01803nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100005300105245006600158260004400224300006300268505071500331506003601046538044601082856006901528268.9Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aCol. Arthur C. Wittich, DO, Casey L. Meier, RN 10aFemale Foley Catheter InsertioncCol. Arthur C. Wittich, DO aBostonbJournal of Medical Insightc2019 a1 online resource (1 streaming video file04:26bcolor/sound 0 aA foley catheter is a sterile, flexible tube that is inserted through the urethra to the urinary bladder to drain urine. A urinary catheter is needed in circumstances where there is blockage or injury in the urethra, an enlarged prostate gland in males, birth defects affecting the urinary tract, urinary bladder weakness, and kidney disease, or in cases of ureter or urinary bladder stones. It is also used to accurately measure the urine output of critically ill patients, to deliver medication directly into the urinary bladder, and to drain the urinary bladder before, during, or after surgery. Here, a foley catheter was inserted into a female patient prior to surgery in preparation for a hysterectomy. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/268.9/female-foley-catheter-insertion
02774nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100006800105245004200173260004400215300006300259505170900322506003602031538044602067856005502513268.5Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aEric de Leon, MD, Jaymie Ang Henry, MD, MPH, William B. Hogan 10aAnal FistulectomycEric de Leon, MD aBostonbJournal of Medical Insightc2019 a1 online resource (1 streaming video file10:23bcolor/sound 0 aFistula-in-ano is an abnormal connection between the anal canal and the skin around the anus. It is often the result of a previous or current perianal abscess. The fistula usually originates from infected anal crypts internally and tracks to the perianal skin externally. The majority of the fistulas are cryptoglandular in origin, but Crohns disease, malignancy, radiation, trauma, or unusual infections may also produce fistulas. Diagnosis is usually made by physical examination of the perianal region and sometimes aided by procedures such as a fistulogram, proctoscopy, or sigmoidoscopy. An opening of the fistula may be observed, and the perianal region may be tender and erythematous. An induration may be felt, and malodorous discharge may be seen coming out of the fistula. Imaging studies such as a CT scan or MRI are only indicated for deep and complex anal fistulas. Fistulas are classified by their relationship to parts of the anal sphincter complex and are divided into intersphincteric, transsphincteric, suprasphincteric, and extrasphincteric. These classifications help determine treatment decisions and operative planning. Definitive treatment aims to prevent both recurrence and sphincteric injury, and surgery is almost always necessary to cure an anal fistula. An intersphincteric fistula is treated by unroofing or removing the fistulous tract. A transsphincteric or suprasphincteric fistula is treated by placing a drain through the fistula. An extrasphincteric fistula is treated based on anatomy and etiology. We present the case of an 18-year-old male diagnosed with a fistula-in-ano. Fistulectomy was performed by threading the tract and excising it to prevent a recurrence. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/268.5/anal-fistulectomy
02237nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100007200103245011200175260004400287300006300331505104100394506003601435538044601471856011401917492Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aOlivia D. Flessland, DO, Libby A. Moberg, MD, Thais A. Fortes, MD 10aPartial Mastectomy (Lumpectomy) Utilizing Savi Scout for a Nonpalpable PapillomacOlivia D. Flessland, DO aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file38:27bcolor/sound 0 aPartial mastectomy of the breast, also known as lumpectomy, is a breast-conserving procedure performed to remove many different types of masses and irregularities in the breast tissue. This involves a small incision concealed at the nipple borders or along the natural breast contours, followed by dissection of the area of concern. The excised tissue is then sent to pathology for final tissue diagnosis and, if applicable, to determine if appropriate margins have been achieved. Furthermore, Savi Scout utilization may help to localize the mass when it otherwise would be difficult to identify or locate. Many different breast pathologies can be removed in this fashion, both benign and malignant, depending on both biological and patient-specific details. In the case presented, a nonpalpable papilloma—typically found to be a benign breast lesion with an increased risk of harboring occult premalignant ductal carcinoma in situ (DCIS)—is surgically excised due to the presence of associated concerning symptoms in the patient. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/492/partial-mastectomy-lumpectomy-utilizing-savi-scout-for-a-nonpalpable-papilloma
01977nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003500103245012400138260004400262300006600306505079400372506003601166538044601202856012301648420Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aHugh G. Auchincloss, MD, MPH 10aRobotic Right Middle Lobectomy and Mediastinal Lymph Node Dissection for AdenocarcinomacHugh G. Auchincloss, MD, MPH aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file01:22:55bcolor/sound 0 aThis surgical video provides a comprehensive demonstration of advanced robotic-assisted thoracic surgical techniques, focusing specifically on right middle lobectomy for adenocarcinoma. It documents the strategic decision-making processes involved in complex thoracic interventions. It highlights how technological advancements can enhance patient outcomes. As an educational resource, the video bridges theoretical knowledge with practical application, providing surgeons and medical professionals with a nuanced understanding of advanced surgical techniques. It exemplifies how robotic assistance can enhance surgical precision, reduce invasiveness, and enable more comprehensive tissue management, ultimately representing a significant advancement in the field of oncological surgery. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/420/robotic-right-middle-lobectomy-and-mediastinal-lymph-node-dissection-for-adenocarcinoma
02005nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002500103245013200128260004400260300006600304505080800370506003601178538044601214856013901660430Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aShirin Towfigh, MD 10aBilateral Laparoscopic Inguinal Hernia Repair with Mesh Using the Totally Extraperitoneal (TEP) TechniquecShirin Towfigh, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file01:18:23bcolor/sound 0 aThis video is a comprehensive step-by-step demonstration of laparoscopic inguinal hernia repair using the TEP method. It features a middle-aged male with bilateral inguinal hernias who has experienced left groin pain for several years. This case is significant as it showcases the efficiency of laparoscopic techniques in addressing bilateral hernias, which are relatively common, through a single surgical procedure. The detailed description of the procedure provides valuable insights for surgeons at various stages of their careers. For novice surgeons, it offers a step-by-step guide to the TEP technique, highlighting critical anatomical landmarks and potential pitfalls. Experienced surgeons may benefit from the nuanced discussions on tissue handling, dissection techniques, and mesh placement. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/430/bilateral-laparoscopic-inguinal-hernia-repair-with-mesh-using-the-totally-extraperitoneal-tep-technique
01702nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100001900103245007200122260004400194300006300238505062700301506003600928538044600964856008601410514Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJohn Lee, MD 10aInternal Ptosis Repair by Muller's Muscle ResectioncJohn Lee, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file08:21bcolor/sound 0 aThis instructional video on internal ptosis repair through Müller's muscle resection demonstrates a refined surgical technique for correcting mild to moderate ptosis in patients with good Müller's muscle function. It is particularly valuable for ophthalmology residents, oculoplastic surgery fellows, and practicing surgeons. By clearly illustrating the key steps—eyelid eversion with a precisely placed traction suture, careful isolation of the Müller's muscle, precise shortening of the muscle by a measured amount, and closure of the conjunctival defect—the video provides a comprehensive educational resource. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/514/internal-ptosis-repair-by-mullers-muscle-resection
01614nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006500103245016600168260004400334300006600378505032400444506003600768538044600804856015801250462Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAllison S. Letica-Kriegel, MD, MSc, Antonia E. Stephen, MD 10aOpen Total Thyroidectomy and Central Neck Dissection for Papillary Thyroid Cancer in the Setting of Hashimoto's ThyroiditiscAllison S. Letica-Kriegel, MD, MSc aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file01:40:58bcolor/sound 0 aPapillary thyroid cancer is the most common type of thyroid malignancy. While prognosis is overall favorable, many patients present with clinically positive lymph nodes, most commonly in the central neck compartment. Total thyroidectomy with central lymph node dissection is the treatment of choice in these patients. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/462/open-total-thyroidectomy-and-central-neck-dissection-for-papillary-thyroid-cancer-in-the-setting-of-hashimotos-thyroiditis
01853nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002700103245012400130260004400254300006300298505067300361506003601034538044601070856013101516493Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJonathan A. Levy, MD 10aRobotic Paraesophageal Hernia Repair with Magnetic Sphincter Augmentation Using the LINX DevicecJonathan A. Levy, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file58:22bcolor/sound 0 aRobotic paraesophageal hernia repair with concurrent LINX device placement represents an evolutionary step in the surgical management of complex hiatal pathology. When performed with appropriate patient selection and attention to technical detail, the procedure offers excellent outcomes with acceptable morbidity. This instructional video will be particularly beneficial for surgeons, surgical trainees, and advanced practice providers seeking to enhance their understanding of the technical aspects of robotic paraesophageal hernia repair with LINX placement, as well as for medical educators teaching complex, minimally-invasive upper gastrointestinal procedures. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/493/robotic-paraesophageal-hernia-repair-with-magnetic-sphincter-augmentation-using-the-linx-device
01811nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100001900103245013000122260004400252300006300296505061900359506003600978538044601014856014501460513Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJohn Lee, MD 10aLower Eyelid Full-Thickness Lid Margin Repair for 8-mm Defect Following Mohs Surgery for Basal Cell CarcinomacJohn Lee, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file13:16bcolor/sound 0 aSurgical management of periocular basal cell carcinomas (BCCs) presents unique challenges due to the anatomical complexity and functional significance of the eyelid. This video illustrates the nuanced approach required in periocular reconstructive surgery following skin cancer excision. When choosing the best repair method, surgeons should assess each patient's unique factors, including skin elasticity, defect size, and eye protection needs. This careful approach to lower eyelid reconstruction can deliver good functional results while maintaining appearance and improving patient outcomes and satisfaction. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/513/lower-eyelid-full-thickness-lid-margin-repair-for-8-mm-defect-following-mohs-surgery-for-basal-cell-carcinoma
02011nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004500103245007200148260004400220300006300264505091400327506003601241538044601277856008201723533Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aLinda J. Guan, MD, Joseph Y. Clark, MD 10aFemale Foley Catheter Placement PreoperativelycLinda J. Guan, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file13:20bcolor/sound 0 aUrinary catheterization is a standard procedure performed in the perioperative setting. In this video, the procedure is initiated after the patient has been placed under anesthesia, and the lower extremities are positioned in a frog-leg configuration to provide optimal access to the perineum. A standard Foley catheter tray is utilized, which contains all necessary components for the procedure under sterile conditions. The placement of a Foley catheter in female patients preoperatively represents a fundamental yet critical procedure in perioperative care. Though technically straightforward, its proper execution demands meticulous attention to anatomical detail, strict sterile technique, and awareness of potential challenges. Furthermore, technical proficiency in catheter placement contributes to improved patient outcomes by reducing the risk of urethral trauma and catheter-associated infections. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/533/female-foley-catheter-placement-preoperatively
01788nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100001900103245008400122260004400206300006300250505068800313506003601001538044601037856009901483512Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJohn Lee, MD 10aLateral Tarsal Strip Procedure for Right Lower Eyelid EntropioncJohn Lee, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file10:04bcolor/sound 0 aThe lateral tarsal strip procedure offers several advantages, including addressing the fundamental underlying cause of involutional entropion, providing long-lasting correction, causing minimal postoperative discomfort, and having a low recurrence rate compared to other procedures. Additionally, it can be combined with other procedures when indicated. The accompanying video provides a detailed, comprehensive description of this surgical technique with visual demonstration of each step. This video will be particularly beneficial for ophthalmologists, oculoplastic surgeons, and trainees seeking to refine their understanding and surgical skills in the management of entropion. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/512/lateral-tarsal-strip-procedure-for-right-lower-eyelid-entropion
01857nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003200103245013300135260004400268300006300312505066100375506003601036538044601072856013301518509Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aCharu Paranjape, MD, FACS 10aEsophagogastroduodenoscopy (EGD) with Placement of a Bravo Probe for pH and GERD Symptom MonitoringcCharu Paranjape, MD, FACS aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file15:55bcolor/sound 0 aAccurate diagnosis and monitoring of GERD are crucial for appropriate patient management and treatment selection. This demonstration highlights the advantages of the Bravo wireless system over traditional catheter-based methods for pH monitoring. The procedure proves particularly valuable in post-bariatric surgery patients, as illustrated in this case of a patient with previous sleeve gastrectomy, where GERD symptoms frequently require thorough evaluation. The extended 96-hour monitoring period provides comprehensive data regarding reflux patterns and symptom correlation, facilitating evidence-based decisions about medical or surgical management. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/509/esophagogastroduodenoscopy-egd-with-placement-of-a-bravo-probe-for-ph-and-gerd-symptom-monitoring
02027nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005000103245016800153260004400321300006600365505075600431506003601187538044601223856015201669474Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aHany M. Takla, MD, FACS, FASMBS, DABS-FPMBS 10aOpen Incisional Hernia Repair with Mesh and Unilateral Posterior Component Separation with Excision of Unstable ScarcHany M. Takla, MD, FACS, FASMBS, DABS-FPMBS aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file02:05:47bcolor/sound 0 aYuri Novitsky's description of the posterior component separation in 2012 has revolutionized the world of ventral hernia repairs.1 While large hernia defects above 10 to 12 centimeters seemed impossible to close primarily without tension, the technique of transversus abdominis release as described helped achieve posture as well as anterior abdominal wall closure without tension in addition to providing a highly vascularized medium for mesh integration in between these layers. Not only does the posterior component separation allow for medialization of the posterior rectus sheath to be closed in the midline, but it also gives a release to the anterior components of the abdominal wall to allow for recreation of the linea alba without tension. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/474/open-incisional-hernia-repair-with-mesh-and-unilateral-posterior-component-separation-with-excision-of-unstable-scar
02109nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100013100103245007500234260004400309300006600353505092500419506003601344538044601380856007701826477Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAnthony D. Douglas II, MD, Derrius Anderson, MD, Jelani Williams, MD, Rowan Hussein, Ashley Russell, Konstantin Umanskiy, MD 10aLaparoscopic-Assisted Right HemicolectomycAnthony D. Douglas II, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file02:12:03bcolor/sound 0 aThe patient-centered environment of the operating room often precludes extensive intraoperative discussions or detailed explanations between a resident and the attending surgeon. This constraint in real-time feedback poses a challenge for surgical residents to refine their surgical skills. Implementation of a structured case review between attendings and senior residents at interval timepoints of their rotations could support addressing this gap. In this case, we present a laparoscopic right hemicolectomy. This procedure removes a portion of the colon and is commonly indicated for colon cancer. In this video article, a senior general surgery resident participates in the procedure and then engages in a structured case review with their attending, analyzing the fundamental steps of the procedure as well as identifying opportunities for technical improvement and enhancement of intraoperative decision-making. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/477/laparoscopic-assisted-right-hemicolectomy
01850nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002700103245008500130260004400215300006300259505074800322506003601070538044601106856009201552396Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAlexander Martin, OD 10aIrrigation and pH Check for Unknown Substance in the EyecAlexander Martin, OD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file02:44bcolor/sound 0 aWhen an unknown substance has entered the eye, diagnostic measurement of ocular surface pH and therapeutic irrigation of the eye are essential steps to minimize the risk of long term consequences. These procedures are demonstrated here and represent a critical intervention in emergency eye care. When properly executed, they serve as both diagnostic and therapeutic measures. Their simplicity and effectiveness make them essential skills in emergency and primary care settings, where rapid intervention can prevent permanent ocular damage. Time to irrigation is the most critical factor in determining outcomes, with each minute of delay potentially increasing the risk of permanent visual impairment as this can lead to permanent scarring. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/396/irrigation-and-ph-check-for-unknown-substance-in-the-eye
02224nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002400103245011500127260004400242300006300286505106500349506003601414538044601450856012201896498Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aSudhir B. Rao, MD 10aCarpal Tunnel Repair and Fasciectomy for Carpal Tunnel Syndrome and Dupuytren’s DiseasecSudhir B. Rao, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file47:50bcolor/sound 0 aCarpal Tunnel Syndrome (CTS) and Dupuytren's disease (DD) are two common hand conditions that can significantly impact a patient's quality of life and hand function. In cases where both conditions coexist, as demonstrated in this video, a combined surgical approach is adopted in suitable candidates. Combining carpal tunnel release and fasciectomy in a single surgical setting is safe, cost-effective, and efficient, reducing recovery time and healthcare costs while achieving functional outcomes comparable to staged interventions. This video demonstration is particularly valuable for practicing hand surgeons and surgical trainees, offering detailed insights into technical challenges such as neurovascular bundle protection, management of retrovascular cord components, and the precise balance between complete disease excision and preservation of vital structures. The demonstrated solutions, including the use of vessel loops for nerve protection, staged fascia removal, and careful hemostasis management, provide practical guidance for similar cases. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/498/carpal-tunnel-repair-and-fasciectomy-for-carpal-tunnel-syndrome-and-dupuytrens-disease
02193nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002600103245015900129260004400288300006300332505094500395506003601340538044601376856016501822319Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aRyan A. Hankins, MD 10aCystoscopy, Right Ureteroscopy, and Ureteral Stent Insertion with Aborted Biopsy and Potential Laser Ablation of a Right Renal MasscRyan A. Hankins, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file11:31bcolor/sound 0 aThis article describes a case of a 58-year-old male patient with a renal mass, which was incidentally discovered on an imaging of chest CT scan, without any signs and symptoms indicative for renal masses. The patient has no history of ureteroscopy before, and no prior history of urolithiasis. The multiphasic, contrast-enhanced abdominal CT scan shows 2.5-cm hyperattenuating enhancing mass in the upper pole of the right kidney. Transverse unenhanced CT image shows hyperattenuating mass with no evidence of fat. Transverse CT image shows enhancement of the mass from 60 HU to 116 HU. Thе chest CT scan showed no abnormalities. This video describes a complex urological procedure that initially aimed to perform diagnostic and potentially therapeutic intervention but was modified due to anatomical constraints. The procedure demonstrates the importance of surgical adaptability and the role of staged approaches in urological surgery. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/319/cystoscopy-right-ureteroscopy-and-ureteral-stent-insertion-with-aborted-biopsy-and-potential-laser-ablation-of-a-right-renal-mass
01705nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006500103245008900168260004400257300006600301505057100367506003600938538044600974856007901420461Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAllison S. Letica-Kriegel, MD, MSc, Antonia E. Stephen, MD 10aOpen Total Thyroidectomy for Graves’ DiseasecAllison S. Letica-Kriegel, MD, MSc aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file01:32:02bcolor/sound 0 aGraves disease is an autoimmune condition that causes hyperthyroidism. There are several options for management which include medications, radioactive iodine ablation, and surgery. Over time, total or near-total thyroidectomy has become the gold standard in surgical management of this disease. Although there is a slightly higher risk of complications following total thyroidectomy in patients with Graves disease as compared to their non-Graves' counterparts undergoing thyroidectomy, the absolute risk remains low, especially for high-volume endocrine surgeons. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/461/open-total-thyroidectomy-for-graves-disease
01807nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005800103245008400161260004400245300006600289505067200355506003601027538044601063856009201509487Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aSamuel J. Zolin, MD, Eric M. Pauli, MD, FACS, FASGE 10aOpen Onlay Hernia Repair for Recurrent Incisional HerniacSamuel J. Zolin, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file01:19:55bcolor/sound 0 aAn 80-year-old patient underwent an open onlay repair of a recurrent incisional hernia. This approach was chosen due to the patients prior retromuscular repair, age, history of adhesions, and religious preference against blood products. Following safe abdominal entry and adhesiolysis, a subcutaneous pocket extending 5 centimeters in all directions from the hernia was created. Fascia was closed using mesh-suture and a 12 x 12-centimeter macroporous, medium-weight polypropylene mesh was secured to the anterior fascia with staples and fibrin glue. A subcutaneous drain was placed. This case highlights the utility of an onlay approach for selected circumstances. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/487/open-onlay-hernia-repair-for-recurrent-incisional-hernia
01988nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004800103245007000151260004400221300006300265505089500328506003601223538044601259856007701705488Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJennifer A. Kane, MD, Joseph Y. Clark, MD 10aOpen Hydrocelectomy for Scrotal HydrocelecJennifer A. Kane, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file49:29bcolor/sound 0 aHydrocelectomy is a common and effective surgical procedure used to treat hydrocele, a condition in males defined as an accumulation of benign peritoneal fluid between the layers of the scrotum. The indications for hydrocelectomy include pain, poor cosmetic appearance, or negative impact on patient quality of life. Surgical treatment of hydroceles aims to treat symptoms as well as prevent complications of hydroceles left untreated, including chronic pain or testicular ischemia. A scrotal incision is the most common approach for surgical management of non-communicating hydroceles. The hydrocele sac is isolated, the fluid is drained, and the sac is excised and closed to prevent recurrence. In this video, we present a case of a patient with a left sided non-communicating hydrocele that was treated with hydrocelectomy. As part of the procedure, a surgical drain was left in place. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/488/open-hydrocelectomy-for-scrotal-hydrocele
02057nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004600103245004400149260004400193300006300237505102000300506003601320538044601356856004901802486Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAlexandra J. Lopez, MD, Yu Maw Htwe, MD 10aThoracentesiscAlexandra J. Lopez, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file24:49bcolor/sound 0 aPleural effusions are a frequent problem encountered in pulmonary medicine. Some common causes of pleural effusion include chest infection, heart failure, liver failure, malignancy, and autoimmune diseases such as rheumatoid arthritis, to name a few. Often drainage of this fluid is required for both diagnostic and therapeutic purposes, which is called thoracentesis. For this procedure, we use a Safe-T-Centesis kit to place a temporary catheter in the pleural space and manually drain the fluid, which can then be sent to the lab for further testing, including cell counts, glucose, pH, protein levels, cytology, and bacterial cultures. Based on these results, we can determine if the effusion is exudative or transudative, which helps guide further management. In this case, our patient has a recurrent left-sided exudative effusion of unknown cause with underlying history of colon cancer, and malignant effusion is a concern, and we performed both diagnostic and therapeutic ultrasound-guided thoracentesis. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/486/thoracentesis
02054nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003400103245008400137260004400221300006300265505093500328506003601263538044601299856010301745495Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aArya Rao, Sudhir B. Rao, MD 10aExcision of a Ganglion Cyst from Distal Middle Finger Near Nail BedcArya Rao aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file17:07bcolor/sound 0 aGanglion cysts (GCs) are common benign soft tissue tumors that when presenting near the nail bed of digits, are specifically termed digital mucous cysts (DMCs). The surgical excision of GCs near the nail bed requires precise technique and a thorough understanding of the anatomical relationships to prevent recurrence and minimize complications. This case report describes the surgical management of a GC located on the distal phalanx of the middle finger near the nail bed. The procedure demonstrates several key principles that are essential for successful outcomes, including the necessity of complete cyst excision to prevent recurrence, the importance of careful dissection near the germinal matrix to prevent permanent nail deformity, the value of a bloodless surgical field in maintaining precise visualization, and the significance of proper wound closure technique in ensuring optimal aesthetic and functional outcomes. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/495/excision-of-a-ganglion-cyst-from-distal-middle-finger-near-nail-bed
02197nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003400103245008300137260004400220300006300264505108100327506003601408538044601444856010101890497Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aArya Rao, Sudhir B. Rao, MD 10aFirst Extensor Compartment Release for De Quervain's TenosynovitiscArya Rao aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file19:57bcolor/sound 0 aThis video provides detailed step-by-step instruction for performing first dorsal compartment release in De Quervain's tenosynovitis, with particular emphasis on anatomical landmarks, proper tissue handling, and identification of important neurovascular structures. The surgical release of the first extensor compartment for De Quervain's tenosynovitis is a well-established procedure with consistently favorable outcomes when proper surgical technique is employed. When performed with attention to these technical details, the procedure provides reliable relief of symptoms with a low complication rate.

This surgical technique video would be particularly valuable for orthopaedic and hand surgery residents, as well as practicing surgeons who seek to refine their approach to first extensor compartment release. The detailed demonstration of nerve identification and the management of anatomical variations, especially the emphasis on finding accessory compartments, provides crucial technical aspects which help surgeons avoid complications and improve patient outcomes. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/497/first-extensor-compartment-release-for-de-quervains-tenosynovitis
02237nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002400103245010400127260004400231300006300275505109700338506003601435538044601471856011401917496Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aSudhir B. Rao, MD 10aPosterior Calcaneal Osteophyte Excision with Subsequent Achilles Tendon RepaircSudhir B. Rao, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file31:35bcolor/sound 0 aThe surgical management of posterior calcaneal osteophytes is a complex procedure that requires detailed surgical technique and precise anatomical understanding. Fluoroscopy serves as a real-time guidance tool, aiding in the visualization of the osteophyte during its removal. Specialized surgical instruments, primarily a sharp osteotome are utilized for initial bone removal, followed by a rongeur to refine and smooth any remaining sharp edges. This meticulous approach ensures the complete removal of the problematic bony proliferation while maintaining the surrounding tissue's structural integrity. This surgical demonstration offers important educational value for multiple medical professionals involved in orthopaedic and musculoskeletal care. Orthopaedic surgeons, particularly those specializing in foot and ankle surgery, will find the detailed procedural technique useful for understanding nuanced surgical approaches to posterior calcaneal osteophytes. Orthopaedic residents and surgical trainees can benefit from the step-by-step demonstration of complex surgical techniques. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/496/posterior-calcaneal-osteophyte-excision-with-subsequent-achilles-tendon-repair
02076nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004500103245010500148260004400253300006600297505091400363506003601277538044601313856011101759361Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aEleanor Tomczyk, MD, Todd Francone, MD 10aRobotic Abdominoperineal Resection (APR) with Bilateral Gracilis Muscle FlapscEleanor Tomczyk, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file02:57:03bcolor/sound 0 aRobotic APR with bilateral gracilis flap reconstruction is a vital procedure for managing advanced and metastatic rectal cancer. It offers a precise, minimally-invasive approach that addresses both tumor removal and functional reconstruction, providing significant benefits for patients requiring complex oncological and reconstructive surgery. This step-by-step video guideline is crucial for advancing surgical techniques in complex rectal cancer treatment. It serves as a vital educational resource for surgeons at all levels, demonstrating the combination of APR with gracilis flap reconstruction. The video's importance lies in its ability to standardize the procedure, showcase innovative techniques, and highlight critical aspects that are difficult to convey through text alone. Providing detailed visual instruction on navigating challenges helps prevent complications and improve patient outcomes. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/361/robotic-abdominoperineal-resection-apr-with-bilateral-gracilis-muscle-flaps
02025nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002200103245005400125260004400179300006600223505098200289506003601271538044601307856006601753480Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aGeorge Velmahos 10aRobotic End Colostomy ReversalcGeorge Velmahos aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file02:08:54bcolor/sound 0 aThe case presented in the video illustrates a complex clinical scenario involving a young male patient who sustained multiple traumatic injuries in a motorcycle collision. Following initial emergency management that included an exploratory laparotomy with sigmoid transection and subsequent end colostomy, the patient now undergoes robotic-assisted colostomy reversal. This approach represents an advanced surgical technique that uses minimally-invasive technology to address challenging postoperative reconstructive needs. Robotic-assisted surgery offers several advantages in colostomy reversal, such as better dissection precision and improved surgical field visualization. This video shows how cutting-edge technology improves surgical outcomes, reduces recovery time, and solves complex challenges. It is a valuable resource for medical professionals, especially surgeons and trainees, looking to deepen their understanding of advanced colorectal surgical interventions. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/480/robotic-end-colostomy-reversal
02313nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002500103245010000128260004400228300006300272505118100335506003601516538044601552856010901998434Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aShirin Towfigh, MD 10aOpen Epigastric Hernia Repair Without Mesh for a 1-cm Incarcerated HerniacShirin Towfigh, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file25:23bcolor/sound 0 aEpigastric hernias, predominantly described in the literature as small defects containing mostly preperitoneal fat, are located in the linea alba between the xiphoid process and the umbilicus. The risk of incarceration in epigastric hernias is influenced by the size of the defect. It has been observed that smaller epigastric hernias, particularly those less than 1 cm in diameter, have a higher risk of incarceration compared to larger ones. Various treatment options are available for epigastric hernias, including laparoscopic and open surgical approaches. This video describes an open epigastric hernia repair without mesh for a 1-cm incarcerated hernia. The technique demonstrated addresses both the correction of the hernia and the prevention of recurrence, which is crucial given the higher incarceration rates associated with smaller hernias. This video demonstration of an open epigastric hernia repair without mesh for a 1-cm incarcerated hernia provides valuable insights for surgical trainees, general surgeons, and hernia specialists. The technique showcased is particularly useful for small epigastric hernias and in cases where a rectus diastasis is present. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/434/open-epigastric-hernia-repair-without-mesh-for-a-1-cm-incarcerated-hernia
01931nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003300103245010300136260004400239300006600283505079000349506003601139538044601175856010401621484Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJoshua Ng-Kamstra, MD, MPH 10aRepeat Exploratory Laparotomy for Encapsulating Peritoneal SclerosiscJoshua Ng-Kamstra, MD, MPH aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file02:07:21bcolor/sound 0 aEncapsulating peritoneal sclerosis (EPS), also known as encapsulating sclerosing peritonitis is a rare but serious condition that is characterized by the formation of a thick, fibrotic layer encasing the small bowel. The pathophysiology involves an inflammatory process that triggers excessive fibrin deposition and collagen production, resulting in the development of a thick, cocoon-like membrane around the intestines. This video is an in-depth demonstration of a complex surgical case involving a repeat exploratory laparotomy for bowel obstruction, with a focus on careful dissection of adhesions, managing serosal tears, and ensuring hemostasis. It is particularly valuable for surgeons, surgical trainees, and medical professionals specializing in emergency abdominal surgery. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/484/repeat-exploratory-laparotomy-for-encapsulating-peritoneal-sclerosis
01869nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002500103245008600128260004400214300006300258505076500321506003601086538044601122856009501568433Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aShirin Towfigh, MD 10aOpen Umbilical Hernia Repair Without Mesh for a 1-cm HerniacShirin Towfigh, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file17:34bcolor/sound 0 aUmbilical hernias are common abdominal wall defects that occur when intra-abdominal contents protrude through the umbilical opening in the abdominal muscles. This article focuses on the detailed surgical technique for open umbilical hernia repair without mesh for a 1-cm hernia, emphasizing both functional and aesthetic outcomes. This video demonstration and accompanying description serve as valuable educational resources for surgical trainees, general surgeons, and plastic surgeons seeking to refine their techniques for small umbilical hernia repairs. The step-by-step approach, rationale for each decision, and emphasis on both functional and cosmetic outcomes provide insights that can help surgeons optimize their results in umbilical hernia repair. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/433/open-umbilical-hernia-repair-without-mesh-for-a-1-cm-hernia
02652nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100008100103245016700184260004400351300006600395505132700461506003601788538044601824856017602270441Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJoseph O. Werenski, Paul A. Rizk, MD, Santiago A. Lozano-Calderon, MD, PhD 10aThe Use of Photodynamic Nails for Bone Reinforcement in Combination with Complex Total Hip Arthroplasty in the Setting of Radiation OsteitiscJoseph O. Werenski aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file02:46:43bcolor/sound 0 aHerein, we present a case of diffuse large B-cell lymphoma (DLBCL) with skeletal involvement in a geriatric male. Initially presenting with left hip pain, the patient was diagnosed with DLBCL affecting the left acetabulum. Subsequent treatment with systemic and radiation therapy resulted in radiation osteitis, osteoarthritis, and acetabular collapse, necessitating surgical intervention.

The treatment plan involved total hip arthroplasty (THA) with photodynamic intramedullary nails (PDNs) for pelvic stabilization, augmented with tantalum augments for enhanced support. PDNs provided structural stability while minimizing interference with future oncological interventions. The surgical procedure comprised meticulous insertion of PDNs and placement of tantalum augments, achieving optimal stability and alignment of the acetabular component.

This case underscores the strategic use of PDNs and tantalum augments in for treating major acetabular defects in patients with complex pathologies who require THA for pelvic stabilization. These techniques provide advantages in post-operative radiographic disease monitoring and precision in radiation therapy planning. The multidisciplinary approach emphasizes the importance of carefully selecting the appropriate implants to optimize outcomes in orthopaedic oncology. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/441/the-use-of-photodynamic-nails-for-bone-reinforcement-in-combination-with-complex-total-hip-arthroplasty-in-the-setting-of-radiation-osteitis
01737nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003300103245011300136260004400249300006600293505057800359506003600937538044600973856011201419469Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMichael J. Rosen, MD, FACS 10aComplex Abdominal Wall Reconstruction with Transversus Abdominis Release (TAR)cMichael J. Rosen, MD, FACS aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file01:52:50bcolor/sound 0 aThis video demonstrates a case involving an open complex abdominal wall reconstruction with transversus abdominis release. The case involves an obese patient with a multiply recurrent incarcerated incisional hernia. The CT scan shows a complex defect involving the midline, right linea semilunaris, and inter-rectus hernia. The use of a retromuscular procedure with a posterior component separation will be highlighted and its advantages of allowing wide mesh overlap without creation of subcutaneous tissue flaps to repair defects with these challenging characteristics. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/469/complex-abdominal-wall-reconstruction-with-transversus-abdominis-release-tar
02620nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000540010224500610015626000440021730000630026150515470032450600360187153804460190785600610235331Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJason P. Den Haese Jr., DO, Scott D. Martin, MD 10aDiagnostic Hip ArthroscopycJason P. Den Haese Jr., DO aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file19:26bcolor/sound 0 aDiagnostic hip arthroscopy is a minimally-invasive surgical technique used to accurately provide intraoperative information and potentially treat certain intra-articular (such as labral tears, chondral defects, and femoroacetabular impingement) and extra-articular (such as capsular tears, ischiofemoral impingement, and pediatric deformities) hip pathologies. The use of this procedure in the United States is becoming more common; annual rates are increasing by as much as 365% since 2004. Within this rapid increase of utilization, the three most common procedures being performed with diagnostic hip arthroscopy are labral repair, femoroplasty, and acetabuloplasty. In this case, a young female athlete is being assessed for left anterior hip pain recalcitrant to nonoperative management. The patient was placed in a supine position with an anterolateral portal and modified anterior portal being placed into the left hip. A puncture capsulorrhaphy was performed to examine the labrum, femoral head, and transverse ligament. Then, the medial structures and peripheral compartment were visualized. Throughout the procedure, the only treatable hip pathology identified was labral fraying consistent with a minor labral tear. It was determined that the fraying was not significant enough to require surgical repair, so labral debridement was chosen. Other areas of labral fraying and fatty degeneration were identified, but they were not significant enough to be treated intraoperatively. The procedure was completed with no complications. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/31/diagnostic-hip-arthroscopy
02071nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100005700105245006100162260004400223300006300267505097600330506003601306538044601342856007701788299.2Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aRyan P. Boyle, Elliot Bishop, MD, Peter Bendix, MD 10aLeft Tube Thoracostomy for PneumothoraxcRyan P. Boyle aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file14:27bcolor/sound 0 aThe clinical presentation of pneumothorax ranges from no symptoms to life-threatening tension physiology requiring emergent intervention. The thoracic cavity is lined with parietal while the lungs and mediastinal structures are lined with visceral pleura. Normally in apposition, a potential space exists between these two layers where fluid, air, or a combination of the two may accumulate. If this potential space fills with fluid or air, subsequent collapse of the lung tissue causes symptoms such as shortness of breath and tachypnea. If the fluid or air accumulate to the degree that venous cardiac return is impeded, tension physiology ensues with hypotension, tachycardia, and eventual cardiovascular collapse if the pressure is not relieved. Tube thoracostomy remains the treatment of choice for managing pneumothorax. Here, we present the management of a traumatic pneumothorax with tube thoracostomy in a 51-year-old male injured in a motor vehicle collision. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/299.2/left-tube-thoracostomy-for-pneumothorax
02348nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100008200103245011600185260004400301300006600345505112400411506003601535538044601571856012502017445Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aNelson Merchan, MD, Andrew M. Hresko, MD, Edward Kenneth Rodriguez, MD, PhD 10aLeft Tibia Pilon Open Fracture Open Reduction and Internal Fixation with External FixatorcNelson Merchan, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file01:17:02bcolor/sound 0 aTibial plafond or pilon fractures account for 5 to 10% of all lower extremity fractures and are associated with high energy trauma. They are the result of predominantly axial loading resulting in a typical three fragment and comminuted pattern. These fractures have a high rate of non-union, mal-union, and wound healing issues due to weak metaphyseal bone, a lack of robust soft tissue coverage, and complex intra-articular extension.

Early studies demonstrating higher rates of complications after acute management have promoted a strategy of “staged” management. In this approach, the initial injury is initially stabilized with the use of temporary external fixation and definitive fixation is delayed until soft tissues are amenable to primary closure of incisions. While staged management has been considered the standard of practice, more recent work has reported good outcomes with acute definitive fixation in well selected patients.

In this manuscript and video, we demonstrate a tibial pilon fracture managed acutely with a hybrid fixation approach combining internal fixation with external fixation. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/445/left-tibia-pilon-open-fracture-open-reduction-and-internal-fixation-with-external-fixator
02463nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000540010224500740015626000440023030000660027450513530034050600360169353804460172985600820217515Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMartin Goodman, MD, Vahagn G. Hambardzumyan, MD 10aWhipple Procedure for Carcinoma of the PancreascMartin Goodman, MD aBostonbJournal of Medical Insightc2025 a1 online resource (1 streaming video file01:54:07bcolor/sound 0 aPancreatic ductal adenocarcinoma (PDAC) is the ninth most common cancer in the United States, but due to symptoms—such as back pain, jaundice and unexplained weight loss—usually only presenting when the disease has already moved beyond the pancreas, it is highly lethal, representing the fourth most common cause of cancer death. As a result of widespread abdominal imaging, more early stage pancreatic cancers are being diagnosed, and these patients are candidates for a pancreaticoduodenectomy, more commonly known as the Whipple procedure. The Whipple procedure is used to treat four types of cancer—periampullary, cholangiocarcinoma, duodenal, and pancreatic ductal adenocarcinoma—but is most well known in the setting of PDAC. Although there are only a few basic steps to the procedure—removal of  the pancreatic head, distal bile duct, duodenum, and either distal gastrectomy or pyloric preservation. Next is the reconstruction with bringing up the stapled end of jejunum to the pancreas, then the hepatic duct, and lastly to the stomach. The multiple crucial anatomic structures in the same region, as well as the unforgiving nature of the structures involved in the operation itself, lead to high morbidity and necessitate complex postoperative care. Due to this, most Whipple procedures are performed at higher volume centers. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/15/whipple-procedure-for-carcinoma-of-the-pancreas
01864nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100007700103245006500180260004400245300006600289505074600355506003601101538044601137856007501583109Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAndrew Del Re, MD, Jahan Mohebali, MD, MPH, Virendra I. Patel, MD, MPH 10aThoracoabdominal Aortic Aneurysm RepaircAndrew Del Re, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file02:00:56bcolor/sound 0 aThoracoabdominal aortic aneurysms (TAAAs) are generally asymptomatic and are discovered incidentally on thoracic or abdominal imaging. When they are identified, management is often expectant, depending on the size of the aneurysm and its rate of growth. Surgery is indicated for larger aneurysms and those that expand rapidly so as to avoid the catastrophic rupture of the aneurysm. Here, we present the case of a 70-year-old female with a TAAA, whom we had been following with serial computed tomographic angiography scans. The decision to operate was made when the aneurysm began revealing growth in diameter. Her anatomy was not conducive to endovascular treatment; therefore, we repaired her aneurysm using a traditional open approach. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/109/thoracoabdominal-aortic-aneurysm-repair
03245nam  22002051  4500001000500000003000500005006001900010007000400029008004100033028001100074040001900085100008700104245004700191260004400238300006600282505214800348506003602496538044602532856006102978102bJomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aWilliam Remley, Howard Jen, MD, Jeremy Wiygul, MD, Carl-Christian A. Jackson, MD 10aCloacal Exstrophy RepaircWilliam Remley aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:09:05bcolor/sound 0 aCloacal exstrophy is congenital malformation marked by an abdominal wall defect with open and exposed hindgut and bladder. It is the most severe birth defect within the exstrophy-epispadias complex, and when spinal defects are also present, it is called the OEIS (omphalocele, exstrophy, imperforate anus, and spinal defect) complex. Cloacal exstrophy is rare, occurring in 1/200,000–400,000 births, but it can be diagnosed on prenatal ultrasound. The defect results in two exstrophied hemibladders separated by an exposed cecal plate, with the distal hindgut being foreshortened and blind-ending, resulting in an imperforate anus. There is diastasis of the pubic symphysis, and the genitalia are separated. In males, the phallus is usually split in half, flattened and shortened, with the inner surface of the urethra exposed. In females, the clitoris is split, the labia are widely separated, and there may be two vaginal openings. Cloacal exstrophy is also highly associated with other birth defects, especially spina bifida, which coexist in up to 75% of cases. Multidisciplinary care followed by surgical management should begin immediately following the babys delivery. Surgical goals in the neonatal period include closure of the meningocele and repair of the exstrophy and omphalocele, resulting in approximation of the bladder halves and repair of the hindgut defect with colostomy creation. Closure of the bladder, with positioning within the pelvis, can either occur at the initial operation or be staged to occur after a period of monitored growth, and is best performed with pelvic osteotomies to protect the closure from tension. Subsequent surgeries over several years will address genital reconstruction and colonic pull-through for fecal continence, if the patient is a candidate. Here, we present a patient diagnosed with OEIS complex by prenatal ultrasound, with a postnatal exam confirming the diagnosis and demonstrating a closed (covered) myelomeningocele. The cloacal exstrophy and omphalocele were repaired in one stage, with primary closure of the involved bowel and the bladder, facilitated by pelvic osteotomies. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/102b/cloacal-exstrophy-repair
01441nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002500103245005800128260004400186300006300230505039500293506003600688538044600724856006501170482Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDeanna Rothman, MD 10aNasogastric (NG) Tube InsertioncDeanna Rothman, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file13:39bcolor/sound 0 aNasogastric (NG) tube insertion is a crucial skill in medical practice that involves the placement of a flexible tube through the nasal passage into the stomach, serving multiple purposes in patient care. The video above aims to provide a detailed overview of NG tube insertion, including its indications, contraindications, necessary materials, and the step-by-step process of placement. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/482/nasogastric-ng-tube-insertion
03130nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100008800105245008200193260004400275300006300319505196200382506003602344538044602380856009802826278.2Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJacob Blank, Paulo Castillo, MD, Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES 10aPosterior Sagittal Anorectoplasty (PSARP) for Imperforate AnuscJacob Blank aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file32:44bcolor/sound 0 aImperforate anus is a birth defect in which the anal opening is absent. This condition develops during the fifth to seventh weeks of pregnancy and the cause is unknown. It affects about one in every 5,000 newborns and is noted to be more common among boys than girls. Imperforate anus is usually present with other birth defects such as vertebral defects, cardiac problems, tracheoesophageal fistula, renal anomalies, and limb abnormalities, collectively known as the VACTERL association. These are classified as low or high type. In the low type, in which the rectum remains close to the skin, there may be associated stenosis of the anus, or the anus may be missing altogether, with the rectum ending in a blind pouch. In the high type, in which the rectum is higher up in the pelvis, there may be a fistula connecting the rectum and the bladder, urethra, or the vagina. The diagnosis is made by performing a physical exam after birth. An x-ray of the abdomen and abdominal ultrasound can help reveal the extent of the abnormalities. Treatment is surgical creation of an opening or new anus to allow stool to pass. The type of surgery differs and depends on whether the anus ends high or low in the pelvis. In the case of a low type, an anal opening is made in a single operation, and the rectum is pulled down to the anus. For high type, surgical correction is performed in three stages. The first procedure is bringing the intestine out of the abdomen creating a stoma; the second procedure is pulling the rectum down to the anus where a new anal opening is created; and the third procedure is closure of the intestinal stoma. Here, we present a case of a 9-month-old male who was born with a high-type imperforate anus. A posterior sagittal anorectoplasty (PSARP) was done as the second of three stages of treatment. The first was an emergency sigmoid colostomy, and the third will be to close the colostomy in about 6 to 8 weeks following the PSARP. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/278.2/posterior-sagittal-anorectoplasty-psarp-for-imperforate-anus
02115nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000550010224500780015726000440023530000660027950510070034550600360135253804460138885600750183433Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aCaleb P. Gottlich, MD, MS, Michael J. Weaver, MD 10aIntramedullary Nail for Open Tibial FracturecCaleb P. Gottlich, MD, MS aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:07:18bcolor/sound 0 aThe tibia is particularly susceptible to open fractures because of its subcutaneous location. The status of the overlying soft tissue is regarded as the key determinant of fracture management strategy. Intramedullary nailing is widely recognized by the orthopedic community as the treatment of choice for most displaced, open, tibia shaft fractures due to the extent of soft tissue damage and the risk of infection. Both open and closed fractures are amenable to nailing. Occasionally, plates and external fixators are required to manage certain tibial fractures.

