Surgical Procedures

Left Upper Extremity Reconstruction for Spasticity: A 6-Part, MultiLevel Journey

Peter C. Rhee, DO, MS
We have released our first-ever 6-part surgery – a Multilevel, Left Upper Extremity Reconstruction performed in a Single Event. Read all about it here.
Orthopaedic Surgery


We at GIBLIB mostly produce surgeries in one complete video, but not all surgeries can be neatly wrapped in twenty to thirty minutes. And single event, multilevel surgeries are a prime example of this, which is why we are releasing our first single event, multilevel surgery as a 6-part special release.


A single event, multilevel surgery is for children and adult patients with cerebral palsy and spastic diplegia to address muscle imbalance, contractures, and musculoskeletal deformities secondary to untreated or inadequately treated spasticity

While this procedure has the benefit of fewer follow-up surgeries and shorter recovery times, it is considered controversial because there is no randomized trial demonstrating its safety – and yet it is a mainstream treatment for children with cerebral palsy and spastic diplegia.

How do you handle complex and divisive procedures with your patients, or in the operating room? Your patients are depending on you to tell them if this surgery will work, if they will be fixed, if everything will be over. 

It’s a lot of pressure, and yet those life-or-death decisions make up the foundation of your career – you have gotten to where you are because of your decisiveness under pressure. Luckily, single event, multilevel surgery isn’t a decision that’s made under a beating clock, but it’s still a big decision. That’s why we’re here to support you in your day-to-day career with real-life cases on-demand for your reference.


At a young age, this 48-year-old male patient had a hypertensive issue that caused a cerebral vascular accident, leaving him with left-sided hemiparesis. Peter C. Rhee, DO, MS will address the spasticity from the shoulder all the way to the fingertips and preserve any volusiner control function through a single event, multilevel surgery in the operating room.

Based on our pre-op examination, the patient exhibited a lot of spasticity as to opposed to any type of muscle myostatic contractions, so our techniques will be focused on addressing the spasticity from the shoulder all the way to the fingertips. 

This case is a multi-site operation with the primary goal is to take care of most of the spasticity from the shoulder to the fingertips and preserve any volusiner control function that he has. Here at Mayo Clinic, we will perform this operation safely by using anesthesia thoughtfully and making sure we don't have a lot bleeding and risk for hematoma, as many patients are on some form of anti-coagulation because of there brain injury.

Our mission at GIBLIB is to capture these challenging surgeries for you to watch, learn, and use in your career. Expand your knowledge masterfully by watching this shocking surgical video.

Watch one part of our 6-part release below, or watch the full surgery and earn CME with a GIBLIB premium subscription.

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Watch, learn, and earn unlimited AMA PRA Category 1 Credit(s)™. Our continuing medical education process is simple, fast and efficient. Get access to thousands of accredited medical lectures, surgical videos, and courses. Clinician-learners complete an assessment test and can download CME certificates instantly.


GIBLIB is the premier streaming service with a vast catalog of unrivaled continuing medical education content covering surgical videos, medical lectures, courses, and transcripts. Learn from the world’s best doctors, from the top leading institutions, including Mayo Clinic, UCSF, Cedars-Sinai, Keck Medicine of USC, and many more.

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