Operation offers viewers
a unique opportunity--to enter the
surgical arena and witness the wonders
of today's most innovative surgical
procedures. It takes viewers into
the lives, minds and hearts of patients
Since it first premiered on January
28, 1993 with "Open Heart Surgery",
has educated and informed viewers
about the amazing possibilities of
repairing the human body
Each episode follows
one case from pre-op through surgery
to post-operative recovery. We first
meet the patient and learn of the
processes involved in his or her
decision to undergo the procedure.
Next, the surgeon explains the specific
details of the surgery and how it
can significantly improve the quality
of the patient's life. The actual
surgery is then recorded and each
program concludes with a visit to
the patient during the recovery
is explained in clear, uncomplicated
medical language to accommodate
the average viewer. However, each
program is also in-depth and comprehensive
enough to appeal to medical professionals
who use the program for study or
review. Artistically rendered computer
graphics help illustrate the procedures
and enhance understanding for viewers.
Operation cover such
topics as Laparoscopic Hernia Repair,
Arthroscopic Knee Surgery, Breast
Reduction, Cesarean Section, Back
Microsurgery, Cornea Repair, Prostate
Surgery, Kidney Transplant, Cleft
Palate Repair, Coronary Bypass Surgery,
Tubal Ligation and Vasectomy. The
operations are performed throughout
North America at prominent hospitals
and medical center, such as Duke
University, Johns Hopkins, Cleveland
Clinic, Columbia Presbyterian, Vanderbilt,
Emory, UCSF, and Toronto Western.
ARTHROSCOPIC KNEE SURGERY
This program offers a rare glimpse
inside one of the great ensembles
of human parts,
the knee joint,
a spectacular orchestration of bones,
cartilage, muscles and ligaments
working together to produce a symphony
of movement. Unfortunately, the
knee is as vulnerable as it is remarkable,
held together by elastic cords that
can snap or tear. And that's what
happened to Jeannie King
during a Tae Kwan Doe kick. Now
Dr. Gary Paley will reconstruct
Jean's anterior cruciate ligament
without opening up her knee, a bit
of magic made possible by arthroscopic
surgery on the operation.
More than 2 million Americans suffer
from epilepsy, an abnormal electrical
activity in the brain. Medication
is the first line of defense but
sometime surgery may be an option.
Such is the case with Lynn Venuto.
Neurologist Dr. Rodney Radke
has identified the source of Lynn's
seizures, a tiny cluster of blood
vessels behind her left temple.
Because the site is close to her
brain's language center, Lynn must
stay awake and answer questions
during the operation. The doctors
need to know that her vocal abilities
are not being disturbed. In a moment,
neurosurgeon Dr. Alan Freedman
will remove the lesion in Lynn's
brain. Join us as doctor and patient
prepare for the operation.
This program witnesses the miracle
of birth combined with the technology
of modern medicine. Because childbirth
can sometimes pose a threat to both
mother and baby, a Caesarian section
can be a safe alternative. Named
after Julius Caesar who according
to legend entered the world this
way, a Caesarian is the delivery
of a baby through an incision in
the mother's lower abdomen. Joan
and Tim Barber's baby is
in breech position and if delivered
naturally would travel down the
birth canal feet first. To prevent
the baby from getting stuck, Dr.
Nancy Cheshire will perform
a C-section. Join us as the doctor
and the family prepare for the operation.
More than 40,000 corneal transplants
will be performed in the United
States this year alone. It is the
most common of all tissue transplant
operations. The cornea, the outer
lens of the eye, performs the first
step in the eye's focusing system.
But injury or disease can cloud
this lens, causing impaired vision.
To restore clear sight, a corneal
transplant may be needed. With any
eye surgery, a one millimeter mistake
could mean instant blindness so
doctors perform the surgery through
the lens of a microscope. In a moment,
Dr. Linda Burke will replace
Margaret Hurr's right cornea.
Join us as doctor and patient prepare
for the operation.