This article describes the stabilization of an open tibia shaft fracture using an intramedullary nail. After copious irrigation and debridement of the fracture site, a transpatellar tendon split is used to expose the nail entry point. This is followed by fracture reduction, sequential reaming, and nail insertion and locking. Finally, the technique for proximal tibia traction pin insertion is demonstrated on the contralateral tibia. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/33/intramedullary-nail-open-tibial-fracture
02281nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100003100105245007600136260004400212300006600256505119000322506003601512538044601548856008101994176.1Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aChristopher R. Morse, MD 10aMinimally Invasive Ivor Lewis EsophagectomycChristopher R. Morse, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:27:51bcolor/sound 0 aEsophageal cancer is a growing problem in the United States. Surgical resection, often in combination with chemoradiotherapy, provides the only approach to offer a cure for these patients. Traditional open approaches are burdened by high levels of morbidity and mortality. Minimally invasive esophagectomy (MIE) has been proposed as an alternative approach. Although MIE is complex and perhaps more time-consuming, perioperative results are encouraging and generally trend toward fewer pulmonary complications, lower blood loss, shorter ICU stays, and shorter overall hospitalization durations. There appears to be little cost in terms of oncologic efficacy. Although technically demanding, it appears that the learning curve is approximately 40 cases. With these considerations in mind, it is likely that MIE will continue to grow in favorability for patients with surgically resectable esophageal cancer. Recent advancements include the robotic Ivor Lewis procedure, which facilitates precise intrathoracic anastomosis with comparable complication rates and oncological outcomes. Its feasibility and safety highlight its potential, pending further validation in controlled studies. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/176.1/minimally-invasive-ivor-lewis-esophagectomy
02152nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005000103245012300153260004400276300006600320505097300386506003601359538044601395856010501841475Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aHany M. Takla, MD, FACS, FASMBS, DABS-FPMBS 10aRobotic Roux-en-Y Gastric Bypass (RYGB) for Treatment of Morbid ObesitycHany M. Takla, MD, FACS, FASMBS, DABS-FPMBS aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:46:10bcolor/sound 0 aRobotic surgery as an approach for Bariatric surgery has been a subject of debate for at least two decades since the platform passed FDA approval. One could argue that the exponential growth of robotics in surgery could end such a debate. The robotic platform offers several advantages that are always advertised, but in the morbidly obese population it offers an added advantage. It is arguable that with the advanced ergonomics, superior visual tools, and wristed instruments the robotic platform is superior in its offerings to the surgeon and enables a wider variety of surgeons with variable skill set to adopt minimally-invasive surgery (MIS), especially in bariatrics. The gastric bypass is a technically demanding operation with a variety of steps that require superior technical skills and can be challenging for trainees and young surgeons. In our experience, the robotic platform allows easier adoption and teaching of these technically challenging steps. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/475/robotic-roux-en-y-gastric-bypass-rygb-for-treatment-of-morbid-obesity
02416nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000540010224500830015626000440023930000630028350513000034650600360164653804460168285600820212811Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aVahagn G. Hambardzumyan, MD, Martin Goodman, MD 10aLaparoscopic Gastric Wedge Resection for a GISTcVahagn G. Hambardzumyan, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file32:48bcolor/sound 0 aThe stomach is involved in multiple common ailments, including gastroesophageal reflux disease, gastric ulcers and cancer, the latter of which can take many forms. Originally, GISTs arise from the connective tissue, or stroma, of the stomach, rather than the lining, from which the more common and more deadly gastric adenocarcinoma finds its origin. However, over time, study revealed that GIST arises from a very specific cell, called the interstitial cells of Cajal, that are responsible for the timing of contraction in the stomach and small intestine. GIST masses generally behave more indolently than gastric adenocarcinoma, with distant or lymph node metastases a rare feature, although involvement of the liver and peritoneum has been described. Due to this indolent nature, certain masses, once they have been identified as GIST through endoscopic biopsy, are candidates for surveillance. However, larger masses (as identified through evidence of necrosis on imaging) and rapidly growing masses are treated primarily with surgical resection. While in the past surgical resection would have involved a large abdominal incision and a lengthy postoperative recovery, laparoscopic techniques have allowed gastric resection to become a short procedure necessitating only an overnight stay. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/11/laparoscopic-gastric-wedge-resection-for-a-gist
01980nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005000103245009200153260004400245300006300289505084300352506003601195538044601231856009701677467Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAyse N. Sahin-Efe, MD, Michael Misialek, MD 10aThyroid Biopsy: Fine-Needle Aspiration for Multinodular GoitercAyse N. Sahin-Efe, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file16:47bcolor/sound 0 aThyroid nodules are common with a higher prevalence in women and the older population. They can be found in more than 50% of the older population. Malignancy risk is reported to be 7–15% depending on age, sex, radiation exposure history, and family history. Thyroid nodules can be detected either by palpation or incidentally by imaging done for irrelevant purposes. About 16% of chest CT scans show an incidental thyroid nodule. Subsequent ultrasound scans would evaluate the nodule size and characteristics. If the nodules meet the biopsy criteria based on TIRADS (Thyroid Imaging Reporting and Data Systems) criteria, referral for fine-needle aspiration biopsy (FNA) is necessary. This video delivers a thorough demonstration of the correct technique for ultrasound-guided thyroid FNA with rapid on-site cytology evaluation (ROSE). aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/467/thyroid-biopsy-fine-needle-aspiration-for-multinodular-goiter
01729nam  22002051  4500001000500000003000500005006001900010007000400029008004100033028001100074040001900085100005500104245006100159260004400220300006300264505063700327506003600964538044601000856007701446102aJomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJeffrey Gray, Purushottam Gholve, MD, MBMS, MRCS 10aPelvic Osteotomies for Cloacal ExstrophycJeffrey Gray aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file28:08bcolor/sound 0 aCloacal exstrophy is part of a wide-ranging spectrum of rare congenital abnormalities resulting from the same embryological defect. Conditions include bladder exstrophy, epispadias, cloacal exstrophy, omphalocele, and more. Mortality due to complications with cloacal exstrophy was historically significant as it is among the most severe of these abnormalities. However, advancements in reconstructive surgery have improved the survival of patients. Pelvic osteotomy is typically indicated in cloacal exstrophy as it normally presents with widely separated pubic bones that require approximation as part of abdominal wall closure. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/102a/pelvic-osteotomies-for-cloacal-exstrophy
01785nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100006300106245009000169260004400259300006300303505063100366506003600997538044601033856010001479268.13Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aCasey L. Meier, RN, Lissa Henson, MD, Domingo Alvear, MD 10aPediatric Infant Bilateral Open Inguinal Hernia Repair - Twin BcCasey L. Meier, RN aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file14:53bcolor/sound 0 aIndirect inguinal hernia repair is a common procedure for premature infants because of the frequency of a patent processus vaginalis. Prompt surgical correction decreases the risk of incarceration, strangulation, and necrosis in children. There are various techniques for herniorrhaphy. This repair demonstrates an open bilateral indirect inguinal hernia repair in an infant that avoids high ligation by closing the internal inguinal ring, utilizing a purse-string method to keep the hernia sac intact. This approach limits the amount of anesthesia used and prevents excess bleeding, making it safe, effective and efficient. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/268.13/pediatric-infant-bilateral-open-inguinal-hernia-repair-twin-b
02409nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100007000105245009400175260004400269300006300313505124700376506003601623538044601659856009802105268.1Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJaymie Ang Henry, MD, MPH, Lissa Henson, MD, Domingo Alvear, MD 10aScrotal Hydrocelectomy Made Simple During a Surgical MissioncJaymie Ang Henry, MD, MPH aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file31:47bcolor/sound 0 aA hydrocele is a condition characterized by the abnormal accumulation of serous fluid between the layers of the tunica vaginalis in the scrotum. While most hydroceles are typically asymptomatic or subclinical, larger ones can cause discomfort, heaviness, and cosmetic concerns. The surgical management of hydroceles aims to alleviate symptoms, improve cosmetic appearance, and prevent potential complications associated with untreated hydroceles, such as testicular ischemia or chronic pain.

This video highlights the surgeon's expertise and attention to detail, ensuring a thorough and meticulous surgical technique. The step-by-step approach and clear communication with the surgical team facilitate a smooth and efficient procedure. The importance of this surgical technique extends beyond the individual patient. Providing a simplified and effective treatment option for hydroceles has the potential to improve patient outcomes and reduce the burden on healthcare systems, particularly in resource-limited settings or during surgical missions. Overall, the video serves as a valuable educational resource for surgical trainees and practitioners, demonstrating a simplified and effective approach to the treatment of scrotal hydroceles. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/268.1/scrotal-hydrocelectomy-made-simple-during-a-surgical-mission
02116nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100012500103245018600228260004400414300006600458505071200524506003601236538044601272856019201718456Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMichael Akodu, MBBS, Elyse J. Berlinberg, MD, Miles Batty, MD, Michael McTague, MPH, Kiran J. Agarwal-Harding, MD, MPH 10aLeft Elbow Exploration and Hardware Removal with Ulnar Nerve Decompression, Cubital Tunnel Release, and Anterior Subcutaneous Transposition of the Ulnar NervecMichael Akodu, MBBS aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:31:47bcolor/sound 0 aDistal humeral fractures are injuries worldwide with operative fixation being the preferred method of treatment. Ulnar neuropathy is one of the possible complications of surgery, and may require an additional surgery to achieve symptom resolution. In this video, Dr. Agarwal-Harding manages a patient who was previously treated with open reduction and internal fixation of a distal humerus fracture, but his recovery was complicated by ulnar neuropathy. He performs an ulnar neurolysis, hardware removal from the medial column of the distal humerus, and anterior transposition of the ulnar nerve with an adipofascial flap. Surgical considerations, including rationale and treatment options, are discussed. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/456/left-elbow-exploration-and-hardware-removal-with-ulnar-nerve-decompression-cubital-tunnel-release-and-anterior-subcutaneous-transposition-of-the-ulnar-nerve
02423nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100007300105245012900178260004400307300006600351505117900417506003601596538044601632856013902078290.5Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aYoko Young Sang, MD, Caroll Alvarado Lemus, MD, Domingo Alvear, MD 10aColon Interposition to Replace an Absent Esophagus is the Procedure of Choice in Low-Income CountriescYoko Young Sang, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:07:15bcolor/sound 0 aThe provided video offers a comprehensive demonstration of the colon interposition procedure, highlighting the critical operative steps and technical nuances involved in performing a successful esophageal replacement, particularly in resource-limited settings, where advanced treatment options such as gastric pull-up or jejunal interposition may be limited. Colon interposition remains a viable solution for restoring swallowing function in patients with EA or other esophageal disorders requiring esophageal replacement.

By providing a detailed visual representation of the surgical process, this video serves as a valuable educational resource for surgeons and healthcare professionals involved in the care of patients with EA or related conditions. It underscores the importance of meticulous surgical technique, vascular preservation, and careful planning to ensure successful outcomes. Moreover, the video emphasizes the crucial role of multidisciplinary care in managing these complex cases. The involvement of specialists in pediatric surgery, anesthesiology, and intensive care is essential for optimizing patient outcomes and addressing potential complications. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/290.5/colon-interposition-to-replace-an-absent-esophagus-is-the-procedure-of-choice-in-low-income-countries
02037nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000380010224500420014026000440018230000660022650509990029250600360129153804460132785600580177321Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aTK Pandian, Roy Phitayakorn, MD 10aRight HemithyroidectomycTK Pandian aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:15:27bcolor/sound 0 aHemithyroidectomy, or unilateral thyroid lobectomy, refers to removal of half the thyroid gland. The procedure is typically performed for suspicious thyroid nodules or small differentiated thyroid cancers based on biopsy via fine needle aspiration (FNA) and occasionally for symptomatic benign thyroid nodules. At most institutions the operation can be completed safely in an outpatient fashion with patient discharge from the hospital the same day. It is typically performed via a transcervical collar incision, but endoscopic, transoral routes and remote access approach with robotic instrumentation have been described. The procedure involves mobilization of the thyroid lobe, ligation of thyroid vessels, preservation of parathyroids, protection of the recurrent laryngeal nerve, and dissection away from the trachea. In this patient, a thyroid nodule was detected and found to have indeterminate features on biopsy via FNA. A hemithyroidectomy was then performed for diagnostic purposes. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/21/right-hemithyroidectomy
02357nam  22002051  4500001000300000003000500003006001900008007000400027008004100031028001100072040001900083100006600102245007600168260004400244300006300288505123500351506003601586538044601622856008302068f1Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aLiam A. Peebles, Zachary S. Aman, Matthew T. Provencher, MD 10aLateral Patient Positioning for Shoulder ArthroscopycLiam A. Peebles aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:44bcolor/sound 0 aDiagnostic shoulder arthroscopy or arthroscopic shoulder stabilization procedures can be performed with the patient in the beach chair or lateral decubitus (LD) position. Patient positioning may be dictated by surgeon preference or the specific intended procedure; however, LD setup has been found to result in lower rates of recurrent instability in cases of anterior arthroscopic stabilization procedures. The lateral and axial traction provided by the LD setup allows for lower suture anchor placement on the anterior-inferior aspect of the glenoid, as the surgeon has increased visualization and working room within the glenohumeral joint. Prior to placing the patient in the LD position, meticulous care must be taken to properly position the beanbag device and set up the lateral traction device. Next, a coordinated team approach should be used to roll the patient into the LD position and to ensure that all bony prominences are adequately padded. The shoulder is then placed in 40° of abduction, 20° of forward flexion, with 10–15 pounds of balanced traction. Finally, the shoulder is prepped and draped in the usual sterile fashion and the surgeon is then able to proceed with the necessary arthroscopic procedure. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/f1/lateral-patient-positioning-shoulder-arthroscopy
01832nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003400103245009200137260004400229300006300273505071800336506003601054538044601090856009001536483Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAmory C. de Roulet, MD, MPH 10aPercutaneous Endoscopic Gastrostomy (PEG) Tube PlacementcAmory C. de Roulet, MD, MPH aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file22:30bcolor/sound 0 aPercutaneous Endoscopic Gastrostomy (PEG) is a minimally-invasive medical procedure that creates a safe and effective route for enteral nutrition, fluid administration, and medication delivery. PEG tubes are primarily used for long-term enteral nutrition in patients with impaired swallowing or inadequate oral intake, decompression of the gastrointestinal tract, and administration of medications. This detailed video demonstration of the PEG tube placement procedure is a crucial educational resource for medical professionals. It provides comprehensive visualization of a complex procedure, demonstrates real-time problem-solving, emphasizes safety considerations, and offers valuable tips for practitioners. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/483/percutaneous-endoscopic-gastrostomy-peg-tube-placement
01908nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002800103245009600131260004400227300006300271505078400334506003601118538044601154856010201600481Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aHelen S. Wei, MD, PhD 10aLaparoscopic Appendectomy with Lysis of Adhesions for AppendicitiscHelen S. Wei, MD, PhD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file34:33bcolor/sound 0 aLaparoscopic appendectomy (LA) is a minimally-invasive technique distinguished by the utilization of small incisions through which an endoscopic camera and specialized instruments are introduced to facilitate the excision of an inflamed vermiform appendix. This LA video serves as an educational tool, offering unique insights into complex surgical scenarios. It demonstrates real-time decision-making in the face of adhesions from previous surgery, showcasing how to adapt standard techniques to challenging anatomy. The video provides a clear visualization of advanced laparoscopic skills, including safe adhesiolysis, cautious dissection, and proper use of surgical devices. It emphasizes critical aspects of surgical safety, team communication, and complication management. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/481/laparoscopic-appendectomy-with-lysis-of-adhesions-for-appendicitis
01893nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006700103245012300170260004400293300006600337505068100403506003601084538044601120856012101566238Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aCourtney Gibson, MD, MS, FACS, Tobias Carling, MD, PhD, FACS 10aBilateral Modified Radical Neck Dissection for Metastatic Papillary Thyroid CarcinomacCourtney Gibson, MD, MS, FACS aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:52:34bcolor/sound 0 aRadical neck dissection was once the standard of care for the surgical management of patients with thyroid cancer and cervical lymph node metastases. However, due to the significant morbidity of this procedure, the development of cervical lymphadenectomy procedures that could provide oncologic cure while minimizing morbidity was undertaken by many surgeons. Such an investigation has led to the development of the modified radical neck dissection (MRND). Still, many institutions are not familiar with performing a comprehensive MRND in the setting of thyroid cancer metastatic to the lateral lymph node compartments. We present such an operation under general anesthesia. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/238/bilateral-modified-radical-neck-dissection-for-metastatic-papillary-thyroid-carcinoma
02265nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100004700105245008400152260004400236300006300280505113300343506003601476538044601512856010101958290.3Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJasmine Phun, Col. Arthur C. Wittich, DO 10aAbdominal Hysterectomy as a Surgical Approach in Large FibroidscJasmine Phun aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file37:59bcolor/sound 0 aUterine fibroids, also known as leiomyomas, are usually benign masses that are most commonly found in women of reproductive age. Fibroids are usually asymptomatic and tend to be incidental findings on ultrasound. When clinically relevant, however, patients report symptoms such as menorrhagia, pelvic pain, and bulk-related symptoms. Treatment of symptomatic fibroids may be pharmaceutical with gonadotropin-releasing hormone agonists, radiological using MRI-guided focused ultrasound surgery (or magnetic resonance-guided focused ultrasound), or minimally-invasive uterine artery embolization, but the treatment is largely surgical. There are many different surgical approaches that can be utilized, including myomectomy or hysterectomy. Treatment of choice depends on multiple factors, including the severity of symptoms, size of fibroids, and patients desire to preserve fertility. However, out of all of the different surgical techniques available, hysterectomy is the only definitive treatment for these patients. Here, an abdominal hysterectomy was performed on a 45-year-old patient with symptomatic uterine fibroids.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/290.3/abdominal-hysterectomy-as-a-surgical-approach-in-large-fibroids
02353nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100018500103245011600288260004400404300006600448505104100514506003601555538044601591856011002037460Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMIGUEL ANGEL MENDOZA ROMO RAMIREZ, Jasanai Sausameda-García, MD, Silverio Gutiérrez-Cruz, MD, Kevin Johnson-Molina, MD, Miguel Angel Mendoza-Romo, MD, Carlos Flores-Ramirez, MD 10aTranscervical Open Repair of Extracranial Internal Carotid Artery AneurysmcMIGUEL ANGEL MENDOZA ROMO RAMIREZ aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:13:59bcolor/sound 0 aWe present the case of a 1.8-cm carotid saccular aneurysm dependent on the left internal carotid, limited to the proximal portion of the bifurcation in a 66-year-old male with a history of hypertension and diabetes mellitus, successfully managed with an open surgical technique. Extracranial aneurysms of the carotid artery are rare and may be caused by atherosclerosis, trauma, infection, or other factors. These aneurysms are characterized by an increase in the diameter of the carotid artery and may require treatment to prevent complications such as embolism or rupture. Treatment may include open surgery or endovascular techniques, and the choice of treatment depends on several factors, such as the location and size of the aneurysm. Medical management may also be considered in selected cases. Diagnosis is made through imaging tests such as duplex ultrasound, computed tomography, or magnetic resonance imaging. It is important to perform a careful evaluation to determine the best treatment option and prevent complications. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/460/transcervical-open-repair-of-extracranial-internal-carotid-artery-aneurysm
02621nam  22002051  4500001000300000003000500003006001900008007000400027008004100031028001100072040001900083100007100102245008600173260004400259300006300303505147500366506003601841538044601877856009202323f2Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aTravis J. Dekker, MD, Liam A. Peebles, Matthew T. Provencher, MD 10aPlacing Knotless Suture Anchor Through Mid-Glenoid PortalcTravis J. Dekker, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file02:48bcolor/sound 0 aOptimal portal placement for arthroscopic shoulder stabilization procedures can significantly aid a surgeons visualization during the repair as well as suture anchor placement. A percutaneous knotless anchor insertion kit used through a mid-glenoid portal allows the surgeon to access positions on the glenoid rim that are commonly difficult to reach. Moreover, the knotless kit has the ability to save valuable time during arthroscopic stabilization procedures and also eliminates the risk of postoperative knot impingement. The mid-glenoid portal should be made approximately 1 cm lateral from the joint line of the humeral head and 2–3 cm inferior and 1–2 cm medial from the posterolateral acromial angle. This portal placement avoids injury to the labrum and should be determined after assessing both the thickness of the local soft tissues and the size of the relevant bony architecture. A hole for the knotless anchor should be drilled approximately 1–2 mm onto the face of the glenoid, and the labral tape is then passed a short distance through the eyelet of the knotless fixation device before the construct is inserted into the glenoid. A hemostat is used to hold the tape as it is placed into the drill hole, and a mallet is used to drive the interference portion of the plastic implant to a marked depth. Finally, once the suture anchor is securely affixed, the insertion device is unloaded and pulled out of the portal with 6 counterclockwise turns. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/f2/placing-knotless-suture-anchor-through-mid-glenoid-portal
02873nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100006700105245009400172260004400266300006300310505171300373506003602086538044602122856009902568268.6Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aShai I. B. Stewart, MD, Lissa Henson, MD, Domingo Alvear, MD 10aPediatric Infant Bilateral Open Inguinal Hernia Repair - Twin AcShai I. B. Stewart, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file15:08bcolor/sound 0 aAn inguinal hernia (IH) is a protrusion of intra-abdominal contents through the inguinal canal that can arise at any time from infancy to adulthood. It is more common in males with a lifetime risk of 27% as compared to 3% in females. Most pediatric IHs are congenital and caused by failure of the peritoneum to close, resulting in a patent processus vaginalis (PPV). IH present as a bulge in the groin area that can become more prominent when crying, coughing, straining, or standing up, and disappears when lying down. Diagnosis is based on a thorough medical history and physical examination, but imaging tests such as ultrasound can be used when the diagnosis is not readily apparent. IHs are generally classified as indirect, direct, and femoral based on the site of herniation relative to surrounding structures. Indirect hernias protrude lateral to the inferior epigastric vessels, through the deep inguinal ring. Direct hernias protrude medial to the inferior epigastric vessels, within Hesselbachs triangle. Femoral hernias protrude through the small and inflexible femoral ring. In infants and children, IH are always operated on to prevent incarceration. Surgical correction in infants and children is done by high ligation of the hernia sac only, called a herniotomy. Here, we present a female infant with bilateral IH. Upon exploration, a hernia sac was found, and ligation was performed bilaterally. In female patients, it is believed that failure of the closure of the canal of Nuck alongside the round ligament of the uterus is the etiology. Oftentimes there is a “sliding hernia” where the ovary and or the fallopian tube is attached to the sac, sometimes the uterus itself is attached. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/268.6/pediatric-infant-bilateral-open-inguinal-hernia-repair-twin-a
02778nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000470010224502300014926000440037930000660042350513660048950600360185553804460189185602350233725Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDeborah D. Tsao, BS, Janey Sue Pratt, MD 10aApproach to Marginal Ulceration Following RYGB Surgery: Laparoscopic Excision of the Marginal Ulcer and Retrocolic, Retrogastric Rerouting of the Roux Limb with Truncal Vagotomy and Hiatal Hernia RepaircDeborah D. Tsao, BS aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:44:05bcolor/sound 0 aGastrogastric fistula is a rare complication following a Roux-en-Y gastric bypass procedure wherein there is a communication between the proximal gastric pouch and the distal gastric remnant. Patients typically present with nausea and vomiting, abdominal pain, intractable marginal ulcer, bleeding, reflux, poor weight loss, and weight regain. Etiologies include postoperative Roux-en-Y gastric bypass leaks, incomplete gastric division, marginal ulcers, distal obstruction, and erosion of a foreign body. Diagnosis is made through upper gastrointestinal contrast radiography or CT scan and endoscopy. Barium contrast radiography is particularly useful and is the preferred initial study method for the detection of staple-line dehiscence, which may be small and overlooked during endoscopy. Once identified, a gastrogastric fistula may be treated surgically with remnant gastrectomy or gastrojejunostomy revision. Here, we present a case of a female patient status post Roux-en-Y gastric bypass surgery who presented with abdominal pain. Upon endoscopy, she was noted to have an inflamed gastric pouch and a gastogastric fistula. A laparoscopic gastric bypass revision was done to divide the gastrogastric fistula and to separate the gastric pouch from the gastric remnant in order to alleviate the inflamed gastric pouch and prevent further ulcer formation. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/25/approach-to-marginal-ulceration-following-rygb-surgery-laparoscopic-excision-of-the-marginal-ulcer-and-retrocolic-retrogastric-rerouting-of-the-roux-limb-with-truncal-vagotomy-and-hiatal-hernia-repair
01704nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005500103245012400158260004400282300006600326505049200392506003600884538044600920856013201366450Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAustin Bramwell, MD, Tullika Garg, MD, MPH, FACS 10aCystoscopy and Transurethral Resection of Bladder Tumors with Stent and Foley Catheter PlacementcAustin Bramwell, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:29:07bcolor/sound 0 aBladder cancer is the sixth most common cancer in the United States. Transurethral resection of bladder tumor (TURBT) is a common urologic surgical procedure used to diagnose, stage, and treat bladder cancer. We present a patient who had multiple episodes of gross hematuria and was found to have multifocal bladder tumors. In this case, TURBT was performed to confirm the diagnosis of bladder cancer, remove all visible bladder tumors, and prevent further episodes of gross hematuria. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/450/cystoscopy-and-transurethral-resection-of-bladder-tumors-with-stent-and-foley-catheter-placement
01955nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000450010224500540014726000440020130000630024550508990030850600360120753804460124385600600168912Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aPatrick Vavken, MD, Femke Claessen, MD 10aElbow Arthroscopy (Cadaver)cPatrick Vavken, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file16:59bcolor/sound 0 aElbow arthroscopy is a technically demanding procedure but it is very useful to evaluate the entire elbow joint for pathology with minimal surgical exposure and faster recovery than a traditional arthrotomy. The neurovascular structures of the elbow joint are in close proximity to the joint, thus there is a risk of injury to these structures, so care must be taken to fully understand elbow anatomy and to be prepared for aberrations. Elbow arthroscopy can be used diagnostically, as in this video article, or to surgically treat a variety of conditions including ligamentous tears, loose bodies, capsular stiffness, osteochondritis dissecans of the elbow, osteophyte debridement, and lateral epicondylitis. A patient with a previous ulnar nerve transposition is a relative contraindication to elbow arthroscopy, as there is a high risk of injury to the ulnar nerve during portal placement. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/12/elbow-arthroscopy-cadaver
01909nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100009400106245005200200260004400252300006300296505080200359506003601161538044601197856006001643161.10Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aKristen L. Zayan, BS, Adam Honeybrook, MBBS, C. Scott Brown, MD, Daniel J. Rocke MD, JD 10aThyroidectomy (Cadaver)cKristen L. Zayan, BS aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file19:48bcolor/sound 0 aThyroidectomy may be performed for various pathologies, consisting of either thyroid lobectomy or total gland removal. Both benign and malignant disease processes necessitate surgical intervention. Thyroid nodules, compressive thyroid goiter, or persistent thyrotoxicosis represent some of the benign indications. Malignant conditions affecting the thyroid include papillary, follicular, medullary, and anaplastic carcinomas. In the present case, a thyroidectomy via standard cervical incision is performed on a cadaver with overlying animations to emphasize the key anatomy. The discussion is in relation to a patient with obstructive goiter presenting with worsening wheezing, cough, and dysphagia, with the ultimate goal of relieving the compressive symptoms through the removal of the gland. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/161.10/thyroidectomy-cadaver
02109nam  22002051  4500001000300000003000500003006001900008007000400027008004100031028001100072040001900083100006600102245007300168260004400241300006300285505098900348506003601337538044601373856008401819f3Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aZachary S. Aman, Liam A. Peebles, Matthew T. Provencher, MD 10aTying Arthroscopic Knot for Glenoid Suture AnchorcZachary S. Aman aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file03:25bcolor/sound 0 aAs arthroscopic and minimally-invasive procedures have become increasingly more common over the past decade, a versatile understanding of several arthroscopic knot tying techniques is essential for reproducible and reliable repairs. While there are numerous descriptions of unique arthroscopic knots, selection and correct implementation is critical for adequate soft tissue fixation and successful patient outcomes. Specifically, the Roeder knot, a type of locking sliding knot, with 3 alternating half hitches, has been described to provide the loop and knot security among other sliding knot techniques. Therefore, the Roeder knot has emerged as a preferred knot tying technique amongst orthopedic surgeons, especially in the setting of arthroscopic shoulder stabilization procedures. In this case, we describe the basic fundamentals of performing a Roeder knot with 3 alternating half hitches to anchor the labrum to the glenoid in the setting of an arthroscopic Bankart repair. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/f3/tying-arthroscopic-knot-for-glenoid-suture-anchor
01799nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002900103245014200132260004400274300006600318505058000384506003600964538044601000856014701446227Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aBarbara Smith, MD, PhD 10aLumpectomy and Sentinel Lymph Node Biopsy Using Lumicell System for Intraoperative Detection of Residual CancercBarbara Smith, MD, PhD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:08:20bcolor/sound 0 aThis case presentation involved a female patient with breast cancer who underwent a lumpectomy and sentinel lymph node biopsy using the Lumicell system for intraoperative detection of residual cancer. The aim was to detect residual tumor cells during the initial operation and avoid subsequent surgeries. This video provides a thorough presentation of lumpectomy and sentinel lymph node biopsy utilizing the Lumicell system to detect any remaining cancer during surgery. The video covers the entire process, from preoperative preparation to the final step of skin closure. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/227/lumpectomy-and-sentinel-lymph-node-biopsy-using-lumicell-system-for-intraoperative-detection-of-residual-cancer
02118nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004600103245015000149260004400299300006300343505086900406506003601275538044601311856015501757449Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aKathleen M. Twomey, MD, Yu Maw Htwe, MD 10aBilateral Indwelling Pleural Catheter Placement for Advanced Non-small Cell Lung Cancer with Recurrent Pleural EffusioncKathleen M. Twomey, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file37:41bcolor/sound 0 aPleural effusions are frequently observed in a variety of conditions. Reasons for intervention include obtaining an underlying diagnosis as to the cause and providing symptom relief. One of the most frequent causes of a recurrent pleural effusion is malignancy, which will typically continue to accumulate for as long as the cancer is progressing. When patients have a rapidly recurring effusion, requiring frequent intervention by way of thoracentesis or chest tube, other options for management are considered. An indwelling pleural catheter (IPC) can be offered to a patient to help drain the effusion on a regular basis, without requiring repeat thoracentesis. The goal of the drain placement is to provide symptom relief, and it is often in place for as long as the patient has an appreciable effusion that can be drained intermittently by vacuum canisters. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/449/bilateral-indwelling-pleural-catheter-placement-for-advanced-non-small-cell-lung-cancer-with-recurrent-pleural-effusion
02443nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005500103245009200158260004400250300006600294505129800360506003601658538044601694856009702140192Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDouglas O'Connell, MSc, Christopher R. Morse, MD 10aOpen Left Upper Lobectomy in an Adult Cystic Fibrosis PatientcDouglas O'Connell, MSc aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:05:49bcolor/sound 0 aCystic Fibrosis (CF) is an autosomal recessive genetic disorder characterized by mutations in the cystic fibrosis transmembrane regulator gene. The pathophysiology is based on abnormal chloride secretion from columnar epithelial cells. As a result, patients with CF have symptoms related to their inability to hydrate secretions in the respiratory tract, pancreas, and intestine, among other organs. In the lung, thick, inspissated secretions give rise to chronic obstructive pulmonary disease characterized by severe pulmonary infections, culminating in respiratory failure. Subacute exacerbations of CF lung disease are treated with antibiotics and various forms of chest physiotherapy. When large areas of the lung develop abscesses or necrosis, surgical treatment is often indicated. Options include lobectomy as a temporizing measure and lung transplantation for end-stage CF lung disease. Here, we present an unusual case of a man with CF whose lung function had remained relatively good until adulthood. His left upper lobe became chronically infected and progressively non-functional. Because the patient's overall lung function was moderately preserved, an open left upper lobectomy was performed to prevent recurrences of subacute infections and subsequent damage to the left lung. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/192/open-left-upper-lobectomy-in-an-adult-cystic-fibrosis-patient
01755nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100012500103245007900228260004400307300006600351505056300417506003600980538044601016856008701462455Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMichael Akodu, MBBS, Elyse J. Berlinberg, MD, Miles Batty, MD, Michael McTague, MPH, Kiran J. Agarwal-Harding, MD, MPH 10aLeft Hip Hemiarthroplasty for Femoral Neck FracturecMichael Akodu, MBBS aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:15:06bcolor/sound 0 aHip fractures are a major cause of morbidity and mortality, especially among older patients. They also account for a significant portion of healthcare spending and other non-medical costs. These fractures can be classified into various types based on the parts of the femoral head and neck affected, and fixation options are dependent on both patient and injury characteristics. In this video, Dr. Agarwal-Harding takes us through a hip hemiarthroplasty for a left femoral neck fracture, highlighting various guiding principles and surgical considerations. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/455/left-hip-hemiarthroplasty-for-femoral-neck-fracture
01850nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004200103245010300145260004400248300006300292505068900355506003601044538044601080856011801526121Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aSarita Jamil, Michael J. Weaver, MD 10aClosed Cephalomedullary Nailing of a Diaphyseal Femur Fracture on a Fracture TablecSarita Jamil aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file33:35bcolor/sound 0 aMidshaft femur fractures have an annual incidence of 10 per 100,000 person-years. Femoral fractures typically occur in two major settings: high-energy mechanisms related to trauma and low-energy mechanisms in insufficiency fractures observed in elderly patients with osteopenia. Patients present with pain, swelling, and limited range of motion. Intramedullary nailing is the definitive surgical treatment for femoral fractures to allow secondary healing of bone. Such a repair is performed here on a patient with a diaphyseal femoral fracture. Surgeon preference was to perform a closed cephalomedullary nailing with the patient supine on a radiolucent fracture table for traction. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/121/closed-cephalomedullary-nailing-of-a-diaphyseal-femur-fracture-on-a-fracture-table
02466nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100004300105245011000148260004400258300006300302505129000365506003601655538044601691856012302137268.7Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aLissa Henson, MD, Domingo Alvear, MD 10aRight Orchiopexy to Correct Undescended Testicle and Circumcision to Correct PhimosiscLissa Henson, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file32:02bcolor/sound 0 aCryptorchidism, or undescended testis, is a condition in which one or both testes fail to descend from the abdomen into the scrotum during fetal development. Phimosis, on the other hand, is a condition characterized by the inability to retract the foreskin over the glans penis. This video serves as a step-by-step guide on orchiopexy to correct an undescended testicle and circumcision to correct phimosis. It highlights the importance of proper dissection, identification, and mobilization of the undescended testis, as well as the techniques for lengthening and mobilizing the spermatic cord. It emphasizes the significance of separating and ligating the hernia sac, if present, to prevent future complications. Additionally, the video illustrates the critical steps involved in repositioning the testis within the scrotum. Furthermore, the video addresses the management of phimosis through circumcision, a procedure that may be performed simultaneously with orchiopexy. The importance of this surgical intervention lies in the preservation of testicular function, fertility potential, and the prevention of long-term complications associated with cryptorchidism. Early treatment is crucial, as it significantly reduces the risk of testicular damage and associated complications. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/268.7/right-orchiopexy-to-correct-undescended-testicle-and-circumcision-to-correct-phimosis
02264nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004400103245015300147260004400300300006300344505101000407506003601417538044601453856015901899318Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aRyan A. Hankins, MD, John A. Wahl, MS 10aUreteroscopy, Laser Lithotripsy, and Stent Replacement for an Obstructing Left Proximal Ureteral Stone with Forniceal RupturecRyan A. Hankins, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file18:34bcolor/sound 0 aThe case demonstrates the use of ureteroscopy with laser lithotripsy in the treatment of an obstructed left proximal ureteral stone with forniceal rupture. The patient presented to the emergency department with the signs and symptoms of a ureteral stone and was taken for imaging and a diagnostic ureteroscopy. Following confirmation of the diagnosis, the patient was scheduled for ureteroscopy with laser lithotripsy. A guidewire was placed, followed by visualization with a retrograde pyelogram and a subsequent flexible ureteroscopy. Laser lithotripsy was performed to fragment the stone. Following fragmentation, the renal pelvis and calyces were visualized to examine for retrograde movement of stone fragments. A confirmatory retrograde pyelogram was then performed, followed by placement of a temporary stent for fluid drainage. The patient was then discharged with opioids for pain medication and prophylactic antibiotics to prevent urinary tract infections and the subsequent risk of urosepsis. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/318/ureteroscopy-laser-lithotripsy-and-stent-replacement-for-an-obstructing-left-proximal-ureteral-stone-with-forniceal-rupture
01787nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004500103245006900148260004400217300006600261505069500327506003601022538044601058856007701504126Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDouglas Cassidy, MD, David Rattner, MD 10aLaparoscopic Paraesophageal Hernia RepaircDouglas Cassidy, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:29:36bcolor/sound 0 aSurgical repair should be considered in all symptomatic paraesophageal hernias. Laparoscopic repair is considered the gold standard with a quicker recovery and lower morbidity and mortality compared to open repairs. The patient in this case presented with worsening dysphagia to solids and dyspnea in the setting of an enlarging paraesophageal hernia with a component of organoaxial volvulus. She underwent a laparoscopic paraesophageal hernia repair with a Toupet fundoplication and posterior gastropexy. The patient exhibited subjective improvement in her dysphagia to solids and dyspnea with exertion as well as an objective improvement in her pulmonary function tests postoperatively. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/126/laparoscopic-paraesophageal-hernia-repair
01780nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003300103245010300136260004400239300006600283505063900349506003600988538044601024856010401470470Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMichael J. Rosen, MD, FACS 10aOpen Parastomal Hernia Repair with KeyBaker Mesh Placement TechniquecMichael J. Rosen, MD, FACS aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:09:40bcolor/sound 0 aThis video demonstrates a case involving an open parastomal hernia repair with retromuscular KeyBaker mesh placement. The case involves an obese patient with a large symptomatic parastomal hernia repair after a laparoscopic end sigmoid colostomy. The CT scan shows an intact linea alba with a 7-cm parastomal defect involving the small bowel and sigmoid colon. The use of a retromuscular KeyBaker mesh placement provides the advantages of offsetting the fascial and peritoneal defects afforded by a standard Sugarbaker repair with the added benefit of reinforcing the lateral abdominal wall by performing a keyhole slit in the mesh. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/470/open-parastomal-hernia-repair-with-keybaker-mesh-placement-technique
02388nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100007400103245009700177260004400274300006600318505120400384506003601588538044601624856011202070279Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aShoichi Irie, Mamiko Miyashita, Yu Takahashi, MD, Hiromichi Ito, MD 10aOpen Radical Cholecystectomy with Partial Hepatectomy for Gallbladder CancercShoichi Irie aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file02:05:28bcolor/sound 0 aGallbladder cancer (GBCA) is a relatively uncommon disease with dismal prognosis. As the symptoms associated with GBCA are vague and non-specific, most patients present when the disease is at an advanced stage and the majority are diagnosed when the disease is beyond the possibility of resection. On the other hand, GBCA can be discovered incidentally and appropriate oncologic surgery provides a great chance of cure for patients with GBCA. We present a case of incidentally-diagnosed GBCA and describe the surgical management for operable GBCA with a focus on the operative technique and perioperative management. A 60-year-old male presented with incidentally-discovered GBCA during a follow-up imaging study for his previously treated bladder cancer. The patient had been asymptomatic, and CT showed a growing mass in the gallbladder without evidence of metastatic disease. GBCA was suspected, and resection was recommended. He underwent extended cholecystectomy including cholecystectomy en bloc with partial hepatectomy at segment IVb and 5 and portal lymphadenectomy. His postoperative course was uneventful, and histologic examination confirmed the diagnosis of GBCA, pT3N1M0, stage IIIB. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/279/open-radical-cholecystectomy-with-partial-hepatectomy-for-gallbladder-cancer
01973nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000480010224500520015026000440020230000630024650509140030950600360122353804460125985600620170524Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aWilliam B. Hogan, Eric M. Bluman, MD, PhD 10aPeroneal Tendon DebridementcWilliam B. Hogan aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file36:43bcolor/sound 0 aTenosynovitis of the peroneal tendons is a common lower extremity problem that is often mistaken for other ankle pathology. Diagnosis is suggested with thorough history and physical examination and confirmed with radiographic studies when necessary. Patients with less acute or more severe presentation may improve with rest and physical therapy alone. When conservative management fails, surgical intervention is aimed at excising inflamed synovium with debridement and repair of any tears in the peroneal tendons. Recent literature has emphasized the increased use of tendoscopic approaches to peroneal pathology, although most studies to date have been too underpowered to suggest superiority to an open approach. We present a case of acute tenosynovitis treated by open surgical debridement and irrigation. Tendoscopy was deferred as the size and nature of this patients injury warranted an open repair. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/24/peroneal-tendon-debridement
02324nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000480010224500550015026000440020530000630024950512660031250600360157853804460161485600580206013Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aThomas S. Thornhill, MD, David J. Lee, MD 10aTotal Knee ArthroplastycThomas S. Thornhill, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file59:20bcolor/sound 0 aTotal knee replacement is one of the most common orthopaedic procedures performed in the United States. The most common indication for total knee replacement is osteoarthritis. Clinical signs of knee osteoarthritis include pain with walking, difficulty ranging the knee, knee instability, varus deformity, bony enlargement, extension lag, and flexion contracture. Radiologic evidence for osteoarthritis of the knee includes the presence of osteophytes, joint space narrowing, subchondral sclerosis, subchondral cysts, and malalignment.

