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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.
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.
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.
Nowadays, hysterectomy is, after cesarean section, the most common surgical intervention performed in fertile women. Laparoscopic hysterectomy remains a safe and reproducible intervention that should be in any’s gynecologists therapeutic armamentarium.
Radical cystectomy remains the gold standard for muscle invasive bladder cancer and high-risk superficial tumors resistant to intravesical treatment. Nevertheless, the laparoscopic cystoprostatectomy has rarely been well codified and illustrated.
Please click here to watch the video of the procedure.
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.
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.
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.
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.
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.
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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Gastric bypass: surgical treatment of morbid obesity
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