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General and digestive > Appendix > Appendicitis > Laparoscopic appendectomy

B Navez (Belgium), C Solano (France)

November 2010
 

In 1889, McBurney published his first results on appendectomy, while de Kok published a "new technique for resecting the non-inflamed not-adhesive appendix through a mini-laparotomy with the aid of the laparoscope" in 1977. Currently, appendectomy is the most frequent surgical procedure performed by general surgeons. This dynamic chapter presentation includes embryological and anatomical notions along with indications and contra-indications for the laparoscopic approach, even in particular cases such as pregnancy. All aspects of laparoscopic appendectomy are presented.


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table of contents

1. Introduction
2. Embryology
3. Anatomy
4. Local anatomy
5. Pregnancy
6. Diagnosis
7. Indications/Contraindications
8. Operating room set-up
9. Instrumentation
10. Trocar placement
11. Pneumoperitoneum
12. Exploration
13. Exposure
14. Control of the meso-appendix
15. Ligation and resection of appendix
16. Extraction
17. Cleaning
18. Closure
19. Complications
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General and digestive > Stomach and duodenum > Morbid obesity > Gastric bypass

M Vix (France)

May 2009
 

Morbid obesity is a major health concern in so many countries. It is associated with severe life-threatening co-morbidities. Unfortunately, many studies have proven that non-surgical approaches to lose weight are doomed to fail. There is good evidence that bariatric surgery is the most enduring and efficacious means of tackling morbid obesity with regards to long-term weight loss.

Roux-en-Y gastric bypass is today one of the gold standard surgeries. It is based on several mechanisms: restriction, malabsorption, and changes in gut hormones secretions.
In this chapter, all aspects of this bariatric procedure such as anatomical details, indications, contraindications, surgical setting and technical details are carefully presented.


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table of contents

1. Introduction
2. Anatomy
3. Indications and contraindications
4. Preoperative evaluation
5. Operating room set-up
6. Pneumoperitoneum
7. Trocar placement
8. Instruments
9. Exposure
10. Submesocolic steps
11. Gastrojejunal anastomosis
12. End of procedure
13. Postoperative management
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General and digestive > Colon > Cancer > Laparoscopic right colectomy

J Leroy (France), J Marescaux (France)

May 2009
 

Laparoscopic colorectal surgery has gained wide acceptance as a treatment in a variety of benign and malignant diseases. The reproducibility and safety of all the principal colorectal procedures has been demonstrated. Surgeons performing right hemicolectomy using the laparo-assisted technique consider it more difficult than open colectomy. It is possible to perform a completely laparoscopic right hemicolectomy in advanced laparoscopic centers with many benefits: less postoperative pain, short-term postoperative ileus, earlier return to daily activity. This chapter describes surgical anatomy, indications and techniques of laparoscopic right colon resection for cancer.


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table of contents

1. Introduction
2. Anatomy
3. Surgical anatomy
4. Indications
5. Basic principles
6. Operating room set-up
7. Trocars
8. Exploration
9. Exposure
10. Primary vascular division
11. Transection of transverse colon
12. Division of ileum / mobilization of ascending colon
13. Anastomosis
14. Specimen extraction
15. Postoperative period
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General and digestive > Stomach and duodenum > Morbid obesity > Laparoscopic sleeve gastrectomy

M Vix (France), C Solano (France)

December 2008
 

Laparoscopic sleeve gastrectomy (LSG) as a stand alone procedure for the surgical management of morbid obesity represents 2% of the bariatric operations in the United States of America. In the USA, this technique was developed as a modification of the biliopancreatic diversion in 1988; and in the United Kingdom, the concept of LSG evolved as a modification of the Magenstrasse and Mill procedure. In the latter, SG is essentially a completion of the Magenstrasse distally by completely separating the greater curvature and antrum.


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table of contents

1. Introduction
2. Basics of procedure
3. Anatomy
4. Indications and contraindications
5. Preoperative period
6. Operating room set-up
7. Pneumoperitoneum
8. Trocar placement
9. Instruments
10. Exposure and dissection
11. Gastrolysis
12. Resection
13. Extraction
14. Postoperative period
15. Advantages/disadvantages
16. Complications
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General and digestive > Stomach and duodenum > Hiatal hernia, reflux > Short floppy Nissen fundoplication

B Dallemagne (France)

November 2006
 

The original fundoplication technique as described by Rudolf Nissen in 1955 consisted in wrapping the fundus of the stomach around the esophagus, while leaving the gastrosplenic vessels and the diaphragmatic hiatus intact. Additionally, the vagus nerves were little or not preserved.
The basic principles of a fundoplication are:
- tension-free repositioning of the gastroesophageal junction (along with 2 cm of lower esophagus in a subphrenic position);
- use the gastric fundus to create the fundoplication;
- make sure that the resistance generated by the anti-reflux mechanism matches the preoperative assessment of esophageal peristalsis.