Before considering total knee replacement, patients typically undergo a trial of less invasive treatments, including lifestyle modification, pharmacologic therapy, and injections. If these methods fail to produce satisfactory improvement in the patients symptoms, one should consider the benefits and risks of total knee replacement in conjunction with their surgeon. Outcomes following total knee replacement are excellent, with patients reporting greatly reduced pain, improved mobility, and improved quality of life. However, patients must be aware that there are serious risks that accompany any surgery, which include infection, pulmonary embolism, deep vein thrombosis, nerve damage, and need for further procedures. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/13/total-knee-arthroplasty
01592nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006500103245007700168260004400245300006300289505046900352506003600821538044600857856008301303139Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDr. med. Martin Misch, Peter Vajkoczy, MD, Marcus Czabanka 10aBrain Biopsy of a Suspected Cerebellar LymphomacDr. med. Martin Misch aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file15:40bcolor/sound 0 aIn neurosurgery, brain biopsy is an essential tool for providing adequate histological sampling in neoplastic and non-tumorous lesions. There are two main techniques in obtaining tissue samples: open biopsy requiring craniotomy or needle biopsy. Needle biopsies allow for minimally-invasive tissue diagnosis with less risk of operative morbidity for the patient. Here we show a frameless needle biopsy of a cerebellar lesion using the Brainlab VarioGuide system. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/139/brain-biopsy-of-a-suspected-cerebellar-lymphoma
01833nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100007400103245010000177260004400277300006300321505065800384506003601042538044601078856010301524451Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAhmad N. Alzubaidi, MD, Blake Baer, MD, Tullika Garg, MD, MPH, FACS 10aLeft Ureteroscopy, Stone Retrieval with Basket, and Stent ReplacementcAhmad N. Alzubaidi, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file53:20bcolor/sound 0 aUrolithiasis is one of the most common and costly benign urologic conditions in the United States. While there are many options for managing urolithiasis ranging from conservative medical expulsive therapy to shockwave lithotripsy to percutaneous nephrolithotomy, ureteroscopy with laser lithotripsy is one of the most frequently performed minimally invasive urologic surgeries for treatment. In this video, we present a case of a patient with a ureteral stone that was treated with ureteroscopy, laser lithotripsy, and basket stone extraction. As part of the procedure, the patient also underwent a retrograde pyelogram and a ureteral stent exchange. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/451/left-ureteroscopy-stone-retrieval-with-basket-and-stent-replacement
02428nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100006000105245009100165260004400256300006300300505127300363506003601636538044601672856010402118260.2Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAdrian Estrada, Adam Tanious, MD, Samuel Schwartz, MD 10aFemoral Artery Cut-Down and Proximal Anastomosis Procedure (Cadaver)cAdrian Estrada aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file31:16bcolor/sound 0 aFemoral-to-popliteal/distal bypass surgery is a procedure used to treat femoral artery disease. It is performed to bypass the narrowed or blocked portion of the main artery of the leg, redirecting blood through either a transplanted healthy blood vessel or through a man-made graft material. This vessel or graft is sewn above and below the diseased artery such that blood flows through the new vessel or graft. The bypass material used can be either the great saphenous vein from the same leg or a synthetic polytetrafluoroethylene (PTFE) or Dacron graft. Blockage is due to atherosclerosis that causes peripheral vascular disease. This procedure is recommended for patients with peripheral vascular disease for whom medical management has not improved symptoms, for those with leg pain at rest that interferes with quality of life and ability to work, for non-healing wounds, and for infections or gangrene of the leg where there is a danger of loss of limb caused by decreased blood flow. Here we demonstrate how to perform femoral artery cut-down and proximal anastomosis procedure in a cadaver. This procedure is commonly used when performing a femoral-popliteal below the knee bypass to restore blood flow to areas affected by arterial blockages or injuries․ aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/260.2/femoral-artery-cut-down-and-proximal-anastomosis-procedure-cadaver
01807nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002200103245009400125260004400219300006300263505069300326506003601019538044601055856010001501148Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMarcus Czabanka 10aMicrosurgical Resection of an Intracranial Dural Arteriovenous FistulacMarcus Czabanka aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file34:12bcolor/sound 0 aThis video outlines the surgical steps involved in the microsurgical resection of an intracranial dural arteriovenous fistula (dAVF) in a 74-year-old male patient, highlighting the importance of meticulous planning, intraoperative imaging, and precise dissection techniques. The patient has previously undergone embolization, but recurrence occurred despite the initial treatment and patient symptoms liked headaches and weakness restarted. A decision was made to perform microsurgical resection of dAVF. The video provides a comprehensive illustration of this procedure, emphasizing the value of microsurgery as a definitive treatment modality for these challenging clinical scenarios. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/148/microsurgical-resection-intracranial-dural-arteriovenous-fistula
02559nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100003000106245013000136260004400266300006300310505136100373506003601734538044601770856013702216290.16Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aGeoffrey G. Hallock, MD 10aSquamous Cell Carcinoma Excision from Right Forearm with Split-Thickness Skin Graft from the ThighcGeoffrey G. Hallock, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file31:06bcolor/sound 0 aSkin is the largest organ by surface area of the body and is essential to prevent dehydration as the first barrier to infection, permit unrestricted movement, and provide a normal profile and appearance. A skin graft is a paper-thin piece of skin that has no fat or other body tissues attached and has been completely removed from its blood supply. Therefore, a skin graft can be transferred anywhere in the body as long as where placed, the so-called recipient site, does have a sufficient blood supply to nourish the skin until new blood vessels can grow into it within a short timeframe. Otherwise, if that does not occur, the graft will shrivel up and die. The downside even of a successful skin graft is the variable final color and inharmonious appearance of the skin, a tendency to contract possibly causing deformities especially limiting motion across joints, and similar healing issues at a second wound, that is the donor site of the graft itself. Nevertheless, this is a rapidly performed surgical procedure requiring but the simplest of instrumentation for the harvest of that graft that can then permit replacement of extensive skin deficiencies. In this video article, these virtues are displayed as a split-thickness skin graft is used to replace the skin missing following the removal of a large squamous cell skin cancer of the forearm. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/290.16/squamous-cell-carcinoma-excision-from-right-forearm-with-split-thickness-skin-graft-from-the-thigh
01519nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000380010224501080014026000440024830000630029250503730035550600360072853804460076485601030121018Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMarco Fisichella, MD, MBA, FACS 10aLaparoscopic Heller Myotomy and Partial Fundoplication for AchalasiacMarco Fisichella, MD, MBA, FACS aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file58:08bcolor/sound 0 aThe gold standard for achalasia is surgical correction via laparoscopic Heller myotomy with a partial fundoplication. The goal of this technical report is to illustrate our preferred approach to patients with achalasia and to provide the reader with a detailed description of our operative technique, its rationale, and our preoperative and postoperative management. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/18/laparoscopic-heller-myotomy-and-partial-fundoplication-for-achalasia
02173nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100009300105245008200198260004400280300006300324505100400387506003601391538044601427856009401873290.8Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aSudhir B. Rao, MD, Mark N. Perlmutter, MS, MD, FICS, FAANOS, Arya S. Rao, Grant Darner 10aBilateral Syndactyly Release of Third and Fourth FingerscSudhir B. Rao, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file43:36bcolor/sound 0 aAmniotic band syndrome, or constriction ring syndrome, happens when a developing fetus gets tangled in the fibrous bands of the amniotic sac. Sometimes, fingers and toes can become trapped in these fibrous bands, with results ranging from amputation of the digits, to fusion of the fingers or toes, termed syndactyly. Syndactyly is amongst the most frequent congenital hand anomaly and is termed simple when the digits are connected by soft tissue only, and complex when one or more phalanges are fused. In complicated syndactyly, there are additional bony elements in between the digits making it challenging if not impossible to separate safely. The patient in this case is a 1-year-old male with complex syndactyly of the left hand and simple syndactyly of the right hand. Here, both sides are released, with the left side involving a full-thickness skin graft taken from the patient's groin crease. This case was filmed during a surgical mission with the World Surgical Foundation in Honduras. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/290.8/bilateral-syndactyly-release-of-third-and-fourth-fingers
02375nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100008100103245009100184260004400275300006600319505120200385506003601587538044601623856010002069187Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aC. Scott Brown, MD, Prithwijit Roychowdhury, Calhoun D. Cunningham III, MD 10aRevision Canal Wall Down Mastoidectomy with Mastoid ObliterationcC. Scott Brown, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:42:42bcolor/sound 0 aRevision canal wall down (CWD) mastoidectomy with mastoid obliteration  is most often performed to manage persistent otorrhea and debris accumulation in the mastoid bowl following CWD mastoidectomy. In this case, obliteration is performed for persistent otorrhea from the mastoid bowl and revision CWD mastoidectomy is completed to address a new retraction pocket following a prior CWD mastoidectomy for chronic otitis media with cholesteatoma in a 23-year old male. 

There have been numerous reported techniques used for mastoid obliteration, and in this case, a posterior periosteal flap is made, and the mastoid cavity is filled with autogenous bone paté. Following obliteration of the mastoid, a perichondrial graft is used to cover the area. In this case, a titanium total ossicular reconstruction prosthesis is used to rebuild the ossicular chain, and a second perichondrial graft is used to reconstruct the tympanic membrane. The canal is packed with Gelfoam to secure the fascial grafts in place. Postoperatively, patients are typically advised to remove their head dressing 24 hours following the surgery and to apply a topical antibiotic ointment daily to a cotton ball in the ear. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/187/revision-canal-wall-down-mastoidectomy-with-mastoid-obliteration
01961nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100007500106245004300181260004400224300006300268505088700331506003601218538044601254856005501700299.13Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aStephen Estime, MD, Abdullah Hasan Pratt, MD, Nicholas G. Ludmer, MD 10aAirway EquipmentcStephen Estime, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file19:16bcolor/sound 0 aAirway trauma is a critical and potentially life-threatening condition, and timely diagnosis and management is imperative for patient survival, as concomitant injuries and nonspecific symptoms may otherwise lead to fatal outcomes. Efficient airway management is paramount to addressing airway trauma, necessitating a comprehensive approach involving timely diagnosis, appropriate interventions, and the use of specialized equipment to ensure optimal patient outcomes. Prompt and efficient management not only ensures the patients immediate survival but also plays a pivotal role in minimizing the impact on respiratory function and overall quality of life. The main objective is to establish a secure and patent airway, enabling efficient ventilation and later surgical repair. This video delivers a thorough and detailed exposition of the equipment utilized in airway management. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/299.13/airway-equipment
02185nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005000103245011000153260004400263300006600307505103000373506003601403538044601439856009401885476Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aHany M. Takla, MD, FACS, FASMBS, DABS-FPMBS 10aRobotic Sleeve Gastrectomy for Treatment of Morbid ObesitycHany M. Takla, MD, FACS, FASMBS, DABS-FPMBS aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:03:17bcolor/sound 0 aRobotic surgery as an approach for bariatric surgery has been a subject of debate for at least two decades since the platform passed FDA approval. One could argue that the exponential growth of robotics in surgery could end such a debate. The robotic platform offers several advantages that are always advertised, but in the morbidly obese population it offers an added advantage. It is arguable that with the advanced ergonomics, superior visual tools, and wristed instruments the robotic platform is superior in its offerings to the surgeon and enables a wider variety of surgeons with variable skill set to adopt minimally-invasive surgery (MIS), especially in bariatrics. The Sleeve gastrectomy is technically a straightforward procedure to perform and is easier to learn for trainees and novel surgeons. It could, however, pose some challenges especially in patients with increased BMI, which is a huge advantage for the robotic platform in our experience as it allows easier exposure and comfort during the operation. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/476/robotic-sleeve-gastrectomy-for-treatment-of-morbid-obesity
02260nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100007400105245006900179260004400248300006300292505114400355506003601499538044601535856007301981161.4Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aPrithwijit Roychowdhury, C. Scott Brown, MD, Matthew D. Ellison, MD 10aDCR and Nasolacrimal System (Cadaver)cPrithwijit Roychowdhury aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file18:21bcolor/sound 0 aNasolacrimal duct obstruction (NDO) is the most common disorder of the lacrimal system that affects patients of every age and results in excessive tearing (epiphora) and if untreated, painful infection (dacryocystitis). When NDO symptoms progress and can no longer be managed with conservative measures, endoscopic dacryocystorhinostomy (DCR) is indicated. In this case, DCR exploration of the nasolacrimal anatomy is performed on a cadaver. The typical presentation of NDO is epiphora but the presence of painful swelling of the medial canthus and mucoid or purulent discharge may indicate the presence of dacryocystitis. The approach presented here is similar to the technique described by Tsirbas and Wormald in 2003 and involves the creation of a mucosal flap and subsequent use of the DCR drill to expose the nasolacrimal duct anatomy. Stenting and subsequent marsupialization of the flap is not shown in the cadaveric dissection. Postoperatively, patients are typically advised to use nasal irrigation twice daily with saline for six weeks and complete a 1-week course of PO antibiotics and 5-day course of antimicrobial eye drops. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/161.4/dcr-and-nasolacrimal-system-cadaver
02410nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003100103245007600134260004400210300006600254505131100320506003601631538044601667856009102113180Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aOry Wiesel, Marco Zenati 10aMinimally Invasive Direct Coronary Artery Bypass (MIDCAB)cOry Wiesel aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:18:42bcolor/sound 0 aMinimally invasive direct coronary artery bypass (MIDCAB) utilizes a small (4–5 cm) left anterior thoracotomy incision for direct visualization of the diseased coronary artery on the anterior wall of the left ventricle without the use of cardiopulmonary bypass (CPB). Since its first description in 1967 by Kolesov, many variations have been described including single left internal mammary artery (LIMA) to left anterior descending (LAD) coronary bypass, multivessel (including complete) revascularization, robotics, and video-based endoscopic techniques for IMA harvest and revascularization. Finally, hybrid approaches for revascularization (ie, surgical bypass of the LAD coronary artery followed by percutaneous coronary intervention (PCI) of non-LAD targets) utilize the same approach for complex patients needing coronary revascularization.

In this article, we will describe the basics of the MIDCAB surgery, emphasizing both the left anterior thoracotomy for the harvest of LIMA and direct anastomosis on a beating heart without CPB. This procedure is done on a 72-year-old patient who had significant long LAD stenosis and presented with effort angina. Following a multidisciplinary “heart team” conference, he underwent a successful MIDCAB and was discharged home on postoperative day 4. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/180/minimally-invasive-direct-coronary-artery-bypass-midcab
01597nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005600103245008400159260004400243300006300287505046800350506003600818538044600854856009101300179Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aC. Scott Brown, MD, Calhoun D. Cunningham III, MD 10aLaser Excision of Glomus Tympanicum (Transcanal Approach)cC. Scott Brown, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file21:31bcolor/sound 0 aThe application of minimally-invasive approaches in otologic surgery, including the management of middle ear tumors like glomus tympanicum tumors, represents a promising advancement in the field, potentially improving surgical outcomes and patient recovery. In this article, a patient with pulsatile tinnitus is found to have a glomus tympanicum tumor of the right ear. Calhoun Cunningham III, MD performs a transcanal resection of the mass using the KTP laser. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/179/laser-excision-of-glomus-tympanicum-transcanal-approach
02003nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100007900106245019500185260004400380300006300424505062500487506003601112538044601148856020301594290.10Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aSudhir B. Rao, MD, Mark N. Perlmutter, MS, MD, FICS, FAANOS, Arya S. Rao 10aFlexor Digitorum Superficialis to Flexor Digitorum Profundus (STP) Transfer, Adductor Release, and Z-Plasty for a Pediatric, Stroke-Induced Left Hand Spastic ContracturecSudhir B. Rao, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file48:35bcolor/sound 0 aThis video demonstrates surgical correction of a severe hand deformity in a teenage girl with spastic hemiplegia. This patient has a non-functioning hand due to severe spasticity. Correction of the deformity is indicated primarily to facilitate hygiene and improve the position of the fingers. In some patients with volitional control, a certain degree of prehension may be achieved. The basic principles of deformity correction include differential sectioning of sublimis and profundus tendons followed by repair in a lengthened position. The first web contracture is released by muscular release and a skin Z-plasty. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/290.10/flexor-digitorum-superficialis-to-flexor-digitorum-profundus-stp-transfer-adductor-release-and-z-plasty-for-a-pediatric-stroke-induced-left-hand-spastic-contracture
01921nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000730010224500830017526000440025830000630030250507750036550600360114053804460117685600930162210Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAndrew Scott, MD, Carl-Christian A. Jackson, MD, Walter Chwals, MD 10aAortopexy for Innominate Artery Compression of the TracheacAndrew Scott, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file37:51bcolor/sound 0 aTracheomalacia is a rare congenital condition that results in incompetence of the trachea, the main airway, leading to collapse of the trachea during respiration. Most often this is due to inadequate bone formation in the trachea, and this causes it to be dynamically collapsed, which can result in breathing difficulties for the child. Upper respiratory infections can also be more common. While most cases of tracheomalacia resolve by 18 to 24 months of age, a small percentage either continue or cause such severe breathing or feeding issues that surgical intervention is warranted. In cases where the innominate artery is the cause of compression of the weakened trachea, an aortopexy to elevate the vessel up to the sternum and away from the trachea is performed. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/10/aortopexy-for-innominate-artery-compression-of-the-trachea
02297nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000360010224500570013826000440019530000630023950512440030250600360154653804460158285600630202826Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aPatrick Vavken, MD, Sabah Ali 10aShoulder Arthroscopy (Cadaver)cPatrick Vavken, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file19:08bcolor/sound 0 aShoulder arthroscopy is one of the most common procedures performed in orthopaedic surgery. It can be utilized to identify various pathologies including rotator cuff tears, degenerative arthritis, subacromial impingement, and proximal humeral fractures. With continued advancement in arthroscopy, patients benefit from smaller incisions, reduced risk of postoperative complications, and faster recovery compared to open surgery. Shoulder arthroscopy is performed either in the lateral decubitus position or in the beach chair position (BCP) as seen in this video. The BCP provides greater benefits such as decreased neovascularization during portal placement, fewer cases of neuropathies, and reduced surgical time. In addition to position, there are various portals used in shoulder arthroscopy, with the posterior portal being the most common and used in this video. Complication rates from shoulder arthroscopy are low but include shoulder stiffness, iatrogenic tendon injury, and vascular injury. Therefore, proper patient selection, patient positioning, and appropriate portal selection are essential for successful shoulder arthroscopy. Here, we discuss the shoulder arthroscopy and demonstrate the technique on a cadaver shoulder. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/26/shoulder-arthroscopy-cadaver
01855nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100005300105245005500158260004400213300006300257505078300320506003601103538044601139856006401585161.5Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aC. Scott Brown, MD, Ramon M. Esclamado, MD, MS 10aParotid Dissection (Cadaver)cC. Scott Brown, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file17:42bcolor/sound 0 aParotid dissection is a delicate surgical procedure that requires a deep understanding of the relevant anatomy and a careful approach to ensure the preservation of critical structures, particularly the facial nerve. The comprehensive overview provided in this video is a valuable resource for understanding the step-by-step process of parotid dissection. The detailed narration and visual references help to reinforce the importance of accurate identification and preservation of the facial nerve, as well as the other key anatomical structures involved in the procedure. This information is crucial for surgeons in training, as well as for experienced practitioners, to ensure the safe and effective removal of parotid gland tumors while minimizing the risk of complications. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/161.5/parotid-dissection-cadaver
02185nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003800103245005500141260004400196300006300240505112600303506003601429538044601465856006801911141Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aTyler N. Adams, Marcus Czabanka 10aIntraventricular Tumor ResectioncTyler N. Adams aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file44:48bcolor/sound 0 aThis is a case of a 49-year-old patient who presented with persistent headaches with no focal neurologic deficit. An MRI was performed which revealed an intraventricular tumor. The lesion was seen entering the third ventricle and potentially compressing both foramina of Monro. This was further confirmed through coronal reconstruction. The proposed method for tumor removal is an interhemispheric, transcallosal approach.

Central nervous system (CNS) tumors, such as this, are uncommon neoplasms that often present with symptoms like headache, nausea, vomiting, ataxia, vertigo, and papilledema. There is also the possibility of hydrocephalus, as the tumor can obstruct cerebrospinal fluid (CSF) outflow, and the development of seizures. These tumors often grow slowly and can be managed with surgical resection, chemotherapy, and/or stereotactic radiosurgery. For intraventricular tumor resection, the surgical approach can vary based on the tumor location, experience, and preference of the surgeon. Further details of the procedure and patient outcomes will be discussed in the subsequent sections of this article. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/141/intraventricular-tumor-resection
02463nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100002400105245007400129260004400203300006300247505137900310506003601689538044601725856008602171278.4Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aBeda Espineda, MD 10aPediatric Bilateral Indirect Inguinal HerniotomycBeda Espineda, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file46:13bcolor/sound 0 aThis video presents a case of bilateral open indirect inguinal herniotomy. The patient, a 12-year-old male, presented to our medical facility with complaints of bilateral protruding masses in the inguinal regions. These masses have been causing him discomfort and pain, particularly during physical exertion. Upon palpation, the masses exhibited an elastic consistency, increased in size during bearing in a standing position, and were found to be reducible when the patient was in a supine position. The patient's mother reported that these bulges have been present since his birth. Following a comprehensive clinical evaluation, a clinical diagnosis of congenital bilateral inguinal hernia was made. Consequently, a decision was made to perform a bilateral open inguinal herniotomy with high ligation of the hernia sac. This video demonstrates the essential steps of a bilateral indirect inguinal herniotomy in a pediatric patient, highlighting the importance of proper anatomical dissection, identification of crucial structures, and the high ligation technique for successful hernia repair in children. The detailed procedural description, coupled with the emphasis on anatomical landmarks and technical nuances, makes this video a valuable educational resource for surgical trainees, who are learning the principles and techniques of pediatric inguinal hernia repair. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/278.4/pediatric-bilateral-indirect-inguinal-herniotomy
02113nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100007100103245007700174260004400251300006600295505098000361506003601341538044601377856008401823353Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJ. Miller Allan, MD, Victoria Aucoin, MD, Benjamin J. Pearce, MD 10aThoracofemoral Bypass: A Retroperitoneal ApproachcJ. Miller Allan, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:59:04bcolor/sound 0 aSurgical intervention for aortoiliac occlusive disease (AIOD) remains a vital tool in the management of AIOD. AIOD is caused by occlusion of the infrarenal and/or iliac arteries, often secondary to atherosclerosis. Here, we present a case of a young, male patient with a history of familial hyperlipidemia and chronic tobacco use who underwent a thoracofemoral bypass (TFB) procedure via a retroperitoneal approach. He presented with classic symptoms of bilateral leg pain when walking, nocturnal lower extremity pain, and correlated diminished lower extremity pulses. TFB was the preferred approach due to the aggressive, soft plaque burden extending into the suprarenal aorta, which precluded endovascular repair and would have increased risk for standard infrarenal aortofemoral bypass (AFB). This video and case report present a detailed explanation of a retroperitoneal approach to a TFB procedure and the nuanced indications of the surgical interventions for AIOD.1,2 aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/353/thoracofemoral-bypass-a-retroperitoneal-approach
02296nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100005200105245006100157260004400218300006300262505121300325506003601538538044601574856007002020161.3Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aC. Scott Brown, MD, Ralph Abi Hachem, MD, MSc 10aFrontal Sinus Dissection (Cadaver)cC. Scott Brown, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file20:39bcolor/sound 0 aThis cadaveric study aims to provide a detailed overview of the key steps involved in the dissection of the frontal sinus, including the identification of anatomical landmarks, performing of Draf I, II-A, II-B, and III procedures, and the preservation of mucosal structures. The meticulous identification and preservation of crucial anatomical landmarks, such as the frontal sinus outflow tract, the agger nasi, and the vertical lamella of the middle turbinate, are essential for avoiding complications, including injury to the AEA or inadvertent penetration of the cribriform plate. By familiarizing themselves with the step-by-step approach outlined in this text and the accompanying video, surgeons can enhance their technical proficiency and improve patient outcomes in the management of frontal sinus-related conditions. For medical students and trainees, this video offers an invaluable learning opportunity to develop a deep understanding of frontal sinus anatomy and the nuances of endoscopic dissection techniques. By using this knowledge, healthcare professionals can enhance their surgical skills, improve patient care, and contribute to the advancement of the field of endoscopic sinus surgery. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/161.3/frontal-sinus-dissection-cadaver
01813nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100004600105245010200151260004400253300006300297505065300360506003601013538044601049856011201495290.4Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aYoko Young Sang, MD, Domingo Alvear, MD 10aRight Inguinal Hernia Repair on a 1-Year-Old Boy During a Surgical MissioncYoko Young Sang, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file34:45bcolor/sound 0 aThis comprehensive video is intended to provide a detailed overview of the surgical technique used to repair a right inguinal hernia in Honduras on a 1-year-old boy who presented with a swelling in his scrotum, which had been present since he was two months old. The surgical procedure is narrated by an experienced pediatric surgeon, highlighting the unique challenges and innovative techniques employed in this case, which can be valuable for surgeons facing similar situations. The importance of this video lies in its educational value for surgeons, particularly those involved in surgical missions or practicing in resource-limited settings. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/290.4/right-inguinal-hernia-repair-on-a-1-year-old-boy-during-a-surgical-mission
01661nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100006200105245005600167260004400223300006300267505057500330506003600905538044600941856006801387260.1Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMeghan Robinson, Laura Boitano, MD, Samuel Schwartz, MD 10aCarotid Endarterectomy (Cadaver)cMeghan Robinson aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file16:53bcolor/sound 0 aCarotid stenosis is one of the leading causes of ischemic stroke worldwide. In the United States, nearly 800,000 strokes are reported each year, with ischemia accounting for 87% of them, and 15% traced to a carotid origin. Carotid endarterectomy represents an effective surgical treatment for carotid stenosis in preventing the risk of future ischemic stroke. In this video-article, we demonstrate the surgical technique for carotid endarterectomy on a cadaver and discuss a typical case presentation of an individual who could potentially benefit from this procedure. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/260.1/carotid-endarterectomy-cadaver
02036nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100007200103245005100175260004400226300006600270505095400336506003601290538044601326856005801772203Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aC. Scott Brown, MD, Alex J. Carsel, Calhoun D. Cunningham III, MD 10aTympanoplasty (Revision)cC. Scott Brown, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:07:03bcolor/sound 0 aThe tympanic membrane (eardrum) acts as a protective barrier between the middle and external ear, guarding the middle ear against infection. Additionally, it plays a crucial role in hearing by facilitating impedance matching between the air in the external canal and the fluid in the inner ear. Disruption of the tympanic membrane can lead to hearing loss, recurrent infections, and ear drainage. Common etiologies of perforations include infection and trauma. When perforations persist and cause symptomatic hearing loss or recurrent infections, surgical repair by an otolaryngologist becomes necessary. Although primary tympanoplasty has high success rates (75–95%), failures can complicate subsequent repair attempts. In this case study, we present a 61-year-old female who underwent two prior tympanoplasties without success. Dr. Cunningham demonstrates intraoperative decision-making and surgical techniques for repair in challenging cases. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/203/tympanoplasty-revision
01754nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002200103245005900125260004400184300006300228505070400291506003600995538044601031856007101477221Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aHyunsuk Suh, MD 10aRobotic-Assisted Left AdrenalectomycHyunsuk Suh, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file43:59bcolor/sound 0 aCurrent evidence supports the use of robotic surgery as a method of minimally-invasive treatment for adrenal masses. This article presents the case of a robotic adrenalectomy (RA) for an adrenal tumor. Upon examination of the extracted 1.5-cm specimen, it exhibited typical characteristics of aldosterone-producing adenoma, including a golden tan color, well-circumscribed borders, and surrounding normal adrenal gland tissue and fat. The detailed demonstration of this surgical procedure in the accompanying video provides a thorough understanding of the latest advancements in robotic adrenal surgery, offering comprehensive insights into the nuanced techniques and emerging trends in the field. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/221/robotic-assisted-left-adrenalectomy
01781nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004800103245009100151260004400242300006300286505064200349506003600991538044601027856010201473112Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aWilliam B. Hogan, Eric M. Bluman, MD, PhD 10aFive-Month Patient Results Following Ankle Ligament ReconstructioncWilliam B. Hogan aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file11:32bcolor/sound 0 aWe present the case of a patient who was seen for follow-up after 5 months of rehabilitation following surgical procedures to address instability in both the medial and lateral sides of her ankle. This patient reported achieving an excellent outcome, and her subjective sense of significant improvement after rehabilitation was aligned with her physical exam and radiographic evaluation. This case documents the improvements made by the patient during the rehabilitation process and outlines essential steps to be performed by the practitioner in the clinical examination and radiographic follow-up after surgery for ankle instability. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/112/five-month-patient-results-following-ankle-ligament-reconstruction
02141nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000470010224500910014926000440024030000630028450510080034750600360135553804460139185600980183728Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDerek J. Erstad, MD, David L. Berger, MD 10aOpen Antrectomy and Duodenal Resection for Neuroendocrine TumorcDerek J. Erstad, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file50:38bcolor/sound 0 aThis video describes the surgical technique for an open duodenal resection and antrectomy, which was performed for a neuroendocrine tumor of the duodenal bulb. In this procedure, we start with an upper midline laparotomy and proceed with mobilization of the distal stomach, duodenum, and head of the pancreas. To mobilize, we Kocherize the duodenum, then ligate that right gastric artery and dissect the gastrohepatic ligament, followed by ligation of the right gastroepiploic vessels and take down the gastrocolic ligament exposing the lesser sac. Once the structures are adequately mobilized, we dissect the first portion of the duodenum off of the head of the pancreas and transect it with a TA stapler. The antrectomy is performed next, removing the specimen. For the reconstruction, we perform a retrocolic end-to-side hand-sewn gastrojejunostomy. This technique can be used for multiple indications, including peptic ulcer disease and other mass lesions of the antrum, pylorus, or duodenal bulb. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/28/open-antrectomy-and-duodenal-resection-for-neuroendocrine-tumor
01928nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100005300105245005900158260004400217300006300261505084800324506003601172538044601208856006801654161.2Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aC. Scott Brown, MD, Jeevan B. Ramakrishnan, MD 10aEthmoid Artery Anatomy (Cadaver)cC. Scott Brown, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file07:28bcolor/sound 0 aThe ethmoid arteries, comprising the anterior and posterior branches, are integral vascular structures that hold immense significance in the realm of sinus and skull base surgery. Originating from the third segment of the ophthalmic artery, these arteries traverse through the medial orbit before passing through the respective ethmoidal canals and entering the ethmoid air cells. Understanding the anatomical significance and clinical implications of the anterior and posterior ethmoid arteries is paramount in ensuring safe and effective management of sinus pathologies and associated complications. Accurate preoperative assessment, appropriate surgical techniques, and a thorough knowledge of these vascular structures are essential for optimizing patient outcomes and minimizing the risk of adverse events during surgical interventions. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/161.2/ethmoid-artery-anatomy-cadaver
02007nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100006800105245007400173260004400247300006300291505087800354506003601232538044601268856008701714290.2Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aWilliam B. Hogan, Yoko Young Sang, MD, Shabir Abadin, MD, MPH 10aIntraperitoneal Mesh Repair for Incisional HerniacWilliam B. Hogan aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file48:51bcolor/sound 0 aIncisional hernias remain an important postoperative complication of any procedure involving a laparotomy incision. Although most incisional hernias remain asymptomatic, incarceration and strangulation are emergent complications requiring prompt diagnosis and intervention. Mesh repair has become widely favored over simple suture repair of abdominal fascial defects in recent decades, though recurrence of incisional hernias remains high. Despite the advent of laparoscopic approaches to hernia repair, open approaches are utilized when numerous adhesions are encountered, laparoscopic access is unsafe, or when laparoscopy is not readily available. We present an open surgical repair of a large incisional hernia involving the abdominal midline and parastomal site in a woman with a history of laparotomy and colostomy with a subsequent reversal for a perforated colon. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/290.2/intraperitoneal-mesh-repair-for-incisional-hernia
02544nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004600103245013800149260004400287300006600331505131100397506003601708538044601744856014802190468Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aFiona J. Dore, MD, Nicole B. Cherng, MD 10aRobotic Ligamentum Teres Cardiopexy with Hiatal Hernia Repair for GERD following Longitudinal Sleeve GastrectomycFiona J. Dore, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:13:07bcolor/sound 0 aPatients who undergo longitudinal sleeve gastrectomy (LSG) may develop de novo or worsening of existing gastroesophageal reflux (GERD) symptoms, which include postprandial retrosternal burning, food refluxing, or dysphagia. Often patients with GERD following LSG present with a concomitant hiatal hernia. Workup serves to characterize a patients GERD disease burden by way of fluoroscopic upper gastrointestinal (UGI) series, pH studies, manometry, or esophagogastroduodenoscopy (EGD). Treatment first involves medical management with lifestyle modifications followed by use of pump inhibitors (PPIs) or Histamine H2-receptor antagonists (H2 Blockers or H2B). If GERD symptoms remain intractable to medical management, surgical intervention can be pursued. Historically patients would undergo a conversion to a Roux-en-Y gastric bypass (RYGB). New data demonstrate comparable outcomes regarding GERD symptoms and improvements in anti-reflux medication use in patients status-post LSG who undergo ligamentum teres cardiopexy with hiatal hernia repair. Here, we describe a robotic ligamentum teres cardiopexy with hiatal hernia repair in an adult patient who previously underwent LSG and was experiencing intractable GERD symptoms despite lifestyle modification and optimization on anti-reflux medications. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/468/robotic-ligamentum-teres-cardiopexy-with-hiatal-hernia-repair-for-gerd-following-longitudinal-sleeve-gastrectomy
01663nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100011600106245006900222260004400291300006300335505049600398506003600894538044600930856008101376299.14Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDany Accilien, MD, Dexter C. Graves, MD, Nicholas G. Ludmer, MD, Stephen Estime, MD, Abdullah Hasan Pratt, MD 10aAirway Management: Techniques and EquipmentcDany Accilien, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file59:02bcolor/sound 0 aThis video article discusses airway management techniques in trauma resuscitation. It outlines the preparation and equipment used in patients with impending airway failure that require airway protection and ventilatory support. We discuss the innovative airway towers used in the University of Chicago emergency room as well as the general approach to airway management. We also go over the different types of laryngoscopy, assist devices, and cricothyroidotomy surgical airway procedures. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/299.14/airway-management-techniques-and-equipment
02716nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100005100105245010900156260004400265300006300309505154100372506003601913538044601949856011502395290.7Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aGeoffrey G. Hallock, MD, Yoko Young Sang, MD 10aThe Versatile Latissimus Dorsi Muscle as a Local Flap for Chest Wall CoveragecGeoffrey G. Hallock, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file48:20bcolor/sound 0 aNot only is the skin the largest organ by the surface area of the body, the integument has multiple essential functions such as preventing dehydration, acting as a first-line barrier to infection, permitting unrestricted movement of joints, as well as sustaining a normal profile and appearance. Occasionally, the treatment of breast cancer requires the removal of the breast while also leaving a large chest skin deficit. Especially if radiation has been done or is planned, the best way to restore the missing skin to preserve its essential function would be by the use of a vascularized flap. Sometimes this can be achieved while simultaneously providing a reconstruction of a very aesthetic breast mound. Depending on circumstances and the extent of disease, a simpler solution might be to just close only the chest wound that has been created. A “workhorse” flap alternative that is almost always available to achieve this is the latissimus dorsi (LD) muscle from the back, as this can be moved to almost all regions of the chest. The LD muscle usually can be swung to the chest about its blood vessels that remain attached to the armpit, and so would be called a local flap that as such avoids the complexities of a transfer requiring microsurgery to reconnect the blood supply. The long-term experience by reconstructive surgeons in using the LD muscle as a local flap, not just for the chest but also the back, head, and neck, has proven its deserved accolade to be a versatile flap unparalleled by most other donor sites. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/290.7/the-versatile-latissimus-dorsi-muscle-as-a-local-flap-for-chest-wall-coverage
01879nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002700103245007400130260004400204300006300248505079900311506003601110538044601146856008101592397Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAlexander Martin, OD 10aPlacement and Removal of Bandage Contact LenscAlexander Martin, OD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file02:54bcolor/sound 0 aContact lens insertion and removal proficiency is paramount to successful resolution in several sight-threatening ocular conditions. With contact lenses so often being the culprit for corneal ulcers, it may seem counterintuitive to use them as a Band-Aid. However, in many cases of ocular trauma such as corneal abrasion and foreign body removal, a bandage contact lens along with topical antibiotics is an advisable form of treatment. Bandage contact lenses are also heavily utilized in surgical refractive procedures such as photorefractive keratectomy (PRK) and epi-off corneal cross-linking. There are many new advances in bandage contact lens technology such as contact lenses eluted with antibiotics, steroids, and amniotic tissues for managing both chronic and acute ocular conditions. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/397/placement-and-removal-of-bandage-contact-lens
01965nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005800103245009800161260004400259300006600303505080200369506003601171538044601207856010601653452Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aSamuel J. Zolin, MD, Eric M. Pauli, MD, FACS, FASGE 10aRobotic-Assisted Repair of a Left Lower Quadrant Spigelian-Type HerniacSamuel J. Zolin, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file02:49:55bcolor/sound 0 aA left lower quadrant partial-thickness Spigelian-type incisional hernia resulting from wound complications after deep inferior epigastric perforator (DIEP) flap harvest is repaired in a minimally-invasive, robotic-assisted, transabdominal preperitoneal (TAPP) fashion. Utilizing robotic assistance, a large preperitoneal flap is created, fascial closure is achieved using barbed suture, and the hernia defect is reinforced widely with medium-weight polypropylene mesh. In this patient, this approach also allows for areas that had previously had mesh placed to be avoided, and for repair of a fat-containing indirect left inguinal hernia. Similar approaches can address primary or lateral incisional hernias. This patient had an uncomplicated postoperative course without early wound morbidity. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/452/robotic-assisted-repair-of-a-left-lower-quadrant-spigelian-type-hernia
02079nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005300103245015800156260004400314300006300358505080500421506003601226538044601262856016501708213Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aC. Scott Brown, MD, Ramon M. Esclamado, MD, MS 10aReview of Partial Laryngectomy Techniques and Demonstration of the Supracricoid Laryngectomy with Cricohyodoepiglottopexy (Cadaver)cC. Scott Brown, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file29:36bcolor/sound 0 aPartial laryngectomy, with its roots tracing back to the early 19th century, has evolved over time as an alternative operative approach for a select group of patients with glottic and supraglottic malignancies. The goal was to preserve speech and swallowing without committing to a permanent tracheostomy. In this video, in the context of a cadaver dissection course held at Duke University, the techniques for partial laryngectomy are demonstrated. The initial segment of this video focuses on explaining the two types of laryngeal surgeries: supraglottic laryngectomy and supracricoid laryngectomy with cricohyodopexy, or cricohyodoepiglottopexy (CHEP). Although these surgeries aim to preserve the functionality of the larynx, performing them may impact voice, swallowing, and airway protection. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/213/review-of-partial-laryngectomy-techniques-and-demonstration-of-the-supracricoid-laryngectomy-with-cricohyodoepiglottopexy-cadaver
02006nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002500103245027800128260004400406300006600450505055700516506003601073538044601109856024501555321Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDaniel Oreadi, DMD 10aTreatment of Squamous Cell Carcinoma from Posterior Maxilla with Wide Local Excision of the Tumor and Total Alveolectomy, Reconstruction with Buccal Fat Pad Advancement, Placement of Surgical Obturator, and an Ipsilateral Supraomohyoid Neck DissectioncDaniel Oreadi, DMD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:40:36bcolor/sound 0 aSurgery has been the first line of treatment for oral cavity cancer. After appropriate workup, the decision to include an ipsilateral or bilateral neck dissection is made. The patient presented here was diagnosed with a posterior maxillary alveolar tumor. The treatment plan included wide local excision of the tumor with total alveolectomy, reconstruction with a buccal fat pad advancement, and placement of surgical obturator. Additionally, an ipsilateral supraomohyoid neck dissection was performed due to the relative risk of regional metastases. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/321/treatment-squamous-cell-carcinoma-posterior-maxilla-wide-local-excision-tumor-total-alveolectomy-reconstruction-buccal-fat-pad-advancement-placement-surgical-obturator-ipsilateral-supraomohyoid-neck-dissection
01729nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100004400105245010600149260004400255300006300299505056700362506003600929538044600965856011201411161.1Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aC. Scott Brown, MD, David W. Jang, MD 10aFunctional Endoscopic Sinus Surgery: Maxillary, Ethmoid, and Sphenoid (Cadaver)cC. Scott Brown, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file16:50bcolor/sound 0 aFunctional endoscopic sinus surgery (FESS) is a minimally-invasive technique involving the use of an endoscope to visualize and access the paranasal sinuses, allowing for precise and targeted removal of diseased tissue. The cadaveric video on FESS presented here offers a detailed and comprehensive guide to maxillary, ethmoid, and sphenoid sinus dissection. The step-by-step approach, coupled with the emphasis on anatomical considerations, makes this video an essential resource for healthcare professionals involved in the management of sinonasal disorders. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/161.1/functional-endoscopic-sinus-surgery-maxillary-ethmoid-and-sphenoid-cadaver
02088nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100007400106245006800180260004400248300006300292505096400355506003601319538044601355856008101801268.17Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJonathan E. Sledd, Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES 10aAspiration of Ganglion Cyst on Right WristcJonathan E. Sledd aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file05:14bcolor/sound 0 aGanglion cysts are sacs containing a gel-like fluid that can form over tendons and joints. They are commonly seen as visible lumps on the hand and back of the wrist. Ganglion cysts are not cancerous, and most are asymptomatic. But if a cyst puts pressure on a nerve, it can cause pain, tingling, and muscle weakness. Initial treatment of a ganglion cyst is not surgical. Observation may be recommended because half of ganglion cysts may disappear over time. Activity often causes the cyst to increase in size, and thus immobilization may be an option. If a ganglion cyst causes pain and limits activities, aspiration of the fluid may decrease pressure and relieve pain. Surgical excision may also be recommended if symptoms are not relieved or if the cyst recurs. Here, we present the case of a 51-year-old female who had a ganglion cyst on her right wrist. Treatment options were presented to the patient, and she opted to undergo aspiration over excision. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/268.17/aspiration-of-ganglion-cyst-on-right-wrist
02508nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004700103245006300150260004400213300006600257505142700323506003601750538044601786856007002232314Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aCameron M. A. Crasto, C. Scott Brown, MD 10aTemporal Bone Dissection (Cadaver)cCameron M. A. Crasto aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:35:46bcolor/sound 0 aTemporal bone dissections are a critical learning tool for otologic/neurotologic surgery. The “Temporal Bone Dissection Manual” from the House Institute has long served as a ‘gold standard for the stepwise demonstration of this process. In this video, a progressive step-by-step dissection of the temporal bone is performed. Key anatomical structures and landmarks and outlined, and their physiological importance in the context of different otologic pathologies is explained. The procedure begins with the identification of soft tissue landmarks and surface anatomy before delving into cortical mastoidectomy and facial nerve identification. The mastoid tip region is discussed, before moving on to describe the tegmen and endolymphatic sac. A facial recess dissection is performed and middle ear anatomy is explained. A labyrinthectomy and exposure of the internal auditory canal conclude the dissection. In addition to going over the anatomy of the temporal bone dissection, a discussion of how to execute these procedures safely and efficiently is conducted.

