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 General y Digestiva (88) | |
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Recorded live laparoscopic Heller procedure for mega-esophagus B Dallemagne (France) / S Perretta (France) / J Marescaux (France) 24:00 - 2010 Jul This is the case of a 64-year-old man presenting with a complex history of symptoms of reflux and dysphagia for some years, with a combination of dysmotility, reflux and anatomical problems in terms of hiatal hernia. This video shows a laparoscopic Heller myotomy with an associated antireflux procedure. |
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Recorded live laparoscopic TAPP approach for bilateral hernia with single mesh and absorbable tacker J Leroy (France) / J Marescaux (France) 17:00 - 2010 Jul Laparoscopic hernia repair has become one of the most common laparoscopic operations. Several studies have demonstrated a definite advantage over open repair with regard to reduced postoperative pain and earlier return to work and normal activities, especially when treating bilateral hernias. This video shows the TAPP treatment of a bilateral direct hernia. |
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Laparoscopic single incision sleeve gastrectomy M Vix (France) / J Marescaux (France) 17:00 - 2010 Jul Laparoscopic sleeve gastrectomy has gained increasing popularity due to its simplicity and good results. Nowadays, many attempts are made to minimize port access, and sleeve gastrectomy is no exception for that. This video shows a laparoscopic single incision sleeve gastrectomy in a 40-year-old female patient with a BMI of 40. |
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Minimally invasive Ivor Lewis esophagectomy for cancer B Dallemagne (France) / J Marescaux (France) 27:00 - 2010 Jul Minimally invasive Ivor Lewis esophagectomy is technically challenging but feasible in experienced minimally invasive surgery centers. This video illustrates the surgical approach of an Ivor-Lewis esophagectomy. This surgery was carried out in a patient presenting with a type 2 cardia tumor according to Siewert’s classification. The preoperative workup confirmed the presence of an adenocarcinoma with locoregional lymph nodes. After neoadjuvant chemotherapy, a massive melt of the tumor was evidenced without any residual lesion or any local or distant metastasis. In this context, a curative resection has been proposed. Considering the tumor’s type, a resection combining an abdominal with a thoracic approach was decided upon. |
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Laparoscopic TME in a male patient with side-to-end low colorectal anastomosis and peroperative ultrasonography J Leroy (France) / J Marescaux (France) 29:30 - 2010 Jun Local control of rectal cancer and patient survival have improved remarkably with advances in surgical techniques. The objective of this film is to demonstrate a laparoscopic total mesorectal excision for a rectal adenocarcinoma situated in the upper rectum. |
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Ventral and umbilical hernia: simultaneous laparoscopic management C Callari (France) / D Mutter (France) / J Marescaux (France) 20:00 - 2010 Jun The laparoscopic repair of abdominal wall hernias to treat both spontaneous and incisional hernias has good results. We report the case of a patient presenting with two concomitant pathologies, an umbilical hernia and a linea alba hernia situated on a previous incision’s scar that were treated simultaneously. Currently this patient has a heart transplant. |
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Laparoscopic pericystectomy for an 8cm hepatic hydatid cyst with 3D reconstruction D Mutter (France) / L Soler (France) / J Marescaux (France) 08:02 - 2010 Jun This is the case of a female patient presenting with epigastric pain. An 8cm liver cyst is identified on the examination. Given her previous medical and clinical history, the patient has a hydatid cyst. Serologic tests remain negative. This hydatid cyst is no longer active. Surgery is indicated given the symptomatology and the patient’s strong desire for the intervention. Indications for the surgical resection of non-active hydatid cysts remain rare. They mainly concern big cysts that may generate typical clinical signs of pain, heaviness and epigastric impairment. A standard pericystectomy performed in a stepwise manner should allow to resect this cyst without any resection of the liver parenchyma. |
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Laparoscopic subtotal colectomy with ileo-sigmoid anastomosis for cancer in an elderly patient J Leroy (France) / J Marescaux (France) 21:00 - 2010 Jun Surgery in patients who have previously undergone abdominal operations is always difficult and the risk of complications is high. The objective of this film is to demonstrate a laparoscopic subtotal colectomy in an elderly female patient aged 89. This patient had undergone a laparoscopic right colectomy for cancer in previous years. The film also aims to show the possibilities of a laparoscopic re-intervention. |