In the science fiction film "Fantastic
Voyage," a miniature medical
team travels inside a human body.
Doctors today can repeat that journey,
using tiny cameras instead of tiny
people. That's what they do in gallbladder
surgery. The lens of a microscopic
camera is placed inside the patient
through a tiny slit about the size
of a dime. This gives the surgeon
a bloodless view of the entire abdominal
area. Long, delicate tools are used
to remove the diseased organ leaving
a scar small enough for a bandaid.
Join us as Dr. James C. Rosser
and patient Candice Windhan
take us on a fantastic voyage on
The patient, 12 year old Richard
Nichols, fractured his leg
when he was four. The bone healed
improperly, leaving his shin bone
in his ankle twisted. The treatment
he needs was developed in Siberia
almost 40 years ago, when Dr.
Gabriele Elizara, a Soviety
physician, learned how to manipulate
Much like an orthodontist straightens
teeth, orthopaedists can lengthen
and straighten limbs with this procedure.
In a moment, orthopaedic surgeon
Richard Davis begins the
process of correcting a young boy's
twisted leg. Join us as doctor and
patient prepare for the operation.
The patient Rod Dirkson
has a timebomb in his chest; he
has Mar fan Syndrome, a disease
marked by unusual height, loose
jointedness, and a dangerously weakened
aorta. Mar fan's can bring both
genius and tragedy. It may have
blessed Paganini with his dexterity
on the violin. It struck down Olympic
volleyball player Flo Heinman in
1986. Some say that Abe Lincoln
had it and would have died prematurely
with or without an assasin's bullet.
In a remarkable open heart procedure,
Dr. Vince Gaudiani will
now attempt to defuse the bomb in
Rod Dirkson's chest on
the operation ion.
Maria was born with amniotic
band syndrome. She was missing part
of the ring finger, the middle finger
and the pointer finger was cut all
the way down and half of her thumb.
Dr. Chou did surgery on Maria in
June and her ring finger was like
a little bit attached to the middle
finger. So what he did was he made
an opening to make the finger go
more freely. He like unwebbed it.
And then the last operation that
she had, they built her up a thumb.
So this extra bone that was left
over from the pointer, they transferred
it over and built up her thumb.
The next operation, Dr. Chou will
be taking a toe, O.K. attaching
it to her hand, and making a finger
out of it. They're taking the second
toe, O.K., on each foot. And that
should have no effect on her walking.
SURGERY - MICRODISCECTOMY
The surgery that is going to be
performed on Rick is called a "Microdiscectomy."
This is a relatively new technique
of removing a slipped disc. The
other way of doing it is called
a Lamenectomy - or "open procedure."
Microdiscectomy is exactly what
it sounds like. I'm going to use
microscopic techniques to remove
the disc. The benefits of doing
the surgery this way is that it
is "minimally evasive,"
meaning that it causes less trauma
to the patient. Using this technique,
only about a one inch incision in
the skin has to be made and from
there one can reach the position
needed to remove the disc. In the
open procedure, you need to make
about a eight inch opening in the
skin. The recovery time for an open
procedure is much greater than a
Microdiscectomy. Rick will be operated
on in the morning, and later that
same day he'll be standing and walking
around. It would be days and even
weeks if this operation were to
be done as an open procedure.
Though our patient, Grant
Roberts, is only 47 years old,
he has already suffered one heart
attack and is in danger of another.
Doctors have located blockages in
three of his coronary arteries.
The coronary arteries encircle the
heart and supply it with the blood
it needs to function. Any kind of
blockage in these arteries can be
life threatening. To increase the
blood flow to Grant's heart and
reduce the risk of heart failure,
Dr. James Douglas, Jr.,
of the Duke University Medical Center
needs to create detours around the
blocked arteries. This is a serious
procedure which involves stopping
the heart in order to save it.
The womb of the uterus is lined
with endometrium tissue. It provides
the incubation for fertilized eggs.