By having a thorough understanding of the anatomy of the temporal bone, medical students, residents, and fellows are better able to understand the reasoning behind different otologic procedures and how they can be used to treat patients. This demonstration was created to inform and teach residents and medical students about temporal bone anatomy.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/314/temporal-bone-dissection-(cadaver)
02342nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004100103245007600144260004400220300006300264505123800327506003601565538044601601856008902047431Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aBel Capati, RN, Shirin Towfigh, MD 10aMale Foley Catheter Placement and Removal for SurgerycBel Capati, RN aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file05:44bcolor/sound 0 aFoley catheter insertion is a fundamental medical procedure that is routinely performed across a wide range of clinical specialties. The placement of a Foley catheter remains one of the most commonly executed interventions in the field of medicine. Foley catheter placement is a common medical procedure performed to assist in bladder drainage and management. This procedure is indicated for a variety of reasons, including the need to monitor urine output during surgery, the management of urinary retention or incontinence, and the facilitation of accurate measurement of urine output in critically ill patients. The procedure is often performed before surgical interventions to ensure the bladder is emptied, reducing the risk of complications such as bladder distension or injury during the operation. Foley catheterization is a critical component of the care provided to patients undergoing surgical interventions. The procedure requires careful attention to detail and the implementation of proper sterile techniques to ensure patient safety and optimal outcomes. This video provides a step-by-step demonstration of Foley catheterization in a male patient, highlighting the importance of this procedure for medical personnel. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/431/male-foley-catheter-placement-and-removal-for-surgery
02161nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004100103245013000144260004400274300006300318505101100381506003601392538044601428856008101874142Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aVincent Prinz, MD, Marcus Czabanka 10aExtraventricular Drainage and Hematoma Evacuation to Treat Hydrocephalus Following Lysis of MCA EmbolismcVincent Prinz, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file36:38bcolor/sound 0 aThis is a clinical case of an elderly female patient who developed signs of hydrocephalus after receiving systemic thrombolysis for a middle cerebral artery (MCA) embolism, which was followed by intra-arterial thrombolysis a day before. The procedures were assessed as successful. Later on, despite the initial success, she was found exhibiting impaired consciousness. A follow-up head computed tomography (CT) revealed hemorrhaging of the cerebellum leading to the compression of the fourth ventricle and subsequent hydrocephalus. A decision was made to place an external ventricular drain (EVD), followed by a suboccipital craniotomy and evacuation of the cerebellar hematoma. An EVD is a temporary catheter specifically designed to drain cerebrospinal fluid (CSF) and facilitate the monitoring of intracranial pressure (ICP). This video provides a detailed overview of the key steps involved in the EVD placement and hematoma evacuation, offering critical insights from skin incision to wound closure. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/142/extraventricular-drainage-hematoma-evacuation
02662nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000470010224501230014926000440027230000630031650514650037950600360184453804460188085601300232629Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDerek J. Erstad, MD, David L. Berger, MD 10aOpen Left Colectomy for Colon Cancer: Left Colon and Sigmoid Resection with Colostomy FormationcDerek J. Erstad, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file36:18bcolor/sound 0 aAn open colectomy is the resection of all or part of the colon, typically through a midline incision in the abdomen. This procedure is often indicated for the treatment of colonic diseases such as bowel obstruction, diverticulitis, inflammatory bowel disease, and colon cancer. The patient in this case was a C6 quadriplegic male who presented with colon cancer near the splenic flexure. He also suffered from colonic dysmotility and severe constipation. He was treated with an open left colectomy through an upper midline laparotomy. Regarding the procedure, once the abdomen was entered, the peritoneal cavity was explored, and the tumor was identified. The colon was mobilized, starting with the transverse colon, which was extended laterally to take down the hepatic flexure followed by mobilization of the right colon in a lateral-to-medial fashion. Next, the splenic flexure was mobilized followed by the descending colon, again in a lateral-to-medial fashion. Once mobilized, the margins of transection were identified, and the intervening mesocolon was ligated in a cut and tie fashion. The colon was then transected using and ILA stapler to include the distal transverse, descending and proximal sigmoid colon. Finally, the proximal cut end of the transverse colon was brought up through a left-sided end colostomy. In this video, the key steps of the procedure are demonstrated, and we provide analysis regarding our intraoperative decision making. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/29/open-left-colectomy-for-colon-cancer:-left-colon-and-sigmoid-resection-with-colostomy-formation
02081nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005300103245018000156260004400336300006600380505076600446506003601212538044601248856018101694446Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aPhillip T. Grisdela Jr, MD, Nishant Suneja, MD 10aThe Use of a Magnetic Intramedullary Nail for Management of a Symptomatic Nonunion Following Shortening Osteotomy to Treat Leg-Length DiscrepancycPhillip T. Grisdela Jr, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file02:05:01bcolor/sound 0 aWe present the case of a 31-year-old female with a history of juvenile rheumatoid arthritis and uveitis who presented to our department with a leg-length discrepancy and low back pain refractory to conservative management. She underwent a shortening osteotomy on her left femur around an intramedullary nail that went on to nonunion. She underwent exchange nailing with a magnetic intramedullary nailing with autologous bone graft harvest from her affected femoral reamings. The magnetic intramedullary nail was extended 2 cm prior to insertion, and then implanted in the usual fashion with immediate compression in the operating room. Postoperatively the patient underwent a compressive program using the magnetic nail and went on to heal her osteotomy site. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/446/the-use-of-a-magnetic-intramedullary-nail-for-management-of-a-symptomatic-nonunion-following-shortening-osteotomy-to-treat-leg-length-discrepancy
02091nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100006800106245007900174260004400253300006300297505095800360506003601318538044601354856008501800260.10Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMark R. Rowan, MD, DDS, R. John Tannyhill, III, MD, DDS, FACS 10aSubmandibular Approach to the Mandible (Cadaver)cMark R. Rowan, MD, DDS aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file31:01bcolor/sound 0 aThe submandibular approach, also known as the Risdon approach, is a well-established extraoral surgical technique employed for the treatment of complex mandibular fractures and pathologies. Despite the increasing popularity of intraoral approaches for open reduction and internal fixation, the submandibular approach remains a valuable option in the arsenal of maxillofacial surgeons. This approach offers several advantages, including superior access and visualization of the mandibular body and angle, facilitating better manipulation and reduction of fracture fragments. Furthermore, the submandibular approach enables direct access to the submandibular gland, facilitating its management in cases of pathology or injury. By providing a comprehensive understanding of this technique through cadaveric exploration, this video aims to contribute to the training and education of maxillofacial surgeons, ultimately enhancing patient care and outcomes. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/260.10/submandibular-approach-to-the-mandible-cadaver
02096nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002200103245008800125260004400213300006600257505098800323506003601311538044601347856009701793212Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aHyunsuk Suh, MD 10aRobotic Thyroidectomy: A Bilateral Axillo-Breast Approach (BABA)cHyunsuk Suh, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:36:18bcolor/sound 0 aBilateral axillo-breast approach (BABA) is a contemporary technique for remote-access thyroidectomy. BABA robotic thyroidectomy (RT) offers a number of benefits over other remote-access thyroidectomy techniques, such as provision of a three-dimensional symmetric view of bilateral thyroid lobes and optimal visualization of important anatomical landmarks, including the recurrent laryngeal nerve (RLN), thyroidal vessels, parathyroid glands, and the trachea. This educational video is a thorough demonstration of BABA RT performed on a young female patient diagnosed with a left-sided thyroid nodule in her early thirties. The thyroid fine needle aspiration biopsy of the 4-cm nodule was indeterminate. Additional molecular testing of the specimen had revealed one of the mutations associated with thyroid cancer. Therefore, a diagnostic thyroid lobectomy was planned. The patient had expressed a strong desire to avoid an obvious neck scar, and therefore, the BABA RT was offered. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/212/robotic-thyroidectomy-a-bilateral-axillo-breast-approach-baba
02179nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100007100103245009400174260004400268300006300312505102400375506003601399538044601435856009201881186Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aCalhoun D. Cunningham III, MD, Benjamin Park, C. Scott Brown, MD 10aMiddle Fossa Approach to Repair Cerebrospinal Fluid LeakcCalhoun D. Cunningham III, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file53:31bcolor/sound 0 aThe middle fossa approach is indicated for procedures requiring access to the internal auditory canal, structures within the temporal bone, and adjacent structures. This is one of the three main approaches for the surgical repair of tegmental defects causing cerebrospinal fluid (CSF) leak. The middle fossa approach allows for an optimal view of the middle fossa floor for larger or multiple defects, ease of graft placement, and avoidance of the removal of ossicle to access the tegmen. Surgical intervention for CSF leak is indicated when conservative management fails or when spontaneous closure of a defect is unlikely. In this case, a middle fossa approach is used to surgically close a tegmen defect causing CSF otorrhea refractory to conservative management. This case highlights the step-by-step surgical techniques involved in this procedure including the surgical approach to expose the tegmen defect, repair of the tegmen defect using temporalis fascia and a bone graft, and craniotomy repair and closure. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/186/middle-fossa-approach-to-repair-cerebrospinal-fluid-leak
01449nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002500103245007200128260004400200300006300244505037300307506003600680538044600716856008101162478Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDeanna Rothman, MD 10aSuture Selection and Knot Tying DemonstrationcDeanna Rothman, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file12:17bcolor/sound 0 aKnot tying is a fundamental skill in the surgical field, essential for securing sutures, ligating vessels, and creating secure anastomoses. The art of knot tying requires precision, dexterity, and a thorough understanding of suture materials and techniques. This text aims to provide a comprehensive overview of surgical knot tying, drawing from the presented video. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/478/suture-selection-and-knot-tying-demonstration
02149nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003900103245006300142260004400205300006300249505107900312506003601391538044601427856007001873143Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aStefanie Miller, Marcus Czabanka 10aResection of a Sphenoid Wing MeningiomacStefanie Miller aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file58:57bcolor/sound 0 aSphenoid wing meningiomas are typically benign, slow-growing tumors that may be identified incidentally on imaging or due to a symptomatic presentation from compression of a nearby structure. Located along the sphenoid wing, these tumors may infiltrate or compress the optic nerve, oculomotor nerve, cavernous sinus, or internal carotid artery, causing neurologic deficits such as visual disturbances, headache, paresis, and diplopia. Surgical resection is considered the first-line treatment for a symptomatic meningioma, but is often challenging due to tumor proximity to these critical neurovascular structures. The most important prognostic factor for recurrence is the completeness of the surgical removal of the tumor, but this goal must be adapted to preserve neurologic function based on individual tumor location and invasion. Here we present a case of a 43-year-old patient diagnosed with a sphenoid wing meningioma after presenting with episodic difficulty speaking and aura-like symptoms who underwent total neurosurgical resection of the tumor via craniotomy. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/143/resection-sphenoid-wing-meningioma
02020nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006800103245005400171260004400225300006300269505094400332506003601276538044601312856005601758271Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDavid M. Kaylie, MD, MS, Trey A. Thompson, C. Scott Brown, MD 10aStapedotomy (Endaural)cDavid M. Kaylie, MD, MS aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file30:48bcolor/sound 0 aOtosclerosis is a condition characterized by abnormal bone growth that inhibits the movement of the stapes, leading to a gradual conductive hearing loss. The treatment options encompass observation, the use of hearing aids, and surgical intervention. If the patient opts for surgery, either a stapedotomy or a stapedectomy can be executed to liberate the stapes from the sclerotic bone. In the case of a stapedotomy performed with an endaural approach, access to the middle ear is gained through a minor incision extending from the anterior ear canal to the incisura, also known as the intertragal notch. The surgeon then proceeds to remove the superstructure of the stapes, create an opening in the footplate of the stapes, and subsequently place a prosthesis into the opening, which is then connected to the incus. The outcomes of this procedure are generally positive, with 90–95% of patients experiencing an improvement in hearing. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/271/stapedotomy-endaural
01889nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100004500106245006600151260004400217300006300261505080100324506003601125538044601161856007601607260.12Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aLaura Boitano, MD, Samuel Schwartz, MD 10aLeft First Toe Amputation (Ray, Cadaver)cLaura Boitano, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file09:09bcolor/sound 0 aMinor lower extremity amputations typically involve either toe or ray resections. The first ray is an essential component in the normal anatomy and biomechanics of the foot. By definition, the first ray consists of the hallux and the first metatarsal. The surgical procedure discussed in this educational video is a left first toe ray amputation on a cadaver. Toe amputation is a significant predictor of future limb loss. Ray amputation appears to be preferred over finger amputation in selected cases. However, the literature does not provide precise indications on when to consider a ray over a toe amputation. The choice is therefore left to the operating surgeon, based on their clinical expertise and the patients conditions and expectations, taking into account the underlying pathology. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/260.12/left-first-toe-amputation-ray-cadaver
01836nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100008100105245008000186260004400266300006300310505069100373506003601064538044601100856008401546278.7Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMudassir Shah Akhter, MD, Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES 10aOpen Proctocolectomy for Hirschsprung's DiseasecMudassir Shah Akhter, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file43:29bcolor/sound 0 aHirschsprung's disease is the main genetic cause of functional intestinal obstruction. Most cases are diagnosed in the first few months of life given classical presentation and ease of testing with rectal suction biopsy. The disease is due to the absence of enteric ganglion cells in the distal colon that results in functional constipation. Resection of the affected segment and bringing the normal bowel close to the anus has been the mainstay of treatment. Due to advances in surgical treatment over the past decades, a significant reduction in morbidity and mortality has been observed, and the previously multistage procedure can now be completed in one stage, as presented here. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/278.7/open-proctocolectomy-for-hirschsprungs-disease
02187nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100012200103245010600225260004400331300006600375505095700441506003601398538044601434856010101880184Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMadhukar S. Patel, MD, MBA, ScM, Jahan Mohebali, MD, MPH, Parsia A. Vagefi, MD, FACS, Alex B. Haynes, MD, MPH, FACS 10aLeiomyosarcoma of Inferior Vena Cava: Resection and ReconstructioncMadhukar S. Patel, MD, MBA, ScM aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file02:10:52bcolor/sound 0 aPrimary leiomyosarcomas of the inferior vena cava (IVC) are rare tumors with complex anatomical relationships. Surgical resection remains the primary approach for management, with selective use of preoperative radiation and chemotherapy. Given the propensity for local invasion of these tumors, radical resection of surrounding structures is often required. Herein we describe the presentation, work-up, operative management, and outcomes of these lesions through the case of a patient with a tumor involving the middle segment of the IVC. Given the extent of involvement, IVC resection with en bloc right nephrectomy, right adrenalectomy, and partial left renal vein resection was performed with vascular reconstruction using a prosthetic graft. With appropriate preoperative planning and a well-coordinated multidisciplinary approach, aggressive surgical resection can be safely performed and patients can benefit from favorable long-term survival. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/184/leiomyosarcoma-of-inferior-vena-cava-resection-and-reconstruction
01672nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002500103245004600128260004400174300006300218505064800281506003600929538044600965856005501411479Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDeanna Rothman, MD 10aSuturing TechniquescDeanna Rothman, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file25:21bcolor/sound 0 aProper wound closure techniques are essential for promoting healing, minimizing scarring, and reducing postoperative complications. By providing a detailed, step-by-step guide to various suturing methods, this video serves as an invaluable tool for surgical training programs and continuing medical education. The detailed explanation of each technique, coupled with practical demonstrations, provides a valuable resource for both beginner and experienced practitioners. By emphasizing proper technique, instrument handling, and tissue management, this demonstration contributes significantly to the development of essential surgical skills. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/479/suturing-techniques
01933nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100007800106245012900184260004400313300006300357505070100420506003601121538044601157856012401603299.11Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aCaroline L. Ko, PharmD, BCPS, BCCCP, Laura Celmins, PharmD, BCPS, BCCCP 10aPharmacology for Rapid Sequence Intubation (RSI) Airway Management in Trauma PatientscCaroline L. Ko, PharmD, BCPS, BCCCP aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file07:40bcolor/sound 0 aThe primary survey of every trauma patient begins with ABC: airway, breathing, circulation. If the patient is deemed to require airway management, endotracheal intubation may be performed utilizing rapid sequence intubation (RSI). In RSI, an induction agent and a rapid-acting neuromuscular blocking agent (NMBA or paralytic) are administered and intubation is performed as soon as unconsciousness and paralysis are achieved. Trauma patients may require intubation for a number of reasons. This video review focuses on the pharmacology, dosing, and other considerations for use of common medications for pretreatment, paralysis with induction, and post-intubation management in trauma patients. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/299.11/pharmacology-for-rapid-sequence-intubation-(rsi)-airway-management-in-trauma-patients
01849nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100009000105245007100195260004400266300006300310505070600373506003601079538044601115856008201561299.3Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDavid V. Deshpande, Abigail Clarkson-During, MD, Jennifer Cone, MD, Ashley Suah, MD 10aChest Tube Placement for Possible HemothoraxcDavid V. Deshpande aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file22:56bcolor/sound 0 aA hemothorax is a collection of blood within the pleural cavity. Blood can accumulate within this space as a sequelae of chest trauma (penetrating or blunt), iatrogenic injury (e.g., vascular access injuries), or spontaneously (e.g., due to malignancy). To treat the condition, a chest tube is inserted into the thoracic cavity on the affected side of the body (“tube thoracostomy”). In addition to evacuating blood from the pleural cavity, a chest tube can also be used to treat pneumothorax (air in the pleural space) and pleural effusion (e.g., empyema or chylothorax), and to insert medications into the pleural space. Depending on the specific pathology, a tube or catheter may be utilized. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/299.3/chest-tube-placement-for-possible-hemothorax
02297nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100007400106245010900180260004400289300006300333505109100396506003601487538044601523856012201969268.15Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJonathan E. Sledd, Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES 10aPediatric Surgical Treatment of a Wrist Ganglion Cyst in a Resource-Limited SettingcJonathan E. Sledd aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file14:38bcolor/sound 0 aGanglion cysts are benign, mucinous-filled swellings that overly tendons and joints. They are the most common soft tissue mass found in the hand and wrist but also commonly encountered in the knee and foot. Presenting as a palpable knot, the cyst is asymptomatic until it impinges on local neurovasculature causing pain, numbness, tingling, and/or motor deficits. Pediatric ganglion cysts have different epidemiological characteristics than adults, with the majority found on the volar aspect on the wrist. Treatment of ganglion cysts is most often observation due to the 50% chance of resolution over time. Activity causes the cyst to increase in size, and thus more aggressive treatment is often desirable. If the cyst recurs or symptoms are not relieved with observation alone, a more aggressive treatment such as surgical excision is often desirable. Here, we present a female pediatric patient undergoing surgical excision of a large ganglion cyst on the dorsum of her right wrist. With the treatment options explained to her, she chose excision for the lower rate of recurrence. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/268.15/pediatric-surgical-treatment-of-a-wrist-ganglion-cyst-in-a-resource-limited-setting
01805nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000480010224500480015026000440019830000630024250507540030550600360105953804460109585600580154191Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aWilliam B. Hogan, Eric M. Bluman, MD, PhD 10aDeltoid Ligament RepaircWilliam B. Hogan aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file13:04bcolor/sound 0 aInjury to the medial deltoid ligament complex is rare as it is the strongest of the ankle ligaments. However, damage to this structure can occur, often in association with an avulsion fracture of the medial malleolus due to the ligamentous strength of the complex. Deltoid ligament repair remains a primary option for patients with severe acute injuries, or patients with chronic instability who have failed conservative measures. Repair of the medial ankle ligaments provides improved stability with reduced risk of recurrent sprains and potential damage to local cartilage. We present a case of a young woman with concomitant medial and lateral ankle instability who successfully underwent deltoid ligament repair for her medial ligament injury. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/91/deltoid-ligament-repair
01905nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100008200103245007400185260004400259300006600303505077200369506003601141538044601177856007601623426Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aConstantine M. Poulos, MD, Tong-Yan Chen, MD, Lana Schumacher, MD, MS, FACS 10aRobotic Thymectomy for Myasthenia GraviscConstantine M. Poulos, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:32:39bcolor/sound 0 aMyasthenia gravis is an autoimmune disease affecting acetylcholine transmission involved in skeletal muscle contraction. The approach to myasthenic patients is complex as optimal treatment involves a multidisciplinary technique of combined medical and surgical therapies. Medical therapy with acetylcholinesterases and immunomodulators can provide symptom relief and eliminate feelings of fatigue and weakness. Surgical thymectomy can help by reducing symptoms, preventing recurrence, and reducing daily medication requirements. Thymectomy was traditionally performed via a transsternal approach, but minimally invasive and robotic techniques have become increasingly common. Here, we present our approach for robotic total thymectomy through a left-sided approach. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/426/robotic-thymectomy-for-myasthenia-gravis
02806nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003800103245011300141260004400254300006600298505163500364506003601999538044602035856011902481175Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAndrew Del Re, MD, Marco Zenati 10aCox-MAZE IV with Coronary Artery Bypass Graft (CABG) and Mitral Valve Replacement (MVR)cAndrew Del Re, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file03:06:17bcolor/sound 0 aCardiovascular disease is a leading cause of morbidity and mortality in the United States and abroad, manifesting as shortness of breath, exercise intolerance, palpitations, and chest pain. Common cardiovascular diseases include coronary artery disease (5.6% of the U.S. population), atrial fibrillation (0.95% of the U.S. population), and diseases affecting the heart valves (2.5% of the U.S. population).1-3 While the majority of cases are treated medically, more advanced or severe cases are treated surgically or endovascularly, warranting an open discussion between the provider and the patient to decide the most appropriate treatment modality given the specific characteristics and preferences of the procedure and the patient.

The Cox-MAZE IV is a surgical procedure to treat atrial fibrillation that utilizes mainly applied radiofrequency and cryothermal energy (as opposed to the “cut-and-sew” techniques in prior iterations) to treat atrial fibrillation.4-7 Coronary Artery Bypass Grafting (CABG) allows for the bypass of stenotic or occluded coronary arteries through the use of arterial or venous conduits. Mitral valve repair, or replacement, can be used for correcting mitral valve disease. Though the aforementioned procedures address different pathologies of the heart, some or all may be necessary at the same time due to concomitant disease.

The Cox-MAZE IV combined with CABG and Mitral Valve Replacement is a singular surgical procedure that is carefully planned and executed to address arrhythmic, coronary, and valvular disease while minimizing time on cardiopulmonary bypass with an arrested heart. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/175/cox-maze-iv-with-coronary-artery-bypass-graft-cabg-and-mitral-valve-replacement-mvr
02328nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100007300106245019700179260004400376300006300420505094900483506003601432538044601468856020801914290.14Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aYoko Young Sang, MD, Caroll Alvarado Lemus, MD, Domingo Alvear, MD 10aInfraclavicular Subclavian Vein Cannulation in a Pediatric Patient Without Ultrasonographic Guidance Prior to a Colon Interposition in Honduras During a Surgical MissioncYoko Young Sang, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file08:22bcolor/sound 0 aCentral venous access is a crucial aspect in the management of patients requiring long-term therapies, particularly surgical patients. These therapies include the administration of therapeutic agents, fluid administration, antibiotic therapy, parenteral nutrition, etc. The procedure involves the placement of a catheter into a venous great vessel. Three main sites for central venous access are: internal jugular vein, common femoral vein, and subclavian veins.

In resource-constrained settings, healthcare professionals must rely on their clinical practice and proficiency in performing procedures without the aid of advanced imaging modalities. One such procedure is the infraclavicular subclavian vein cannulation, which can be performed without ultrasonographic guidance, providing a reliable means of obtaining central venous access. Here, this is demonstrated on a pediatric preoperative patient during a surgical mission in Honduras. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/290.14/infraclavicular-subclavian-vein-cannulation-in-a-pediatric-patient-without-ultrasonographic-guidance-prior-to-a-colon-interposition-in-honduras-during-a-surgical-mission
02383nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004800103245008800151260004400239300006300283505125500346506003601601538044601637856009402083276Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aSeth M. Cohen MD, MPH, C. Scott Brown, MD 10aDirect Microlaryngoscopy and Excision of Vocal Cord LesioncSeth M. Cohen MD, MPH aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file13:04bcolor/sound 0 aLaryngeal granulomas are benign non-neoplastic lesions, primarily located on the posterior third of the vocal folds, particularly on the vocal process or in the arytenoid region. These lesions often arise as complications of vocal abuse (33%), gastroesophageal reflux disease (GERD) (30%), external laryngeal trauma, or resulting from prior endotracheal intubation (23%). Laryngeal granulomas present with clinical signs and symptoms including dysphonia, hoarseness, discomfort or pain in the throat, and dyspnea. Notably, vocal granuloma, despite its name, pathologically is not a true granulomatous process. Instead, it is characterized as a reactive/reparative process where intact or ulcerated squamous epithelium is underlaid by granulation tissue or fibrosis. Although granulomas are typically of benign nature, they often require surgical treatment. Other options for treatment include Proton-pump inhibitors (PPIs) and steroid inhalations, botulinum neurotoxin injection, and phonotherapy. Nearly half of the cases usually remit through clinical management involving PPIs, topical inhalant steroids, and phonotherapy. Additionally, surgical removal of the granuloma, when combined with clinical management, proved effective in 90% of cases. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/276/direct-microlaryngoscopy-and-excision-of-vocal-cord-lesion
02643nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006100103245012200164260004400286300006300330505143700393506003601830538044601866856012502312419Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAndrew S. Chung, MD, PhD, Hugh G. Auchincloss, MD, MPH 10aInsertion of a Right-Sided PleurX Catheter for Palliation of a Malignant Pleural EffusioncAndrew S. Chung, MD, PhD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file19:00bcolor/sound 0 aThe following case describes a 91-year-old woman with no significant past medical history who presented to her primary care physician with several months of cough and progressive dyspnea. After appropriate workup she was found to have a stage IVa lung adenocarcinoma with an associated malignant pleural effusion that contributed to her symptoms. There are several therapeutic options for treating a malignant pleural effusion. An indwelling tunneled pleural catheter (PleurX catheter) is a reliable way to manage a chronic pleural effusion. The device is most commonly used to manage malignant pleural effusions, but the same technique may be applied for a range of benign, non-infectious indications as well. PleurX catheters may be inserted in an outpatient clinic, interventional radiology suite, inpatient setting, or operating room under local or general anesthesia. Once in place, they are designed to be managed in an outpatient setting either by the patients caregivers or by the patient themselves and serve to palliate the respiratory symptoms of a large effusion without the need for repeated thoracenteses. They can remain in place for several months, and removal in an outpatient setting with local anesthetic is trivial. Following placement of the PleurX catheter, the patient reported symptomatic improvement in her dyspnea, and she was started on dose-reduced Mobocertinib under the guidance of thoracic oncology. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/419/insertion-of-a-right-sided-pleurx-catheter-for-palliation-of-a-malignant-pleural-effusion
01780nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100008800106245005300194260004400247300006300291505067500354506003601029538044601065856006301511260.11Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aFelix L. Hong, DDS, Mark R. Rowan, MD, DDS, R. John Tannyhill, III, MD, DDS, FACS 10aCoronal Approach (Cadaver)cFelix L. Hong, DDS aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file33:05bcolor/sound 0 aFor treatment of facial trauma such as a frontal sinus fracture, orbital fractures, or zygoma fractures, the coronal or bi-temporal approach is used. The approach can also be used for superficial temporal artery biopsy. This approach exposes the anterior cranial vault, forehead, and upper and middle regions of the facial skeleton including the zygomatic arch. It provides access to these areas with minimal complications and cosmetically acceptable hidden scars. The subperiosteal or subgaleal planes are commonly used for coronal flap dissection. Here, we present a demonstration of the coronal approach to exposing the upper or middle facial skeleton in a cadaver. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/260.11/coronal-approach-cadaver
01868nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004800103245005300151260004400204300006600248505080700314506003601121538044601157856005901603191Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAndrea L. Merrill, MD, John T. Mullen, MD 10aOpen Distal GastrectomycAndrea L. Merrill, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:22:35bcolor/sound 0 aA complete margin-negative (R0) resection remains the only potentially curative treatment for gastric adenocarcinoma. The choice of operation depends on the location of the tumor as well as the stage of disease. This patient presented with symptomatic anemia, and workup demonstrated gastritis and a small tumor in the distal stomach. Biopsies confirmed adenocarcinoma, and an endoscopic ultrasound (EUS) staged this tumor as T2 N0. Staging scans showed no evidence of distant metastatic disease. Given that this patient had a relatively early stage tumor, we elected to proceed with upfront surgery, which in this case entailed a distal gastrectomy. This video shows an experienced gastric surgeons technique for performing an open distal gastrectomy with an “extended” D1 lymph node dissection. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/191/open-distal-gastrectomy
02488nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100010200105245013500207260004400342300006300386505121000449506003601659538044601695856014102141261.1Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAleia M. Boccardi, DO, Robert J. Dabek, MD, Lisa Gfrerer, MD, PhD, Daniel N. Driscoll, MD, FACS 10aSplit-Thickness Skin Graft for Scar Release, Permanent Pigment Transfer, and Fractional CO2 Laser TherapycAleia M. Boccardi, DO aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file48:48bcolor/sound 0 aPediatric burns are one of the most common forms of injury affecting children worldwide. Of these, hand involvement occurs in 80–90% of such incidents. With the skin in children already diffusely thinner throughout the body than adults, this provides a particular challenge for areas naturally possessing thinner skin, such as the dorsal hand. There, the cutaneous tissue is the only protection for vital structures in the hand that allow full function, such as extensor tendons, nerves, and vessels. Injury to this area early in life can have a detrimental impact on how the survivor interacts with the physical world, affecting their functional capacity and quality of life. Today we present a case of burn contractures on the right hand of an 8-year-old boy that will be released using a split-thickness graft, along with a pigment transfer graft for his left knee and fractional CO2 laser therapy over areas of hypertrophic scar tissue on his bilateral upper extremities. The split-thickness graft will greatly decrease the tension built up from the burn contracture, while the fractional CO2 laser procedure can soften the surrounding scar, allowing mild remodeling and increased range of motion. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/261.1/split-thickness-skin-graft-for-scar-release-permanent-pigment-transfer-and-fractional-co2-laser-therapy
02250nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004600103245009700149260004400246300006300290505110200353506003601455538044601491856010701937465Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJade Refuerzo, BS, Nicole B. Cherng, MD 10aLaparoscopic Lysis of Adhesions for Closed Loop Small Bowel ObstructioncJade Refuerzo, BS aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file18:24bcolor/sound 0 aLaparoscopic lysis of adhesions is a minimally-invasive approach to the resolution of a closed loop small bowel obstruction (SBO) due to adhesions. A patient with an SBO can present with nausea, vomiting, abdominal pain, and obstipation. History of prior abdominal surgeries serves as a significant risk factor for development of intra-abdominal adhesions. Imaging using either plain abdominal radiography or computed tomography (CT) can be diagnostic for closed loop SBOs. Conservative management with gastrografin can be considered in some SBOs, but closed loop SBOs are considered surgical emergencies. Utilization of specific signs (two transition points, pneumoperitoneum, signs of bowel ischemia) on imaging and patient presentation can facilitate earlier intervention. Laparoscopic lysis of adhesions can resolve symptoms through releasing the bowel from the adhesion to improve flow. Lysis of adhesions can be performed open, laparoscopically, or with robotic techniques. In this case, we present a laparoscopic lysis of adhesions in a patient with a closed loop small bowel obstruction. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/465/laparoscopic-lysis-of-adhesions-for-closed-loop-small-bowel-obstruction
01945nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100003400105245005300139260004400192300006300236505090300299506003601202538044601238856005501684300.3Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aBrandon Buckner, CST, CRCST 10aSurgical StaplerscBrandon Buckner, CST, CRCST aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file11:54bcolor/sound 0 aFor nearly two centuries, surgeons have been using mechanical devices to approximate tissues and facilitate their healing process. Currently, surgical staplers are widely used and have become essential tools in surgery. Staples facilitate rapid wound closure, hence shortening the duration of the surgical procedure. In comparison to intradermal sutures, stapling is associated with better cosmetic outcomes.

Staplers are classified into five categories: circular, linear, linear cutting, ligating, and skin staplers. With distinct names, color-coded features, and variations in length and tissue thickness, each stapler serves a specific purpose in the surgical setting. The distinct characteristics of various tissue types in the human body significantly influence the selection of staples. This video aims to provide a comprehensive overview of stapling instruments and their associated use. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/300.3/surgical-staplers
01864nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005400103245011300157260004400270300006600314505067800380506003601058538044601094856011801540181Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aM. Lucia Madariaga, MD, Henning A. Gaissert, MD 10aCombined Thymectomy and Right Lower Lobe Pulmonary Wedge Resection by ThoracoscopycM. Lucia Madariaga, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:08:05bcolor/sound 0 aWith the increasing use of computed tomography (CT) for screening and diagnostic workup, increasing numbers of patients are found to have pulmonary nodules. The patient in this case presented with vision changes, neck weakness, and dysphagia. Workup revealed non-thymomatous myasthenia gravis as well as an incidental right lower lobe lung nodule that was suspicious for malignancy based on imaging characteristics, interval growth, and history of breast cancer. She required a lung resection for diagnostic and therapeutic purposes. Additionally, a thymectomy was indicated to help control her myasthenia gravis symptoms. Consequently, a combined approach was conducted. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/181/combined-thymectomy-and-right-lower-lobe-pulmonary-wedge-resection-by-thoracoscopy
01854nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005000103245012000153260004400273300006300317505066300380506003601043538044601079856012301525447Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aVictoria J. Grille, MD, Randy S. Haluck, MD 10aLaparoscopic Totally Extraperitoneal (TEP) Left Indirect Inguinal Hernia Repair with MeshcVictoria J. Grille, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file40:22bcolor/sound 0 aThis video demonstrates the surgical technique for a laparoscopic totally extraperitoneal (TEP) left inguinal hernia repair with mesh. This is a technically challenging operation with a steep learning curve; however, it is one useful option for patients with bilateral hernias, recurrent hernias, or when a minimally-invasive approach is desired. It provides tension-free repair and allows exposure to the entire groin area to evaluate and repair indirect, direct, and femoral hernias. The only absolute contraindication to laparoscopic TEP repairs is the inability to undergo general anesthesia due to significant cardiopulmonary disease or other factors. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/447/laparoscopic-totally-extraperitoneal-tep-left-indirect-inguinal-hernia-repair-with-mesh
02087nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006200103245015400165260004400319300006300363505081400426506003601240538044601276856015901722444Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAndrew M. Hresko, MD, Edward Kenneth Rodriguez, MD, PhD 10aRight Distal Tibial Oblique Fracture Open Reduction and Internal Fixation (ORIF) with Medial Neutralization Non-locking PlatecAndrew M. Hresko, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file40:29bcolor/sound 0 aDiaphyseal tibial fractures are common injuries that are most often treated with intramedullary nailing. However, certain patient factors may necessitate alternative treatment strategies such as open reduction internal fixation (ORIF) with plates and screws. Presence of a total knee arthroplasty (TKA) in the injured extremity is one such factor. TKA is a common operation that is only increasing in popularity, and management of tibia fractures distal to TKA may be a frequently encountered clinical scenario. In this video, we present a technique for ORIF of a distal diaphyseal tibia fracture distal to a TKA that precludes intramedullary nail fixation. The fracture is fixed with lag screws and secured with an anatomically-contoured distal tibia locking-compression plate (LCP) in neutralization mode. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/444/right-distal-tibial-oblique-fracture-open-reduction-and-internal-fixation-orif-with-medial-neutralization-non-locking-plate
02977nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100008100103245009900184260004400283300006600327505178600393506003602179538044602215856011002661443Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aPaul A. Rizk, MD, Joseph O. Werenski, Santiago A. Lozano-Calderon, MD, PhD 10aCarbon Fiber Implant for Fixation of a Pathologic Subtrochanteric FracturecPaul A. Rizk, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:14:47bcolor/sound 0 aHerein, we present a patient with a pathologic subtrochanteric femur fracture secondary to an undiagnosed primary lung adenocarcinoma. The fracture, occurring in the context of persistent atraumatic thigh and knee pain, prompted swift identification of its pathological nature in the Emergency Department. The treatment plan involved open reduction and internal fixation utilizing a carbon fiber nail, considering the immediate need for stabilization and underlying oncologic factors.

The primary focus was on achieving fracture fixation, traditionally accomplished with intramedullary devices. However, the decision to employ a carbon fiber nail was made due to the pathological nature of the fracture and the subsequent need for post surgery oncologic intervention. The unique radiolucency of carbon fiber aids in postoperative radiation planning, ensuring optimal visualization and precision in targeting bone lesions. This approach contributes to fracture reduction while minimizing interference with radiation therapy.

The surgical procedure involved intramedullary rodding with a carbon fiber nail, achieving successful fracture reduction and optimal hardware positioning. Histopathological assessment confirmed metastatic lung adenocarcinoma. Postoperatively, the patient received palliative radiation and targeted therapy, demonstrating substantial improvement at the two-month follow-up (Figure 6).

The case highlights the strategic use of carbon fiber implants in managing pathologic fractures, offering advantages in postoperative imaging, disease monitoring, and precision in radiation therapy planning. The multidisciplinary approach underscores the importance of considering implant selection nuances, especially in metastatic bone disease, to optimize outcomes. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/443/carbon-fiber-implant-for-fixation-of-a-pathologic-subtrochanteric-fracture
02309nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000480010224500790015026000440022930000630027350512000033650600360153653804460157285600850201823Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aWilliam B. Hogan, Eric M. Bluman, MD, PhD 10aBrostrom-Gould Procedure for Lateral Ankle InstabilitycWilliam B. Hogan aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file20:59bcolor/sound 0 aAcute ankle sprains are most frequently treated conservatively, although some surgeons may advocate acute repairs in certain situations. Surgery is indicated for chronic sprains with persistent ankle instability despite well-designed conservative management. Several anatomic and nonanatomic operative procedures are available. The Broström-Gould procedure is a widely-used operative intervention for the treatment of chronic lateral ankle sprains. It consists of an anatomic repair or reconstruction of the injured lateral ankle ligament complex (Broström procedure), followed by suturing of the inferior extensor retinaculum to the periosteum of the distal fibula (Gould modification).

