Surgical Procedures, Operative Commons^™

Effect Of Patient Resilience On Functional Outcomes After Meniscectomy, Adeeb Hanna, Andres Perez, Alice He, John Sonnier, Henson Destine, Rahul Muchintala, Ralph Cook, Sean Bryan, Fotios Tjoumakaris, Kevin Freedman

Rothman Institute Papers

BACKGROUND: Recent literature has identified that patient resilience may affect outcomes after meniscectomy. Research into psychological risk factors for poor surgical outcomes has been a focus in orthopaedic surgery.

PURPOSE/HYPOTHESIS: The purpose of this study was to examine the relationship between preoperative patient resilience and 2-year postoperative outcomes after arthroscopic meniscectomy. It was hypothesized that there would be no relationship between resilience and patient-reported outcomes after meniscectomy.

STUDY DESIGN: Cohort study; Level of evidence, 2.

METHODS: Patients who underwent meniscectomy between January and June 2020 at a single multicenter institution were identified, and those aged ≥18 years without evidence of …

Takeout Or Delivery? Reoperation Rates In Lower Extremity Long Bone Osteomyelitis Treated With Debridement And Local Antibiotic Delivery Systems, Nolan M. Reinhart, Jackson P. Tate, Jacob S. Budin, Julianna E. Winter, Olivia C. Lee, William F. Sherman

School of Medicine Faculty Publications

BACKGROUND: Early diagnosis and treatment of osteomyelitis is essential to prevent potential complications including sepsis, extensive bone resection, amputation, and death. Despite current treatment strategies for management of osteomyelitis, recurrence rates reported in the literature are upwards of 25 %. Current evidence comparing the efficacy of differing surgical treatments of osteomyelitis is inconclusive. The purpose of this study is to compare rates of re-debridement and amputation in patients who receive either debridement alone or debridement with placement of local antibiotic delivery systems as initial treatment for lower extremity long bone osteomyelitis. METHODS: A retrospective cohort study was performed to investigate …

Dobbs And Sterilization Decision-Making: Understanding The Coercive Spillover Effects In Reproductive Choice, Thomas Wilson Williams

Pace Law Review

The Supreme Court majority in Dobbs v. Jackson Women’s Health Organization argued their decision would have limited impact beyond abortion rights. This Article examines how Dobbs and subsequent state abortion restrictions are likely to increase women’s reliance on permanent sterilization procedures, particularly among already marginalized populations. Drawing on emerging data and historical context, I argue that some post-Dobbs sterilizations should be understood as effectively coerced by state policies, implicating reproductive justice concerns and potentially undermining fundamental rights established in Skinner v. Oklahoma. Then, I demonstrate how interdisciplinary bioethics frameworks and methodologies can help courts better understand the full …

Endovascular Removal Of A Symptomatic Intracranial Foreign Body Via Contact Aspiration: Illustrative Case, Jared M. Robichaux, Sarah E. Lawhon, Taylor W. Girolamo, Kapland Q. Owens, Lucido L. Ponce Mejia

School of Medicine Faculty Publications

BACKGROUND: With the growing utilization of general endovascular techniques, iatrogenic endovascular foreign bodies have become more prevalent. Contact aspiration has proven to be a valuable technique in treating ischemic strokes by removing the intraluminal thrombus causing cerebral perfusion deficits and neurological symptoms. The authors present a case of the removal of a foreign body from the vasculature via contact aspiration, which had embolized in a delayed fashion after aortic valve replacement. OBSERVATIONS: A 54-year-old male developed intermittent left-sided weakness 8 days after aortic valve replacement. A head computed tomography scan showed a metallic foreign body within the origin of the …

Ansa Cervicalis-To-Phrenic Nerve Transfer: Technical Note With Potential Application For Diaphragmatic Reanimation In Patients With High Cervical Spinal Cord Injury, Jonathan Melnick, Mohammadali M. Shoja, Gary B. Schwartz