It is every babies first chance
for life. Ironically when this tissue
spreads into a woman's ovaries or
abdomen it can cause infertility
as well as severe pain. This condition
is called endometriosis and it affects
10 million women in the United States
alone. In this episode, Dr.
Ana Murphy at the Emory Clinic
in Atlanta will use a slender microscopic
viewing device to locate our patient's
excess endometrial tissue and remove
it on the operation.
We are about to watch a
procedure commonly known as a face
lift. It is sought by men and women
in search of a more youthful appearance.
While gossip columns have made cosmetic
surgery a popular topic, in reality
the choice to have a face lift is
made every day by hundreds of people
who have never been in the headlines.
In this program, our patient is
Beverly Strong, a 51 year
old, single working mother who wants
to restore her face to a younger
more vibrant look. Beverly's decision
was the result of careful thought
about the serious nature of this
delicate operation. Her plastic
surgeon is Dr. Neal Handel who
will perform facial liposuction
and eyelid surgery in addition to
the face lift procedure. Join us
now as Dr. Handel and Beverly prepare
for the operation.
We're about to witness
one of the most significant advances
in modern medicine — laparoscopic
surgery. Using a tiny video camera,
surgeons can now enter the body's
inner world through an incision
of only half an inch in length.
Once inside, the laparoscope serves
as the surgeon's eyes while he performs
a range of complex medical procedures.
In this program, you will meet Dr.
Carlos Gracia and his patient,
37 year old Charles Garrison.
A policeman and father of three
small children, Charles' physically
demanding life style has been interrupted
by a tear in the muscle wall of
his abdomen, commonly known as a
hernia. This condition used to require
extensive recovery time following
surgery. The use of the laparoscope
will allow Charles to return more
quickly to his family and his job.
Join us as Dr. Gracia and Charles
prepare for the operation.
One out of four couples
in the United States choose a vasectomy
or tubal ligation as a way to plan
their families. Their next important
and intimate decision is which partner
will undergo the surgery. Fortunately,
both surgical procedures are equally
safe and reliable. Lets join the
doctors and their patients for the
Because many men are hesitant
to lose the option of having children
later in life, the decision to have
a vasectomy is significant. However,
thanks to the latest microsurgery
techniques that choice is now reversible.
While a vasectomy blocks the tube
that carries the sperm, the reversal
removes that blockage and reconnects
the tube allowing the sperm to pass
freely. Lets join Dr. and patient
as they begin the operation.
Tammy Lee Hart
is a 33 year old aspiring singer
and mother of two. In her quest
for the spotlight, she has developed
most of her adult life to building
a successful career. And in the
competitive town of Nashville, Tammy
Lee knows that her voice must always
be at its best. Yet recently her
future has been threatened by the
formation of cysts on her vocal
chords. To correct this problem,
Dr. Robert Osof, the medical
director of the Vanderbilt Voice
Center, will remove these cysts,
allowing her vocal chords to once
again function effectively. For
Tammy Lee, the surgery is a necessity
if she is to ultimately fulfill
her dream. Join us now as Dr. Osof
and Tammy prepare for the operation.
RADICAL RETRPUBIC PROSTATECTOMY
Joe Rascoff is
49 years old and is the father of
a college-age son and two 20-month-old
twins. He and his wife are in the
process of moving to New York City
from California. Through the use
of a PSA test, Joe was diagnosed
as being within an early stage of
prostate cancer. Traditionally,
removal of the prostate would leave
a patient impotent. Dr. Patrick
C. Walsh developed this technique
that allows post-op sexual functional
in a high percentage of cases. Due
to the early detection, Joe can
reasonably expect that this surgery
will cure him of his cancer.
A bunion is an arthritic
bump that forms as a result of malalignment
of the big toe. Bunions are genetic.
Wearing tight shoes can aggravate
an existing condition. Most bunion
surgeries fail to correctly realign
the joint. 30% of bunions return
after a year of surgery. The Tri-Correctional
Bunionectomy usually gets the patient
back in shoes in 2-3 weeks as opposed
to 6-8 weeks with other procedures.