This article describes the standard Broström-Gould procedure starting with the identification of the anatomic landmarks. The skin incision follows the anterior border of the distal fibula, and careful subcutaneous dissection is carried out to expose the extensor retinaculum and the torn ligaments. This is followed by bone preparation and ligament repair utilizing a box stitch technique while holding the ankle in an appropriate position. Finally, the Gould portion of the procedure is demonstrated. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/23/brostrom-gould-procedure-lateral-ankle-instability
01744nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002700103245006200130260004400192300006300236505068800299506003600987538044601023856006901469395Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAlexander Martin, OD 10aCorneal Staining with FluoresceincAlexander Martin, OD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file03:41bcolor/sound 0 aPatient ocular complaints often center around discomfort, foreign body sensation, and/or recent trauma. Determining the cause of the ailment is not always straightforward, and the use of fluorescein can provide valuable information that aids in clinical diagnosis. Many corneal conditions and emergencies can be identified with the aid of fluorescein such as corneal erosion, superficial punctate keratitis, corneal abrasion, foreign bodies, and tracking patterns of foreign bodies. This article and video will demonstrate proper technique to instill fluorescein and examine ocular tissues, as well as some examples of staining defects characteristic of compromised ocular tissues. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/395/corneal-staining-with-fluorescein
01961nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006400103245009900167260004400266300006300310505079300373506003601166538044601202856010701648262Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aRobert J. Dabek, MD, Harrison McUmber, Branko Bojovic, MD 10aPulsed Dye and Fractional CO2 Laser Therapy for Treatment of Burn ScarscRobert J. Dabek, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file48:04bcolor/sound 0 aBurn injuries are often devastating accidents that result in long-term physical and psychosocial consequences. Burn-related injuries frequently lead to the formation of hypertrophic scars. These scars not only lack aesthetic appeal, but can also cause pruritus, restricted range of motion, and have a negative overall impact on mental health. Surgical scar removal and contracture release are crucial corrective treatments that require postoperative adjuvant therapies to minimize the risk of recurrence of scar formation. Laser treatment is a low risk minimally invasive approach. Research has shown that laser therapy effectively decreases the thickness of burn scars and alleviates neuropathic pain. Furthermore, it improves pigmentation, texture, height, and itchiness of the scars. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/262/pulsed-dye-and-fractional-co2-laser-therapy-for-treatment-of-burn-scars
02447nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100012500103245016600228260004400394300006600438505107500504506003601579538044601615856018002061414Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aCheryl Yu, MD, Sarah Debs, MD, Peter Kwak, MD, Nima Vahidi, MD, Daniel Hawkins, DDS, Thomas Lee, MD, FACS, Derek Sheen 10aOpen Reduction and Internal Fixation of Mandibular Body and Parasymphyseal Fractures with Maxillomandibular Fixation and Broken Tooth ExtractioncCheryl Yu, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:47:45bcolor/sound 0 aThis is a case discussing a 21-year-old male who suffered from both non-comminuted mandibular parasymphyseal and body fractures as a result of a motor vehicle accident, requiring open reduction internal fixation (ORIF) without postoperative maxillomandibular fixation (MMF). The fracture was complicated by a broken tooth root, which required extraction. After intraoperative MMF, ORIF was performed. The parasymphyseal fracture was plated using two locking four-hole 2-mm thick miniplates utilizing two locking screws on either side of the fracture with one plate along the alveolar surface (monocortical screw) and one along the basal surface (bicortical screw). For the right body fracture, a three-dimensional locking ladder plate was used via a transbuccal trocar approach for additional exposure needed for proper screw placement. Once the hardware was secured, the patient was taken out of MMF and restoration of premorbid occlusion was confirmed. Lastly, watertight mucosal closure was performed using absorbable sutures and Dermabond (cyanoacrylate adhesive). aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/414/open-reduction-and-internal-fixation-of-mandibular-body-and-parasymphyseal-fractures-with-maxillomandibular-fixation-and-broken-tooth-extraction
02254nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100008100103245010200184260004400286300006300330505106200393506003601455538044601491856011101937309Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aC. Scott Brown, MD, Paulo Dominaitis, CST, Fred F. Telischi, MEE, MD, FACS 10aMicroscope Drape for Aerosol-Generating Procedures During COVID-19 PandemiccC. Scott Brown, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file04:16bcolor/sound 0 aCoronavirus disease 2019 (COVID-19) has emerged as a worldwide pandemic, profoundly impacting healthcare systems. Otolaryngologists have confronted significant challenges amid the COVID-19 outbreak, given the heightened risk of infection due to occupational exposure. Despite the use of personal protective equipment, concerns remain over the potential transmission of SARS-CoV-2. This is owing to the virus's capability to remain alive and infectious in aerosols (i.e., suspensions of particles in a gas, for example, in air) for extended periods of time, as well as on surfaces for several days. Transmission occurs via respiratory droplets and aerosolized virus particles, which are generated during specific interventions such suctioning, bone drilling, and the application of diathermy. The mastoid and middle ear mucosa are connected to the nasopharyngeal mucosa and can serve as a potential source of viral particles in an infected patient. This highlights the need for the development and implementation of strategies that minimize aerosol spread. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/309/microscope-drape-for-aerosol-generating-procedures-during-covid-19-pandemic
02791nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005800103245011500161260004400276300006300320505159100383506003601974538044602010856012902456287Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aRyan P. Boyle, Jonah Poster, Jonathan Friedstat, MD 10aContracture Release and Full-Thickness Skin Graft to Volar Index Finger with K-Wire InsertioncRyan P. Boyle aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file49:24bcolor/sound 0 aTrauma-related deaths cause many deaths per year, with burns contributing to many of these deaths. The morbidity and mortality of burns have shown a decline since the development of more scrupulous management. The complications stemming from a poorly-healed burn wound can lead to functional deficits and overall aesthetically unfavorable results leading to psychological distress. Due to the inquisitive nature of infants and toddlers, and their nature to learn the world with their hands, their sensitive regions like the hands become likely targets for burns. The rapid growth of infants places extra stress on the surgeon to recreate the normal anatomy of the flawed hand. Management differs depending on the size and depth of the burn wound. Superficial burns can be managed on an outpatient basis with spontaneous healing expected in 2 or 3 days with minimal scarring. Deep burns, particularly in pediatric populations, need considerable attention to avoid secondary contracture that leads to deformity. Many treatment options exist, but in sensitive areas like the hands and face, full-thickness skin grafts are favored due to their superior healing and decreased likelihood of secondary contracture. Advancements in modern medicine have expanded treatment options with nonoperative and operative procedures, along with the utilization of growth factors, such as TGF-B1 that accelerate healing. This article aims to guide the surgeon in managing a pediatric burn wound with an arsenal of treatment options with the goal of achieving full mobility and functionality of the hand. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/287/contracture-release-and-full-thickness-skin-graft-to-volar-index-finger-with-k-wire-insertion
01950nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004400103245008300147260004400230300006300274505083500337506003601172538044601208856009001654448Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMarcus S. Alpert, MD, Yu Maw Htwe, MD 10aFlexible Bronchoscopy and Bronchoalveolar Lavage (BAL)cMarcus S. Alpert, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file21:58bcolor/sound 0 aFlexible bronchoscopy is a commonly utilized endoscopic procedure allowing for direct visualization of the airways, as well as a variety of therapeutic and diagnostic interventions. Common indications of flexible bronchoscopy include evaluation of pulmonary infiltrates, hemoptysis, airway obstruction, foreign body aspiration, tracheal stenosis, bronchopleural fistula, and post-lung transplant. The procedure involves the insertion of a flexible bronchoscope through the vocal cords and into the lumen of the trachea and bronchi. Direct visualization is provided by fiberoptic video imaging. Bronchoalveolar lavage (BAL) further refers to instillation and subsequent recovery of sterile saline into the airways. In this article, we will detail the technique, considerations, and complications of flexible bronchoscopy and BAL. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/448/flexible-bronchoscopy-and-bronchoalveolar-lavage-(bal)
01517nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004100103245006000144260004400204300006300248505044800311506003600759538044600795856007001241140Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aVincent Prinz, MD, Marcus Czabanka 10aAcute Subdural Hematoma EvacuationcVincent Prinz, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file19:25bcolor/sound 0 aSubdural hematoma (SDH) is a type of intracranial bleeding that occurs between the dura and the arachnoid membrane surrounding the brain. The presented video is a step-by-step demonstration of a hematoma evacuation by craniotomy performed on an elderly female patient with an acute-on-chronic SDH, presumably resulting from recurrent head injuries sustained from falls. The patient presented with altered mental status with a GCS score of 8. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/140/acute-subdural-hematoma-evacuation
02000nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100008400103245011200187260004400299300006600343505078800409506003601197538044601233856011501679418Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aSrilakshmi Atthota, MBBS, Jessica Grasso, PA-C, Leigh Anne Dageforde, MD, MPH 10aRobotic-Assisted Laparoscopic Left Donor Nephrectomy for Living Kidney DonationcSrilakshmi Atthota, MBBS aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:34:57bcolor/sound 0 aKidney transplantation is the preferred treatment for patients with end-stage renal disease and is associated with a better quality of life and survival compared to other renal replacement therapies. Compared to deceased donor kidneys, living donor kidney donation is associated with shorter wait times, improved patient and graft survival, and the possibility of preemptive transplantation. After the initial learning curve, robotic assisted living donor nephrectomy has similar outcomes compared to open and laparoscopic nephrectomy, and in some settings an overall decreased length of stay. In this article, we present a case of a robotic-assisted living donor nephrectomy, including evaluation, technique, and considerations for the surgeon preoperatively and intraoperatively. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/418/robotic-assisted-laparoscopic-left-donor-nephrectomy-for-living-kidney-donation
02206nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100007700103245004900180260004400229300006300273505112700336506003601463538044601499856005501945209Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aLiana Puscas, MD, MHS, C. Scott Brown, MD, Vahagn G. Hambardzumyan, MD 10aPartial GlossectomycLiana Puscas, MD, MHS aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file21:15bcolor/sound 0 aJaw and oral cavity involvement by metastatic disease is very rare, occurring in less than 1% of all oral malignancies. Unfortunately, oral metastasis is usually a manifestation of an advanced stage of primary cancer and indicates widespread disease and poor prognosis.

In this clinical case, a patient presented with a left breast lump and a well-circumscribed lesion on her tongue, causing interference with eating as it grew. Despite its benign appearance, an initial in-office biopsy was performed. Further investigations included a mammography that revealed an irregular mass in the upper outer quadrant of the breast, along with enlarged ipsilateral lymph nodes. Contrast-enhanced CT scans further showed a lesion on the right side of the tongue, a left breast lump, and spinal metastasis. Osteoscintigraphy confirmed multiple bone metastases. Subsequent breast core biopsy results indicated invasive ductal carcinoma, and the tongue biopsy revealed an unexpected diagnosis of metastatic lesion secondary to breast cancer. Hormone therapy was initiated, and the patient underwent a palliative partial glossectomy. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/209/partial-glossectomy
02185nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100007200103245016100175260004400336300006600380505088700446506003601333538044601369856016401815427Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aRaja R. Narayan, MD, MPH, Jane C. Kim, MD, Do Joong Park, MD, PhD 10aRobotic-Assisted Proximal Gastrectomy with a Laparoscopic-Assisted Double-Tract Reconstruction for Proximal Early Gastric CancercRaja R. Narayan, MD, MPH aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:21:14bcolor/sound 0 aAt most institutions caring for patients with early gastric cancer (EGC), tumors arising in the upper third of the stomach are usually managed with total gastrectomy and Roux-en-Y esophagojejunostomy. Given the impaired quality of life related to associated reflux and vitamin deficiencies, several high-volume centers have sought alternative gastrectomy and reconstruction strategies to total gastrectomy. In this case, a patient with EGC in the cardia found on screening endoscopy undergoes robotic proximal gastrectomy with double tract reconstruction. His postoperative course was unremarkable, and he was discharged on postoperative day 7. His pathology demonstrated no residual tumor after preoperative endoscopic submucosal dissection. This video demonstrates the technique of an experienced surgeon performing robotic proximal gastrectomy with double tract reconstruction. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/427/robotic-assisted-proximal-gastrectomy-with-a-laparoscopic-assisted-double-tract-reconstruction-for-proximal-early-gastric-cancer
01892nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003300103245010100136260004400237300006300281505075800344506003601102538044601138856010201584458Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJoshua Ng-Kamstra, MD, MPH 10aVacuum-Assisted Closure (VAC) Change for a Complex Right Hip WoundcJoshua Ng-Kamstra, MD, MPH aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file32:34bcolor/sound 0 aVacuum-assisted closure (VAC) is a method of wound management commonly employed as an adjunct to surgery that uses negative pressure to accelerate healing. This video is a comprehensive step-by-step demonstration of VAC change for a complex right hip wound. The patient is a male in his fourth decade with a history of paralysis beginning in childhood due to a spinal tumor. He was admitted to the hospital with a right hip joint infection complicated by methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia. Given his immobility at baseline, the patient was deemed a suitable candidate for a Girdlestone procedure, which involved resection of the femoral head and proximal aspect of the femur, resulting in a complex wound with exposed bone. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/458/vacuum-assisted-closure-(vac)-change-for-a-complex-right-hip-wound
01546nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100002400105245011100129260004400240300006300284505038800347506003600735538044600771856012301217299.4Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aPriya Prakash, MD 10aTrauma Resuscitation Demonstration in a Stable Patient with a Minor Perforating WoundcPriya Prakash, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file11:54bcolor/sound 0 aThis is the case study of a 17-year-old male Reserve Officers Training Corps (ROTC) cadet who suffered a superficial perforating saber wound to the medial part of the right knee during a routine practice session. This video demonstrates the step-by-step patient assessment process and subsequent saber removal, providing a detailed account of the challenges faced by the personnel. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/299.4/trauma-resuscitation-demonstration-in-a-stable-patient-with-a-minor-perforating-wound
01862nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003700103245006400140260004400204300006300248505078300311506003601094538044601130856008001576129Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDaniel Rice, David Rattner, MD 10aLaparoscopic Resection of Gastric GIST TumorcDaniel Rice aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file25:34bcolor/sound 0 aThis 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. 
 aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/129/laparoscopic-resection-of-gastric-gist-tumor
01653nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100003400105245006000139260004400199300006300243505059700306506003600903538044600939856006201385300.6Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aBrandon Buckner, CST, CRCST 10aLaparoscopic InstrumentscBrandon Buckner, CST, CRCST aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file10:08bcolor/sound 0 aThe origins of laparoscopic surgery trace back to the introduction of diagnostic laparoscopy in the 1960s. Subsequently, the approach underwent a notable evolution, transitioning from a primarily diagnostic procedure to a surgical technique. Laparoscopy, a type of minimally invasive surgery, was introduced to address issues related to significant tissue trauma, large cosmetic scars, and prolonged hospitalizations. This video provides a step-by-step demonstration of the assembly, disassembly, use, and handling of laparoscopic tools on the example of a basic Karl Storz laparoscopy kit. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/300.6/laparoscopic-instruments
01585nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004800103245007600151260004400227300006300271505048100334506003600815538044600851856008201297149Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aSeth M. Cohen MD, MPH, C. Scott Brown, MD 10aTranscervical Vocal Fold Injection (In-Office)cSeth M. Cohen MD, MPH aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file10:57bcolor/sound 0 aVocal fold injection (VFI) is a treatment modality applicable to various laryngeal diseases and is successfully used as an alternative to laryngeal framework surgery. The indications for in-office VFI include vocal fold paralysis, paresis, atrophy, and scarring along with their sequelae. This video is a detailed demonstration of office-based VFI in a patient with unilateral vocal fold paralysis (UVFP), which is the most common neurologic disorder affecting the larynx.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/149/transcervical-vocal-fold-injection-(in-office)
02571nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005300103245010600156260004400262300006300306505140500369506003601774538044601810856010902256442Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aRachel M. Schneider, MPH, Nicole B. Cherng, MD 10aLaparoscopic Subtotal Fenestrating Cholecystectomy in a Cirrhotic PatientcRachel M. Schneider, MPH aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file46:26bcolor/sound 0 aIn patients with difficult gallbladders due to anatomy prohibiting a clear critical view of safety, a subtotal cholecystectomy can be considered as a safer alternative to a total cholecystectomy.1, 2, 5 Subtotal cholecystectomies can be divided into “reconstituting” or “fenestrating.” Subtotal reconstituting cholecystectomies include closing off the lower end of the gallbladder to create a remnant gallbladder, while subtotal fenestrating cholecystectomies do not occlude the gallbladder and instead may involve suturing the cystic duct.1 The most common indication for subtotal fenestrating cholecystectomy is inflammation in the hepatocystic triangle, and subtotal fenestrating cholecystectomy has proven to be useful specifically for patients with a history of cirrhosis.1, 2, 6, 7 

This case report describes the performance of a subtotal fenestrating cholecystectomy for the management of acute on chronic cholecystitis in a patient with cirrhosis initially managed with transcystic stent placement endoscopically. Management of this patients omental adhesions to the gallbladder required alterations to typical surgical technique, which will be described in this report. Additionally, we will discuss the indications for subtotal fenestrating cholecystectomy and the benefit of this technique to specific patient populations presenting with acute on chronic cholecystitis.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/442/laparoscopic-subtotal-fenestrating-cholecystectomy-in-a-cirrhotic-patient
02087nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000360010224500650013826000440020330000630024750510180031050600360132853804460136485600710181027Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aPatrick Vavken, MD, Sabah Ali 10aRotator Cuff Repair (Cadaver Shoulder)cPatrick Vavken, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file12:41bcolor/sound 0 aRotator cuff tears represent the vast majority of shoulder disorders treated by orthopaedic surgeons. From partial-thickness tears in overhead throwing athletes to full-thickness tears in the elderly, the prevalence of rotator cuff tears continues to increase over time. While some cases are asymptomatic, most patients with rotator cuff tears report shoulder pain, limited range of motion, and nighttime pain with difficulty sleeping on the affected shoulder. When nonsurgical treatment is insufficient in relieving the symptoms, arthroscopic rotator cuff repair becomes a viable option for many patients. Here we present the case of a rotator cuff repair of a full-thickness tear that extends into the infraspinatus on a cadaver shoulder in the beach chair position. The tear was repaired by placing an anchor, retrieving and passing three suture arms, and tying the suture. We outline the natural history, preoperative care, intraoperative technique, and postoperative considerations of rotator cuff repairs. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/27/rotator-cuff-repair-cadaver-shoulder
02338nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003000103245012500133260004400258300006600302505115300368506003601521538044601557856012902003359Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aKatherine H. Albutt, MD 10aExploratory Laparotomy for Bowel Obstruction with Primary Repair of Two Diaphragmatic HerniascKatherine H. Albutt, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:34:21bcolor/sound 0 aA diaphragmatic hernia (DH) is characterized by protrusion of abdominal organs into the chest cavity through an opening in the diaphragm. A sliding or paraesophageal hernia is the most prevalent type, characterized by its occurrence near the esophageal hiatus. Typically present since birth, it can also develop later in life, occasionally arising as a result of severe trauma or iatrogenic injury. Less often, congenital DHs protrude through posterolateral or substernal diaphragmatic defects, referred to as Bochdalek and Morgagni hernias, respectively.

DH can remain asymptomatic and is commonly detected as an incidental finding during evaluation for other medical issues. Hiatal hernias differ from abdominal wall hernias in that they are influenced by the constant motion of the diaphragm, which exerts continuous friction and pressure changes on the esophagus and the stomach. As a result, hiatal hernias have a higher likelihood of recurrence following surgical correction in comparison to abdominal hernias.

This is the case of an exploratory laparotomy for bowel obstruction and primary pledgeted repair of two diaphragmatic hernias.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/359/exploratory-laparotomy-for-bowel-obstruction-with-primary-repair-of-two-diaphragmatic-hernias
01344nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100005000105245008200155260004400237300006300281505022800344506003600572538044600608856008401054300.5Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aBrandon Buckner, CST, CRCST, Crystal Romero 10aOpening Sterile Surgical Instrument ContainerscBrandon Buckner, CST, CRCST aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file03:53bcolor/sound 0 aWelcome to our Basic Skills for the OR Series!

Complete series includes:

Scalpels
Surgical Sutures
Surgical Staplers
Opening Sterile Surgical Packs
Opening Sterile Surgical Instrument Containers
Laparoscopic Instruments aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/300.5/opening-sterile-surgical-instrument-containers
01739nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100003400105245006600139260004400205300006300249505067100312506003600983538044601019856006801465300.4Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aBrandon Buckner, CST, CRCST 10aOpening Sterile Surgical PackscBrandon Buckner, CST, CRCST aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file05:08bcolor/sound 0 aSurgical site infection (SSI) poses a significant risk to patients undergoing surgery. The prevalence of SSI is influenced by various factors. Within an ideal perioperative environment, exclusively sterile surgical instruments are employed. Care should be taken to thoroughly explore all methods of maintaining a contamination-free operating room (OR) environment. The proper opening of sterile surgical instrument packs has critical importance in maintaining aseptic conditions in the OR. This video demonstrates all the nuances of this process, emphasizing the importance of package integrity checks and adherence to strict protocols for sterile surgical attire. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/300.4/opening-sterile-surgical-packs
02341nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100012800103245013500231260004400366300006300410505103100473506003601504538044601540856014901986411Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aCheryl Yu, MD, Katherine M. Yu, MD, Sarah Debs, MD, Peter Kwak, MD, Kevin J. Quinn, MD, Thomas Lee, MD, FACS, Derek Sheen 10aLocal Tissue Advancement: Reconstructing Superior Helical Rim Defect and Exposed Ear Cartilage After Mohs SurgerycCheryl Yu, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file40:06bcolor/sound 0 aReconstruction of external ear defects often poses various challenges due to the complex anatomy of the ear and its significant role in overall facial aesthetics. The location of the defect independently impacts the repair as various locations present distinct, additional factors to consider during planning. Specifically, defects of the superior auricle complicate the reconstructive process, due to the role of the helical root and superior rim in providing mechanical support for facial accessories such as glasses or hearing aids. The approach to reconstruction must be systematic while also being individually tailored in order to appropriately restore both optimal cosmesis and function.

The featured case involves the reconstruction of a full-thickness superior helix and auricular defect in a patient who wears eyeglasses with a cochlear implant on the same side. The discussion highlights the complexity of superior auricular reconstruction as well as the various surgical options used and challenges encountered. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/411/local-tissue-advancement:-reconstructing-superior-helical-rim-defect-and-exposed-ear-cartilage-after-mohs-surgery
02243nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100002700105245010400132260004400236300006300280505109900343506003601442538044601478856011301924218.2Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aFrancis McGovern, MD 10aCystoscopy and Placement of Ureteral Stents: Preoperative for HIPEC SurgerycFrancis McGovern, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file08:02bcolor/sound 0 aThis video provides a comprehensive overview of the PUS and cystoscopy performed on a patient with advanced metastases of appendiceal cancer who is scheduled for CRS-HIPEC. The video focuses on urethral instrumentation, identification of ureteral orifices, stent placement, and subsequent bladder inspection. The patient's preoperative evaluation had revealed no evidence of ureteral involvement with the tumor. The cystoscopic technique employed in this case allowed the surgeons to visualize the bulbar urethra, sphincter, and prostatic urethra, illustrating the step-by-step process of advancing into the bladder. Next, the vesical trigone is identified, aiding in the visualization of the ureteral orifices. The careful placement of stents into both ureters is demonstrated. No resistance was encountered in the process of stent placement, suggesting no involvement of the ureters with the tumor. A thorough bladder inspection revealed no unusual findings such as abnormal lesions, masses, or other pathology. The stents were secured with silk sutures to prevent inadvertent dislodgement. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/218.2/cystoscopy-and-placement-of-ureteral-stents:-preoperative-for-hipec-surgery
02670nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003000103245011000133260004400243300006300287505151800350506003601868538044601904856011402350358Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aKatherine H. Albutt, MD 10aLaparoscopic-Assisted Percutaneous Endoscopic Gastrostomy (PEG) Tube PlacementcKatherine H. Albutt, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file24:40bcolor/sound 0 aFor long-term enteral nutrition, percutaneous endoscopic gastrostomy (PEG) is considered the standard of care; however, it often leads to a number of complications: tube migration, blockage, inadvertent tube slipping and removal, and less often, perforation. PEG involves insertion of a feeding tube through the skin and into the stomach, with the assistance of endoscopic intraluminal visualization of the stomach. PEG is a blind procedure, making it difficult to detect organs interposed between the stomach and the abdominal wall (e.g., colon, small intestine, greater omentum). To avoid these complications, laparoscopic-assisted PEG (LAPEG) was introduced.

LAPEG tube placement stands out as a minimally invasive surgical intervention that combines the techniques of laparoscopy and endoscopy to establish enteral access for nutritional support. The laparoscopic approach provides visualization for the feeding tube insertion and for approximation of the gastric and abdominal walls. This method proves particularly beneficial for individuals who require long-term enteral feeding while having obstacles with conventional approaches to stomach access due to diverse medical conditions. The merits of this approach extend to reduction in postoperative discomfort, expedited recovery time, and a diminished risk of infection compared to conventional open surgical techniques. Multiple studies have demonstrated a success rate of 100% and no reported postoperative complications with this surgical technique. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/358/laparoscopic-assisted-percutaneous-endoscopic-gastrostomy-(peg)-tube-placement
02555nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100009200103245004800195260004400243300006600287505145200353506003601805538044601841856006202287249Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJelena Ivanis, Andrew Ding, Dennis Barbon, Fabian Laage-Gaupp, MD, Jeffrey Pollak, MD 10aPulmonary AVM EmbolizationcJelena Ivanis aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:11:34bcolor/sound 0 aPulmonary arteriovenous malformations (PAVMs) are rare fistulous connections between pulmonary arteries and veins that, as in our case, are commonly associated with hereditary hemorrhagic telangiectasia (HHT). Embolotherapy, the mainstay of treatment for PAVMs, is a procedure in which the feeding arteries of a malformation are endovascularly occluded under fluoroscopic guidance. Effective and well-tolerated, embolotherapy has been shown to decrease right-to-left shunting following treatment and decrease risks of paradoxical embolization and lung hemorrhage and to improve pulmonary gas exchange and lung function. Patients are selected for treatment according to clinical suspicion for the presence of a PAVM and feeding artery diameter. The occlusion of PAVMs with arteries that exceed 2–3 mm in diameter is recommended.

Diagnostic contrast-enhanced pulmonary angiography is performed via injection of contrast through a percutaneous catheter to characterize and confirm PAVMs suitable for embolization. Lesions are then treated by catheter-directed placement of embolic material— vascular plugs in our case—into the feeding artery, terminating blood flow to the area of the lesion. Although multiple PAVMs may be embolized during a single session, in patients with HHT, who may present with large numbers of PAVMs, treatment is limited by maximum contrast dosage, and additional sessions may be performed if PAVMs remain perfused. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/249/pulmonary-avm-embolization
02535nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100002800105245008000133260004400213300006300257505143900320506003601759538044601795856008802241218.1Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aXiaodong Bao, MD, PhD 10aEpidural at T9-T10: Preoperative for HIPEC SurgerycXiaodong Bao, MD, PhD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file08:12bcolor/sound 0 aHeated Intraperitoneal Chemotherapy (HIPEC) coupled with cytoreduction is increasingly being used to treat isolated peritoneal dissemination of intra-abdominal malignancies. Cytoreductive surgery (CRS) is initially performed using either a conventional open or laparoscopic approach. CRS includes removal of the main tumor, excision of any other visible tumors, peritonectomy, omentectomy, and intestinal resections, if necessary. Following CRS, a chemotherapeutic solution is administered at a temperature of 40 to 41.5°C. Infusing chemotherapy immediately following CRS facilitates a uniform distribution of the solution throughout the entire peritoneal cavity. This strategy prevents localized spread that may arise from postoperative adhesion formation, ensuring that peritoneal surfaces are exposed to a concentrated chemotherapy dose while minimizing systemic toxicity.

This high-risk surgical procedure induces substantial hemodynamic and metabolic changes. Therefore, it requires a careful and detailed approach to the administration of anesthesia. Furthermore, hemodynamic status and cardiac function should be continuously evaluated with advanced hemodynamic monitoring. Besides primary disease and complexity of surgery, it has shown that the type and amount of fluids administered during surgery, possible blood transfusions, and the choice of anesthetic agents directly influence the outcomes experienced by patients. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/218.1/epidural-at-t9-t10:-preoperative-for-hipec-surgery
02531nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000450010224500620014726000440020930000630025350514600031650600360177653804460181285600670225830Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aSteven D. Sartore, Scott D. Martin, MD 10aPortal Placement for Hip ArthroscopycSteven D. Sartore aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file13:24bcolor/sound 0 aHip arthroscopy is a well-established technique that has become a mainstay in the repair of bony and ligamentous injuries when conservative methods fail to return adequate joint mobility and function. The technique has both diagnostic and therapeutic utility and its use as a minimally invasive orthopedic surgery continues to advance. Several studies have suggested that arthroscopic surgical management has more favorable outcomes in certain circumstances when compared to hip-specific conservative measures. The approach to establishing adequate sites for portal placement is dependent upon recognizing the pertinent anatomy of the surgical site.  At the same time, the operator must be mindful of the desired views once access to the joint space has been obtained. Proper visualization of the desired joint region is critical to reducing the conversion of THAs into inherently riskier total joint procedures. Additionally, the neurovascular landscape of the groin presents technical challenges with the procedural approach, which requires significant skill to avoid vital structures in the area. Acetabular labral tears are frequently repaired with this type of operative management as techniques and approaches become more refined. Here, we present the case of a 24-year-old woman who is undergoing an arthroscopic anterior labral repair, highlighting both the anatomical landmarks and the access points for portal placement used in the procedure. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/30/portal-placement-hip-arthroscopy
01505nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004100103245006000144260004400204300006300248505043500311506003600746538044600782856007101228170Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aShoko Kimura, MD, Tatsuo Kawai, MD 10aLeft Laparoscopic Donor NephrectomycShoko Kimura, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file38:35bcolor/sound 0 aOver the past decade, laparoscopic donor nephrectomy has gradually replaced the conventional open approach and has become the standard of care in living donor kidney transplantations. Compared to open nephrectomy, laparoscopic nephrectomy reduces postoperative pain, shortens the length of hospital stay, and improves the cosmetic outcome. The following illustrates our standard technique of pure laparoscopic donor nephrectomy. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/170/left-laparoscopic-donor-nephrectomy
02460nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100008500103245013900188260004400327300006300371505120300434506003601637538044601673856013502119357Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aNathaniel D. Sisterson, MD, MSc, Brian Hsueh, MD, PhD, Katherine H. Albutt, MD 10aEmergent Right Frontal Camino Bolt Placement for Intracranial Pressure Monitoring for a GCS Under 8cNathaniel D. Sisterson, MD, MSc aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file17:42bcolor/sound 0 aIntracranial hypertension is a critical concern in traumatic brain injury (TBI), with elevated intracranial pressure (ICP) significantly impacting patient outcomes.1 ICP monitoring is an essential component in managing patients with various brain pathologies that can lead to dangerously elevated intracranial pressure. In neurosurgical practice, accurate monitoring and timely intervention are critical when dealing with the challenges of intracranial hypertension, and its timely resolution is crucial for preventing severe neurological sequelae and fatal outcomes.

The risk of Infections or hemorrhage of significance associated with ICP devices, which can lead to patient morbidity, usually do not outweigh the benefit of continuous ICP monitoring in TBI. Therefore, these should not deter the decision to monitor ICP.

This video provides step-by-step visual guidance for placing a right frontal Camino bolt to guide optimal patient care. In this clinical case a patient presents without prior opportunity for clinical exam and with reported signs of a cranial hemorrhage, coupled with a right occipital fracture, thereby requiring ICP monitoring to proceed with further neurosurgical care. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/357/emergent-right-frontal-camino-bolt-placement-for-intracranial-pressure-monitoring-for-a-gcs-under-8
02522nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100007500106245006400181260004400245300006300289505140600352506003601758538044601794856007602240299.12Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aStephen Estime, MD, Abdullah Hasan Pratt, MD, Nicholas G. Ludmer, MD 10aAirway Assessment for Trauma PatientscStephen Estime, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file08:43bcolor/sound 0 aAirway injury remains a leading cause of early mortality in patients with trauma. Despite its rarity, direct traumatic airway injury and tracheobronchial injury (TBI) pose significant challenges for emergency clinicians, with an estimated incidence of 0.5–2% among trauma patients. Blunt or penetrating injuries to the head, oropharynx, neck, or upper chest can result in immediate or delayed airway blockage. Trauma can cause airway obstruction by itself or by blood clots, tissue edema, or gastric contents clogging the airway lumen. The added complexity of associated spinal injuries further underscores the need for precise and timely airway assessment.

In the context of trauma patients, a fundamental aspect of care involves prompt airway assessment. The Advanced Trauma Life Support (ATLS) algorithm, a cornerstone in trauma care, outlines a systematic approach focusing on a sequential assessment and management of Airway, Breathing, Circulation, Disability, and Exposure (ABCDE), as part of the initial evaluation of the injured individual. While adapted for battle and disaster environments, the ATLS algorithm consistently emphasizes the timely assessment and treatment of life-threatening airway and breathing issues before shifting focus to circulation problems. Notably, there is no empirical evidence supporting alterations to this sequence in the treatment of non-military trauma. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/299.12/airway-assessment-for-trauma-patients
02657nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100015800103245021300261260004400474300006600518505115900584506003601743538044601779856022602225410Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aCheryl Yu, MD, Sarah Debs, MD, Katherine M. Yu, MD, Alyssa N. Calder, MD, Kevin J. Quinn, MD, Dimitrios Sismanis, MD, Thomas Lee, MD, FACS, Derek Sheen 10aNeuronavigation and Endoscopy as Adjunctive Tools in Orbital Floor Implant Revision: Surgical Management of Infected, Misplaced Orbital Floor Implant with Chronic Eyelid Fistula and SinusitiscCheryl Yu, MD aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file01:49:04bcolor/sound 0 aOrbital floor fractures represent common sequelae of facial trauma that may result in significant functional and aesthetic consequences. This article presents a comprehensive overview of the management of a revision case involving an orbital floor fracture, focusing on complications related to extruded, infected orbital hardware. In addition, common mistakes that involve improper placement of orbital floor implant, poor implant sizing, and lack of adequate implant fixation are discussed.

The featured case involves delayed wound healing and a sino-orbital cutaneous fistula (SOCF) due to infected orbital hardware from a previous orbital floor fracture repair. The discussion centers on preoperative planning, including the choice of surgical approach (transconjunctival with lateral canthotomy) and implant material. Intraoperative neuronavigation was utilized as an adjunctive tool to confirm the position of the newly placed orbital implant. This case provides valuable insight on preventable complications for this procedure, nuances in surgical approach, and uncommon challenges faced by providers who perform operative facial trauma repair. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/410/neuronavigation-and-endoscopy-as-adjunctive-tools-in-orbital-floor-implant-revision:-surgical-management-of-infected-misplaced-orbital-floor-implant-with-chronic-eyelid-fistula-and-sinusitis
01525nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100005000105245005200155260004400207300006300251505046900314506003600783538044600819856005401265300.2Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aBrandon Buckner, CST, CRCST, Crystal Romero 10aSurgical SuturescBrandon Buckner, CST, CRCST aBostonbJournal of Medical Insightc2024 a1 online resource (1 streaming video file05:06bcolor/sound 0 aSurgical sutures, an essential component of wound closure, are designed to facilitate the healing process. Most surgical or traumatic wounds require approximation of the wound edges of some kind. Typically, this is more often performed using sutures, rather than staples or surgical adhesives. Suturing provides a number of advantages, including reduced rates of wound dehiscence and higher resistance to tension compared to alternative methods of approximation. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/300.2/surgical-sutures
02135nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006300103245009100166260004400257300006300301505098500364506003601349538044601385856009801831402Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aLilit Arzumanian, MD, Alexander Martin, OD, John Lee, MD 10aLateral Tarsal Strip Procedure for Left Lower Eyelid EntropioncLilit Arzumanian, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file13:09bcolor/sound 0 aLower lid entropion or inversion is a common involutional inward rotation of the tarsus and eyelid margin. It is caused by a combination of horizontal laxity of the eyelid, attenuation or disinsertion of eyelid retractors, and overriding of preseptal over pretarsal orbicularis muscle fibers. These changes result in the instability of the eyelid with age. The inverted eyelid leads to constant rubbing of eyelashes against the cornea and the globe, causing irritation, foreign body sensation, and in severe cases, corneal erosion, pannus formation, and ulceration. The lateral tarsal strip procedure is aimed at addressing the causes of entropion, thus correcting the eyelid position and improving its function. Upon successful surgical intervention, normal eyelid position and function are restored. Cosmesis of the eyelid also improves. This article will discuss the preoperative assessment of the patient, the preparation, the surgical procedure, and possible complications. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/402/lateral-tarsal-strip-procedure-for-left-lower-eyelid-entropion
02069nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005100103245015300154260004400307300006300351505081000414506003601224538044601260856015701706423Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aKathleen C. Clement, MD, Keaton L. Altom, MD 10aSmall Bowel Obstruction Following Robotic Transabdominal Preperitoneal Ventral Hernia Repair (rTAPP) Due to Barbed SuturecKathleen C. Clement, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file08:54bcolor/sound 0 aBarbed suture is an increasingly popular type of suture used by surgeons across the world. It is an efficient suture that provides several benefits, including better distributed tensile strength, reduced surrounding inflammatory reaction and local tissue hypoxia, and less foreign body exposure. However, there have been a handful of cases of complications with barbed sutures over the past few decades. We present a case of a patient who initially underwent an uncomplicated robotic transabdominal preperitoneal ventral hernia repair (rTAPP) and re-presented postoperative day two with a small bowel obstruction. We demonstrate our operative findings from our return to the operating room with the identification of a barbed suture that had become caught in the mesentery, causing kinking of the bowel. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/423/small-bowel-obstruction-following-robotic-transabdominal-preperitoneal-ventral-hernia-repair-(rtapp)-due-to-barbed-suture
02433nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100003400105245004400139260004400183300006300227505140900290506003601699538044601735856004602181300.1Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aBrandon Buckner, CST, CRCST 10aScalpelscBrandon Buckner, CST, CRCST aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file05:53bcolor/sound 0 aSurgical instruments have a long history, but their modern versions have only been around for a relatively short period of time. The macairion, a surgical knife introduced by Hippocrates, served as the precursor to the modern scalpel, which nevertheless carries a notable similarity to its ancient predecessor.1 

Available in different shapes and sizes for diverse surgeries, contemporary scalpel blades and handles are typically crafted from hardened and tempered steel, stainless steel, and high carbon steel, with blade shapes designed according to their intended use. Recognized as indispensable surgical tools, scalpel blades contribute to precise incisions and minimal scarring, which is particularly crucial in minimally invasive, ophthalmic, cardiovascular, and endoscopic surgeries. Cutting in a firm and controlled way, usually at angles of 30–90 degrees from the tissues, necessitates holding the instrument in various ways, often placing a steadying forefinger along the back of the instrument. The tissue through which the scalpel is incising should also be steadied and put under a slight degree of tension.2

The demonstration of surgical scalpels in this video provides valuable insights into their usage. The handles are available in different designs, serving two functions: fitting the appropriate size of surgical blades and ensuring a firm hold to reduce the chance of slipping aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/300.1/scalpels
02484nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100012400103245016800227260004400395300006300439505111200502506003601614538044601650856018202096412Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aCheryl Yu, MD, Katherine M. Yu, MD, Alyssa N. Calder, MD, Christopher J. Kandl, MD, Thomas Lee, MD, FACS, Derek Sheen 10aIntegra Scalp Reconstruction: Addressing a Full-Thickness Scalp Defect with Exposed Calvarium Along Vertex in an Elderly Immunocompromised PatientcCheryl Yu, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file16:48bcolor/sound 0 aReconstruction of full-thickness scalp defects often poses various challenges depending on the complexity and characteristics of the wound as well as independent patient health factors. Despite a range of reconstructive options ranging from primary closure, adjacent tissue transfer, and autografts to free flap reconstruction, there is no universally adopted decision algorithm.

Integra, an acellular matrix composed of crosslinked bovine collagen and glycosaminoglycan covered by a silicone membrane, is widely used for scalp reconstruction and has been shown to produce excellent functional and cosmetic results.