HCA-NSU MD Research Day

Objective. This study was conducted to determine whether utilization of the superior root of ansa cervicalis (SRAC) as the donor for phrenic nerve (PN) transfer is technically feasible. Background. In patients with high cervical spinal cord injury resulting in diaphragmatic paralysis, another donor, the spinal accessory nerve, has been used successfully to reinnervate the PN and restore diaphragmatic function. Methods. Eight neck sides underwent cadaveric surgery. The sternocleidomastoid muscle was retracted posteriorly, the SRAC and PN were isolated, and the SRAC was cut near its distal end and transposed to the ipsilateral PN as it crossed the anterior scalene muscle. …

Bilateral Popliteal Entrapment Syndrome: A Rare And Challenging Case Report, Jose Burgos, Gabriela Llerena, Spencer Rheingold, Jorge De La Portilla

HCA-NSU MD Research Day

Bilateral Popliteal Entrapment Syndrome: A Rare and Challenging Case Report Burgos, Jose Julian, MD, MDIV, HCA Florida Kendall Department of Vascular Surgery Miami, Florida. Llerena, Gabriela2, OMSIV, Nova Southeastern University Dr. Kiran Patel College of Osteopathic Medicine. Rheingold, Spencer, MSIV, Nova Southeastern University Dr. Kiran Patel College of Allopathic Medicine. De La Portilla, Jorge MD, assistant professor, HCA Florida Kendall Department of Vascular Surgery Miami, Florida1 Objective: This case describes an atypical presentation of PES in an older male patient who presented with a sudden onset of symptoms without a history of claudication. Background: Popliteal entrapment syndrome (PES) is a …

Physician Modified Stent Grafts Created Using 3-Dimensional Printing In The Management Of Aortic Disease: A Systematic Review, Gregory Alfieri, Jack Stensland, Sydney Elness, Khavir Sharieff Do,Mba

HCA-NSU MD Research Day

Objective: This study evaluates the effectiveness and applicability of PMSGs created from 3D-printed models in managing aortic disease. Background: Endovascular treatment of aortic disease can be challenging, especially with complex anatomy. Three-dimensional (3D) printed models, derived from computed tomography (CT) and magnetic resonance imaging (MRI) scans, have been used to create physician-modified stent grafts (PMSGs) for vascular procedures involving the aorta. Methods: A systematic search was conducted in July 2024 across Embase, Ovid Medline, and Web of Science using PRISMA guidelines. Keywords included “aorta”, “3-dimensional printing”, and “implant”. Only studies reporting use of 3D printing-assisted PMSGs in aortic disease repair, …

Use Of Electrical Bone Growth Stimulators In High-Risk Patients Following Spinal Fusion, Soumya Malhotra, Khavir Sharieff

HCA-NSU MD Research Day

Title: Use of Electrical Bone Growth Stimulators in High-Risk Patients Following Spinal Fusion Authors: Soumya Malhotra, BA., MS1 & Khavir Sharieff, DO, MBA2 1Class of 2027, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL 2Assistant Professor of Surgery, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Tampa Bay, FLNova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine Objective: This study aimed to elucidate the advantages of EBGSs following high-risk spinal fusions. Background: Pseudarthrosis is a condition where bones fail to fuse after an injury or surgery. It causes significant …

Hemodynamic Collapse From Perforated Splenic Angiosarcoma: A Rare Case, Juliette Camejo, Tiffany Guillen, Rahul Ramakrishnan, Romany Harkas

HCA-NSU MD Research Day

Introduction: Splenic angiosarcoma is an uncommon, malignant neoplasm of vascular endothelial origin. Given its unique nature and rupture potential, we present a case of perforated splenic angiosarcoma. Case Description: A 79 year-old female with a history of vocal cord paralysis, recurrent laryngeal nerve palsy, and thyroidectomy presented for a second time with stridor and worsening shortness of breath. Due to desaturation and bradycardia, unsuccessful intubation led to a tracheostomy and ICU transfer. She stabilized and showed no major complications for seven days. On discharge day, the patient became diaphoretic, pale, and non-responsive, prompting a rapid response and code blue. Major …

