopic approach, which has gained significant popularity over the previous two decades compared to classic “open” approaches. Although this approach demonstrates improved perioperative outcomes while still achieving oncologic margins, further work is required to evaluate long-term survival.

General Surgery, Otolaryngology, Print Release

PUBLISHED: Minimally Invasive Parathyroidectomy Under Local Cervical Block Anesthesia for Primary Hyperparathyroidism and Parathyroid Adenoma

Minimally Invasive Parathyroidectomy Under Local Cervical Block Anesthesia for Primary Hyperparathyroidism and Parathyroid Adenoma

Tobias Carling, MD, PhD, FACS
Yale School of Medicine

With improvement in both preoperative parathyroid tumor identification and the use of intraoperative parathyroid hormone assay, minimally invasive parathyroidectomy (MIP) is now performed more frequently in patients with primary hyperparathyroidism (pHPT). Still, many institutions are not familiar with performing MIP under regional or local anesthesia. Here, Dr. Tobias Carling presents an MIP performed under local cervical block anesthesia on a patient with pHPT and parathryoid adenoma.

Announcement, General Surgery, Preprint Release

PREPRINT RELEASE: Right Posterior Retroperitoneoscopic Adrenalectomy

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Right Posterior Retroperitoneoscopic Adrenalectomy
Smilow Cancer Hospital at Yale New Haven

Tobias Carling, MD, PhD, FACS
Associate Professor of Surgery
Yale School of Medicine

One of the early adaptors of the approach, Tobias Carling, MD, PhD, FACS, performs a right posterior retroperitoneoscopic adrenalectomy on a patient that presented with subclinical Cushing's syndrome. Specifically, she had elevated urinary cortisol, failed a dexamethasone suppression test, and had a growing adrenal tumor as revealed by serial imaging. Due to the patient’s anatomy, Dr. Carling used a lateral approach to ligating the right adrenal vein; this video includes his usual medial approach as an additional module.
Neurosurgery, Preprint Release

PREPRINT RELEASE: Intraventricular Tumor Resection

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Intraventricular Tumor Resection
Charite Hospital Berlin
PD Dr. med. Marcus Czabanka

Neurosurgeon Marcus Czabanka treats an intraventricular tumor found in a patient with persistent headaches by resecting the tumor via an interhemispheric transcallosal approach.
Fundamentals, Otolaryngology, Preprint Release

PREPRINT RELEASE: Parotid Dissection (Cadaver)

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Parotid Dissection (Cadaver)
Duke University Medical Center
Ramon M Esclamado MD, MS
Professor, Department of Surgery
Chief, Division of Head and Neck Surgery & Communication Sciences

Dr. Esclamado instructs a cadaver lab at Duke University Hospital to assist resident training on a standard parotid dissection. The approach should be adjusted depending on tumor malignancy, as Dr. Esclamado explains.
Neurosurgery, Preprint Release

PREPRINT RELEASE: Resection of a Sphenoid Wing Meningioma

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Resection of a Sphenoid Wing Meningioma
Charite Hospital Berlin
Marcus Czabanka PD Dr. Med.

Watch as Dr. Czabanka navigates delicate territory to expose and excise a meningioma from the sphenoid wing of a symptomatic patient. Use of the microscope becomes crucial to prevent damage to healthy tissue while devascularizing the tumor.
General Surgery, Preprint Release

PREPRINT RELEASE: Open Antrectomy, Duodenal Resection, and Gastrojejunostomy for a Multiple Endocrine Neoplasia Tumor

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Open Antrectomy, Duodenal Resection, and Gastrojejunostomy for a Multiple Endocrine Neoplasia Tumor
David Berger, MD
Department of Orthopedic Surgery, Children’s Hospital Associate Professor of Surgery, Massachusetts General Hospital