The featured case involves staged scalp reconstruction utilizing the Integra bilayer matrix wound dressing for an elderly immunocompromised patient presenting with two adjacent full-thickness scalp defects resulting in exposed calvarial bone over the vertex. The discussion centers on determining the most optimal scalp reconstructive option and exploring the treatment algorithm used at our institution. Furthermore, application of Integra for calvarial bone coverage will be discussed. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/412/integra-scalp-reconstruction:-addressing-a-full-thickness-scalp-defect-with-exposed-calvarium-along-vertex-in-an-elderly-immunocompromised-patient
02048nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006900103245004500172260004400217300006300261505098700324506003601311538044601347856004901793222Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDavid M. Kaylie, MD, MS, Adam A. Karkoutli, C. Scott Brown, MD 10aMastoidectomycDavid M. Kaylie, MD, MS aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file10:12bcolor/sound 0 aMastoidectomy involves the removal of bone and air cells contained within the mastoid portion of the temporal bone. Common indications for this procedure include acute mastoiditis, chronic mastoiditis, cholesteatoma, and the presence of tympanic retraction pockets. Mastoidectomy may also be performed as part of other otologic procedures (e.g. cochlear implantation, lateral skull base tumors, labyrinthectomy, etc.) in order to gain access to the middle ear cavity, petrous apex, and cerebellopontine angle. The procedure involves dissecting within the confines of the mastoid cavity, which include the tegmen superiorly, the sigmoid sinus posteriorly, the bony ear canal anteriorly, and the labyrinth medially. Mastoidectomy is traditionally classified as: simple (cortical/Schwartze), radical, and modified radical/Bondys mastoidectomy. The procedure can also be classified based on the preservation of the posterior canal wall: canal wall up (CWU) or canal wall down (CWD).  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/222/mastoidectomy
01881nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002900103245007900132260004400211300006300255505079100318506003601109538044601145856008401591383Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aLauren Beausoleil, CST 10aSurgical Technologist Prepares the OR for a CasecLauren Beausoleil, CST aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file17:13bcolor/sound 0 aEstablishing a sterile field, opening and organizing equipment and supplies, and preparing the operating room (OR) for a case are the foundations for ensuring an environment conducive to a safe and efficient operation. Surgical donning of gown and gloves is an integral component of infection control in the OR. Healthcare professionals must adhere to strict protocols to protect both patient and healthcare worker safety. Proper training, vigilance, and attention to detail are crucial in maintaining a sterile environment before and during surgical procedures. This article explores key considerations for healthcare professionals as they open up surgical equipment, establish and maintain a sterile field, doff and don gowns and gloves, and prepare the OR for a surgical procedure. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/383/surgical-technologist-prepares-the-or-for-a-case
02382nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100008200103245008400185260004400269300006600313505122500379506003601604538044601640856009002086408Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aChloe A. Warehall, MD, Divyansh Agarwal, MD, PhD, Charu Paranjape, MD, FACS 10aRobotic-Assisted Laparoscopic Interval CholecystectomycChloe A. Warehall, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file01:07:42bcolor/sound 0 aAcute cholecystitis occurs when gallstones become impacted in the neck of the gallbladder or cystic duct in approximately 90–95% of cases. Symptoms may include acute right upper quadrant pain, fever, nausea, and emesis often associated with eating. Acute cholecystitis generally has imaging findings of gallbladder wall thickening, edema, gallbladder distension, pericholecystic fluid, and positive sonographic Murphy sign. However, acute cholecystitis is largely a clinical diagnosis of persistent right upper quadrant (RUQ) pain and associated tenderness on palpation of the RUQ in the setting of gallstones. The standard treatment is a cholecystectomy to prevent recurrent cholecystitis or sequelae of gallstones. Timing of the cholecystectomy is dependent on length of symptoms, which reflect the degree of inflammation.  Here we present the case of a 74-year-old male who presented with six days of acute cholecystitis symptoms who was initially managed with antibiotics. After improvement of his pain and no systemic symptoms of infection, he underwent an interval robotic cholecystectomy. This article and the associated video describe the pertinent history, evaluation, and operative steps of the procedure. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/408/robotic-assisted-laparoscopic-interval-cholecystectomy
01914nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100009700106245006300203260004400266300006300310505077300373506003601146538044601182856008001628268.11Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJasmine Beloy, Jaymie Ang Henry, MD, MPH, Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES 10aDrainage of Cystic Mass on First Left ToecJasmine Beloy aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file09:36bcolor/sound 0 aCutaneous cysts are closed, sac-like, or encapsulated structures that may be filled with air, liquid, or semi-solid material, and are generally benign. Many types of cysts can occur in almost any place throughout the body and can form in all ages. They are seen as slow-growing and painless lumps underneath the skin. However, some cysts may be painful if they are particularly large. Treatment depends on several factors including the type of cyst, location, size, and the degree of discomfort caused. Large, symptomatic cysts can be removed surgically, while smaller, asymptomatic cysts can be drained or aspirated. Here, we present the case of a 12-year-old male with a pus-filled cystic mass on his first left toe and discuss surgical management and follow-up.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/268.11/drainage-of-cystic-mass-on-first-left-toe
01835nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006300103245007100166260004400237300006300281505072500344506003601069538044601105856007801551400Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aLilit Arzumanian, MD, Alexander Martin, OD, John Lee, MD 10aBlepharoplasty for Bilateral Upper EyelidscLilit Arzumanian, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file17:42bcolor/sound 0 aUpper blepharoplasty is one of the most commonly performed oculoplastic procedures. It is aimed at correcting the involutional changes of the upper eyelids, characterized by loose, excess eyelid skin (dermatochalasis) and preaponeurotic fat herniation (steatoblepharon) as well as some cases of ptosis. These conditions could result in functional symptoms, such as reduced visual fields, as well as cosmetic concerns and perceived body dysmorphia. In this case, the patient underwent upper blepharoplasty for cosmetic improvement and to remove xanthomatous lesions. This article discusses and demonstrates the preoperative assessment of the patient, the preparation, the surgical technique, and possible complications. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/400/blepharoplasty-for-bilateral-upper-eyelids
02610nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006600103245006200169260004400231300006300275505151700338506003601855538044601891856006702337138Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aOzanan R. Meireles, MD, Julia Saraidaridis, MD, Amir Guindi 10aLaparoscopic Sleeve GastrectomycOzanan R. Meireles, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file33:41bcolor/sound 0 aMorbid obesity is defined as excess weight or body fat to an extent that may have negative effects on health. It increases the risk of developing heart disease, diabetes, hypertension, and obstructive sleep apnea. Excessive food intake and lack of physical activity are thought to explain most cases of obesity; others are associated with genetic disorders, organic diseases, and psychiatric conditions. Obesity is defined as body mass index (BMI) 30 kg/m2 or higher and is further sub-classified into three groups: BMI 30.0 to 34.9 kg/m2 is class I, 35.0 to 39.9 kg/m2 is class II, and greater than or equal to 40 is class III. The goal of obesity treatment is to reach and maintain a healthy weight. The primary treatment consists of diet and physical exercise; however, maintaining weight loss is difficult and requires discipline. Medications such as orlistat, lorcaserin, and liraglutide may be considered as adjuncts to lifestyle modification. One of the most effective treatments for obesity is bariatric surgery. There are several bariatric surgery procedures, including laparoscopic adjustable gastric banding, Roux-en-Y gastric bypass, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch. Sleeve gastrectomy is the most commonly performed bariatric surgery worldwide. It is performed by removing 75% of the stomach, leaving a tube-shaped stomach with limited capacity to accommodate food. Here, we present the case of an obese patient who undergoes laparoscopic sleeve gastrectomy. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/138/laparoscopic-sleeve-gastrectomy
01780nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003200103245014900135260004400284300006300328505055300391506003600944538044600980856014801426417Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDanielle Shibley, BSN, RN 10aFoley Catheter Placement: Indications, Maintenance, Complications, and Demonstration on a Preoperative Male PatientcDanielle Shibley, BSN, RN aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file05:40bcolor/sound 0 aFoley catheterization is a frequently-employed medical procedure to treat urinary retention, aid in bladder drainage/decompression, and facilitate measurement of urine output. This article provides an overview of the indications for Foley catheterization, the steps involved in its insertion, proper care guidelines, and potential complications associated with its use. It is of utmost importance for healthcare practitioners to be comfortable with catheterization procedures to guarantee the comfort, safety, and general welfare of the patients. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/417/foley-catheter-placement:-indications-maintenance-complications-and-demonstration-on-a-preoperative-male-patient
02015nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100011300105245011800218260004400336300006300380505075900443506003601202538044601238856012501684299.9Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aSebastian K. Chung, MD, Ashley Suah, MD, Daven Patel, MD, MPH, Nadim Michael Hafez, MD, Brian Williams, MD 10aExploratory Laparotomy and Splenectomy for Ruptured Spleen Following Blunt Force TraumacSebastian K. Chung, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file56:16bcolor/sound 0 aThe spleen is highly vascular, is the largest secondary lymphoid organ, and is the most commonly injured organ in the setting of blunt abdominal trauma. Patients may present asymptomatically or with abdominal pain, nausea and vomiting, or signs of hemodynamic instability. . Although many splenic injuries caused by blunt abdominal trauma may be managed conservatively, free intra-abdominal fluid with hemodynamic instability warrant surgical management in the form of exploratory laparotomy and splenectomy.

In this video report, we demonstrate the management of a patient who was assaulted, sustaining blunt abdominal trauma and a hemodynamically significant grade IV splenic laceration. Here, we perform an exploratory laparotomy and splenectomy.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/299.9/exploratory-laparotomy-and-splenectomy-for-ruptured-spleen-following-blunt-force-trauma
02336nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100003000105245014300135260004400278300006300322505111400385506003601499538044601535856014901981290.6Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aGeoffrey G. Hallock, MD 10aBasal Cell Carcinoma Excision from the Lower Lip with Versatile Keystone Flap for Vascularized Skin ReplacementcGeoffrey G. Hallock, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file30:10bcolor/sound 0 aMaintenance of intact skin throughout the body is essential to prevent dehydration, to act as a barrier to infection, to allow unrestricted movement, and to provide a normal appearance. A flap is a piece of body tissue, usually skin and fat, that always has its own blood supply. Therefore, a flap can be moved anywhere it can reach without worrying about the circulation present at the place that needs it, which is called the recipient site. When compared with all other possible choices, a flap best meets all the requirements for any area needing skin replacement. The keystone type flap as one such option is so named because its design has the shape of the keystone of a Roman arch. If taken from loose tissues adjacent to a defect, it can be simply cut and advanced for any necessary skin coverage. Direct closure of the donor site where this flap comes from is possible so that usually a quite good overall cosmetic result is also obtained. These virtues are shown as an overview in this video where a keystone flap is transferred after removal of a common basal cell skin cancer from the lower lip. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/290.6/basal-cell-carcinoma-excision-from-the-lower-lip-with-versatile-keystone-flap-for-vascularized-skin-replacement
01878nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005000103245011300153260004400266300006300310505071200373506003601085538044601121856010501567119Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aIkechukwu C. Amakiri, Michael J. Weaver, MD 10aOpen Reduction and Internal Fixation of a Diaphyseal Periprosthetic Humeral FracturecIkechukwu C. Amakiri aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file56:48bcolor/sound 0 aPeriprosthetic humeral shaft fractures are increasing in incidence as shoulder replacements become more common. Surgical management of humeral shaft fractures can only be deemed appropriate when the degree of pain, the extent of disability, and the number of comorbid conditions are taken into consideration. Among trauma surgeons there exists no preferred surgical approach to fractures of different segments of the humerus; however, the anterolateral approach to midshaft fractures is the most common although viable alternative approaches exist. In this case, we perform an open reduction and internal fixation of a diaphyseal periprosthetic humeral fracture with a posterior triceps sparing approach.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/119/open-reduction-and-internal-fixation-of-a-diaphyseal-humeral-fracture
01538nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100009300106245009000199260004400289300006300333505035100396506003600747538044600783856010301229290.13Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aSudhir B. Rao, MD, Mark N. Perlmutter, MS, MD, FICS, FAANOS, Arya S. Rao, Grant Darner 10aBone Graft for Nonunion of Right Thumb Proximal Phalanx FracturecSudhir B. Rao, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file38:17bcolor/sound 0 aIn this video, we describe a surgical technique for the treatment of an unstable nonunion of a proximal phalangeal fracture of the thumb. The video describes the surgical exposure, preparation of the nonunion site, harvesting of autogenous iliac corticocancellous bone graft, bone grafting of the defect, and stabilization with K-wire fixation. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/290.13/bone-graft-for-nonunion-of-right-thumb-proximal-phalanx-fracture
01621nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005600103245004300159260004400202300006300246505057200309506003600881538044600917856005201363178Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aC. Scott Brown, MD, Calhoun D. Cunningham III, MD 10aCochlear ImplantcC. Scott Brown, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file46:32bcolor/sound 0 aFor patients who present with bilateral severe-to-profound sensorineural hearing loss who have little-to-no benefit from conventional hearing aids, cochlear implants can restore hearing by directly stimulating the cochlear nerve. A standard mastoidectomy and facial recess approach is performed to visualize the round window niche and membrane. The round window membrane is opened, and the cochlear implant electrode is carefully inserted into the scala tympani. After several weeks, the patient returns for implant activation with a dedicated team of audiologists. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/178/cochlear-implant
02436nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100006000106245006400166260004400230300006300274505132800337506003601665538044601701856008302147290.12Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJake Mesiti, Yoko Young Sang, MD, Peter F. Rovito, MD 10aOpen Cholecystectomy for Gallbladder DiseasecJake Mesiti aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file30:21bcolor/sound 0 aGallbladder diseases are a subset of a spectrum of pathologies of the biliary system and are a particularly common etiology of abdominal pain encountered in modern medicine. These pathologies most often share a similar underlying mechanism of disease: obstruction of a portion of the biliary tree by cholelithiasis, or gallstones. Gallstones are initially formed in the gallbladder. Risk factors include a wide variety of conditions both pathologic and physiologic, including hyperlipidemia, hemolysis, and pregnancy. The resulting obstruction creates a state of biliary stasis, eventually leading to inflammation, pain, and an increased risk of infection. The anatomical location of the obstruction contributes greatly to both the clinical presentation and the ultimate treatment of the disease. A hallmark of the treatment of gallbladder disease, ranging from simple biliary colic to life-threatening emphysematous cholecystitis, is the cholecystectomy. In modernized countries, this procedure is almost invariably performed laparoscopically. However, in certain clinical scenarios, such as when a patient cannot tolerate the pneumoperitoneum associated with laparoscopic surgery or when the procedure takes place in a developing country with limited access to laparoscopic capabilities, an open approach is preferred.
 aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/290.12/open-cholecystectomy-for-gallbladder-disease
02787nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004400103245008200147260004400229300006300273505167200336506003602008538044602044856009102490125Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJoshua M. Harkins , David Rattner, MD 10aLaparoscopic Right Colectomy with Ileocolic AnastomosiscJoshua M. Harkins  aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file39:24bcolor/sound 0 aColonic polyps are projections from the surface of the colonic mucosa. Most are asymptomatic and benign. Over time, some colonic polyps develop into cancers. Colorectal polyps are classified as non-neoplastic and neoplastic. Non-neoplastic polyps include hyperplastic, inflammatory, and hamartomatous polyps. They are typically harmless and do not become cancerous. Neoplastic polyps include adenomas and serrated polyps. They are premalignant lesions that may progress to colon cancer over time. In general, the larger the polyp, the greater the risk of cancer, especially with neoplastic polyps. Polyps are diagnosed using colonoscopy and are removed via polypectomy if they are small and pedunculated. If the polyps are too large or cannot be removed safely, they may be removed by colonic resection.
Carcinoid tumors develop from cells in the submucosa. They are slow-growing neoplasms. Carcinoid tumors of the colon are rare, comprising less than 11% of all carcinoid tumors and only 1% of colonic neoplasms. The majority of patients diagnosed with carcinoid tumors have no symptoms, and their tumors are found incidentally during endoscopy. Treatment of these tumors depends on the size, location, and presence of metastatic disease. Tumors less than 1 cm can often be excised locally either by endoscopy or for rectal lesions via a transanal approach. Carcinoid tumors larger than 2 cm require formal oncologic resection.
Here we present a middle-aged male who had an unresectable polyp in the ascending colon and a carcinoid tumor in the ileocecal valve. The patient underwent laparoscopic right colectomy with ileocolic anastomosis to remove both lesions.
 aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/125/laparoscopic-right-colectomy-with-ileocolic-anastomosis
01749nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005600103245007200159260004400231300006300275505064000338506003600978538044601014856008301460207Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aCiro Andolfi, MD, Marco Fisichella, MD, MBA, FACS 10aLaparoscopic Cecal Wedge Resection AppendectomycCiro Andolfi, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file33:47bcolor/sound 0 aThis is the case of a 66-year-old man with a history of colon polyps, who undergoes colonoscopy every 3 years for surveillance. During the last colonoscopy, he was found to have a polyp at the appendiceal orifice. The biopsy showed the presence of adenoma. Therefore, the patient underwent a laparoscopic appendectomy with wedge resection of the cecum. The operation went well and took less than an hour. We opened the specimen and found the adenoma within the lumen of the appendix, with at least 1.5 cm of clear margin. The patient was sent home the same day, and resumed regular diet and physical activities the following morning. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/207/laparoscopic-cecal-wedge-resection-appendectomy
01911nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100005800105245011200163260004400275300006600319505071100385506003601096538044601132856012701578299.8Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMatthew Daniel, Ashley Suah, MD, Brian Williams, MD 10aExploratory Laparotomy in a Hemodynamically Stable Patient for an Abdominal Gunshot WoundcMatthew Daniel aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file01:14:36bcolor/sound 0 aGunshot wounds to the abdomen are one of the most classic trauma cases a surgeon will come across in their career. The high velocity of a bullet can cause massive internal and external trauma to the abdomen. Exploration of the small bowel using laparotomy is often indicated after a penetrating traumatic injury or when peritoneal signs are present. This video article shows the most common techniques for performing an exploratory laparotomy. In this case, the abdomen was explored and was revealed to show a through-and-through gunshot wound to the jejunum, as well as a partial-thickness tear of the proximal cecum; the abdomen was explored for any smaller bleeds or leaks, and the abdomen was closed. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/299.8/exploratory-laparotomy-in-a-hemodynamically-stable-patient-for-an-abdominal-gunshot-wound
02089nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100007900103245008600182260004400268300006300312505092300375506003601298538044601334856010301780270Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJohn Grove, Naomi Sell, MD, Thomas O'Donnell, MD, Noelle N. Saillant, MD 10aLaparoscopic Interval Appendectomy and Open Umbilical Hernia RepaircJohn Grove aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file10:34bcolor/sound 0 aAcute appendicitis is a medical condition where the appendix becomes inflamed and causes pain in the lower right quadrant of the abdomen. In addition to pain, appendicitis can cause peritonitis, perforations, and can lead to death if left untreated. Laparoscopic appendectomy is the standard surgical procedure to treat the symptoms of appendicitis as well as prevent further spread of infection. While appendicitis typically advances in an irreversible fashion necessitating surgery, conservative management with antibiotic therapy can sometimes resolve symptoms. In this case, a 24-year-old patient had a delayed presentation with acute perforated appendicitis. Following successful non-operative treatment with antibiotics, she presented for a laparoscopic interval appendectomy. She also had a non-symptomatic umbilical hernia, which was repaired following removal of the laparoscopic ports for the appendectomy. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/270/laparoscopic-interval-appendectomy-and-open-umbilical-hernia-repair
02210nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005100103245014500154260004400299300006300343505096500406506003601371538044601407856015101853100Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aRobert W. Burk IV, MS, Michael J. Weaver, MD 10aClosed Cephalomedullary Nail Fixation of a Reverse Oblique Subtrochanteric Femoral Fracture in the Lateral PositioncRobert W. Burk IV, MS aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file26:13bcolor/sound 0 aSubtrochanteric femoral fractures commonly present in two different populations under very different circumstances. The elderly are commonly affected by low-energy events, such as a simple fall to the floor, while younger populations are more likely to be involved in high-energy events such as motor vehicle accidents. The majority of elderly injuries can be attributed to fragility fractures due to loss of bone density, but it is important to note an atypical fracture pattern that is present in those who have been taking bisphosphonates. This video demonstrates an intramedullary fixation of a reverse oblique trochanteric femoral fracture in the lateral position. There is a classic deformity seen in subtrochanteric fractures due to strong muscular attachments in the region. In this video, we show that while the lateral position may be more difficult for obtaining x-rays, it provides natural external forces that make reduction and fixation easier. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/100/closed-cephalomedullary-nail-fixation-of-a-reverse-oblique-subtrochanteric-femoral-fracture-in-the-lateral-position
03327nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006800103245013400171260004400305300006300349505208400412506003602496538044602532856014302978365Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMardi R. Karin, MD, Arash Momeni, MD, Candice N. Thompson, MD 10aInternal Mammary Perforator Preserving Nipple-Sparing Mastectomy (IMP-NSM) to Reduce Ischemic ComplicationscMardi R. Karin, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file20:16bcolor/sound 0 aNipple-Sparing Mastectomies (NSMs) with breast reconstruction are commonly performed for both breast cancer treatment or risk-reducing prophylactic mastectomies and have superior aesthetic results compared to total mastectomy or skin-sparing mastectomy. Preservation of the Nipple Areolar Complex (NAC) results in a more natural aesthetic appearance of the reconstructed breast, as well as greater patient satisfaction, as indicated by improved psychosocial and sexual well-being compared to total mastectomy. Preservation of vascular supply is of utmost importance for NAC and mastectomy skin flap viability after surgery, since postoperative ischemic complications can significantly undermine the aesthetic outcomes.

This report describes a contemporary NSM surgical technique developed by the senior author (MK), to preserve the dominant NAC vascular supply, and decrease postoperative ischemic complications. A total of 114 NSM were performed from 2018 to 2020 by the senior author. Based on preoperative breast MRI with contrast visualization of the vascular supply to the NAC, the Internal Mammary Perforator (IMP) vessels exiting the pectoralis major muscle at the sternal border were found to provide the dominant blood supply to the NAC in 92% and could be preserved in 89% of cases.

The Internal Mammary Perforator Preserving Nipple-Sparing Mastectomy (IMP-NSM) surgical technique was developed to preserve this important IMP blood supply to the NAC, resulting in decreased postoperative ischemic complications. Following implementation of this surgical technique, NAC necrosis requiring NAC removal occurred in 0.9%, and mastectomy skin necrosis requiring reoperation in 1.8% of cases, resulting in successful NAC preservation in the majority of patients. Furthermore, due to the consistent anatomical location of the IMP vascular supply to the NAC, this critical vascular supply can routinely be preserved even without preoperative MRI, thereby improving clinical outcomes. The IMP-NSM surgical technique is described in detail in this report with a case example. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/365/internal-mammary-perforator-preserving-nipple-sparing-mastectomy-(imp-nsm)-to-reduce-ischemic-complications
02137nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000470010224500770014926000440022630000630027050510320033350600360136553804460140185600840184787Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDerek J. Erstad, MD, David L. Berger, MD 10aLaparoscopic Sigmoid Resection for DiverticulitiscDerek J. Erstad, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file40:42bcolor/sound 0 aLaparoscopic sigmoid resection is indicated for disease of the distal sigmoid or rectum that requires resection, most notably diverticulitis and colorectal cancer. Here, we perform an sigmoid resection for diverticular disease. In this procedure, we used four laparoscopic port sites. In the first step, we mobilized the splenic flexure and left colon to allow for a tension-free colorectal anastomosis low in the pelvis. Second, the mesorectum was dissected to mobilize the rectum down to the level of the pelvic floor. Third, the left colic and inferior mesenteric arteries were ligated, the colonic mesentery was transected with an energy device, and the distal resection margin was stapled intracorporeally. Fourth, the specimen was extracorporealized through the umbilical port site, and the proximal transection was performed. Finally, an anvil was inserted, and the colon was placed back into the abdomen where a trans-anal, stapled end-to-side Baker-type anastomosis was performed and endoscopically tested for leaks. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/87/laparoscopic-sigmoid-resection-for-diverticulitis
02283nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005600103245008200159260004400241300006300285505116400348506003601512538044601548856008301994171Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMaggie L. Westfal, MD, MPH, Nahel Elias, MD, FACS 10aRecipient Kidney Transplant from a Living DonorcMaggie L. Westfal, MD, MPH aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file54:55bcolor/sound 0 aEnd stage renal disease (ESRD) is the final stage in the progression of chronic kidney disease (CKD). CKD has a multitude of etiologies, presents in a variety of ways, and progresses in a patient-dependent manner. Despite the heterogeneity of CKD, once ESRD ensues, patients require Renal Replacement Therapy (RRT). RRT is one of three prongs: hemodialysis, peritoneal dialysis, or kidney transplant. Of these, kidney transplantation provides the patient with the best quality of life, an improved survival, and an opportunity for cure. However, the success of kidney transplantation with improved outcomes and tolerance to the required immunosuppression has led to an extreme organ shortage despite the increase in deceased organ donors. As a result, the push for living donors has become increasingly more important. For recipients, the best outcomes are with transplants from a living donor due to superior graft quality and elimination of the need for waiting and dialysis. This article will present such a case and discuss the important considerations a physician must make preoperatively and intraoperatively when performing kidney transplantations.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/171/recipient-kidney-transplant-from-a-living-donor
02172nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006600103245008600169260004400255300006300299505102800362506003601390538044601426856009401872422Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJonathan Durgin, MD, Emily Mackey, MD, Nicole B. Cherng, MD 10aRobotic Heineke-Mikulicz Pyloroplasty for Pyloric StenosiscJonathan Durgin, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file28:05bcolor/sound 0 aPyloric stenosis resulting in gastric outlet obstruction can present with nausea, vomiting, and early satiety. Imaging including fluoroscopic upper gastrointestinal series and computed tomography can diagnose gastric outlet obstruction. Upper endoscopy is included in the work-up to visualize the extent of stenosis and to obtain a tissue biopsy. After a malignancy is ruled out, treatment involves management of underlying causes. This may include acid suppression, treatment of H. pylori, and dietary modification. Patients who fail conservative management may benefit from endoscopic therapies including pneumatic dilation and botulinum toxin injection. However, these therapies may not offer lasting symptomatic relief. Pyloroplasty can be performed with the goal of widening the pylorus to improve gastric emptying. Pyloroplasty can be accomplished through open, laparoscopic, and robotic techniques. Here we describe a robotic-assisted Heineke-Mikulicz pyloroplasty in an adult patient with benign pyloric stenosis. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/422/robotic-heineke-mikulicz-pyloroplasty-for-pyloric-stenosis
01888nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005100103245008700154260004400241300006600285505075800351506003601109538044601145856009101591285Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aKatherine H. Albutt, MD, Peter Fagenholz, MD 10aRives-Stoppa Retromuscular Repair for Incisional HerniacKatherine H. Albutt, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file01:59:54bcolor/sound 0 aThere is no consensus on the optimal method of ventral hernia repair, and the choice of techniques is typically dictated by a combination of patient factors and surgeon expertise. Component separation techniques allow medial advancement of the rectus abdominis muscle to create a midline tension-free fascial closure. In this case, we describe a posterior component separation with retrorectus mesh placement, also known as a Rives-Stoppa retromuscular repair. With low morbidity and mortality, this technique provides a durable repair with low rates of recurrence and surgical site infection while providing dynamic muscle support and physiologic tension, preventing eventration, and allowing incorporation of mesh into the existing abdominal wall.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/285/rives-stoppa-retromuscular-repair-for-incisional-hernia
02196nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100008500103245005400188260004400242300006600286505108700352506003601439538044601475856006901921236Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aPaul Irons, Dennis Barbon, Fabian Laage-Gaupp, MD, Rajasekhara R. Ayyagari, MD 10aProstatic Artery Embolization (PAE)cPaul Irons aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file01:23:36bcolor/sound 0 aBenign prostatic hyperplasia (BPH) is a common condition affecting the majority of men over 60 years of age. BPH incidence increases with age and often leads to lower urinary tract symptoms including frequency, urgency, and straining. In patients that do not respond to pharmacological therapy, options include transurethral procedures such as transurethral resection (TURP) or photovaporization, surgical prostatectomy, and prostate artery embolization (PAE).

The goal of PAE is to occlude arterial supply to the prostate by selective catheterization and subsequent embolization, most commonly with spherical tris-acryl gelatin microspheres. Over weeks to months, reduced blood flow leads to necrosis of prostatic adenomatous tissue, resulting in reduction of prostate size and decreased urethral impingement, eventually allowing for long-term resolution of symptoms in a majority of patients. Advantages of this technique compared with the standard surgical option, TURP, include faster recovery times, fewer side effects, and lower complication rates with near equal efficacy. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/236/prostatic-artery-embolization-pae
02375nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100008300103245005400186260004400240300006300284505127600347506003601623538044601659856006402105246Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aRussel Kahmke, MD, Adam Honeybrook, MBBS, Clayton Wyland, C. Scott Brown, MD 10aHypoglossal Nerve StimulatorcRussel Kahmke, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file48:44bcolor/sound 0 aObstructive sleep apnea (OSA) is a common condition with several effective treatment strategies centered around relieving airway obstruction. The gold standard for OSA treatment remains continuous positive airway pressure (CPAP), but other options exist. A recent therapy developed within the past decade utilizes hypoglossal nerve stimulation (HGNS) through a surgically implanted device. As the patient inspires, the device sends an electrical impulse similar to a cardiac pacemaker. The impulse activates targeted branches of the hypoglossal nerve, leading to stimulation of muscles that protrude the tongue and open the airway posteriorly. This mechanism has been shown to reduce airway obstruction by activating these muscles during inspiration. Along with detailing the chronological order of events, this case outlines various complex anatomical structures that are identified in order to safely and effectively implant the hypoglossal nerve stimulator. Please note that an update device and surgical procedure have since been developed, and that this specific video article addresses the original device and surgical technique. The updated procedure is an FDA-approved alternative to this 3-incision technique, where the device is implanted through 2 incisions. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/246/hypoglossal-nerve-stimulator
01842nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100006600105245007600171260004400247300006300291505072000354506003601074538044601110856008001556278.3Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aLiborio "Jun" Soledad, MD, Enrico Jayma, MD, Ted Carpio, MD 10aOpen Cholecystectomy for Gallstone DiseasecLiborio "Jun" Soledad, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file40:49bcolor/sound 0 aGallstone disease is one of the most common disorders affecting the digestive tract. Most individuals with gallstones are asymptomatic and do not require treatment. For symptomatic patients, however, cholecystectomy is recommended. Cholecystectomy is one of the most common abdominal surgeries performed worldwide. Indications include moderate-to-severe symptoms, stones obstructing the bile duct, gallbladder inflammation, large gallbladder polyps, and pancreatic inflammation due to gallstones. Here, we report the case of a 53-year-old male with stones in his biliary duct. Despite having uncomplicated disease, the patient was treated with a primary open cholecystectomy because laparoscopy was not available. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/278.3/open-cholecystectomy-for-gallstone-disease
02023nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100007400103245005800177260004400235300006300279505091800342506003601260538044601296856007501742334Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aEvan Bloom, Amir R. Kachooei, MD, PhD, Asif M. Ilyas, MD, MBA, FACS 10aThumb Extensor Tendon Laceration RepaircEvan Bloom aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file05:55bcolor/sound 0 aThis case consists of repairing an extensor tendon laceration of a thumb. Extensor tendon lacerations are one of the most common soft tissue injuries of the hand. Surgical repair of the tendon was offered, and the operation was performed using wide-awake local anesthesia no tourniquet (WALANT) technique. Intraoperatively, a complete laceration of the extensor tendon was confirmed repaired using a modified Kessler technique and reinforced with an epitendinous repair. Before closure, the patient tested competency of the repair with confirmation of restoration with the active extension to ensure proper function. The patient was placed in a reverse thumb spica splint following wound closure. Postoperatively, the patient was immobilized in full thumb extension for approximately two weeks and then converted to a removable splint and prescribed supervised hand therapy for a total recovery of 8–12 weeks. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/334/thumb-extensor-tendon-laceration-repair
01941nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100006700106245003400173260004400207300006300251505088500314506003601199538044601235856005401681268.18Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJohn Grove, Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES 10aLipoma ExcisioncJohn Grove aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file16:41bcolor/sound 0 aLipomas 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. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/268.18/lipoma-excision
02481nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005300103245011100156260004400267300006300311505130100374506003601675538044601711856011802157370Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJennifer Shearer, MD, Brooke Gurland, MD, FACS 10aAnal Examination Under Anesthesia with Abscess Drainage and Evaluation for FistulacJennifer Shearer, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file17:06bcolor/sound 0 aAnorectal abscesses most commonly result from obstruction of glandular crypts in the anorectal canal. Abscesses are commonly diagnosed by clinical exam with fluctuance, induration, and tenderness around the perianal tissue. Abscesses are managed with incision and drainage. For superficial perianal abscesses bedside lancing can be performed, but for more complex or ischiorectal or postanal abscess, examination under anesthesia in the operating room is preferred. Complete evacuation of the abscess with breakdown of loculated abscess pockets is critical to fully control the infection. Drains may also be left in a deep abscess pocket to prevent the skin prematurely closing before the cavity has healed. Imaging is selectively performed with CT or MRI to identify occult infections or further identify proximal extent of abscess cavity or associated fistula. For recurrent abscesses, associated fistula tracts should also be identified and, if possible, treated intraoperatively. Antibiotics are utilized for patients with cellulitis or those who are immunosuppressed. We present an adult male with recurrent anorectal abscesses with a new anterior abscess collection, which was managed with anal exam under anesthesia with incision and drainage of abscess collection and drain placement.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/370/anal-examination-under-anesthesia-with-abscess-drainage-and-evaluation-for-fistula
02713nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005300103245010800156260004400264300006300308505153900371506003601910538044601946856011502392371Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJennifer Shearer, MD, Brooke Gurland, MD, FACS 10aAnal Examination Under Anesthesia and Botox Injection for Chronic Anal FissurescJennifer Shearer, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file18:00bcolor/sound 0 aMost individuals associate anal pain with hemorrhoids. However, there are many conditions that can cause anal pain and bleeding, and physical examination helps to differentiate between these diagnoses: anal fissures, hemorrhoids, or infections. An anal fissure is a superficial tear in the anoderm. Fissures are diagnosed clinically by history and physical exam with careful spreading of the anus and direct visualization of a break in the mucosa and exposed sphincter fibers. Increased tone of the internal anal sphincter can inhibit fissure healing by decreasing blood flow to the mucosa. Conservative management includes stool softeners and warm sitz baths to avoid traumatizing the fissure with hard stools and relaxing the sphincters with warm water. Topical nitrates or calcium channel blockers applied at the anal verge dilate and relax the internal sphincter muscle to promote healing. Alternatively, injection of Onobotulinumtoxin A into the fissure and intersphincteric groove paralyzes sphincter muscle, decreasing muscle spasm and supporting healing of the fissure. For individuals who fail these conservative therapies, lateral internal sphincterotomy is considered. This procedure involves dividing the internal sphincter muscles but carries a small risk of fecal incontinence. We present the case of young adult male with a history of a chronic anal fissure, who failed medical management. Posterior anal fissure was appreciated on exam and treated with Onobotulinumtoxin A injection for relaxation of anal sphincter. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/371/anal-examination-under-anesthesia-and-botox-injection-for-chronic-anal-fissures
02678nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004600103245014300149260004400292300006600336505143600402506003601838538044601874856015202320342Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aPrabh R. Pannu, MD, David L. Berger, MD 10aLaparoscopic Low Anterior Resection with Diverting Loop Ileostomy for Rectal Cancer with Conversion to Open ApproachcPrabh R. Pannu, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file01:04:20bcolor/sound 0 aLaparoscopic low anterior resection (LAR) is a complex surgical procedure used for resecting the distal sigmoid colon or rectum while preserving sphincter function. The patient is a 37-year-old, obese male with rectal cancer. Abdominal access is gained through four laparoscopic port sites. The omentum is freed from the transverse colon to enter the lesser sac. The splenic flexure and descending colon are mobilized from the retroperitoneum. The left colic artery is identified and divided. Following proximal mobilization, the dissection is carried towards the pelvis. The sigmoid colon is mobilized, and the presacral space is entered. The inferior mesenteric artery is divided between clips. The dissection in this case could not be carried down low enough in a laparoscopic fashion, and a lower midline incision was made. A suitable area on the descending colon is identified and the marginal artery divided. The proximal bowel is then divided with a stapler. A flexible colonoscope is then used to confirm tumor location and the rectum is divided below the tumor. Finally, a Baker type side-to-end anastomosis is performed with a powered EEA stapler, and its integrity verified endoscopically under water. A diverting loop ileostomy is then created at a previously marked site and the abdomen closed. In this video, we demonstrate the surgical steps of this procedure and provide insight into our intraoperative decisions. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/342/laparoscopic-low-anterior-resection-with-diverting-loop-ileostomy-for-rectal-cancer-with-conversion-to-open-approach
02313nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100008900103245015300192260004400345300006600389505101800455506003601473538044601509856015201955399Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aHannah A. Bougleux Gomes, MD, Divyansh Agarwal, MD, PhD, Charu Paranjape, MD, FACS 10aRobotic-Assisted Laparoscopic Paraesophageal Hiatal Hernia Repair with Fundoplication and EsophagogastroduodenoscopycHannah A. Bougleux Gomes, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file01:12:46bcolor/sound 0 aA hiatal hernia occurs when part of an intra-abdominal organ, most commonly the stomach, migrates through the diaphragmatic crura. The condition can cause a range of uncomfortable symptoms, including heartburn, chest pain, and difficulty swallowing. While several individuals with a hiatal hernia can manage their symptoms with lifestyle changes and anti-reflux medications, some with refractory symptoms or complications secondary to the hernia require surgical treatment to repair the defect. Here we present the case of a 60-year-old female with a paraoesophageal hiatal hernia and chronic gastrointestinal reflux disease (GERD) refractory to proton-pump inhibitors (PPI), dietary changes, and lifestyle modifications. She underwent an elective robotic hiatal hernia repair, fundoplication, and esophagogastroduodenoscopy (EGD) as a two-hour procedure with routine postprocedure recovery. This article and the associated video describe the pertinent history, evaluation, and operative steps of the procedure. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/399/robotic-assisted-laparoscopic-paraesophageal-hiatal-hernia-repair-with-fundoplication-and-esophagogastroduodenoscopy
01795nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000260010224500890012826000440021730000630026150506870032450600360101153804460104785600960149314Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aScott D. Martin, MD 10aHip Arthroscopy with Acetabular Osteoplasty and Labral RepaircScott D. Martin, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file22:41bcolor/sound 0 aHip arthroscopy with femoral neck or acetabular osteoplasty with or without labral repair can be used for treatment of femoroacetabular impingement (FAI). Patients may present with insidious onset of hip pain and mechanical symptoms and pain worse with activity and sitting. On physical exam hip flexion and internal rotation may be reduced and anterior impingement testing will produce groin pain in the majority of patients with FAI. Imaging may demonstrate lesions responsible for cam-type or pincer-type impingement, and MRI may demonstrate labral tear or cartilaginous lesions. Arthroscopic surgical treatment is indicated for patients who have failed conservative treatment. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/14/hip-arthroscopy-with-acetabular-osteoplasty-and-labral-repair
02937nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100007500105245004300180260004400223300006300267505186500330506003602195538044602231856005402677278.1Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aM. Grant Liska, BS, Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES 10aAnal FistulotomycM. Grant Liska, BS aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file10:20bcolor/sound 0 aFistula-in-ano is a chronic abnormal communication between the anal canal and, usually, the perianal skin. It can be described as a hollow tract that is lined with granulation tissue and connects a primary opening inside the anal canal to a secondary opening in the perianal skin. It usually originates from the anal glands and is frequently the result of a previous anal abscess. Anal fistulae present with pain, swelling, pruritus, skin irritation, and purulent or bloody drainage. Most anal fistulae are diagnosed based on clinical findings, but complex and deep anal fistulae usually require imaging studies such as CT scan or MRI to delineate the tract. Fistulae are categorized based on their relationship to the anal sphincter complex. An intersphincteric fistula tracks through the distal internal sphincter and intersphincteric space to an external opening near the anal verge. A trans-sphincteric fistula extends through both the internal and external sphincters. A suprasphincteric fistula originates in the intersphincteric plane and tracks up and around the entire external sphincter. An extrasphincteric fistula originates in the rectal wall and tracks around both sphincters to exit laterally, usually in the ischiorectal fossa. Currently, there is no medical treatment available and surgery is almost always necessary. A simple intersphincteric fistula can often be treated with fistulotomy or fistulectomy, while trans-sphincteric and suprasphincteric fistulae are treated by placement of a seton to maintain drainage and induce fibrosis. Extrasphincteric fistula treatment depends on the anatomy and etiology of the fistula. We present the case of a 1-year-old male with a history of recurrent perianal infection, which led to the development of an anal fistula. The anal fistula was noted to be superficial and a fistulotomy was performed. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/278.1/anal-fistulotomy
02641nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004600103245012000149260004400269300006600313505144500379506003601824538044601860856012902306341Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aPrabh R. Pannu, MD, David L. Berger, MD 10aAnterior Component Separation for Multiple Incisional Hernias Along an Upper Midline IncisioncPrabh R. Pannu, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file01:00:29bcolor/sound 0 aAnterior component separation is an abdominal wall reconstruction technique used in the repair of ventral wall defects to avoid the use of prosthetic mesh. The procedure releases the external oblique fascia to provide a tension-free midline approximation. The patient is a 72-year-old, obese female who has multiple large incisional hernias along an upper midline incision. An anterior component separation technique is used to repair the defect. An incision is made over the previous abdominal scar. The dissection is carried down to the hernia sac. The hernia sac is then separated from the surrounding tissue to identify the fascial edges. The hernia sacs are removed from the fascia. Surrounding adhesions are lysed. A colotomy occurred, which was repaired in two layers: the outer layer with interrupted 3-0 silk suture, and the inner layer with running 3-0 Vicryl suture. The fascial incision is extended to ensure complete removal of the hernia sacs along with completion of adhesiolysis. Bilateral subcutaneous flaps separating the subcutaneous fascia from the external oblique fascia are developed. Perforating vessels are ligated with 2-0 or 3-0 silk. The dissection is carried laterally to the anterior axillary line. The external oblique fascia is released bilaterally using electrocautery. The midline defect is then closed with running #1 Prolene. After achieving hemostasis, two drains are placed, and the skin is closed.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/341/anterior-component-separation-for-multiple-incisional-hernias-along-an-upper-midline-incision
01893nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100008900103245008200192260004400274300006300318505074000381506003601121538044601157856008401603335Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aHarish S. Appiakannan, BS, Amir R. Kachooei, MD, PhD, Asif M. Ilyas, MD, MBA, FACS 10aBiceps Tenodesis for Distal Biceps Tendon RepaircHarish S. Appiakannan, BS aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file16:39bcolor/sound 0 aThe annual incidence of distal biceps tendon ruptures is 1.5 per 10,000 per year. In 93% of cases, men aged 30–59 are involved, mainly in the dominant extremity. Distal biceps tendon ruptures can result in loss of supination and elbow flexion strength, for which surgical repair is often indicated to restore preinjury level of functionality. The distal biceps tendon can be repaired via single- or double-incision techniques using several associated implants, including endobuttons, suture anchors, or interference screws. Here, we present the case of a middle-aged male presenting with an acute distal biceps tendon rupture. The tendon was repaired via a single-incision technique using an endobutton and an interference screw.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/335/biceps-tenodesis-for-distal-biceps-tendon-repair
01790nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100007500106245005000181260004400231300006300275505070200338506003601040538044601076856006201522268.19Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aCasey L. Meier, RN, Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES 10aSebaceous Cyst ExcisioncCasey L. Meier, RN aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file14:59bcolor/sound 0 aSebaceous 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, we present a 33-year-old male patient who underwent complete resection of a 2-year-old cyst. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/268.19/sebaceous-cyst-excision
02888nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002400103245009100127260004400218300006300262505177400325506003602099538044602135856010102581182Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aRichard Hodin, MD 10aLeft Laparoscopic Transperitoneal Adrenalectomy for AldosteronomacRichard Hodin, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file41:35bcolor/sound 0 aPrimary hyperaldosteronism refers to the autonomous secretion of the hormone aldosterone from the adrenal gland, resulting in low renin levels. This usually occurs in individuals between the ages of 30 to 50 years old. The majority of these cases are caused either by a solitary, functioning adrenal adenoma or aldosteronoma (70%) or by idiopathic bilateral hyperplasia (30%). Other uncommon causes include adrenal carcinoma and familial hyperaldosteronism. Patients typically present with hypokalemia and long-standing hypertension that is difficult to control despite multi-drug therapy; nevertheless, further tests are required for diagnosis. An elevated plasma aldosterone level with a suppressed plasma renin level is strongly suggestive of the diagnosis. Once confirmed, further evaluation should be directed toward determining if the cause is a unilateral aldosteronoma or bilateral adrenal hyperplasia. This is done through imaging studies and adrenal vein sampling. Unilateral aldosteronoma is best managed by adrenalectomy, with the laparoscopic approach being the preferred method. Bilateral adrenal hyperplasia is often best treated medically because only 20–30% benefit from surgery. Here, we present the case of a 48-year-old woman who had long-standing hypertension and hypokalemia and was found to have hyperaldosteronism and low renin levels. A CT scan showed a small mass in the left adrenal gland, and adrenal vein sampling showed higher levels of aldosterone on the left side than on the right, confirming a unilateral aldosteronoma. Laparoscopic access was gained, the adrenal gland was exposed and dissected by controlling the periadrenal tissues with the harmonic scalpel, the adrenal vein was then ligated, and the adrenal gland was removed. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/182/left-laparoscopic-transperitoneal-adrenalectomy-for-aldosteronoma
02189nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100009100103245016700194260004400361300006300405505087200468506003601340538044601376856016101822337Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aKailan Sierra-Davidson, MD, DPhil, Ogonna N. Nnamani Silva, MD, Sonia Cohen, MD, PhD 10aWide Local Excision of an Intermediate-Thickness Back Melanoma with a Sentinel Lymph Node Biopsy of Left Axillary Lymph NodescKailan Sierra-Davidson, MD, DPhil aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file53:37bcolor/sound 0 aWide local excision (WLE) with sentinel lymph node biopsy (SLNB) remains the cornerstone for treatment of patients with intermediate-thickness and thick melanoma lesions with clinically negative nodes. This procedure involves resection of the melanoma with circumferential margins including all the subcutaneous tissue to the level of the deep fascia. WLE is accompanied by lymphatic mapping in order to localize, resect, and analyze the sentinel node(s) for the presence of lymph node metastases. In this paper with accompanying animation and video, a 40-year-old otherwise healthy patient presents with a new melanoma on his back diagnosed via biopsy. The surgical management of intermediate-thickness melanoma and rationale for treatment are reviewed. We also highlight recent advances in postoperative treatment of those with clinically occult regional disease. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/337/wide-local-excision-of-an-intermediate-thickness-back-melanoma-with-a-sentinel-lymph-node-biopsy-of-left-axillary-lymph-nodes
01814nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100010100105245012500206260004400331300006300375505055700438506003600995538044601031856013101477299.7Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJohnathan R. Kent, MD, James Jeffries, MD, Andrew Straszewski, MD, Kenneth L. Wilson, MD, FACS 10aAnkle-Brachial Index, CT Angiography, and Proximal Tibial Traction for Gunshot Femoral FracturecJohnathan R. Kent, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file22:10bcolor/sound 0 aThis video demonstrates an algorithm for evaluating suspected vascular injury secondary to penetrating extremity trauma. Descriptions of how to perform an arterial-brachial index (ABI) and arterial-pulse index (API) are reviewed, along with criteria to determine if a computed tomography angiography (CTA) is indicated. Relevant imaging is reviewed with a radiology resident with descriptions of how to systematically assess the scans for injury. The technique for a tibial traction pin, a temporizing measure for long bone fractures, is described.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/299.7/ankle-brachial-index-ct-angiography-and-proximal-tibial-traction-for-gunshot-femoral-fracture
01926nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006200103245009300165260004400258300006600302505077300368506003601141538044601177856009701623363Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aKatherine L. Morrow, MD, Anahita Dua, MD, MS, MBA, FACS 10aFemoral Endarterectomy for Severe Peripheral Arterial DiseasecKatherine L. Morrow, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file01:46:13bcolor/sound 0 aThis case describes an 85-year-old gentleman with significant peripheral arterial disease and lifestyle-limiting claudication who had previously undergone an unsuccessful attempt at endovascular treatment of his significant right common femoral artery stenosis. At our institution, we proceeded with open surgical intervention and performed a right common femoral endarterectomy to remove his significant plaque burden. Postoperatively, the patient noted significant improvement in his right lower extremity claudication, and his postoperative pulse volume recordings show improved arterial inflow. This article provides background information regarding this particular patients case, as well as a detailed description of the steps of the surgical procedure itself. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/363/femoral-endarterectomy-for-severe-peripheral-arterial-disease
02346nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100010300103245009300206260004400299300006300343505115100406506003601557538044601593856010102039132Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDavid W. Jang, MD, Ali R. Zomorodi, MD, Feras Ackall, MD, Josef Madrigal, BS, C. Scott Brown, MD 10aAnterior Skull Base Resection of Esthesioneuroblastoma (Endoscopic)cDavid W. Jang, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file13:41bcolor/sound 0 aFirst 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. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/132/anterior-skull-base-resection-of-esthesioneuroblastoma-endoscopic
02869nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004600103245009800149260004400247300006300291505172200354506003602076538044602112856010502558240Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aSonia Cohen, MD, PhD, Richard Hodin, MD 10aTransperitoneal Laparoscopic Right Adrenalectomy for Cortical AdenomacSonia Cohen, MD, PhD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file43:02bcolor/sound 0 aPrimary hyperaldosteronism, or Conn's syndrome, is a disease in which one or both adrenal glands produce excess amounts of aldosterone, leading to hypertension and hypokalemia. Common conditions resulting in this disorder include adenoma of the adrenal gland or hyperplasia of both adrenal glands. In rare cases, it is caused by malignant growth in the adrenal cortex or familial hyperaldosteronism. High blood pressure may cause headaches or blurred vision. Low potassium may cause fatigue, muscle cramps, muscle weakness, numbness, or temporary paralysis.