The Tri-Correctional Bunionectomy
is a three dimensional realignment
of the big toe joint done in an
attempt to eliminate the forces
that caused the bunion. In this
program we will watch as Dr.
Allen J. Selner removes his
patient's extra bone growth and
realigns the joint of his big toe.
Mary injured her neck during
gymnastics. One of her vertebra
moved out of place and then popped
back into place moments later. Unfortunately,
the surrounding ligaments have been
stretched, leaving her neck unstable
and susceptible to further and more
serious injury. The goal of surgery
is to stabilize the vertebrae which
are currently pushing against her
spinal cord and causing shooting
pains in her arms. Without this
surgery, Mary could be paralyzed
if she were to have another accident.
Dr. John A. Jane will make a 3-inch
incision in Mary's neck. Using a
high-powered microscope, he'll clear
away the surrounding tissue to access
the damaged vertebrae, C5 and C6.
He will then drill holes into the
vertebrae and place pins in the
holes. He'll then lasso these pins
with cable, pulling the separated
vertebrae together. This procedure
will stabilize the vertebrae to
prevent against further injury to
her spinal cord.
Ashley Fridley was born
with a deformed heart. She does
not get enough oxygenated blood
into her bloodstream. Her illness
is commonly referred to as "Blue
Baby Syndrome" because her
skin actually takes on a grayish-blue
skin tone. She also tends to be
lethargic and tires easily. Dr.
Ross Ungerleider of Duke University
Medical Center will perform a procedure
called a Fontan. Ashley has had
two previous surgeries, and the
Fontan will be the third and final
in the series. Dr. Ungerleider will
reroute the plumbing in her heart
by hooking up her atrium to her
pulmonary arteries. This will deliver
more oxygenated blood into her bloodstream.
After a successful surgery, Ashley's
skin tone will become more pink,
and she will be less lethargic.
Ashley needs this surgery to live.
Without it, her life span will be
Clifford Stahl is
a 54-year-old high school math teacher
who has been diagnosed with failing
kidneys and requires a transplant.
All of Clifford's five brothers
and sisters had close genetic matching
with Clifford, but there was one
problem. Clifford has an unusual
blood type which his brothers and
sisters did not. His son Jeff became
his only hope because they have
similar blood types. Doctors
Robert and Rafael Mendez are
identical twin brothers. The two
work together to complete the kidney
transplant. As Dr. Rafael Mendez
works on removing the donor kidney,
Dr. Robert Mendez prepares the recipient
for surgery in a neighboring operating
room. Clifford Stahl's original
diseased kidneys will remain intact.
One of his son's kidneys —
a healthy kidney — will be
removed and then implanted in an
area just below Clifford's abdomen.
It will then be attached to the
iliac artery and the bladder.
Kevlin Morgan has Chrone's
disease, a chronic inflammation
of the digestive tract. Chrone's
disease causes cramping, bleeding,
diarrhea, fever and depression.
Fortunately, the inflammation is
in an area (ileum and colon) that
can be easily removed and has a
lesser risk of reoccurrence of inflammation.
Using laparoscopic surgery, Dr.
Joseph Uddo will attempt to
remove the inflamed section of colon
and reconnect the two ends not affected
by the inflammation.
Our patient, Mike Larkin,
is diabetic. Recently the vision
in his left eye has become completely
blurred due to diabetic retinopathy,
a condition that weakens blood vessels
in the eye and causes them to leak
and impair vision. A decade ago
doctors could offer little hope
for Mike's sight. Today, however,
using tiny surgical tools and high-powered
microscopes, they can reach inside
the eye and repair the damage. Dr.
Julia Haller of the Johns Hopkins
Hospital will perform this vision
restoring, called a vitrectomy.
10% of the adult population
suffer from heartburn on a daily
basis and 10% of these (some 1.5
million individuals) have severe
reflux requiring intensive medial
management for the disease. Gastric
Esophageal Reflux Disease (GERD)
is the number one reason for referrals
to Gastroenterologists in the U.S.
and accounts for the largest pharmaceutical
expenditure for diseases of the
gastrointestinal tract. GERD is
a life-long disease which doesn't
"burn out" like ulcer
disease and can result in a condition
associated with esophageal cancer,
an essentially incurable disease.