A Contemporary Review Of Robotic Resection For Hepatocellular Carcinoma, William A. Preston, Nina R. Spitofsky, Adam S. Bodzin

Department of Surgery Faculty Papers

Background: Robotic hepatectomy represents an appealing treatment modality for resectable hepatocellular carcinoma (HCC). A contemporary review of robotic hepatectomy compared to laparo- scopic/open hepatectomy is necessary. Methods: We performed a literature review to identify studies between 2018–2024 comparing robotic to laparoscopic/open hepatectomy for HCC with measurable outcomes. Results: A total of 10 studies were identified, including 943 patients undergoing robotic hepatectomy compared to 1678 patients undergoing laparoscopic/open hepatectomy. Generally, while similar short/long-term survival was noted across all resection modalities, robotic hepatectomy was associated with longer operative time, shorter length of stay, and less post-operative compli- cations. An additional 4 studies …

Cataract Simulator Training And Medical Student Attitudes Towards Ophthalmology, Victor Sanchez, Christian Diaz, Zachary Elkin, Laura Palazzolo, Andrea Blitzer, Manjool Shah, Christina R. Prescott

Journal of Academic Ophthalmology

Introduction: Simulation-based learning offers novel opportunities to teach ophthalmology to medical students and inspire interest in the field. Eyesi surgical simulators have become widely adopted by ophthalmology departments and may serve a purpose in medical student education. The purpose of this study was to evaluate the effect of cataract simulators on medical student attitudes towards ophthalmology and to assess their performance/improvement on a series of simulator tasks.

Methods: This was a prospective, cross-sectional study of 31 medical students. Participants were recruited through an email sent via the school’s listserv. Enrolled students completed a series of tasks on the …

A Case Of Cecal Volvulus In The Setting Of Multiple Sclerosis, S. Jiaming Lin, Paige M. Kieper, Michael Mullinax, Jake W. Vogel, Kimberly Syres

Advances in Clinical Medical Research and Healthcare Delivery

This case report describes a patient with a history of multiple sclerosis (MS) and optic neuritis, who presented with acute onset of generalized abdominal pain. The patient was ultimately diagnosed with cecal volvulus requiring emergent laparotomy and right hemicolectomy. This case highlights the relationship between neurogenic bowel dysfunction (NBD) associated constipation in patients with MS and intestinal volvulus. Additionally, this case demonstrates the importance of NBD associated constipation management through various modalities including laxative regimens, behavioral and diet modification, and reduction of polypharmacy, with an emphasis on individualized patient management.

Editorial To Advances In Minimally Invasive Spine Surgery, Gabriel C. Tender, George A. Crabill

School of Medicine Faculty Publications

No abstract provided.

Hematopoietic Cell Transplant Compared With Standard Care In Adolescents And Young Adults With Sickle Cell Disease, Mark C. Walters, Mary Eapen, Yiwen Liu, Fuad El Rassi, Edmund K. Waller, John E. Levine, John J. Strouse, Joseph H. Antin, Suhag H. Parikh, Nitya Bakshi, Carlton D Dampier, Jennifer J. Jaroscak, Shayla Bergmann, Trish E. Wong, Vamsi K. Kota, Betty Sue Pace, Lazaros J. Lekakis, Premal D. Lulla, Robert Nickel, Kimberly A. Kasow, Uday R. Popat, Wally R. Smith, Lolie C. Yu, Nancy L. Difronzo, Nancy L. Geller, Naynesh Kamani, Elizabeth Sue Klings, Kathryn Hassell, Adam M. Mendizabal, Et Al