Primary hyperaldosteronism is diagnosed by measuring serum levels of aldosterone, renin, and potassium. Patients classically have high aldosterone levels, suppressed renin levels, and low potassium levels. Once the diagnosis is established, the localization of the source is performed using imaging studies. Adrenal vein sampling is also performed to determine more precisely and directly the side that is producing excess aldosterone.

Primary hyperaldosteronism caused by an adrenal gland tumor is treated with adrenalectomy. Approximately 95% of patients will notice a significant improvement in their hypertension after successful surgery. Here, we present the case of a 58-year-old female with hypokalemia and long-standing hypertension refractory to medical treatment. Her blood tests showed high aldosterone levels and low renin levels, confirming the diagnosis of hyperaldosteronism. On CT scan, an adrenal nodule was noted on both sides. Adrenal vein sampling identified the right adrenal nodule as the cause. Laparoscopic access was gained, the adrenal gland was dissected and exposed, the adrenal vein ligated, and the adrenal gland was removed. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/240/transperitoneal-laparoscopic-right-adrenalectomy-for-cortical-adenoma
02142nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005600103245005900159260004400218300006300262505105900325506003601384538044601420856007001866208Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aCiro Andolfi, MD, Marco Fisichella, MD, MBA, FACS 10aLaparoscopic Nissen FundoplicationcCiro Andolfi, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file54:43bcolor/sound 0 aThis is the case of a 63-year-old man with a long-standing history of gastroesophageal reflux disease, refractory to medical management with high-dose proton pump inhibitors and H2-blockers. The preoperative workup consisted of: 1) an upper endoscopy, which was normal; 2) a barium swallow, which showed a normal anatomy (no hiatal hernia or diverticula); and 3) esophageal function tests, including high-resolution esophageal manometry, which showed normal peristalsis, and 24-hour pH monitoring, which confirmed the presence of gastroesophageal reflux disease. Considering the amount of pathologic reflux, and the normal anatomy and esophageal peristalsis, it was decided to proceed with a laparoscopic Nissen (360°/total) fundoplication. The operation went well and lasted less than 90 minutes. The patient was discharged the following morning after resuming a light diet, and recovered quickly. With this surgical approach, complete control of reflux was achieved, and the patient was able to discontinue his treatment with proton pump inhibitors. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/208/laparoscopic-nissen-fundoplication
02106nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100008900103245012600192260004400318300006300362505086500425506003601290538044601326856012801772333Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aLasya P. Rangavajjula, BS, Amir R. Kachooei, MD, PhD, Asif M. Ilyas, MD, MBA, FACS 10aArthrodesis of the Distal Interphalangeal (DIP) Joint of the Right Ring Finger for ArthritiscLasya P. Rangavajjula, BS aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file08:31bcolor/sound 0 aAbstract
Osteoarthritis commonly impacts the finger distal interphalangeal (DIP) joints. The prevalence of DIP joint arthritis is high, with more than 60% of individuals older than 60 having DIP joint arthritis. Operative treatment for arthritis of the DIP joint is indicated for pain, deformity, dysfunction, and instability in patients who are recalcitrant to conservative measures. Arthrodesis, or the fusion, of the DIP joint is a widely accepted surgical treatment for DIP joint arthritis. Several surgical techniques have been historically described, with headless compression screw (HCS) fixation being a particularly common technique because of its advantages, including reliable compression, rigid fixation, lack of prominence, and no need for removal. This video demonstrates arthrodesis using HCS for arthritis in the right ring finger DIP joint. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/333/arthrodesis-of-the-distal-interphalangeal-(dip)-joint-of-the-right-ring-finger-for-arthritis
01742nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005600103245006100159260004400220300006300264505065700327506003600984538044601020856007001466189Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aC. Scott Brown, MD, Calhoun D. Cunningham III, MD 10aLaser Stapedotomy for OtosclerosiscC. Scott Brown, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file44:26bcolor/sound 0 aOtosclerosis can lead to progressive conductive hearing loss, significantly affecting quality of life. For patients who choose surgery, the tympanic membrane is elevated, and the middle ear space is explored. If the surgeon confirms that the stapes is fixed in the oval window, either a stapedotomy or stapedectomy can be performed. In the stapedotomy, the surgeon removes the stapes superstructure, creates a fenestration in the footplate, and places a prosthesis from the incus through the fenestration into the vestibule. In this instance, the patient was able to regain nearly all of the hearing that had been lost as a result of stapes fixation. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/189/laser-stapedotomy-for-otosclerosis
01617nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005800103245007700161260004400238300006300282505050100345506003600846538044600882856008301328330Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aGregory Schneider, BS, Asif M. Ilyas, MD, MBA, FACS 10aTriceps Repair for Acute Triceps Tendon RupturecGregory Schneider, BS aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file13:44bcolor/sound 0 aThe function of the triceps tendon is elbow extension. Triceps tendon ruptures are uncommon tendon injuries of the upper extremity and generally result from either direct injury and/or forced eccentric contracture during a fall on an outstretched hand. The treatment goal is re-approximating the distal triceps tendon to the olecranon in order to restore elbow extension strength and upper extremity function. The surgical technique demonstrated in this video is the suture bridge technique.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/330/triceps-repair-for-acute-triceps-tendon-rupture
02010nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005000103245006200153260004400215300006300259505093200322506003601254538044601290856006801736390Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aTaylor P. Stewart, MD, Juliana B. Taney, MD 10aPrimary Low Transverse C-SectioncTaylor P. Stewart, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file23:22bcolor/sound 0 aCesarean sections, often referred to as c-sections, are the most common operation performed for pregnant people across the US. They are viewed as a safe mode of fetal delivery. While there are many indications for planned, non-elective primary cesarean deliveries, there are growing numbers of planned, elective primary c-sections in the US. Vaginal delivery should still be considered in all cases in which an elective c-section is requested. The decision regarding mode of delivery often involves an interdisciplinary discussion between obstetrical, anesthesia, and specialty teams as well as joint decision making between a patient and their provider, taking into consideration their concerns and long-term goals. In this case, an elective primary c-section was performed on a 31-year-old gravida 1 para 0 patient with a term, singleton gestation in the setting of prior lumbar sacral fusion and pelvic fixation surgeries. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/390/primary-low-transverse-c-section
01774nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100007700103245012200180260004400302300006300346505055400409506003600963538044600999856012301445267Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aEmily C. Von Bargen, DO, Patricia L. Hudson, MD, Lori R. Berkowitz, MD 10aVaginal Hysterectomy, Uterosacral Ligament Suspension, Anterior Repair, and PerineorrhaphycEmily C. Von Bargen, DO aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file51:42bcolor/sound 0 aThe patient is a 74-year-old female who presented with bothersome stage III pelvic organ prolapse. She desired definitive surgical management for her prolapse and opted for total vaginal hysterectomy, uterosacral ligament suspension, and anterior/posterior vaginal repairs. She had urodynamic testing before the surgery that showed no stress urinary incontinence, no detrusor overactivity, and normal bladder capacity. The surgery was uncomplicated. She was discharged home the same day as surgery, and her postoperative recovery was unremarkable. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/267/vaginal-hysterectomy-uterosacral-ligament-suspension-anterior-repair-and-perineorrhaphy
03463nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005100103245014500154260004400299300006300343505222200406506003602628538044602664856014703110259Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aWinta T. Mehtsun, MD, MPH, Richard Hodin, MD 10aLaparoscopic Total Abdominal Colectomy with Ileorectal Anastomosis for Crohn's Colitis and Multifocal DysplasiacWinta T. Mehtsun, MD, MPH aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file55:28bcolor/sound 0 aCrohn's disease is a type of inflammatory bowel disease that can chronically affect the entire gastrointestinal tract, with a propensity for the distal ileum. It causes transmural inflammation of the intestines, where it can cause abdominal pain, severe diarrhea, fatigue, weight loss, and malnutrition. It occurs in about 200 patients per 100,000 and follows a bimodal distribution pattern with peaks in the 3rd and 6th decades of life. The exact cause of Crohn's disease is unknown; however, it is believed to be influenced by immune system disorders, genetics, and environmental factors. Diagnosis is usually made by endoscopy and clinical history. Endoscopic findings show characteristic skip lesions, and a cobblestone-like appearance is seen in approximately 40% of cases, representing areas of ulceration separated by narrow areas of healthy tissue. There is no cure for Crohn's disease; the goal of treatment is to palliate symptoms, accomplished with both medical and surgical options. Medications such as antibiotics, aminosalicylates, corticosteroids, immunomodulators, and a variety of biologic medications are used to reduce inflammation and prevent recurrence. Surgery is generally reserved for patients who are unresponsive to aggressive medical therapy or those who develop complications such as intestinal obstruction due to stricture, bleeding from ulcers, abscesses, and fistulas. Segmental intestinal resection of grossly evident disease followed by primary anastomosis is the usual procedure of choice. Here, we present the case of a 59-year-old male with chronic gastrointestinal problems thought to be Crohn's colitis. Colonoscopy with biopsy of multiple areas showed dysplasia, prompting surgical resection. In this case, the entire colon was affected with rectal sparing; therefore, a total abdominal colectomy with ileorectal anastomosis was performed. Laparoscopic access was gained, and the colon was mobilized and divided at the distal sigmoid colon. The colon was pulled through the infraumbilical port site and divided at the ileum, and a J-pouch was made. Anastomosis was achieved using an end-to-end anastomosis stapler and was tested using a scope; the port sites were then closed. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/259/laparoscopic-total-abdominal-colectomy-with-ileorectal-anastomosis-for-crohn's-colitis-and-multifocal-dysplasia
01844nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005600103245005800159260004400217300006300261505076500324506003601089538044601125856006701571202Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aC. Scott Brown, MD, Calhoun D. Cunningham III, MD 10aEndolymphatic Sac DecompressioncC. Scott Brown, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file43:46bcolor/sound 0 aThe endolymphatic sac (ELS) decompression can be performed for patients with Menieres disease that have failed conservative treatment such as dietary changes and medical therapy. The full pathophysiological mechanisms that result in Menieres disease are not entirely understood. The variation in techniques for performing ELS decompression support this; there is no concrete data to justify one approach over another. Regardless, in the correct patient, ELS decompression can significantly alleviate the patients symptoms. To do so, a mastoidectomy is performed to expose the bony labyrinth as well as the bone overlying the sigmoid sinus. Decompression of the sac can be accomplished by removing overlying bone, incising the dura, or stenting the dura open. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/202/endolymphatic-sac-decompression
01459nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005000103245008800153260004400241300006300285505032600348506003600674538044600710856009701156248Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aC. Scott Brown, MD, David M. Kaylie, MD, MS 10aTransmastoid Repair of Superior Semicircular Canal DehiscencecC. Scott Brown, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file33:01bcolor/sound 0 aSemicircular canal dehiscence is associated with conductive hearing loss, autophony, and pressure/sound induced vertigo. Patients who are symptomatic may elect to undergo surgical intervention. The transmastoid approach affords the opportunity for an outpatient procedure to expose and plug the canal around the defect. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/248/transmastoid-repair-of-superior-semicircular-canal-dehiscence
01784nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100005000105245005700155260004400212300006300256505070400319506003601023538044601059856007301505206.5Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aIrene Kalbian, Asif M. Ilyas, MD, MBA, FACS 10aUlnar Nerve Transposition (Cadaver)cIrene Kalbian aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file23:16bcolor/sound 0 aUlnar 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. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/206.5/ulnar-nerve-transposition-(cadaver)
02270nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005300103245010400156260004400260300006300304505110000367506003601467538044601503856011501949331Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJasmine Wang, BS, Asif M. Ilyas, MD, MBA, FACS 10aRepair of a Chronic Degenerative Sagittal Band Rupture of the Right Ring FingercJasmine Wang, BS aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file07:13bcolor/sound 0 aSagittal band rupture is an injury that causes rupture of the sagittal band, leading to subluxation of the extensor digitorum communis (EDC) tendon at the metacarpophalangeal (MCP) joint. The sagittal band encircles the EDC tendon at the MCP joint and functions as an important part of the extensor mechanism to stabilize the extensor tendon. It is a relatively uncommon injury, typically involving the long finger, that may occur with direct trauma in athletes or atraumatically in inflammatory or spontaneous cases; the mechanism may be acute or chronic. The common presentation involves pain and swelling at the MCP joint, visualization of extensor tendon subluxation during flexion, and inability to actively extend the MCP joint from a flexed position. The treatment for chronic rupture, as in this case, involves surgical repair followed by six weeks in a relative motion splint, in which the injured MCP joint is placed in greater extension relative to adjacent joints. The video here demonstrates direct repair of a chronic degenerative sagittal band rupture of the right ring finger.
 aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/331/repair-of-a-chronic-degenerative-sagittal-band-rupture-of-the-right-ring-finger
01995nam  22002051  45000010002000000030005000020060019000070070004000260080041000300280011000710400019000821000023001012450108001242600044002323000063002765050851003395060036011905380446012268560117016727Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDaniel J. Hu, MD 10aCataract Extraction with Phacoemulsification and Posterior Chamber Intraocular LenscDaniel J. Hu, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file19:35bcolor/sound 0 aCataract is a leading cause of treatable blindness in the world. While there is a significant difference in access to surgical care in developing vs. industrial nations, cataract is a significant contributor to visual impairment in both. The diagnosis of cataract is made through assessment of visual acuity, visual disability, and slit lamp biomicroscopy. Common indications for surgery include difficulty with glare, night driving, decrease in best corrected vision impairing distance and/or near vision, and impairment of view to the retina that is precluding necessary treatment. In the US, the standard for cataract extraction has become phacoemulsification. The article demonstrates and reviews the technique of cataract extraction using phacoemulsification with intraocular lens implantation using the “divide and conquer” technique. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/7/cataract-extraction-with-phacoemulsification-and-posterior-chamber-intraocular-lens
01909nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005600103245006100159260004400220300006300264505082500327506003601152538044601188856006901634332Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aKeenan R. Sobol, BS, Asif M. Ilyas, MD, MBA, FACS 10aLateral Epicondylitis DebridementcKeenan R. Sobol, BS aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file09:03bcolor/sound 0 aLateral epicondylitis (LE), commonly referred to as “tennis elbow,” is a common condition of the extensor tendons of the forearm that can lead to pain along the lateral epicondyle with radiation into the forearm, decreased grip strength, and difficulty lifting objects. When LE symptoms progress and can no longer be managed with non-operative measures, LE debridement may be indicated. The approach presented here is an open debridement of the extensor carpi radialis brevis (ECRB) tendon origin. A 3–4-cm longitudinal incision was placed longitudinally over the lateral epicondyle, radial head, and capitellum. The ECRB was exposed then debrided, the lateral epicondyle was decorticated, the lateral collateral ligament was repaired, the wound was closed in layers, and a soft dressing and splint were placed. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/332/lateral-epicondylitis-debridement
02130nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100007900103245016200182260004400344300006300388505082700451506003601278538044601314856016401760266Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aChristopher L. Kalmar, MD, Caleb L. Cutherell, MD, Farrell C. Adkins, MD 10aRobotic Right Hemicolectomy for Tubulovillous Adenoma with High-Grade Dysplasia: Multimedia Analysis of a Contemporary TechniquecChristopher L. Kalmar, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file44:59bcolor/sound 0 aRobotic right hemicolectomy is a minimally invasive technique for right colon resections. The technique utilizes a robotic laparoscopic instrument to perform dissection of the right colon and to perform intracorporeal anastomoses, allowing for smaller abdominal incisions, quicker recovery times, and decreased short- and long-term complications. In this case, a robotic right hemicolectomy was performed to remove an endoscopically unresectable mass at the ileocecal valve. An intracorporeal-stapled ileocolic anastomosis was performed, and the colon was removed through a trocar insertion site. The robotic-assisted minimally invasive technique allows for clear visualization of the dissection planes and facilitates intracorporeal anastomoses that would otherwise be difficult to perform using traditional laparoscopy aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/266/robotic-right-hemicolectomy-for-tubulovillous-adenoma-with-high-grade-dysplasia:-multimedia-analysis-of-a-contemporary-technique
02150nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003800103245011000141260004400251300006600295505099700361506003601358538044601394856010401840230Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDavid Lourié, MD, FACS, FASMBS 10aRobotic-Assisted Laparoscopic (rTAPP) Bilateral Inguinal Hernia RepaircDavid Lourié, MD, FACS, FASMBS aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file01:02:13bcolor/sound 0 aThere are over 1 million hernia repairs performed annually in the US.  Robotics is revolutionizing the adoption of minimally-invasive hernia repairs lately.  For 20 years, in spite of the literature supporting the benefit of laparoscopic minimally-invasive repairs, only 25-30% of all hernias were performed laparoscopically. From 2015 to 2018, robotic laparoscopic hernia repairs have explosively grown from less than 2% to 20% of all hernia repairs performed in the US. Hernia repairs are among the most basic procedures for general surgeons, and there is substantial enthusiasm on the part of surgeons regarding the rapid changes in techniques as well as the best methods of teaching them. Surgical training programs may find it difficult to maintain training for their residents and fellows in the face of rapidly evolving technology. Therefore, we present the case of a 28-year-old male with bilateral inguinal hernias that were repaired using a robotic-assisted laparoscopic approach. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/230/robotic-assisted-laparoscopic-rtapp-bilateral-inguinal-hernia-repair
01820nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005100103245007800154260004400232300006600276505070500342506003601047538044601083856008501529214Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJeffrey S. Zarin, MD, Gustavo Barrazueta, MD 10aMako Robotic-Arm Assisted Total Knee ArthroplastycJeffrey S. Zarin, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file01:22:08bcolor/sound 0 aTotal knee arthroplasty (TKA) has been around for decades and serves as a very successful procedure to alleviate pain and restore function in a knee with advanced degenerative joint disease. Over the years, there have been many advancements in surgical technique and even more so in implant design. One of the more recent technological breakthroughs in TKA is the use of a robotic-assisted arm for enhanced preoperative planning and intraoperative guidance with dynamic joint balancing and bone preparation. This video article outlines the operative technique used by the primary author in performing a posterior stabilizing TKA in a varus deformity degenerative knee using Mako robotic assistance. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/214/mako-robotic-arm-assisted-total-knee-arthroplasty
01989nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100009300103245004600196260004400242300006300286505090100349506003601250538044601286856005101732177Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aCharles R. Woodard, MD, Alexandra L. Elder, BS, Helen A. Moses, MD, C. Scott Brown, MD 10aBotox InjectioncCharles R. Woodard, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file08:10bcolor/sound 0 aBotox injection is one of the most common cosmetic procedures performed. Botox temporarily paralyzes targeted skeletal muscles of the face, reducing the patients ability to produce unwanted dynamic wrinkles. Commonly treated areas of the face include the procerus and corrugator supercilii muscles to treat glabellar frown lines, the frontalis muscle to treat horizontal rhytids of the forehead, and the orbicularis oculi muscle to treat “crows feet” wrinkles along the lateral aspect of the orbit. A thorough facial analysis is necessary to develop a treatment plan for each problem area, particularly by engaging the patient to determine what his or her goals for treatment are. Providers must take care when injecting into the face to avoid complications of overtreatment, such as brow ptosis from over-injecting the forehead or elevated brow from over-injecting the periorbital muscles. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/177/botox-injection
02457nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100010200105245011800207260004400325300006300369505121900432506003601651538044601687856011802133261.2Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDaniel N. Driscoll, MD, FACS, Lisa Gfrerer, MD, PhD, Robert J. Dabek, MD, Aleia M. Boccardi, DO 10aLocal Tissue Rearrangement for Hypertrophic Chemical Burn: Z-Plasty and VY-PlastycDaniel N. Driscoll, MD, FACS aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file29:01bcolor/sound 0 aHypertrophic scarring following burn injuries has been shown to occur in up to 70% of patients, potentially causing both long-term psychological and physical morbidity. Increased rates of depression and anxiety are seen to arise from aesthetic dissatisfaction, affecting patient rehabilitation and subsequent societal interaction. Mobility is jeopardized from contractures that develop within the damaged tissue, leading to decreased range of motion and function of the area. Both sequelae leave the patient with an overall decreased quality of life. Surgical techniques involving local tissue rearrangement, including Z-plasty and VY-plasty can be employed to improve both the function and cosmetic effects of burn scars. Essentially, these techniques illicit a decrease in tension through a lengthening of contracted tissue of up to 50–70%, allowing for better static alignment and increased mobility over joint surfaces. This video depicts the combination of both tissue rearrangement techniques as applied to hypertrophic scar contractures resulting from prior burn injuries. The authors find these techniques an invaluable part of a reconstructive surgeons armamentarium when approaching scar revision.  
 aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/261.2/local-tissue-rearrangement-for-hypertrophic-chemical-burn-z-plasty-and-vy-plasty
01929nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000280010224500990013026000440022930000630027350508010033650600360113753804460117385601040161922Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMichael J. Weaver, MD 10aOpen Reduction and Internal Fixation of a Trimalleolar Ankle FracturecMichael J. Weaver, MD aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file45:21bcolor/sound 0 aAnkle fractures are the second most common lower limb fractures after those involving the hip, accounting for 10% of all fractures, with an incidence that has been increasing.1,2 The goal of management is to restore a stable and congruent joint. Operative management is recommended for most displaced fractures, fractures with dislocations, and open fractures.

In this video, Dr. Weaver walks us through the surgical management of a 23-year-old male who sustained a trimalleolar ankle fracture with concomitant dislocation and syndesmotic injury following a motor vehicle collision. Dr. Weaver discusses the surgical landmarks and approaches to the ankle, the methods of fixing the malleoli and the syndesmosis, and common concerns that arise during the surgical management of ankle fractures. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/22/open-reduction-and-internal-fixation-of-a-trimalleolar-ankle-fracture
02163nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003200103245011800135260004400253300006300297505099500360506003601355538044601391856012001837323Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAjaipal S. Kang, MD, FACS 10aReconstruction of a Large Nasal Cutaneous Defect Using Nasolabial and Rhomboid FlapscAjaipal S. Kang, MD, FACS aBostonbJournal of Medical Insightc2023 a1 online resource (1 streaming video file29:55bcolor/sound 0 aResection of cutaneous malignancies may result in substantial skin defects. Often, skin grafting is a first-line option for reconstruction of such defects but may be limited by poor cosmetic outcomes and incomplete graft acceptance. Accordingly, skin flaps, tissue rearrangement techniques, and more complex procedures may be needed. This case report presents the successful use of a combination of nasolabial flap and rhomboid flap for reconstruction of a 3-cm × 2-cm left nasal sidewall and ala skin defect that remained following a basal cell cancer Mohs resection. The flaps were quickly and easily fashioned, did not require any special instruments, and resulted in a good cosmetic outcome. There were no wound complications and the flaps healed completely with excellent contour, texture, thickness, color match, and complete patient satisfaction. This case is an example of the technical aspects of successful planning, elevation, and inset of a nasolabial flap and rhomboid flap. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/323/reconstruction-of-a-large-nasal-cutaneous-defect-using-nasolabial-and-rhomboid-flaps
02798nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006000103245008200163260004400245300006600289505167200355506003602027538044602063856008302509215Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMichael Reinhorn, MD, FACS, C. Haddon Mullins, IV, MD 10aRevision Bascom Cleft Lift Pilonidal CystectomycMichael Reinhorn, MD, FACS aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file01:05:53bcolor/sound 0 aPilonidal disease is a chronic skin and subcutaneous infection emanating from the center of the natal cleft, often extending to the buttocks. It is more common in males than females and usually occurs between the time of puberty and 40 years of age. A common theory is that pilonidal disease is caused by an ingrown hair at the center of the cleft resulting in inflammation and infection extending to the buttocks. Presentation of the pilonidal disease can range from an asymptomatic cyst or midline pits to chronically inflamed cyst, large open wounds in the midline, long draining sinus tract, or an acute abscess. Only in exceptionally rare cases is imaging required. Treatment depends on the disease pattern. An acute abscess is treated with drainage and antibiotics, while a complex or recurring infection is treated surgically with either excision of a cyst or unroofing of a sinus tract. Reconstructive flap techniques such as the Bascom cleft lift procedure, Karydakis flap, rhomboid, or Z-plasty can be done to reduce the risk of recurrence by leaving less scar tissue and flattening the region between the buttocks. Recent data has suggested that off-midline incision closure may lead to a lower risk of recurrence. Here, we present the case of a male patient who had previously had flap surgery for the pilonidal disease, but experienced recurrence and the development of a sinus tract. Due to the extensive nature of the disease, a deep flap was required to mobilize tissues and close the eventual wound. A deep flap like this is often only required in re-do surgery, rather than for primary disease, for which only a 1-cm subcutaneous flap is required. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/215/revision-bascom-cleft-lift-pilonidal-cystectomy
01992nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004800103245008300151260004400234300006600278505087100344506003601215538044601251856008901697336Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aZhi Ven Fong, MD, MPH, John T. Mullen, MD 10aProphylactic Total Gastrectomy for CDH1 Gene MutationcZhi Ven Fong, MD, MPH aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file01:48:04bcolor/sound 0 aThe Hereditary Diffuse Gastric Cancer (HDGC) syndrome is due to a mutation in the CDH-1 gene that predisposes patients to a high lifetime risk of developing gastric cancer. As such, a total gastrectomy is typically recommended for patients with this syndrome. In this case, the patient presented with an incidentally discovered CDH-1 mutation on genetic testing obtained after she was diagnosed with early-onset rectal cancer. She underwent a prophylactic total gastrectomy with a retrocolic Roux-en-Y esophagojejunostomy. Her postoperative course was unremarkable, and she was discharged on postoperative day 3. Her pathology demonstrated several foci of signet ring cell carcinoma limited to the mucosa. This video demonstrates an experienced surgeons technique for performing a prophylactic total gastrectomy with a Roux-en-Y esophagojejunostomy reconstruction. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/336/prophylactic-total-gastrectomy-for-cdh1-gene-mutation
01616nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005600103245011000159260004400269300006300313505043300376506003600809538044600845856011901291244Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aNeeta Erinjeri, MD, Tobias Carling, MD, PhD, FACS 10aRight Posterior Retroperitoneoscopic Adrenalectomy (PRA) for Adrenocortical AdenomacNeeta Erinjeri, MD aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file38:10bcolor/sound 0 aPosterior retroperitoneoscopic adrenalectomy (PRA) allows the surgeon to approach the adrenal gland through the back rather than the more traditional laparoscopic transabdominal adrenalectomy (LTA) approach.  This technique was popularized in Germany but is being used increasingly throughout the United States.  Our institution was one of the early adopters of this technique in the US, and we present such an operation here. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/244/right-posterior-retroperitoneoscopic-adrenalectomy-(pra)-for-adrenocortical-adenoma
01656nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005000103245007200153260004400225300006300269505055500332506003600887538044600923856008101369274Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aC. Scott Brown, MD, David M. Kaylie, MD, MS 10aMyringoplasty and Tympanostomy Tube PlacementcC. Scott Brown, MD aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file10:26bcolor/sound 0 aMyringoplasty with tympanostomy tube placement may be performed for patients with a variety of middle ear conditions. Often, eustachian tube dysfunction causes otitis media, tympanic membrane perforation, or conductive hearing loss. In the present case, myringoplasty was performed using the CO2 laser, providing reorganization of collagen fibers and improved compliance of the tympanic membrane. Given the ongoing eustachian tube dysfunction, a pressure equalization tube was placed to prevent recurrent retraction and atelectasis of the ear drum. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/274/myringoplasty-and-tympanostomy-tube-placement
01885nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004200103245012000145260004400265300006600309505069100375506003601066538044601102856013101548343Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJon Harrison, MD, Todd Francone, MD 10aRobotic Low Anterior Resection with Diverting Loop Ileostomy for Locally Advanced Rectal CancercJon Harrison, MD aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file01:37:21bcolor/sound 0 aThis video demonstrates a robotic low anterior resection for locally advanced rectal cancer after neoadjuvant FOLFOX-based chemoradiation treatment. Low anterior resection is recommended for rectal tumors in which a 1-cm distal margin is achievable without sphincter encroachment. A key component of this operation is a complete mesorectal dissection, which is highlighted with the robotic technique. In this case, our patient had a 2.6-cm tumor located 6 cm above the anal verge, which was treated with eight cycles of FOLFOX followed by consolidative radiation therapy. A robotic low anterior resection was performed, and the final pathology revealed a complete pathologic response. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/343/robotic-low-anterior-resection-with-diverting-loop-ileostomy-for-locally-advanced-rectal-cancer
02824nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006900103245008400172260004400256300006600300505168600366506003602052538044602088856008402534339Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMorgan L. Hennessy, MD, PhD, Carlos Fernandez-del Castillo, MD 10aOpen Distal Pancreatectomy for Pancreatic CancercMorgan L. Hennessy, MD, PhD aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file01:43:58bcolor/sound 0 aDistal pancreatectomy is a procedure performed most often for pancreatic tumors – both benign and malignant – but can also be indicated in the treatment of pancreatitis. The operation can be performed with an en-bloc resection of the spleen, or with splenic preservation – splenectomy is indicated for oncologic resection. The operative approach - laparoscopic, robotic, or open – is dictated by the patient and clinical scenario at hand. In this case, we perform an open distal pancreatectomy with splenectomy in a patient who has undergone neoadjuvant treatment for pancreatic adenocarcinoma. This is a unique case of a patient undergoing surgical resection after initial diagnosis of metastatic disease. The patient is a 69-year-old woman who initially presented with abdominal pain and bloating, and was found to have a 2 cm suspicious tumor in the body of her pancreas and biopsy-proven single liver metastasis. She was treated with an extended course of neoadjuvant chemotherapy, and re-staging scans showed significant response. Chemoradiation was completed and the liver metastasis was no longer visible on imaging. 27 months after diagnosis she was taken to the operating room for distal pancreatectomy and splenectomy; no liver or peritoneal metastases were seen. Her postoperative course was overall uneventful and she recovered well. Final surgical pathology demonstrated complete pathological response with no evidence of disease seen and 0/11 lymph nodes positive for malignancy. She is currently being followed with CT scans and tumor markers every three months by her medical oncology team and as of now, February 2022, there is no evidence of recurrence. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/339/open-distal-pancreatectomy-for-pancreatic-cancer
01915nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006300103245005300166260004400219300006300263505084200326506003601168538044601204856005901650308Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMichael E. Hoffer, MD, Benjamin Park, C. Scott Brown, MD 10aEndoscopic StapedectomycMichael E. Hoffer, MD aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file52:30bcolor/sound 0 aThe evolution of stapes surgery for otosclerosis has undergone several advancements to reach its current form. Although the microscopic approach to stapes surgery  is still the current treatment standard for otosclerosis, endoscopic stapedectomy is a relatively new approach that has been gaining traction as a minimally invasive option. Endoscopic stapedectomy includes several important steps including incudostapedial joint separation, downfracture and removal of the stapes suprastructures, and prosthesis placement. These steps require a high level of technical skill and present a steep learning curve. However, this approach includes several technical advantages to decrease morbidity and support patient outcomes.  Here, we present the endoscopic approach to repair otosclerosis and ultimately improve conductive hearing loss.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/308/endoscopic-stapedectomy
01703nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100005000105245005300155260004400208300006300252505063100315506003600946538044600982856006901428206.3Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aIrene Kalbian, Asif M. Ilyas, MD, MBA, FACS 10aDe Quervain's Release (Cadaver)cIrene Kalbian aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file11:40bcolor/sound 0 aDe Quervains release is a surgical procedure performed to curatively treat stenosing extensor tenosynovitis of the first extensor compartment of the wrist, after nonoperative management fails. This procedure involves surgical release of the first dorsal compartment with care taken to fully release the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons from their respective sheaths, while protecting the radial sensory nerve, in order to decompress the extensor tendons. This video outlines the operative technique used by Dr. Asif Ilyas for performing a De Quervains release on a cadaveric wrist.   aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/206.3/de-quervain's-release-(cadaver)
02455nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004900103245007600152260004400228300006300272505134100335506003601676538044601712856009102158329Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aChaim Miller, Asif M. Ilyas, MD, MBA, FACS 10aFlexor Tendon Repair for a Zone 2 FDP Tendon LacerationcChaim Miller aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file12:06bcolor/sound 0 aThis case is of a zone 2 flexor tendon repair for flexor tendon injury in a little finger. The attending surgeon presents a repair with a 4-0 Ethibond suture with a modified Kessler stitch which resulted in an 8-core strand repair. The procedure was done under Wide Awake Local Anesthesia No Tourniquet (WALANT) protocol which among other strengths allows the surgeon to test the repair and set post-rehabilitation expectations for the patient. The procedure starts with a Brunner incision and is closed with 5-0 chromic suture in a horizontal mattress fashion. After closure, a dorsal extension block plaster splint was applied. The indication for this surgery was to restore little finger flexion at the Distal Interphalangeal Joint (DIP). Finger flexor tendons include the Flexor Digitorum Superficialis (FDS) and Flexor digitorum Profundis (FDP). Common causes of zone 2 flexor tendon injuries include superficial and deep lacerations to the volar aspect of the hand, crush injuries, and saw blade cuts. Early surgical repair is the definitive treatment for greater than 60% rupture of tendon. Post-operatively, patients undergo active extension – passive flexion to achieve functional gliding of the tendon. Patients can expect to return to light activities after 6 to 8 weeks and resume heavy activities around 10 to 12 weeks. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/329/flexor-tendon-repair-for-a-zone-2-fdp-tendon-laceration
01768nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100007500103245005000178260004400228300006300272505069100335506003601026538044601062856005401508273Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDavid M. Kaylie, MD, MS, Cecilia G. Freeman, BSc, C. Scott Brown, MD 10aBonebridge ImplantcDavid M. Kaylie, MD, MS aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file21:12bcolor/sound 0 aBone conduction implants can improve hearing in patients with conductive or mixed hearing loss as well as in cases of single-sided deafness (SSD). The Bonebridge implant h as three components: a magnet, an internal transducer, and an external audio processor. The patient in this case previously underwent resection of a vestibular schwannoma via a middle fossa craniotomy in an attempt to preserve hearing. Unfortunately, the patient ultimately lost hearing in the right ear, resulting in SSD. Here, we demonstrate the step-by-step surgical technique for the Bonebridge implant to allow sound transmission from the patients deaf ear to the contralateral cochlea via bone conduction.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/273/bonebridge-implant
01770nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100008000103245008600183260004400269300006600313505060900379506003600988538044601024856009401470356Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMadison S. McCarthy, Charlotte M. Rajasingh, MD, Brooke Gurland, MD, FACS 10aAltemeier Perineal Proctosigmoidectomy for Rectal ProlapsecMadison S. McCarthy aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file01:07:24bcolor/sound 0 aFull-thickness rectal prolapse occurs when the rectum invaginates into the anal canal and beyond the anal sphincters. It is estimated to occur in 2.5 per 100,000 people, and most commonly affects women, particularly elderly women with other pelvic floor disorders. The only definitive treatment for rectal prolapse is surgery. In this case, we present an 80-year-old female with full-thickness rectal prolapse who underwent Altemeier proctosigmoidectomy. The redundant rectum is delivered and then excised through a transanal approach, and the proximal colon is sutured to the distal end of the rectum. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/356/altemeier-perineal-proctosigmoidectomy-for-rectal-prolapse
02020nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005200103245007100155260004400226300006300270505092100333506003601254538044601290856007801736322Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAllyson Peterson, MD, Nadim Michael Hafez, MD 10aIntroduction to Bedside Cardiac UltrasoundcAllyson Peterson, MD aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file13:44bcolor/sound 0 aThe following write up is meant to accompany the JOMI “Introduction to Bedside Cardiac Ultrasound” video. In this video the basics regarding point-of-care cardiac ultrasound will be covered. However, knobology or physics will not be covered and are a prerequisite to the material covered in both the video and this write up. 