Using five tiny incisions, Dr.
Tom A. Paluch manipulates a
camera and laparoscopic tools in
order to "wrap" part of
the stomach around the esophagus.
The esophagus will accept this wrap
to increase the "area of pressure"
which keeps food and stomach acid
from refluxing back up the esophagus
and into the mouth -- causing heartburn,
burping, painful swallowing and
Diagnosed with breast cancer
in 1992, Jean Dubravoc
was forced to part with her breast
after an unsuccessful Lumpectomy
in 1993 gave way to a Mastectomy
in 1994. Today she looks forward
to her breast reconstruction. Dr.
Susan Downey will take
tissue from Jean's abdomen and tunnel
beneath the skin to the breast to
form a new breast mound.
A cleft palate is among
the most common of birth defects
among caucasian Americans, affecting
nearly 1 out of every 700 individuals.
Dr. Steven R. Buchman will
repair 9-month-old Jackson Lamb's
cleft palate prior to his first
VASCULARIZED FIBULAR GRAFT
A Free Vascularized Fibular
Graft consists of removing dead
bone that has poor blood supply
from the hip, and replacing it with
a healthy segment of vascularized
(blood rich) bone from the fibula,
which serves as a graft. The surgery
is done by two teams of specialized
doctors. One team works on the h
ip area, and the other team works
on the lower leg. During the surgery,
an incision is made along the hip
so that the dead bone may be removed
and the remaining bone may be prepared
to receive the graft. An incision
is made in the lower leg to remove
a segment of the fibula and its
attached blood vessels. The fibular
segment of bone is then inserted
into the hip bone, and the vessels
(artery and vein) in the hip region
are connected to the vessels of
the fibular graft using microsurgical
thenique by either sutured connection
or 3M vascular coupler. The circulation
is carefully checked to insure blood
flow into the h ip, and the incisions
are closed. A splint is applied
to the lower leg to immobilize it
for comfort, which is usually removed
after five days.
Although Hysterectomy surgery
has probably been over-utilized
in the past, there are many situations
where removal of the uterus is the
best or only solution to a woman's
health problems. Today, women seek
alternative therapy before resorting
to a hysterectomy. A vaginal hysterectomy
is a much less invasive operation
that the traditional open procedure
and is much better tolerated by
the patient with a faster recovery
and less hospitalization. Certain
situations preclude vaginal hysterectomy,
but by using laparoscopic instruments
for part of the surgery, many open
hysterectomies may be turned into
vaginal ones instead.
As of October 1995, the waiting
list for liver transplants has grown
Helen Bennett has been on the donor
waiting list for 9 months. Our patient,
along with about 20% of other people
waiting for a liver transplant,
has liver disease of unknown origin
(not related to any form of alcohol
abuse or hepatitis). The surgery
can be subdivided in four consecutive
stages: (1) preparation of the donor
liver (called back table work),
(2) removal of the diseased liver,
(3) implantation of the donor liver
and revascularization, and (4) reconstruction
of the hepatic artery and bile duct.
I in 700 persons has hyperparathyroidism.
There are 100,000 new cases reported
each year. The symptoms can be diabolical
in that patients may be treated
for individual symptoms (e.g. depression)
before the correct diagnosis is
made. Dr. Orlo Clark will
make an incision across the neck
above the Thyroid and will carry
down through muscle by sharp dissection.
A dry field is maintained so that
blood does not stain fat and other
tissues. Staining makes it more
difficult to distinguish between
normal and abnormal parathyroid
glands. The Thyroid Gland is retracted
and held up out of the way by a
silk thread. The parathyroid Tumor
(adenoma) is located and excised.