School of Medicine Faculty Publications

Disease-modifying therapies are standard of care (SOC) for sickle cell disease (SCD), but hematopoietic cell transplantation (HCT) has curative potential. We compared outcomes prospectively through 2-years after biologic assignment to a Donor or No Donor (SOC) Arm based on the availability of an HLA-matched sibling or unrelated donor (BMTCTN 1503; NCT02766465). A donor search was commenced after eligibility confirmation. The primary endpoint was the comparison of survival 2 years after biologic assignment between treatment arms. Power calculations required 60 participants on the Donor Arm and 140 on the No Donor Arm to determine if early transplant-related mortality might be balanced …

An Evaluation Of The Safety Of Half-Dose Direct Oral Anticoagulants Following Total Joint Arthroplasty: A Pilot Study., Harrison A Patrizio, Rex W Lutz, Stephanie A Kwan, Adam Lencer, Gregory K Deirmengian

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Background Total joint arthroplasty (TJA) patients on preoperative anticoagulation therapy present a challenge for adult reconstruction surgeons. The goal in managing such patients is to limit bleeding complications associated with administering the medications while preventing medical complications from withholding them. At our institution, we began a protocol in 2017 that utilizes a half-dose direct oral anticoagulant (DOAC) regimen for one week followed by resuming of the full-dose regimen in select patients who underwent TJA. This study investigated the 90-day safety profile associated with this protocol compared to previous literature. Methodology A retrospective review of 898 patients from a single institution …

Challenges In Paediatric Xenotransplantation: Ethical Components Requiring Distinct Attention In Children And Obligations To Patients And Society, Anthony Merlocco, Daniel J Hurst

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The transplantation of non-human organs into humans, or xenotransplantation (XTx), has recently garnered new attention and is being developed to help address the problem of organ scarcity in transplantation. Ethical issues surrounding XTx have been studied since initial interest arose decades ago and have experienced renewed discussion in the literature. However, the distinct and relevant differences when applied to children has largely been overlooked with few groups attending to the concerns that XTx in children raises. In this paper, we explore ethical challenges to be expected in paediatric XTx, in particular exploring organ sizing concerns, infectious risks, psychological burdens, and …

Same Or Different? Resolution Of Diagnostic Difficulty Of Two Mixed Cell-Type Tumors In Ovarian Pathology., Sarah Ingram, Priyanka Raju Md, Wei Shaw Do, Steve Sowers Pa, Kelly Brenan-Rothschild Md

Transformative Medicine

Introduction: When confronted by two disease processes, physicians in all disciplines are faced with the question: Are they manifestations of a common etiology, or distinct entities co-occurring? Inherent in this dilemma is whether an aberration from normal is even a disease process at all. Tissue pathology plays a key role in resolving this conundrum. Although diagnoses can be challenging, there are various methodologies used in the field of pathology to ascertain whether two tumors are of the same or different origins.

Case Description: This case report reviews two patients with large ovarian neoplasms and surgical pathology revealing histopathological features of …

Higher 10-Year Survival With Breast-Conserving Therapy Over Mastectomy For Women With Early-Stage (I-Ii) Breast Cancer: Analysis Of The Cdc Patterns Of Care Data Base, Pratibha Shrestha, Mei Chin Hsieh, Tekeda Ferguson, Edward S. Peters, Edward Trapido, Qingzhao Yu, Quyen D. Chu, Xiao Cheng Wu

School of Graduate Studies Faculty Publications

Background: Studies in the United States are scarce that assess the survival differences between breast-conserving surgery plus radiation (Breast-Conserving Therapy; BCT) and mastectomy groups using population-based data while accounting for sociodemographic and clinical factors that affect the survival of women with early-stage breast cancer (ESBC). Objective: To assess whether BCT provides superior long-term overall survival (OS) and breast cancer-specific survival (BCSS) compared with mastectomy in women with ESBC, while considering key factors that impact survival. Design: Cohort study. Methods: We analyzed data on women aged 20 years and older diagnosed with stage I-II breast cancer (BC) in 2004 who received …

