May Surgery Spotlight hightlights two surgeries from Dr. William Kuzon

IN THE MAY SURGERY SPOTLIGHT, William Kuzon, MD, demonstrates a genital sex reassignment procedure in a 41-year-old male. Dr. Kuzon discusses the importance of ensuring that patients for this procedure have met the criteria set forth by the World Professional Association for Transgendered Health (WPATH) including adaption to hormonal therapy and living full-time in the female gender for more than one year. Preoperatively, he also discusses the importance of confirming normal male anatomy with no testicular mass or in-groinal hernias, which would complicate the planned procedure.

In collaboration with a urologist, Dr. Kuzon demonstrates the procedure for designing the flap which will become the back wall of the new vagina, prior to dissecting the bulbocavernosus and identifying the juncture of the anal sphincter. He performs an orchiectomy and then the penis is degloved and the penile skin tube separated from the penile corporal bodies. The dorsal neurovascular bundle is isolated and a portion of the glans harvested to form the neo clitoris. The corpus spongiosum is then separated from the corpora cavernosa and a catheter inserted into the urethra. Dr. Kuzon demonstrates the blunt dissection of the new vagina and discusses the risks of rectal tear and rectal vaginal fistula. Finally, he demonstrates the placement of the neo clitoris on the midline, the anchoring of the penile urethra, the inversion of the penile tissue and the trimming and position of the remaining scrotal skin to form the new labia.

Also this launched this month, Dr. Kuzon performs an approach for treating a condition known as “Buried” or “Hidden Penis.” In this instance, a 53-year-old patient had previously had difficulty with phimosis, had undergone a circumcision at a different institution and subsequently developed recurrent cicatrix difficulties with urination, hygiene and sexual function. Dr. Kuzon notes that while each patient’s treatment is personalized depending on the extent of the deformity, his general approach, demonstrated in this video, is to deglove the penile shaft, retrieve the corpora, and in combination with a superpubic lipectomy, anchor the corpora in a projected position with deep dermal sutures to the corpus cavernosum. This often requires skin grafting to the penile shaft. Watch Dr. Kuzon perform this procedure on PSEN.

Dr. Kuzon is the Reed O. Dingman Professor of Surgery in the Section of Plastic Surgery at the University of Michigan. He has performed a large number of gender-related procedures and is the director of surgical services at the University of Michigan Comprehensive Gender Services Program. In addition, Dr. Kuzon performs a wide array of surgical procedures, including the reconstruction of patients with facial paralysis, the management of difficult wounds, the management of patients after weight loss, and the management of defects resulting from the excision of sarcomas and other forms of cancer.

Past Surgery Spotlight programs remain freely available to view on PSEN. Hard copies of these programs can also be purchased from the PSEN DVD Library. Surgery Spotlight is a video-based product line produced by the Plastic Surgery Education Network (PSEN).

New surgical videos feature hand and reconstructive procedures

CHECK OUT THE NEW procedure videos posted on PSEN in January:

Type 1 and Type 2 Duplicated Thumb Reconstruction 

In these congenital hand reconstructions, Dr. Kevin Chung performs thumb reconstructions on patients with two types of duplicated thumbs. Watch as he assesses which thumb to remove to preserve the best function of the ligaments of the thumb.

 

Management of Chronic Calf Wound

In this video, Dr. Paul Cederna treats a chronic calf wound in a 61-year-old patient with many health issues not limited to morbid obesity, diabetes and lymphedema. The calf wound had been managed by her primary care provider for many years with a variety of treatments. After three years of treatment, she presents to plastic surgery with a non-healing wound extending to the muscular fascia. Watch as Dr. Cederna completes debridement of wound and discusses the various stages of management of chronic wounds.

 

Treatment of Bilateral Pressure Sore

In this video, Dr. Paul Cederna performs treatment of a contralateral pressure sore in a parapalegic patient who has received previous reconstruction of a left-sided bilateral pressure sore. Dr. Cederna has previously performed an aggressive debridement of the contralateral wound with a six-week course of antibiotics. Watch as he performs a second aggressive debridement of bone to assess residual infection of the bone and determine further treatment of the pressure sore.

Preview Surgery Spotlight: Vascularized Lymph Node Transfer

In the new Surgery Spotlight David W. Chang, MD performs a vascularized lymph node transfer to treat a 63-year-old Hispanic patient who developed lymphodema following lumpectomy radiation to the right breast axilla. Watch Dr. Chang evaluate the patient’s current lymphatic status in her arm via a lymphangiography to assess appropriate surgical management. Dr. Chang then surgically explores potential donor sites to determine whether the lymph node from the neck or from the groin can be used. In this particular patient, watch Dr. Chang’s technique to reducing the progression of lymphodema. The video is now streaming for free on PSEN, or can be purchased as part of an online course to receive CME credit.

Past Surgery Spotlight programs remain freely available to view on PSEN. Hard copies of these programs can also be purchased from the PSEN DVD Library. Surgery Spotlight is a video-based product line produced by the Plastic Surgery Education Network (PSEN).

PSEN captures AAHS ASPN ASRM Annual Meetings

Last month, PSEN was a part of the annual meetings of our founding partners, the American Association for Hand Surgery, American Society for Peripheral Nerve and American Society for Reconstructive Microsurgery on January 9-15, 2013 in Naples, Florida. In addition to providing demos of the website in the meeting exhibit hall, PSEN’s video news crew interviewed a number of attendees about the scientific highlights of the clinical programs, as seen in the video above. PSEN also recorded over 30 hours of panels and lecture presentations from the meetings. A selection is now available to view in the PSEN presentations area. More lecture recordings from the meetings will be posted over the next couple of weeks. Some of the presentation topics include:

  • Tissue Engineering and Regenerative Medicine
  • Atypical Microsurgical Indications
  • Refinements in Toe Transfer
  • DRUJ Instability
  • Graded Motor Imagery (GMI)

Members of AAHS, ASPN or ASRM have free access to PSEN through their society membership. Your username is always your email address — if you don’t know or remember your password, just click the forgot my password link on the PSEN Login page or contact PSEN at onlineeducation@plasticsurgery.org.

2012 AAHS ASPN ASRM Annual Meetings


The Plastic Surgery Education Network (PSEN) headed to the red rocks for the 2012 Annual Meetings of the American Association of Hand Surgeons, American Society of Peripheral Nerve and the American Society of Reconstructive Microsurgery. In addition to demoing PSEN in the exhibit hall, the team recorded many lectures and panels. The meeting was held January 11-16, 2011 at the Red Rock Resort and Spa in Las Vegas. Watch the PSEN video news coverage, including interviews with attendees by clicking the player above.

The first set of presentations recorded in Vegas are now available in the Presentations section of the website. Be on the lookout for more presentations in the coming weeks.

What was your favorite presentation from the annual meetings in Las Vegas?