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We report the case of a 45-year-old woman, G2P2, who presents with rectal bleeding, constipation and subocclusive syndrome caused by rectosigmoid endometriosis. The laparoscopic exploration revealed a sigmoid stuck by a few adhesions to the lateral abdominal wall underneath the left ovary and ...
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The video entitled "Fully laparoscopic segmental rectosigmoid resection with Natural Orifice Specimen Extraction (NOSE) for bowel endometriosis", authored by A. Wattiez, J. Leroy, S. Maia, A, Vazquez, P. Trompoukis, J. Alcocer, is analyzed by Dr. Resad Pasic, MD, PhD, sharing in this way his own personal experience and highlighting the different surgical approaches available with tips and tricks.
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The objective of this film is to demonstrate a wedge resection of the right anterior colonic wall carried out to manage a flat polyp. A Surgiquest™ Airseal™ 12mm trocar is used for that purpose, along with two other trocars: a suprapubic trocar and an epigastric trocar. Two 12mm trocars are ...
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Laparoscopic surgery for colorectal cancer requires an abdominal incision to extract the resected specimen. Transanal extraction avoids the need to make any additional abdominal incisions for specimen retrieval. This video demonstrates various tricks for the removal of a huge specimen.
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Some surgical techniques and devices are shown in this uncommon myomectomy case. The procedure is begun with transitory clipping of uterine arteries and infundibulopelvic (IP) ligaments to avoid massive bleeding. Once the myomectomy has been performed, the uterine serosa is closed using the ...
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Patients with paraesophageal hernia (PEH) are usually symptomatic with GERD or obstructive symptoms, such as dysphagia. The underlying surgical principles for successful repair include reduction of hernia contents, removal of the hernia sac, closure of the hiatal defect, and an antireflux ...
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Duodenal atresia is one of the more common intestinal anomalies treated by pediatric surgeons, occurring 1 in 2,500-5,000 live births. The treatment is surgical and consists of duodeno-duodenostomy in the newborn period. This video shows the laparoscopic treatment of this congenital anomaly.
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The goal of this video is to illustrate the surgical possibilities of pneumovesicoscopy in children. The principle is to insufflate the bladder with CO2 and to introduce 3 trocars in this natural cavity. The patient is placed across the table to provide an access to the perineum and a good ...
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Choledochal cysts are congenital anomalies of the bile ducts. They consist of cystic dilatations of the extrahepatic biliary tree, intrahepatic biliary radicles, or both. This video shows the treatment of a choledochal cyst diagnosed antenatally. This procedure is performed in an 8-month-old girl.
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Total coloproctectomy with ileal pouch-anal anastomosis is the operation of choice for both ulcerative colitis and familial adenomatous polyposis. The objective of this film is to demonstrate the benefits of mesenteric lengthening using vascular divisions in order to perform an ileoanal anastomosis ...
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Laparoscopic resection of the sigmoid colon is currently considered a feasible option for open surgery. Many attempts have been made to reduce scars. The objective of this film is to demonstrate a transanal extraction technique for the laparoscopic management of sigmoid diverticulitis using three ...
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The combination of standard laparoscopy and specimen extraction through a natural orifice has the potential to decrease wound-related complications, the number of the trocars and the size of the incisions in order to avoid traumatic specimen extractions at the level of the abdominal wall. This ...
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Critical analysis
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Totally laparoscopic gastrectomy for cancer remains limited because of technical problems, expecially for lymphadenectomy. We present the case of a 75-year-old patient with no specific history in which an adenocarcinoma of the lesser curvature of the stomach was found. An endoscopic ultrasound had ...
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Critical analysis
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Laparoscopic sleeve gastrectomy as a redo surgery after gastric band removal is a challenging operation. Many technical problems are encountered during this procedure. Care must be taken in finding anatomical planes, understanding the type of adhesions and avoiding a gastric injury, especially in ...
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English - 16'04''
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Patients who have undergone bariatric surgery and present with upper abdominal symptoms pose a diagnostic and management challenge.
Laparoscopic vertical banded gastroplasty (VBG) is associated with high revisional rates. In the case of failed VBG, repeat VBG seems to be a poor option and conversion to gastric bypass yields better results.
This is the case of a 35-year-old female patient who underwent a vertical banded gastroplasty by laparotomy 8 years ago and presents with dysphagia. A gastroscopy and a contrast swallow exam using radio-opaque markers do not show any fistulas, but peroperative surgical exploration discovers a gastro-gastric fistula. This video clearly shows all the technical aspects of a revisional bariatric procedure. Keywords: Laparoscopic Roux-en-Y gastric bypass, RYGB, vertical banded gastroplasty
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The objective of this video is to demonstrate the laparoscopic sigmoidectomy using three ports with the transanal extraction of the sigmoid colon for the treatment of a diverticular sigmoiditis. The interest of this technique is the ability to limit the number of ports used; as a result, parietal ...
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Critical analysis
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Laparoscopic TAPP hernia repair is technically difficult, but in the hands of a well-trained surgeon, it is safe and effective in recurrent hernia too. The objective of this video is to demonstrate how a multi-recurrent hernia in the right inguinal region can be treated laparoscopically using a ...
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The management of patients with recurrent incisional hernia continues to test the skills and judgments of gastrointestinal surgeons. Several different surgical techniques and types of mesh prostheses are available for repair. The purpose of this video is to show a technique for a recurrent ...
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This video demonstrates the technique of a total laparoscopic hysterectomy with unilateral adnexectomy and the excision of a vesical endometriotic nodule.
This patient is a 46-year-old lady with a previous surgical history of one laparotomy for a hemoperitoneum (endometriotic ovarian cyst ...