Synovial Fluid Cutibacterium Acnes Antigen Is Detected Among Shoulder Samples With High Inflammation And Early Culture Growth, Krista Toler, Pearl Paranjape, Alex Mclaren, Thomas Jefferson University

Rothman Institute Papers

Background: An emerging paradigm suggests that positive Cutibacterium acnes shoulder cultures can result from either true infection or contamination, with true infections demonstrating a host inflammatory response and early culture growth. This clinical retrospective study examines the relationship between C. acnes antigen, C. acnes culture results, and inflammation.

Methods: From January 2021 to July 2023, 1,365 periprosthetic synovial fluid samples from 347 institutions were tested for shoulder infection at a centralized clinical laboratory. A biomarker scoring system based on the 2018 International Consensus Meeting (ICM) definition was utilized to assign each sample an inflammation score. Associations between inflammation, culture results, …

Safety And Efficacy Of Minimally Invasive Posterior Cervical Fusion: A Single Center, Single Surgeon Retrospective Review, George A. Crabill, Kaleb Derouen, Kierany B. Shelvin, John M. Wilson, Gabriel C. Tender

School of Medicine Faculty Publications

Standard posterior cervical fusion is a common surgical technique that utilizes lateral mass screws and rods for fixation. A relatively new, minimally invasive technique involving interfacet decortication and placement of spacers has shown promise in terms of outcomes. We sought to determine fusion rates and complications of this new technique at our institution to bolster current literature. We retrospectively reviewed all patients that underwent a 3-level or less minimally invasive posterior cervical fusions by a single surgeon. Patients were evaluated to determine fusion rates and postoperative complications. Twenty-eight patients underwent minimally invasive posterior cervical fusion. Twenty-seven demonstrated fusion (96%). One …

Transcatheter Aortic Valve Replacement Is Ready For Most Low-Risk Patients: A Systematic Review Of The Literature, Ahmad Jabri, Anas Alameh, Gennaro Giustino, Pedro Engel Gonzalez, Brian O'Neill, Rodrigo Bagur, Pedro Cox, Tiberio Frisoli, James Lee, Dee Dee Wang, William W. O'Neill, Pedro Villablanca

School of Medicine Faculty Publications

Transcatheter aortic valve replacement (TAVR) has undergone rapid expansion, emerging as a viable therapeutic option for low-risk patients in lieu of surgical aortic valve replacement. This paper aims to provide a review of the scientific evidence concerning TAVR in low-risk patients, encompassing both observational and clinical trial data. Furthermore, a substantial proportion of low-risk patients possesses a bicuspid aortic valve, necessitating careful examination of the pertinent anatomic and clinical considerations to TAVR that is highlighted in this review. Additionally, the review expands upon some of the unique challenges associated with alternate access in low-risk patients evaluated for TAVR. Last, this …

Effect Of Cemented Vs Uncemented On Outcomes For Hemiarthroplasty In The Elderly: A Meta-Analysis Of Randomized Clinical Trials, Yuning Feng, Jun Wan, Haidong Deng, Lvlin Chen, Yangchun Xiao, Tiangui Li, Jialing He, Peng Wang, Weelic Chong, Yang Hai, Lu Jia, Yu Zhang

Department of Medical Oncology Faculty Papers

PURPOSE: In patients undergoing hemiarthroplasty in the elderly, the choice of the cemented method remains controversial. This meta-analysis was undertaken to compare the impact of cemented vs uncemented on outcomes for hemiarthroplasty in the elderly.