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table of contents

1. Introduction
2. Types of total fundoplications
3. Anatomy
4. Classification of hiatal hernias
5. Antireflux barrier
6. Operating room set-up
7. Trocar placement
8. Instrumentation
9. Exposure
10. Dissection/cardioesophageal junction
11. Mobilization of esophagus
12. Mobilization of gastric fundus
13. Cruroplasty
14. Creation of the fundoplication
15. Intraoperative complications
16. Closure
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General and digestive > Abdominal wall > Inguinal hernia > 4DDOME®

J Leroy (France), D Mutter (France), M Vix (France), J Marescaux (France)

March 2006
 

The description of the 4DDOME® inguinal hernia repair covers all aspects of the surgical procedure used for the management of inguinal hernia.
Operating room set up, position of patient and equipment, instruments used are thoroughly described. The technical key steps of the surgical procedure are presented in a step by step way: local anesthesia, dissection of indirect inguinal hernia, repair: 4DDOME® technique, 4DDOME® placement, anterior mesh placement, end of procedure, other types of hernias.
Consequently, this operating technique is well standardized for the management of this condition.


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table of contents

1. Introduction
2. Technical principles
3. Anatomy
4. Indications/contraindications
5. Operating room set-up
6. Instruments
7. Local anesthesia
8. Dissection/indirect inguinal hernia
9. Repair: 4DDOME® technique
10. 4DDOME® placement
11. Anterior mesh placement
12. End of procedure
13. Other types of hernias
14. Postoperative management
15. Discussion
16. Conclusions
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Urology > Prostate > Cancer > Laparoscopic prostatectomy

T Piéchaud (France), C Saussine (France)

February 2006
 

The description of the laparoscopic radical prostatectomy: transperitoneal approach covers all aspects of the surgical procedure used for the management of prostate cancer.
Operating room set up, position of patient and equipment, instruments used are thoroughly described. The technical key steps of the surgical procedure are presented in a step by step way: initial dissection of seminal vesicles, intrafascial dissection, specimen retrieval, vesicourethral anastomosis, end of procedure.
Consequently, this operating technique is well standardized for the management of this condition.


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table of contents

1. Introduction
2. Anatomy
3. Indications
4. Preop management
5. Operating room
6. Instruments
7. Trocar placement
8. Standard technique
9. Operative protocol
10. Initial dissection/seminal vesicles
11. Intrafascial dissection
12. Specimen retrieval
13. Vesicourethral anastomosis
14. End of procedure
15. Conclusions
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Urology > Prostate > Cancer > Laparoscopic prostatectomy

T Piéchaud (France), C Saussine (France)

February 2006
 

The description of the laparoscopic radical prostatectomy: extraperitoneal approach covers all aspects of the surgical procedure used for the management of prostate cancer.
Operating room set up, position of patient and equipment, instruments used are thoroughly described. The technical key steps of the surgical procedure are presented in a step by step way: creation of extraperitoneal space, operative protocol, intrafascial dissection, specimen retrieval, vesicourethral anastomosis, end of procedure.
Consequently, this operating technique is well standardized for the management of this condition.


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table of contents

1. Introduction
2. Anatomy
3. Indications
4. Preop management
5. Operating room
6. Instruments
7. Trocar placement
8. Standard technique
9. Creation/extraperitoneal space
10. Operative protocol
11. Intrafascial dissection
12. Specimen retrieval
13. Vesicourethral anastomosis
14. End of procedure
15. Conclusions
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Equipment > Devices > Devices > Endoscopes

D Mutter (France), A Garcia (France), I Jourdan (France)

September 2005
 

The description of the Endoscopes covers all aspects of the surgical procedure used for the management of (description de la pathologie en cause).
Operating room set up, position of patient and equipment, instruments used are thoroughly described. The technical key steps of the surgical procedure are presented in a step by step way: Introduction, Structure/function, Choice of endoscopes, Advantages/disadvantages, Practical issues, Usage problems, Conclusions.
Consequently, this operating technique is well standardized for the management of this condition.


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table of contents

1. Introduction
2. Structure/function
3. Choice of endoscopes
4. Advantages/disadvantages
5. Practical issues
6. Usage problems
7. Conclusions
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Equipment > Devices > Devices > Insufflator

A Garcia (France), D Mutter (France), I Jourdan (France)

September 2005
 

The description of the insufflator in laparoscopy covers all aspects of this piece of equipment.
The technical key steps of the chapter are presented in a step by step way: background, operating principles, prerequisite for laparoscopy, available features, advantages and disadvantages, use and settings, pathophysiological effects, surgical complications, alternatives, criteria for purchase.


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table of contents

1. Introduction
2. Background
3. Operating principles
4. Prerequisite for laparoscopy
5. Available features
6. Advantages and disadvantages
7. Use and settings
8. Pathophysiological
9. Surgical complications I
10. Surgical complications II
11. Criteria for purchase
12. Conclusions

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