The remaining Parathyroids are examined
on either side of the neck. In doing
so great care is exercised in identifying
the recurrent laryngeal nerve; If
this is injured the voice will be
Kelly Flanders has
been suffering from extreme headaches
her entire life. She was misdiagnosed
for years until, when at 30 years
old, she had 2 strokes. As she was
waiting for the third stroke to
kill her, she heard of Dr. Spetcler
and his innovative technique. Dr.
Robert F. Spetcler harvests an artery
under the cheekbone in front of
the ear; removes the artery; removes
the skull; and sutures the new artery
to the existing deteriorated artery…
in effect building a new temporal
Ed is a 58 year old retiree,
who loves to play golf. While undergoing
tests for an upcoming ear surgery,
three aneurysms were discovered.
One on the left side behind the
eye, one very large aneurysm on
the left side near the brain stem
and one on the right behind the
eye. The surgery we will profile
will correct the two on the left
side. In the future there will be
a second procedure to correct the
aneurysm on the right side. The
aneurysm near the brain stem is
in the most inaccessible part of
the body. It presents a challenge
to Dr. Julian Bailes, the
Allan has cerebral palsy.
Most of the children undergoing
a dorsal rhizotomy have cerebral
palsy, though children with traumatic
brain injuries also can be helped
by the surgery. Selective dorsal
rhizotomy can improve the affected
child's ability to sit, stand, crawl
and, in Allan's case, hopefully,
result in his being able to walk.
Dr. Karin M. Muraszko will
open up spine, locate and test nerves.
Nerves that over respond (hyperactive
nerves) will have a portion clipped
in order to reduce spasticity. To
receive the most benefit from the
surgery, children must have some
control over their legs. They also
cannot have other movement disorder
problems. Finally, they have to
be able to participate cognitively
in the program. The last point is
crucial because the program is more
than just surgery. After the four
to five hour procedure, patients
recover in the hospital for several
weeks. That is followed by a year
BROWLIFT and COSMETIC LASER SURGERY
Five to six small incisions
are placed in the scalp a few inches
behind the hairline. An "endoscope",
which is a long tube with a video
camera at one end, is inserted into
one of the incisions. Into one of
the other incisions the surgeon
inserts special endoscopic surgical
instruments. He then is able to
operate through these tiny incisions
by watching his movements on a video
monitor. The small muscles between
the eyebrows that cause frown lines
are removed. The eyebrows are carefully
elevated and precisely secured at
a slightly higher, more youthful
A local anesthetic is given in the
areas being treated. Since the laser
light can be harmful to the eyes,
the patient, physicians and nurses
wear protective eyewear. The amount
of laser energy being delivered
are important variables which the
surgeon determines prior to treating
each patient The surgeon aims the
laser with a handpiece and turns
the laser on and off with a foot
switch. The surgeon treats each
area individually, and can vary
the depth of the treatment from
area to area, depending on how deep
the wrinkles or scars are. After
each "pass", the surgeon
carefully inspects the treated areas
to determine if the treatment is
adequate. He wipes away the wrinkled
or scarred upper layers of the skin
that have been treated with the
laser and inspects the color and
texture of the remaining deeper
layers to determine how much deeper
the treatment needs to go.
Orthognathic Surgery: The
word "orthognathic" comes
from the Greek words orthos, meaning
straight, and gnathos, meaning jaws.
Orthognathic surgery shapes up the
face by straightening teeth with
orthodontics and repositioning jaws
with corrective jaw surgery. The
orthognathic team consists of an
orthodontist and surgeon. The orthodontist
specializes in the straightening
of teeth and uses braces to move
the teeth into correct position
for the bite expected after orthognathic
surgery. The surgeon, trained in
corrective jaw surgery reshapes
jaws and possibly other facial bones
during surgery to form a better
bite and a more pleasing appearance.