METHODS: This study included randomized controlled trials comparing the postoperative effects of cemented vs uncemented in patients with hemiarthroplasty. With no language restrictions, we searched Medline (Ovid), Embase (Ovid), Cochrane Central Register of Controlled Trials (Cochrane Collaboration), Clinical Trials.gov, the ISRCTN registry, as well as gray literature with no language restrictions from January 1966 to April 2023. Data were quantitatively summarized using a random-effects model. …

Efficacy Of Thoracic Endovascular Aortic Repair Versus Medical Therapy For Treatment Of Type B Aortic Dissection, Karam Motawea, Samah Rouzan, Rowan Elhalag, Abdelrhaman Abdelwahab, Hussam Al Hennawi, Salem Elshenawy, Mai Saad Mohamed, Pensée Chébl, Mohamed Salem Madian, Mostafa Elsayed Elsayed Hewalla, Sarya Swed, Wael Hafez, Bisher Sawaf, Samer Kaspo, Naim Battikh, Mohammed Najdat Seijari, Amr Farwati, Amine Rakab

Abington Jefferson Health Papers

BACKGROUND: Techniques in endovascular therapy have evolved to offer a promising alternative to medical therapy alone for Type B aortic dissections (TBADs).

AIM: The aim of this meta-analysis was to compare mortality and overall complications between thoracic endovascular aortic repair (TEVAR) and best medical therapy (BMT) in patients with TBADs.

METHODS: We included randomized control trials and prospective or retrospective cohort studies that compared TEVAR and BMT for the treatment of type B aortic dissection. Multiple electronic databases were searched.

RESULTS: Thirty-two cohort studies including 150,836 patients were included. TEVAR was associated with a significantly lower 30-day mortality rate than …

Transcatheter Closure Of Complex Multifenestrated Atrial Septal Defect Using Three Septal Occluders: Is Three Too Many?, Hussam Al Hennawi, Appa Bandi, Ahmad Abulshamat, Shaurya Srivastava, Mohammed Qintar

Abington Jefferson Health Papers

Atrial septal defects (ASDs) are a common form of adult congenital heart disease, with surgical or transcatheter closure being the mainstay of treatment in patients with hemodynamic or clinical complications. Transcatheter repair of secundum ASD is safe and effective. Complex secundum ASDs with multifenestrated defects pose a unique challenge to transcatheter repair. We report a successful but complex transcatheter closure of an ASD using three overlapping Amplazter devices.

An International Consensus Panel On The Potential Value Of Digital Surgery, Jamie Erskine, Payam Abrishami, Jean Christophe Bernhard, Richard Charter, Richard Culbertson, Jo Carol Hiatt, Ataru Igarashi, Gretchen Purcell Jackson, Matthew Lien, Guy Maddern, Joseph Soon Yau Ng, Anita Patel, Koon Ho Rha, Prasanna Sooriakumaran, Scott Tackett, Giuseppe Turchetti, Anastasia Chalkidou

School of Public Health Faculty Publications

OBJECTIVES: The use of digital technology in surgery is increasing rapidly, with a wide array of new applications from presurgical planning to postsurgical performance assessment. Understanding the clinical and economic value of these technologies is vital for making appropriate health policy and purchasing decisions. We explore the potential value of digital technologies in surgery and produce expert consensus on how to assess this value. DESIGN: A modified Delphi and consensus conference approach was adopted. Delphi rounds were used to generate priority topics and consensus statements for discussion. SETTING AND PARTICIPANTS: An international panel of 14 experts was assembled, representing relevant …

Assessing The Accuracy And Utility Of Chatgpt Responses To Patient Questions Regarding Posterior Lumbar Decompression, Alec Giakas, Rajkishen Narayanan, Teeto Ezeonu, Jonathan Dalton, Yunsoo Lee, Tyler Henry, John Mangan, Gregory Schroeder, Alex Vaccaro, Christopher Kepler