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Laparoscopic techniques have allowed surgeons to perform complicated intra-abdominal surgery with minimal trauma. Recently, the use of single incision laparoscopic surgery (SILS) has increased the potential of further reducing the trauma of surgical access respecting the basic principles of ...
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Critical analyses
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English - 06'07''
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The reduction of the number of trocars is one of the ways to minimize the invasiveness of the surgical intervention. This video shows a cholecystectomy with a single site access, using a Gelport. This device was designed for hand-assisted surgery. Standard laparoscopic trocars are inserted through the gel. Articulated instruments are used to recreate the triangulation of a standard laparoscopy. The intervention itself is performed in a standard way.
Keywords: Single port site access, cholecystectomy, symptomatic cholelithiasis
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Critical analysis
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Single port access surgery may be the next generation of minimally invasive surgery thanks to the obvious advantages (e.g., scarless surgery, lesser pain, and faster postoperative recovery). Performing a cholecystectomy via a single trocar imposes a few technical constraints. The first is the ...
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Nowadays, with the accuracy of the modern imaging techniques, the diagnosis of incidental renal tumors has become increasingly frequent. These tumors are often small in size and minimally invasive procedures represent an optimal indication to perform nephron-sparing surgery (NSS). In addition, the ...
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Critical analysis
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In recent years, local treatment procedures have been developed to manage benign lesions of the rectum. This is the case of a superficial tumor of the anal margin located at the lower third of the rectum on its right anterior aspect. The objective of the video is to demonstrate a submucosal ...
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Transanal Endoscopic Microsurgery (TEM) is a minimally invasive technique for the resection of adenomas and early rectal carcinomas unsuitable for local or colonoscopic excision, which would otherwise necessitate major surgery. The objective of this film is to demonstrate the transanal resection of ...
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Critical analysis
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Pancreatic endocrine tumors (PETs) are uncommon but clinically challenging and fascinating tumors. Small, benign neoplasms are readily curable by surgical resection. This video presents the case of a 40-year-old woman with a tumor at the level of the pancreatic body. The patient’s virtual ...
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This video demonstrates a three-trocar laparoscopic splenectomy performed for atypical idiopathic thrombocytopenic purpura in a 33-year-old patient. An anterior approach, as in this case, is a very interesting one as the spleen does not need to be manipulated in this patient.
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English - 25'00''
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This video shows a laparoscopic total hysterectomy and a bilateral pelvic lymphadenectomy for endometrial cancer. The patient is obese with a BMI of 34, which makes the surgical intervention more difficult. Anatomical landmarks are very well shown. Keywords: Laparoscopic total hysterectomy, bilateral pelvic lymphadenectomy, endometrial cancer
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Critical analysis
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Endoscopic polypectomy still remains the cornerstone of therapy for colorectal polyps and adenomas. However, if colorectal polyps are too large or not accessible for endoscopic ablation or cannot be removed without an increased risk of perforation, operative procedures are required. In such ...
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Critical analysis
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Laparoscopic cholecystectomy is the gold standard for symptomatic cholecystolithiasis. Technical maturation and advances in instrumentation have enabled the application of this procedure for acute cholecystitis.
This video demonstrates the surgical approach to performing a laparoscopic ...
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Critical analysis
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The laparoscopic approach has increasingly assumed a central role in the management of benign and malignant urological diseases. Laparoscopy is less morbid than open surgery and requires small incisions.
We present the case of an heminephrectomy, with a stepwise approach for the identification of ...
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This video shows the operative steps of the excision of a congenital choledochal cyst and the subsequent Roux-en-Y reconstruction.
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Esophageal leiomyomas are approximately 50 times less common than carcinomas, but they represent 80% of benign tumors of the lower esophagus.
An esophageal leiomyoma can be enucleated safely and effectively through minimally invasive surgery. The laparoscopic approach is a conventional option for ...
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English - 26'46''
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We present the case of a TME dissection performed with monopolar cautery. A good knowledge of the anatomy and adequate surgical skills permit to effectively complete the mesorectal excision.
This video is recommended for advanced digestive surgeons. Keywords: Laparoscopic TME dissection, monopolar cautery, total mesorectal excision
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Critical analysis
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Hiatal hernia is a common disorder of the digestive tract. Most patients are elderly and with significant co-morbidities. Historically, the surgical repair of paraesophageal hernias (PHH) has been advocated regardless of the presence of symptoms. In fact, despite patients being symptom-free, the ...
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In recent years, the advances in preoperative localization studies, the availability of intraoperative parathyroid hormone (PTH) assay and the introduction of cervicoscopy revolutionized the surgical treatment of primary hyperparathyroidism (PHPT).
Minimally invasive video-assisted ...
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Critical analysis
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In this video, we present the technique of a TEP approach for the management of an inguinal hernia in a male patient. The technique is meticulously explained, emphasizing on the main anatomical landmarks, the key steps of the procedure and the potential injuries to be avoided.
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Critical analysis
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English - 16'37''
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This video presents the laparoscopic treatment of a perforated acute diverticulitis of the sigmoid colon. The patient has a Hinchey stage IIb peritonitis. Because of a stable clinical presentation, a laparoscopic treatment was offered. The cavity of the abscess is opened and cleaned. Local inflammation makes the dissection planes more difficult to define and the progression of the mobilization can be challenging. A sigmoidectomy is then carried out with a primary anastomosis.
Keywords: Laparoscopy, sigmoidectomy, acute diverticulitis, Hinchey stage IIb
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English - 15'19''
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We present a laparoscopic Nissen technique for the surgical management of a hiatal hernia. In order to better understand the technique, a stepwise approach is performed and tips and tricks on how to avoid major problems are presented. Keywords: laparoscopy, treatment, GERD, fatty patient, gastroesophageal reflux disease
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Critical analyses
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Laparoscopic Roux-en-Y gastric bypass after vertical banded gastroplasty
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