The mitrovalve is a one-way
valve within the heart As the blood
is pumped from one chamber to the
other the mitrovalve opens and then
snaps shut. Mitrovalve prolapse
is a condition where the valve begins
to malfunction, allowing the blood
that was just pumped out of the
chamber to backwash back into it
The heart is therefore forced to
work harder to accompb'sh it's work
and sometimes even begins to enlarge
as a result The malfunctioning mitrovalve
can be seen via a trans-esophogeal
echo. By running this down the patient's
throat the heart can be seen in
motion much like an ultrasound.
The valve's "floppiness"
is fairly easy to see even for the
lay person. The operation is begun
with an incision being made down
the sternum. The sternum is cut
and spread. The patient is then
placed on a heart/lung machine so
the heart can be stopped for the
operation. The heart is stopped.
The mitrovalve is on the backside
of the heart, so the heart is folded
over to expose the surface above
the mitrovalve. The valve itself
looks like a hole with a series
of bungee cord-like strands which
pull the edges of the opening together.
Dr. Stephen F. Boiling
will assess the mitrovalve and decide
how best to move the tissue around
at that time. He will use stitches
to re-position the tissue to make
a smaller opening. A plastic ring
is then used to create a tight wall
for the opening. The bungee cord
tissues are then reattached at the
right tightness. The heart is closed
In 1994, over 37,000 people
had breast reduction surgery. Almost
half were between the ages of 19
and 34, and another third were in
the 35-50 year old range. Relief
of symptoms was the most common
reason women gave for having surgery.
Women with large breasts usually
experience back, shoulder and neck
pain as well as deep grooves where
the bra straps pass over the shoulders.
The condition also affects posture.
It is not uncommon for a woman to
lose more than two pounds of tissue
from each breast during surgery.
Using markings drawn on the patient
in the standing position, a design
tailored to the individual patient
is measured and drawn. The nipple
areolar complex is then transposed
while getting its blood supply from
the underlying breast tissue. Tissue
(breast and fat which make up the
tissue of the breast) is removed
from the medial, lateral and superior
aspects of the breast then measured
and sent to pathology for analysis.
The remaining "skin bassiere"
is redraped over the remaining tissue
to support the breast and to produce
an esthetically pleasing new contour
to the breast.
A shoulder capsular reconstruction
is among the most common shoulder
surgeries for young, athletic people.
Dr. Peter McCann uses an
arthroscope to document the pathology.
We will be able to see how far the
shoulder has separated with this
view. While he does this, he explains
the anatomy to us and discusses
the benefits of being able to look
at the damage before he actually
makes the open incision. He also
explains why he doesn't actually
do the surgery through the arthroscope.
(Because the ligament can't be tightened
enough—he can tighten it better
in the open procedure.) The field
of anatomy will be seen to the sternum.
McCann makes an incision in the
deltoid area. He separates the subcapularious
muscle and detaches the ligaments.
He can then expose the dislocated
socket Using a drill, he attaches
two "anchors" to the glenoid.
Then, he attaches the opposite end
of the anchors to the stretched
ligament and begins to essentially
wrench it down, taking up the slack,
slowing, the ligament is pulled
taut across the capsule, into its
The pituitary tumor surgery
takes about 3 hours and the patient
is under general anesthesia. Dr.
Edward R. Laws makes an incision
inside the nose and a small incision
underneath the upper lip. The incision
is made inside the nose for cosmetic
reasons. Working through the nose,
Dr. Laws moves the nasal septum
out of the way. He then begins working
under the microscope. Reaching the
back of the nasal cavity, he breaks
through the thin boney wall separating
the sinus cavity from the pituitary
gland. At this point, the tumor,
a white jellylike substance will
be clearly seen. Dr. Laws will carefully
remove the tumor, scraping it free
from the surrounding pituitary gland
and the brain structures nearby.
He has to take great care to avoid
damaging the carotid artery and
optic nerves that sit just above
the tumor. Once the tumor is removed,
Dr. Laws will begin to close. He
will fill up the extra space in
the cavity with a piece of fat from
the belly, and then make a small
stent, of cartilage or bone, to
close the opening at the back of
the sinus cavity. Finally, the incisions
will be sutured and the nose packed.