Department of Orthopaedic Surgery Faculty Papers

Aim: To examine the clinical accuracy and applicability of ChatGPT answers to commonly asked questions from patients considering posterior lumbar decompression (PLD). Methods: A literature review was conducted to identify 10 questions that encompass some of the most common questions and concerns patients may have regarding lumbar decompression surgery. The selected questions were then posed to ChatGPT. Initial responses were then recorded, and no follow-up or clarifying questions were permitted. Two attending fellowship-trained spine surgeons then graded each response from the chatbot using a modified Global Quality Scale to evaluate ChatGPT’s accuracy and utility. The surgeons then analyzed each question, …

Factors Associated With Recanalization And Reintervention Following Below Knee Polidocanol Endovenous Microfoam Ablation For Great Saphenous And Small Saphenous Veins, John Fang, Christian Fang, Andy Moyal, Enrico Ascher, Anil Hingorani, Natalie Marks

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Polidocanol endovenous microfoam (PEM) has been used to treat lower extremity venous reflux for almost one decade with specific advantages for below knee (BK) truncal veins where thermal ablation poses a risk of injury to adjacent nerves. The current literature of the BK segment often examines short-term outcomes with modest sample sizes. We aim to identify factors associated with recanalization and reintervention in this subset of patients.

METHODS: We performed a retrospective study of a prospectively maintained database of patients from a single institution who underwent 1% PEM ablation for BK great saphenous vein (GSV) and small saphenous vein …

Bilio-Cecal Stent Migration Presenting As Massive Rectal Bleeding., Lefika Bathobakae, Shady Geris, Mohita Jariwala, Mansi Patel, Jessica Escobar, Ruhin Yuridullah, Kamal Amer, Yana Cavanagh

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Endoscopic biliary stenting is a well-established intervention for the treatment of biliary, hepatic, and pancreatic disorders. The common indications include strictures, neoplasms, stones, infections, and bile leaks. Stents can be occluded, predisposing patients to ascending cholangitis and biliary sepsis. Distal stent migration is another known complication of endoscopic stenting and is usually spontaneous. Bowel perforation, abscesses, bleeding, and pancreatitis are rare complications of distal stent migration and are usually limited to the duodenum. Herein, we describe an extremely rare case of bilio-cecal stent migration presenting as rectal bleeding.

Endoscopic Transventricular "Inside-Out" Corpus Callosotomy: Illustrative Case, Michael Baumgartner, Elias Atallah, Kathleen Galligan, Pamela Mcdonnell, Benjamin Kennedy

Department of Neurosurgery Faculty Papers

BACKGROUND: Tonic and atonic "drop attack" seizures are a classic and morbid semiology in Lennox-Gastaut syndrome, resulting in frequent injuries and emergency room visits, in addition to neurocognitive sequelae. Recent years have seen a growing interest in less invasive techniques for performing the classic surgical treatment for drop attacks in Lennox-Gastaut syndrome, that is, corpus callosotomy.

OBSERVATIONS: A 5-year-old boy with Lennox-Gastaut syndrome presented for surgical evaluation. He experienced up to 20 daily tonic seizures despite multiple antiseizure medications. Preoperative imaging revealed highly abnormal anatomy with severe ventriculomegaly and thinning of the cortex and corpus callosum. Open microsurgery or an …

Microvascular Autologous Breast Reconstruction With The Lateral Thigh Perforator Flap, Stefania M.H. Tuinder, Joep A.F. Van Rooij, Robert J. Allen

School of Medicine Faculty Publications

The lateral thigh perforator flap is an excellent alternative to the deep inferior epigastric artery perforator (DIEP) flap for patients with absolute or relative contraindications for a DIEP flap and adequate volume at the lateral thigh. Preoperative physical examination, preoperative markings, and radiological perforator mapping are essential for adequate surgical preparation. The flap is based on septocutaneous perforators of the lateral circumflex femoral artery, located in the posterior septum between the tensor fascia latae and the gluteus medius muscle. Being relatively stiff, septocutaneous perforators are sensitive to kinking and compression, which is important to keep in mind during flap inset. …