Point of care cardiac ultrasound is a key diagnostic tool in evaluating any patient who is in extremis. Indications for a bedside cardiac ultrasound include cardiac arrest, unexplained hypotension, syncope, shortness of breath, chest pain, and altered mental status. There are no absolute contraindications for a limited bedside cardiac ultrasound. Point of care cardiac ultrasound mainly consists of four views which include the parasternal long, parasternal short, apical four chamber, and the subxiphoid, but can also include other fields such as lungs, depending on context.   aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/322/introduction-to-bedside-cardiac-ultrasound
01784nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005200103245009900155260004400254300006300298505063000361506003600991538044601027856010501473269Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aLori R. Berkowitz, MD, Patricia L. Hudson, MD 10aSite-Specific Posterior Colporrhaphy and Perineorrhaphy for RectocelecLori R. Berkowitz, MD aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file46:54bcolor/sound 0 aThe patient is a 38-year-old female who presented with fecal incontinence, constipation, and stress urinary incontinence. She was found to have stage II posterior vaginal wall prolapse. She desired definitive surgical management of her prolapse and opted for posterior vaginal repair. Although stress urinary incontinence was demonstrated on urodynamic testing, the decision was made not to proceed with concurrent mid-urethral sling given her history of pelvic floor dyssynergia and intermittent urinary retention. The surgery was uncomplicated, and she was discharged on the day of surgery. Her recovery was unremarkable. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/269/site-specific-posterior-colporrhaphy-and-perineorrhaphy-for-rectocele
02384nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100007800103245008200181260004400263300006300307505124200370506003601612538044601648856008402094340Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDivyansh Agarwal, MD, PhD, Lauren Ott, PA-C, Michael Reinhorn, MD, FACS 10aShouldice Repair for Left Direct Inguinal HerniacDivyansh Agarwal, MD, PhD aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file49:13bcolor/sound 0 aIt is estimated that approximately one in four men, and one in 20 women will develop an inguinal hernia over the course of their lifetime. An inguinal hernia occurs when a hole in the lower abdominal wall allows abdominal contents to herniate into the groin. This may occur through a natural opening such as the internal ring, or through a weakness in transversalis fascia in the “direct” space, or a widening of the femoral canal. This abdominal wall defect can present as a burning, heavy, or aching sensation in the groin, and while watchful waiting can be an option for asymptomatic inguinal hernias, patients with significant symptoms of discomfort that affect their daily quality of living benefit from repair of the hernia. Surgery is most commonly performed as an elective procedure. Here we present the case of a 51-year-old male who presented with left groin pain and a bulge in the area, worsened while straining or after a long day of physical activity. The patient underwent a mesh-free hernia repair performed via the four-layer Shouldice technique as a 50-minute ambulatory/day-surgery procedure. This article and the associated video describe the pertinent history, evaluation, and operative steps of the procedure. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/340/shouldice-repair-for-left-direct-inguinal-hernia
01948nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100007600103245013600179260004400315300006600359505069400425506003601119538044601155856014101601272Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMarcus V. Ortega, MD, Emily C. Von Bargen, DO, Liliana Bordeianou, MD 10aLaparoscopic Suture Rectopexy with Culdoplasty, Vaginal Wall Repair, and Perineorrhaphy for Rectal ProlapsecMarcus V. Ortega, MD aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file01:20:15bcolor/sound 0 aThe patient is an 87-year-old female who presented with a history of constipation and bothersome rectal prolapse that required manual rectal prolapse reduction. On exam, she was found to have full-thickness rectal prolapse and stage II posterior vaginal wall pelvic organ prolapse. She desired definitive surgical management of her prolapse and opted for a laparoscopic suture rectopexy and posterior vaginal wall repair and perineorrhaphy. She had anorectal physiology and urodynamic testing, as well as a defecography before surgery to assist surgical planning. The surgery was uncomplicated. She was discharged on postoperative day one and her postoperative recovery was unremarkable. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/272/laparoscopic-suture-rectopexy-with-culdoplasty-vaginal-wall-repair-and-perineorrhaphy-for-rectal-prolapse
01388nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004300103245013400146260004400280300006600324505017100390506003600561538044600597856013901043286Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJonathan Friedstat, MD, Jonah Poster 10aBilateral Dorsal Foot Scar Contracture Release with Split-Thickness Skin Grafts from the Anterior ThighcJonathan Friedstat, MD aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file01:16:35bcolor/sound 0 aIn this case, a 5-year-old male with burn scars undergoes a bilateral dorsal foot scar contracture release with split-thickness skin grafts from the anterior thigh. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/286/bilateral-dorsal-foot-scar-contracture-release-with-split-thickness-skin-grafts-from-the-anterior-thigh
01862nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006600103245007200169260004400241300006300285505074300348506003601091538044601127856008301573127Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDaniel Hashimoto, Ozanan R. Meireles, MD, David Rattner, MD 10aPeroral Endoscopic Myotomy (POEM) for AchalasiacDaniel Hashimoto aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file28:00bcolor/sound 0 aAchalasia, a primary motility disorder of the esophagus, is the result of improper relaxation of the lower esophageal sphincter and has an incidence ranging from 1 to 6 in 100,000. Impaired transit of food and liquid from the esophagus to the stomach results in symptoms of dysphagia, regurgitation, retrosternal fullness/pain, and weight loss. Symptoms can be managed with a range of medical or procedural therapy. However, the best results are obtained from surgical management with myotomy. Per oral endoscopic myotomy (POEM) has emerged as a less invasive manner through which to perform a myotomy and provides relief of dysphagia comparable to laparoscopic Heller myotomy – the current standard of surgical therapy for achalasia. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/127/peroral-endoscopic-myotomy-(poem)-for-achalasia
01761nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003600103245016800139260004400307300006300351505049300414506003600907538044600943856016601389225Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aTobias Carling, MD, PhD, FACS 10aMinimally Invasive Parathyroidectomy Under Local Cervical Block Anesthesia for Primary Hyperparathyroidism and Parathyroid AdenomacTobias Carling, MD, PhD, FACS aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file28:13bcolor/sound 0 aWith both improvement in preoperative parathyroid tumor identification and the use of intraoperative parathyroid hormone (PTH) assay, minimally invasive parathyroidectomy (MIP) is now performed more frequently in patients with primary hyperparathyroidism (pHPT) compared to both historically and to cervical exploration. Still, many institutions are not familiar with performing MIP under regional or local anesthesia. We present such an operation under local cervical block anesthesia. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/225/minimally-invasive-parathyroidectomy-under-local-cervical-block-anesthesia-for-primary-hyperparathyroidism-and-parathyroid-adenoma
02515nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100011100103245009700214260004400311300006300355505130800418506003601726538044601762856010102208275Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aSeth M. Cohen MD, MPH, David Straka, MD, Blaine D. Smith, MD, Douglas O'Connell, MSc, C. Scott Brown, MD 10aZenker’s Diverticulum: Endoscopic Staple-Assisted DiverticulotomycSeth M. Cohen MD, MPH aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file21:56bcolor/sound 0 aZenker's diverticulum (ZD) results from a posterior mucosal herniation through Killians triangle, an area situated above the cricopharyngeus (CP) muscle and below the inferior pharyngeal constrictor muscle. ZD is likely caused by incomplete relaxation of the upper esophageal sphincter as well as increased intraluminal pressure. ZD can be asymptomatic, and the most common symptom associated with symptomatic ZD is dysphagia. The definitive treatment for symptomatic Zenkers diverticulum is a surgical correction, either by an open transcervical or an endoscopic approach. The open surgical approach involves a transcervical incision usually involving concurrent cricopharyngeal (CP) myotomy, whereas the endoscopic utilizes an endoscope to visualize and divide the diverticulum from the inside. Endoscopic approaches have gained widespread acceptance due to shorter hospital stays, lower rates of complications, ease of access in case of recurrence, and shorter operation times. Thus, endoscopic access is often considered the first-line choice for the treatment of ZD. We present a case of a patient with a symptomatic ZD that is treated with an endoscopic staple-assisted diverticulotomy. The clinical presentation, diagnostic criteria, surgical procedure, and postoperative care are highlighted.
 aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/275/zenker's-diverticulum:-endoscopic-staple-assisted-diverticulotomy
02259nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005500103245009600158260004400254300006300298505110500361506003601466538044601502856010501948302Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aM. Grant Liska, BS, Asif M. Ilyas, MD, MBA, FACS 10aScaphoid Open Reduction and Internal Fixation Through Dorsal ApproachcM. Grant Liska, BS aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file07:52bcolor/sound 0 aScaphoid fractures are the most common carpal injury and have a high complication propensity. In particular, the unique blood supply of the scaphoid leads to an increased rate of avascular necrosis, while the geometry of the scaphoid causes relatively high rates of nonunion.

Among operative approaches, percutaneous and open reduction internal fixation (ORIF) may both be considered, with ORIF being preferred for displaced, comminuted, proximal pole and nonunion/delayed healing fractures. With internal fixation, a dorsal or volar approach can be undertaken based on fracture alignment.
 
Here, we discuss the case of a proximal pole scaphoid fracture repaired with ORIF via a dorsal approach. After dissection through the joint capsule and exposure of the base of the scaphoid, a headless compression screw is placed anterograde in line with the thumb in all planes. This procedure provides increased stability and improved rate of the union in correlation with the accuracy of intraoperative reduction, leading to improved outcomes for surgical candidates over more conservative approaches. 
 aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/302/scaphoid-open-reduction-and-internal-fixation-through-dorsal-approach
01943nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005600103245007800159260004400237300006300281505082500344506003601169538044601205856008601651301Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aBradley Richey, MSc, Asif M. Ilyas, MD, MBA, FACS 10aDistal Radius Open Reduction and Internal FixationcBradley Richey, MSc aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file14:10bcolor/sound 0 aFractures of the distal radius are common injuries, with an annual incidence of 27 per 10,000 per year. As many as two-thirds of these fractures are displaced, necessitating reduction to restore wrist function and avoid neurovascular compromise. When adequate reduction cannot be achieved by closed reduction alone, closed reduction and percutaneous pinning versus open reduction and internal fixation is considered. Here we present the case of a middle aged female presenting with a dorsally displaced and angulated fracture of the distal radius after a fall on the outstretched hand. The fracture was treated by open reduction and internal fixation with a volar locking plate. We outline the natural history, preoperative care, intraoperative technique, and postoperative considerations of distal radial fractures. 
 aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/301/distal-radius-open-reduction-and-internal-fixation
02018nam  22002051  4500001000700000003000500007006001900012007000400031008004100035028001100076040001900087100006700106245005500173260004400228300006300272505092000335506003601255538044601291856007501737268.16Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJohn Grove, Marcus Lester R. Suntay, MD, FPCS, FPSPS, FPALES 10aExcision of Epidermal Inclusion CystcJohn Grove aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file19:18bcolor/sound 0 aEpidermal inclusion cysts, also called keratin or epithelial cysts, are benign lumps that develop beneath the skin. They are the most common cutaneous cysts and can be found anywhere on the body, with the face, neck, and trunk being the most common locations. Epidermal inclusion cysts are caused by a build-up of keratin due to obstruction or disruption of the skin or skin follicle. It presents as a slow-growing, painless lump, usually with a punctum in the middle that represents the blockage of keratin excretion. No treatment is usually necessary unless they cause pain, cosmetic concerns, or become infected. Surgical excision appears to be the mainstay of treatment, which prevents cyst recurrence. Here, we present the case of a 64-year-old male with a mass on his upper back. The mass was noted to be gradually enlarging, and thus excision was performed in order to prevent further growth and infection. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/268.16/excision-of-epidermal-inclusion-cyst
02103nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004500103245013600148260004400284300006300328505088000391506003601271538044601307856014401753298Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDerek J. Erstad, MD, Richard Hodin, MD 10aIleostomy Reversal for a Two-Stage Laparoscopic Proctocolectomy with Ileoanal J-Pouch for Ulcerative ColitiscDerek J. Erstad, MD aBostonbJournal of Medical Insightc2022 a1 online resource (1 streaming video file19:56bcolor/sound 0 aThis video describes a technique for an ileostomy reversal, which was performed as a second-stage procedure for a total proctocolectomy with ileoanal J-pouch for medically-refractory ulcerative colitis. In this procedure, we start by incising around the ileostomy near the junction of the skin and bowel mucosa. To mobilize the intestine within the abdominal wall, we use electrocautery dissection through the subcutaneous tissues to the level of the fascia. The fascial opening is extended to complete the mobilization of the intestine. Stay sutures are then placed between loops of intestine at the planned site of the anastomosis, and ILA staplers are used to create a side-to-side functional end-to-end anastomosis. The abdominal fascia is then closed with running sutures, the wound is washed with antiseptic, and the skin is brought together with vertical mattresses. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/298/ileostomy-reversal-for-a-two-stage-laparoscopic-proctocolectomy-with-ileoanal-j-pouch-for-ulcerative-colitis
03491nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100014000103245011700243260004400360300006300404505220800467506003602675538044602711856012803157313Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJ. Corbin Norton, Amrit Singh, MD, Laura L. Hollenbach, MD, Georgia Gamble, MD, Laura A. Gonzalez-Krellwitz, MD, Stephen J. Canon, MD 10aProphylactic Laparoscopic Bilateral Gonadectomy for Complete Androgen Insensitivity SyndromecJ. Corbin Norton aBostonbJournal of Medical Insightc2021 a1 online resource (1 streaming video file55:31bcolor/sound 0 aAndrogen insensitivity syndrome (AIS) is a rare condition caused by an X-linked mutation of the androgen receptor with an estimated incidence of 1–5 per 100,000 individuals. Varying degrees of presentation exist for complete, partial, or mild depending on the severity of androgen resistance. Patients with complete AIS (CAIS) are born phenotypically female but have male XY chromosomes and testes instead of ovaries. They exhibit normal secondary female sex characteristics such as breast development and external female genitalia but lack a uterus and other Müllerian duct structures due to testicular production of Müllerian-inhibiting factor (MIF). Due to androgen-resistance, androgen-dependent Wolffian duct products fail to develop such as the epididymis, vas deferens, and the seminal vesicles. These patients often present either during infancy with inguinal hernias or sublabial masses, or during adolescence with primary amenorrhea. On physical exam, they will typically have normal breast development, lack pubic or axillary hair, and will have a blind-ending vaginal pouch of varying vaginal lengths. Diagnostic work-up is often conducted using ultrasound or MRI, serum hormone levels, and karyotype analysis. 
For patients with CAIS, their testes can be located within the inguinal canal, sublabially or intra-abdominally. Following puberty, patients with intra-abdominal testes are at a 15% increased risk (range 0–22%) of developing germ cell tumors (GCT). Management consists of prophylactic gonadectomy with subsequent hormone replacement therapy (HRT) to maintain normal pubertal development and promote adequate bone health. The debate regarding the timing of prophylactic gonadectomy is ongoing with some patient support groups arguing against gonadectomy citing concerns with long-term hormone therapy and the desire to preserve fertility. The current convention promotes delaying gonadectomy until after physiologic puberty has been achieved as the risk of developing prepubertal GCT is relatively low (0.8–2%). We outline the presentation, diagnosis, intraoperative techniques, and postoperative considerations for managing CAIS via bilateral laparoscopic gonadectomy.
 aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/313/prophylactic-laparoscopic-bilateral-gonadectomy-for-complete-androgen-insensitivity-syndrome
02252nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100004600105245005000151260004400201300006300245505118600308506003601494538044601530856007001976206.2Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aVivian Xu, Asif M. Ilyas, MD, MBA, FACS 10aTrigger Finger Release (Cadaver)cVivian Xu aBostonbJournal of Medical Insightc2021 a1 online resource (1 streaming video file07:52bcolor/sound 0 aStenosing flexor tenosynovitis of the digital flexor tendon sheath, also known as trigger finger, occurs when there is a size mismatch between the flexor tendon and the surrounding retinacular pulley system at the first annular (A1) pulley. The A1 pulley overlies the metacarpophalangeal (MCP) joint at the base of the finger. When the flexor tendon thickens or becomes inflamed, its ability to properly glide through the flexor tendon sheath becomes impaired. Thus, the tendon catches as the finger is flexed and extended. Trigger finger is a frequently encountered condition for most hand surgeons, and it often coexists with other disorders such as diabetes, rheumatoid arthritis, amyloidosis, and carpal tunnel syndrome.<sup>1–3</sup> The cause is often idiopathic, though it has been speculated to result from overuse or repetitive movements of the finger.<sup>1,4</sup> Conservative management includes activity modification, splinting, short-term nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroid injection, and other adjuvant therapies. This video demonstrates a surgical approach to the treatment of trigger finger via the open A1 pulley release procedure. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/206.2/trigger-finger-release-(cadaver)
01994nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100003000103245009500133260004400228300006600272505086900338506003601207538044601243856009901689315Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aRockson C. Liu, MD FACS 10aRobotic eTEP Retrorectus Rives-Stoppa Repair for Ventral HerniacRockson C. Liu, MD FACS aBostonbJournal of Medical Insightc2021 a1 online resource (1 streaming video file02:05:00bcolor/sound 0 aMinimally invasive repair for ventral and incisional hernias has rapidly improved over the last years, mostly due to the introduction of new robotic techniques. With the introduction of the robotic extended view totally extraperitoneal repair (eTEP), which combines the best aspects of laparoscopic and open surgery without the disadvantages of either, minimizing entry into the abdominal cavity is now possible. With robotic eTEP retrorectus hernia repair, the robotic ports are placed directly into the retrorectus space. Using the crossover technique, the retrorectus spaces are combined with a pre-peritoneal bridge of the peritoneum. The defects are closed robotically, and the mesh is placed within the retrorectus space. Here, we present the robotic eTEP retrorectus Rives-Stoppa repair of an upper midline primary ventral hernia in a 63-year-old female.
 aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/315/robotic-etep-retrorectus-rives-stoppa-repair-for-ventral-hernia
01591nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006000103245007500163260004400238300006300282505047900345506003600824538044600860856007901306303Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aAlexander D. Selsky, BS, Asif M. Ilyas, MD, MBA, FACS 10aThumb Ulnar Collateral Ligament Tear RepaircAlexander D. Selsky, BS aBostonbJournal of Medical Insightc2021 a1 online resource (1 streaming video file08:42bcolor/sound 0 aUlnar collateral ligament (UCL) injuries of the thumb are among the most common injuries of the hand. Whether the injury is acute or chronic, a complete rupture of the ligament is usually managed with operative repair to restore thumb stability with pinch and grip, as well as to avoid arthritic changes. Here we present a patient who underwent UCL repair. We will discuss the natural history, preoperative care, intraoperative technique, and postoperative considerations. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/303/thumb-ulnar-collateral-ligament-tear-repair
01912nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100004900103245005900152260004400211300006300255505083200318506003601150538044601186856007401632296Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aJasmine Phun, Asif M. Ilyas, MD, MBA, FACS 10aSubcutaneous Ulnar Nerve TranspositioncJasmine Phun aBostonbJournal of Medical Insightc2021 a1 online resource (1 streaming video file11:37bcolor/sound 0 aCubital tunnel syndrome is one of the most common compression neuropathies affecting the upper extremity. Physical exam findings include loss of sensation, muscle weakness, and clawing of the fingers. More severe cases also show irreversible muscle atrophy, hand contractures, and loss of function. There are several approaches to treating cubital tunnel syndrome. Here, a subcutaneous anterior transposition was performed on this patient. The patients ulnar nerve subluxed upon elbow flexion and extension upon physical examination, which was a primary indication for choosing this surgical approach over other techniques. This procedure not only decompresses the affected nerve but also transposes the nerve anterior to the medial epicondyle so as to relieve strain on the nerve upon the full range of motion of the elbow.
 aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/296/subcutaneous-ulnar-nerve-transposition
02185nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005900103245005100162260004400213300006300257505112100320506003601441538044601477856005601923297Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aRachel M. Drummey, MSc, Asif M. Ilyas, MD, MBA, FACS 10aJersey Finger RepaircRachel M. Drummey, MSc aBostonbJournal of Medical Insightc2021 a1 online resource (1 streaming video file10:18bcolor/sound 0 aJersey finger, also known as rugby finger, is an avulsion to the flexor digitorum profundus at its insertion on the base of the distal phalanx (zone I). It is frequently caused by forceful extension of the distal interphalangeal joint while actively flexing the flexor digitorum profundus. The tendon may tear from the distal phalanx independently or may avulse with a bony fragment. A classification system has been developed to categorize distinct injury patterns based upon the level to which the flexor digitorum profundus tendon retracted and the presence or absence of a bony avulsion fracture. Flexor digitorum profundus tendon rupture has been reported in all age groups but is most common in athletes. The injury frequently occurs during contact sports, notably American football and rugby, when grabbing the jersey of an opposing player as the player pulls or runs away. Surgical repair is the definitive treatment for all cases of complete rupture of the flexor digitorum profundus tendon. This video demonstrates a surgical approach using the suture anchor technique to repair a jersey finger injury. 
 aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/297/jersey-finger-repair
01997nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006200103245012300165260004400288300006300332505078800395506003601183538044601219856012601665282Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aTaylor C. Brown, MD, MHS, Tobias Carling, MD, PhD, FACS 10aBilateral Posterior Retroperitoneoscopic Adrenalectomy with Cortical Sparing on Right SidecTaylor C. Brown, MD, MHS aBostonbJournal of Medical Insightc2021 a1 online resource (1 streaming video file44:48bcolor/sound 0 aCortical sparing adrenalectomy allows for resection of adrenal tumor(s) while preserving unaffected adrenal tissue to prevent adrenal insufficiency. This is especially important in patients affected with bilateral adrenal tumors, typically pheochromocytomas. Posterior retroperitoneoscopic adrenalectomy (PRA) allows for a minimally invasive approach to adrenal gland resection compared to the more traditional laparoscopic transabdominal adrenalectomy and open approaches. The PRA technique is increasingly used by high-volume endocrine surgeons throughout the world. This approach is ideal to address patients with bilateral disease and was utilized in this case of a patient presenting with bilateral pheochromocytomas in the setting of multiple endocrine neoplasia 2A syndrome. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/282/bilateral-posterior-retroperitoneoscopic-adrenalectomy-with-cortical-sparing-on-right-side
02116nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100006400103245010100167260004400268300006300312505094100375506003601316538044601352856011201798277Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aBridget N. Kelly, Carson L. Brown, Michelle C. Specht, MD 10aLeft Lumpectomy with Wireless Seed Localization for Ductal Carcinoma In SitucBridget N. Kelly aBostonbJournal of Medical Insightc2021 a1 online resource (1 streaming video file38:18bcolor/sound 0 aBreast-conserving surgery with radiation for early stage breast cancers provides equivalent survival rates to mastectomy when all surgical margins are clear of residual cancer. For patients whose tumors are not palpable upon physical examination, pre-operative localization of the malignant tissue to be removed is necessary. While wire localization is the traditional method of localization, a variety of wireless localization devices have become available as viable alternatives. Seed localizations provide several advantages over wire localization, including fewer scheduling issues, less patient anxiety, and reduced patient discomfort. Wire localizations must occur on day of surgery, while seed localizations may occur prior to surgery. Seed localization devices guide the breast surgeon to the target, typically a malignancy that must be removed in its entirety to give the patient the best likelihood of disease-free survival. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/277/left-lumpectomy-with-wireless-seed-localization-for-ductal-carcinoma-in-situ
01639nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100009700105245009600202260004400298300006300342505044300405506003600848538044600884856010301330299.6Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aDaven Patel, MD, MPH, Kristin Lewis, MD, MA, Allyson Peterson, MD, Nadim Michael Hafez, MD 10aExtended Focused Assessment with Sonography for Trauma (EFAST) ExamcDaven Patel, MD, MPH aBostonbJournal of Medical Insightc2021 a1 online resource (1 streaming video file26:48bcolor/sound 0 aThis video-article covers pertinent information related to the focused assessment with sonography for trauma exam, which evaluates the pericardial, hepatorenal, splenorenal, and suprapubic regions for free fluid in a trauma patient. It also covers additional information regarding the extended focused assessment with sonography for trauma (EFAST) exam, which includes an additional evaluation of the pleural spaces for a pneumothorax.  aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/299.6/extended-focused-assessment-with-sonography-for-trauma-efast-exam
02413nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100010600103245008600209260004400295300006300339505122900402506003601631538044601667856009402113122Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aEitan M. Ingall, MD, Ishaq O. Ibrahim, MD, Akachimere C. Uzosike, MD, Christopher W. DiGiovanni, MD 10aSubtalar Arthrodesis for Post-Traumatic Subtalar ArthritiscEitan M. Ingall, MD aBostonbJournal of Medical Insightc2021 a1 online resource (1 streaming video file54:51bcolor/sound 0 aSubtalar arthrodesis is currently the mainstay treatment option for the management of recalcitrant subtalar arthrosis. Arthrosis is a degenerative joint condition that results in a painful, functionally-impaired joint. In the subtalar joint, this typically follows trauma to the hindfoot resulting in talus or calcaneus fractures in particular. Although anatomic reduction of these injuries reduces the chance of later complications, arthrosis is reported even following anatomical repairs. The goal of the fusion in this circumstance is to remove a painful joint. A broad range of both congenital and acquired foot conditions include subtalar arthrodesis as part of their management strategy.

This video article details the methods and techniques involved in subtalar arthrodesis. After an Ollier approach was used to expose the subtalar joint, the subchondral plates were prepared by inserting an autogenous bone graft. Finally, compression was achieved by two lag screws. The process of obtaining an autogenous bone graft from the proximal tibia using a bone harvesting device is also illustrated, and opinions and expectations on the future direction of the management of this arthritic joint condition are discussed. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/122/subtalar-arthrodesis-for-post-traumatic-subtalar-arthritis
01642nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100005100105245005500156260004400211300006300255505056600318506003600884538044600920856007001366206.4Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aZachary Herman, Asif M. Ilyas, MD, MBA, FACS 10aCubital Tunnel Release (Cadaver)cZachary Herman aBostonbJournal of Medical Insightc2021 a1 online resource (1 streaming video file12:11bcolor/sound 0 aCubital 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. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/206.4/cubital-tunnel-release-(cadaver)
02144nam  22002051  4500001000600000003000500006006001900011007000400030008004100034028001100075040001900086100005300105245005600158260004400214300006300258505106600321506003601387538044601423856006901869206.1Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aSubhadra Acharya, Asif M. Ilyas, MD, MBA, FACS 10aCarpal Tunnel Release (Cadaver)cSubhadra Acharya aBostonbJournal of Medical Insightc2021 a1 online resource (1 streaming video file12:10bcolor/sound 0 aCarpal tunnel syndrome (CTS) is the most common peripheral compression neuropathy, and results in symptoms of numbness and paraesthesia in the thumb, index finger, middle finger, and half of the ring finger. When CTS symptoms progress and can no longer be managed with non-operative measures, carpal tunnel release (CTR) surgery is indicated. In this case, CTR surgery is performed on a 45-year-old female who presented with many weeks of a pins and needles sensation in her right hand that was most pronounced at night, affecting her ability to sleep, and which was not able to be controlled conservatively. The approach presented here is referred to as the “Mini-Open” CTR technique. A 2 cm longitudinal incision was placed directly over the carpal tunnel, and the transverse carpal ligament was exposed and then released. The wound was closed, and the patient was sent home with instructions to use her hand immediately postoperatively, while avoiding strenuous use until the incision has healed. Splinting and therapy are not required postoperatively. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/206.1/carpal-tunnel-release-(cadaver)
01801nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100002600103245007600129260004400205300006600249505071400315506003601029538044601065856008401511250Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aPeter Fagenholz, MD 10aPancreatic Debridement via Sinus Tract EndoscopycPeter Fagenholz, MD aBostonbJournal of Medical Insightc2021 a1 online resource (1 streaming video file01:18:58bcolor/sound 0 aSinus tract endoscopy (STE) is a minimally invasive technique for debridement of dead or infected tissue. STE is usually used for treatment of infected pancreatic or peripancreatic necrosis, though other applications have been described. STE involves placement of a percutaneous drain followed by fluoroscopically guided dilation of the drain tract to allow placement of a working sheath. An endoscope is then introduced through the sheath and used to debride necrotic tissue. A drain is then replaced through the same tract at the conclusion of the procedure. In this case we use STE to debride infected peripancreatic necrosis caused by a traumatic pancreatic injury and complicated by an enteric fistula. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/250/pancreatic-debridement-via-sinus-tract-endoscopy
01979nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000280010224501040013026000440023430000630027850508430034150600360118453804460122085601070166617Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMichael J. Weaver, MD 10aLess Invasive Stabilization System (LISS) for Distal Femur Fracture RepaircMichael J. Weaver, MD aBostonbJournal of Medical Insightc2020 a1 online resource (1 streaming video file49:32bcolor/sound 0 aDistal femur fractures can occur in both high- or low-energy settings, and, in the latter, they are often associated with fragility fractures, such as in elderly or osteoporotic patients. In fragility fractures, poor bone quality can make adequate reduction challenging. Diagnosis is typically made with imaging, and obtaining both x-ray and computed tomography is crucial for adequate evaluation of fracture pattern and pre-procedural planning.

In this case, a displaced intra-articular distal femoral fracture was seen. An open reduction and internal fixation (ORIF) was used with an anterolateral approach to visualize the joint surface and obtain anatomic reduction of the articular surface. Then, a lateral lock plate was placed percutaneously to bridge the area of comminution while restoring leg length, alignment, and rotation. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/17/less-invasive-stabilization-system-liss-for-distal-femur-fracture-repair
01969nam  22002051  4500001000400000003000500004006001900009007000400028008004100032028001100073040001900084100005000103245008100153260004400234300006300278505085300341506003601194538044601230856008701676110Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aNahel Elias, MD, FACS, Sahael Stapleton, MD 10aCreation of a Radial-Cephalic Arteriovenous FistulacNahel Elias, MD, FACS aBostonbJournal of Medical Insightc2020 a1 online resource (1 streaming video file37:27bcolor/sound 0 aEnd stage renal disease is common in the United States. It is most commonly caused by diabetes and hypertension. Renal function progressively declines over an unpredictable period of months to years, such that the kidneys are no longer able to perform their function. If failing renal function is not corrected or aided, premature demise is certain. Fortunately, several reliable techniques exist for establishing durable vascular access to aid in renal replacement therapy, specifically hemodialysis. Here we present the case of a middle aged male with progressive renal failure who underwent arteriovenous fistula creation for the purposes of aiding in renal replacement. We outline the scope of the problem, its natural history, preoperative care, selected intraoperative techniques, and relevant postoperative considerations for this process. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/110/creation-of-a-radial-cephalic-arteriovenous-fistula
01874nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000450010224500930014726000440024030000660028450507350035050600360108553804460112185601010156716Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aKeith Lillemoe, MD, Andrew Loehrer, MD 10aWhipple Procedure for Multiple Endocrine Neoplasia of the PancreascKeith Lillemoe, MD aBostonbJournal of Medical Insightc2018 a1 online resource (1 streaming video file01:35:39bcolor/sound 0 aMultiple endocrine neoplasia type 1 (MEN-1) is an uncommon autosomal dominant inherited condition with an estimated frequency of 1:30,000 across the general population. 35% –75% of patients with MEN-1 ultimately develop neuroendocrine tumors of the pancreas, which present the most significant threat to long-term survival. Pancreatectomy remains the only curative therapy for such patients and has become increasingly safe over the past few decades. Here we present the case of a young woman with MEN-1 who was found to have a 3.5 cm well-differentiated pancreatic neuroendocrine tumor in the head of the pancreas. We outline the natural history, preoperative care, intraoperative technique, and postoperative considerations. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/16/whipple-procedure-for-multiple-endocrine-neoplasia-of-the-pancreas
01786nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000270010224500810012926000440021030000630025450506940031750600360101153804460104785600870149320Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aRichard D. Scott, MD 10aPosterior Cruciate-Retaining Total Knee ArthroplastycRichard D. Scott, MD aBostonbJournal of Medical Insightc2017 a1 online resource (1 streaming video file50:40bcolor/sound 0 aTotal 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 pre-operative varus deformity. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/20/posterior-cruciate-retaining-total-knee-arthroplasty
02487nam  22002051  450000100030000000300050000300600190000800700040002700800410003102800110007204000190008310000510010224501210015326000440027430000660031850513060038450600360169053804460172685601090217245Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aXinning "Tiger" Li, MD, Nathan D. Orvets, MD 10aArthroscopic ACL Reconstruction with Bone Patellar Bone Graft using Anteromedial TechniquecXinning "Tiger" Li, MD aBostonbJournal of Medical Insightc2016 a1 online resource (1 streaming video file01:09:49bcolor/sound 0 aThere are approximately 200,000 anterior cruciate ligament (ACL) injuries per year in the United States and more than half will be treated with ACL reconstruction. The diagnosis is made by physical exam supplemented by radiographs and MRI scan. Successful ACL reconstruction returns most athletes to pre-injury activity; however, outcome depends on appropriate preoperative evaluation, surgical timing, surgical technique, and an effective postoperative physical therapy program. Specifically, graft choice, graft positioning, and fixation technique have been shown to play important roles in patient outcome. Surgeons must also be aware of concomitant meniscal tears and cartilage injury that may need to be addressed at the time of ACL reconstruction. In this case, we perform an anatomic ACL reconstruction with bone-patellar tendon-bone (BTB) autograft using an anteromedial drilling technique and flexible reamers for a young college athlete. The anteromedial approach offers the advantage of reliably reproducing the native anatomy of the ACL on the femur footprint by drilling the femoral tunnel independently of the tibial tunnel. Furthermore, using a flexible reamer instead of a straight rigid reamer allows for a longer femoral tunnel and lower risk of posterior wall blowout or fracture. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/45/arthroscopic-acl-reconstruction-btb-autograft-using-anteromedial-technique
02487nam  22002051  45000010002000000030005000020060019000070070004000260080041000300280011000710400019000821000033001012450095001342600044002293000063002735051383003365060036017195380446017558560080022018Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMichael Reinhorn, MD, FACS 10aMinimally Invasive Open Preperitoneal Inguinal Hernia RepaircMichael Reinhorn, MD, FACS aBostonbJournal of Medical Insightc2014 a1 online resource (1 streaming video file43:11bcolor/sound 0 aInguinal hernia is the most common form of hernia in adults, and is the result of either a congenital or acquired weakness in the lower abdominal wall, resulting in a defect through which the lining of the abdomen, or peritoneum, protrudes. An indirect inguinal hernia results from dilation of the internal ring over time, or a congenital patent processus vaginalis. In either case, a peritoneal sac herniates through the internal ring and often the external ring as well. In a direct inguinal hernia, transversalis fascia stretches out allowing for preperitoneal fat or peritoneal contents to herniate through Hasselbachs triangle. This can result in swelling of the lower abdomen and, at times, pain. In severe cases, abdominal contents such as bowel can protrude through the weakness as well, creating a life-threatening condition. The aim of inguinal hernia surgery is to repair the structural integrity of the lower abdomen, and, in adults, placement of a mesh reduces the risk of reformation, or recurrence, of the hernia. The difficult recovery associated with traditional inguinal hernia repair, where the inguinal canal is opened, has driven interest in less invasive alternatives, such as laparoscopic and open preperitoneal approaches. In experienced hands, these latter approaches result in equivalent rates of recurrence with much improved postoperative recovery. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/8/minimally-invasive-open-inguinal-hernia-repair
01292nam  22002051  45000010002000000030005000020060019000070070004000260080041000300280011000710400019000821000022001012450045001232600044001683000063002125050274002755060036005495380446005858560055010316Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aLouis Jenis, MD 10aCervical LaminoplastycLouis Jenis, MD aBostonbJournal of Medical Insightc2014 a1 online resource (1 streaming video file39:20bcolor/sound 0 aCervical spine laminoplasty is a treatment for multi-level cervical spondylotic myelopathy (CSM) without accompanying instability or cervical kyphosis. The goal is to decompress the spinal canal and relieve pressure on the spinal cord without destabilizing the spine. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/6/cervical-laminoplasty
02201nam  22002051  45000010002000000030005000020060019000070070004000260080041000300280011000710400019000821000032001012450125001332600044002583000066003025051020003685060036013885380446014248560125018705Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMatthew T. Provencher, MD 10aArthroscopic Bankart Repair for Anterior Shoulder Instability Using a Posterolateral PortalcMatthew T. Provencher, MD aBostonbJournal of Medical Insightc2014 a1 online resource (1 streaming video file01:05:34bcolor/sound 0 aA successful surgical outcome for patients with shoulder instability requires a complete preoperative evaluation, a thorough diagnostic arthroscopy to evaluate for concomitant co-pathology, and an effective postoperative therapy program tailored to the repair strategy. In addition to the Bankart lesion, the surgeon must be aware of other co-pathologies such as the HAGL lesion, the ALPSA lesion and SLAP tears, all of which may occur in concert with capsular pathology and which present as potential barriers to a successful outcome. We have previously described the use of a posterolateral arthroscopic portal, 4 cm lateral to the posterolateral corner of the acromion. This portal simplifies and improves anchor placement, trajectory, and anatomic capsulolabral repair of the inferior glenoid. In this case, we perform a hybrid repair using the posterolateral portal to place the first suture anchor at the 6 oclock position on the glenoid and the mid-glenoid portal to place two labral tape knotless anchors. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/5/arthroscopic-bankart-repair-for-anterior-shoulder-instability-using-a-posterolateral-portal
01956nam  22002051  45000010002000000030005000020060019000070070004000260080041000300280011000710400019000821000032001012450115001332600044002483000063002925050798003555060036011535380446011898560115016354Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aMatthew T. Provencher, MD 10aFemoral Resurfacing with an Osteochondral Allograft for Osteochondritis DissecanscMatthew T. Provencher, MD aBostonbJournal of Medical Insightc2014 a1 online resource (1 streaming video file56:34bcolor/sound 0 aOsteochondritis dissecans (OCD) of the knee has multiple possible etiologies. Among these are repetitive microtrauma, disruption of normal endochondral ossification, as well genetic factors. The male to female ratio is approximately 4:1 in the United States and has been found to have the highest incidence in the African American population. Diagnosis is usually made by physical examination in association with radiographs (flexion notch view) and magnetic resonance imaging. Lesions are usually found on the lateral aspect of the medial femoral condyle. Arthroscopy continues to be the gold standard for assessing the stability of OCD lesions. Many unstable lesions may be treated with stabilization, and cartilage restoration may provide benefit; however long term data is still limited. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/4/femoral-resurfacing-with-an-osteochondral-allograft-for-osteochondritis-dissecans
01827nam  22002051  45000010002000000030005000020060019000070070004000260080041000300280011000710400019000821000029001012450110001302600044002403000066002845050676003505060036010265380446010628560113015083Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aFotios Tjoumakaris, MD 10aArthroscopic Repair of Posterior Labral Tear with Paralabral Cyst DecompressioncFotios Tjoumakaris, MD aBostonbJournal of Medical Insightc2014 a1 online resource (1 streaming video file01:00:53bcolor/sound 0 aPosterior shoulder instability is a relatively rare phenomenon compared to anterior instability, comprising only 5-10% of all shoulder instability. Posterior instability most often occurs either as a result of high force direct trauma to the shoulder such as from a motor vehicle accident or indirect trauma such as from seizures or electrocution. Many cases of posterior shoulder instability are the result of micro-trauma that cause repetitive subluxation of the joint, ultimately compromising the shoulder in certain provocative positions. Surgical treatment of posterior instability is indicated only after an extended trial of rest and physical therapy has failed. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/3/arthroscopic-repair-of-posterior-labral-tear-with-paralabral-cyst-decompression
01801nam  22002051  45000010002000000030005000020060019000070070004000260080041000300280011000710400019000821000026001012450089001272600044002163000063002605050695003235060036010185380446010548560095015002Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aYelena Akelina, DVM 10aMicrosurgical Technique for 1mm Vessel End to End AnastomosiscYelena Akelina, DVM aBostonbJournal of Medical Insightc2014 a1 online resource (1 streaming video file40:30bcolor/sound 0 aThis article describes the technique of performing an end-to-end arterial anastomosis on a 1mm diameter rat femoral artery. Microsurgery anastomosis is a technique required for free flap transfers, transplant surgery and other surgical applications. This video article shows the microsurgical anastomosis technique in detail, covering aspects that are difficult to grasp without direct visualization. The laboratory environment is ideal tor practicing the delicate and meticulous maneuvers of microsurgery and for becoming familiar with the microscope and specialized tools involved. We hope this article will familiarize the prospective trainee prior to taking courses at our laboratory. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/2/microsurgical-technique-for-1mm-vessel-end-to-end-anastomosis
02001nam  22002051  45000010002000000030005000020060019000070070004000260080041000300280011000710400019000821000043001012450094001442600044002383000063002825050866003455060036012115380446012478560102016931Jomim####fo##m########cmv250519c20259999-us|||||||||||||||||eng#d 50bJomi aJomibengcJomi 1 aRuben Gobezie, MD, Samuel Dubrow, MD 10aArthroscopic Total Shoulder Resurfacing with Osteochondral AllograftcRuben Gobezie, MD aBostonbJournal of Medical Insightc2014 a1 online resource (1 streaming video file30:27bcolor/sound 0 aLimited treatment options exist for glenohumeral osteoarthritis in a young and active patient. To address the pain and limitation of significant osteoarthritis while avoiding a total shoulder arthroplasty (TSA), we have been using a minimally invasive technique to resurface both the glenoid and the humeral head using osteochondral allografts. After identifying the areas of most severe chondral damage during a diagnostic arthroscopy, a transhumeral tunnel is drilled using a transhumeral guidepin. Through this tunnel the allograft donor sites are prepared by retrograde reaming the humeral head and antegrade reaming the glenoid socket. Allograft constructs are sized and cut intra-operatively on a back table, inserted through the anterior portal and secured into the graft sites using chondral darts for the glenoid and a press fit for the humeral head. aaccess restricted to subscribers aSystem requirements: Browser compatibility: updated Mozilla Firefox, Google Chrome, Safari or Internet Explorer 8+. Browser settings: enable JavaScript, enable cookies from the Henry Stewart Talks site. Required Desktop Browser plugins & viewers: Updated Adobe Flash Player & Adobe Acrobat Reader. Mobile device & operating system versions: Android v4.0+, iPhone 4+ (iOS v6.x+), iPad 2+ (iOS v6.x+), BlackBerry OS v7.0+, Windows Phone v6.5.1+ 40uhttps://jomi.com/article/1/arthroscopic-total-shoulder-resurfacing-with-osteochondral-allograft