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Laparoscopic left pancreatectomy with spleen preservation and splenic vessels resection B Dallemagne (France) / S Perretta (France) / L Soler (France) / J Marescaux (France) 23:00 - 2010 Jun This film demonstrates the laparoscopic resection of a pancreatic tumor in a 47-year-old woman who consulted for epigastric pain. The preoperative exam showed a tumor larger than 4cm situated at the body of the pancreas. |
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Three-trocar laparoscopic sigmoidectomy with transanal extraction for diverticulitis and endometriosis J Leroy (France) / J Marescaux (France) 14:57 - 2010 May The combination of standard laparoscopy and specimen extraction through a natural orifice has the potential to decrease wound-related complications. The objective of this film is to demonstrate a three-trocar sigmoidectomy technique performed without any abdominal incision and with transanal extraction of the sigmoid colon followed by a fully laparoscopic colorectal anastomosis. This procedure was used for benign inflammatory conditions but not for malignant tumoral conditions. |
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Laparoscopic sleeve gastrectomy after gastric band removal: two different clinical cases M Vix (France) / F Costantino (France) / J Marescaux (France) 18:52 - 2010 May Sleeve gastrectomy after gastric band is a challenging procedure due to the alteration of anatomy caused by the band; the identification of anatomical landmarks is crucial. The objective of this video is to successively demonstrate two different sleeve gastrectomy cases after gastric band removal. |
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Live surgeries of laparoscopic inguinal hernia repair: TAPP and TEP approaches J Leroy (France) / B Dallemagne (France) / J Marescaux (France) 32:41 - 2010 May This video shows the TransAbdominal PrePeritoneal (TAPP) and Totally ExtraPeritoneal (TEP) procedures for inguinal hernia repair. These are live operations performed by Professor Joel Leroy (TAPP procedure) and Doctor Bernard Dallemagne (TEP procedure). The different technical details for each procedure are clearly exposed. |
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Laparoscopic distal pancreatectomy with spleen and vessel preservation D Mutter (France) / L Soler (France) / J Marescaux (France) 18:39 - 2010 Apr This is the case of a female patient presenting with a 12mm endocrine tumor located at the pancreatic isthmus. To manage this case, a distal pancreatectomy is decided upon. This tumor measures 16mm in its transverse diameter and it is located just above the portal vein. The CT-scan and its 3D reconstruction helps us to plan the surgical intervention. The whole pancreas along with the splenic vessels (splenic vein and artery) are reconstructed. The objective is to precisely locate the tumor in order to determine the resection modalities. A distal pancreatectomy with preservation of the splenic vessels is therefore decided upon. |
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Laparoscopic redo Nissen fundoplication using the EndoFLIP® (Endolumenal Functional Lumen Imaging Probe) Imaging System B Dallemagne (France) / S Perretta (France) / J Marescaux (France) 10:51 - 2010 Apr This video demonstrates a redo laparoscopic Nissen fundoplication in a 46-year-old woman with recurrent gastroesophageal reflux symptoms 10 years after the previous antireflux repair, in which a functional lumen imaging probe "the endoFLIP" was used. |
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Difficult case of ureteral identification during laparoscopic sigmoidectomy: interest of augmented reality J Leroy (France) / L Soler (France) / J Marescaux (France) 15:00 - 2010 Mar The aim of this video is to show the benefit of imaging when faced with anatomical abnormalities to avoid incidents during the surgical procedure. In this case, it is the left ureter that is abnormal, passing behind a section of the left iliac ureter, the latter being in fact an abnormally long left iliac artery and its course partially hiding the ureter. The procedure is a sigmoidectomy for cancer of the sigmoid colon in an averagely obese patient. |
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Laparoscopic hepatectomy for a left 8cm hepatocellular carcinoma after embolization for bleeding D Mutter (France) / L Soler (France) / J Marescaux (France) 22:00 - 2010 Mar This is the case of a patient presenting with a hepatocellular carcinoma, referred to the emergency department because of a hemorrhage. The first step consisted in an arterial embolization. The patient recovers from the embolization and two months later, a left lateral segmentectomy is decided upon. The tumor measures 8cm and is located in segment II and III of the liver. The procedure is performed laparoscopically, away from the digestive bleeding. |
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Perigastric band abscess: laparoscopic approach M Vix (France) / F Costantino (France) / J Marescaux (France) 07:22 - 2010 Mar Band infection after gastric banding is a relatively rare complication. In most cases, it manifests itself through abdominal pain associated with fever, and/or an abscess surrounding the access port. This is the case of a 37-year-old female patient in whom a gastric band was placed 5 years ago. The patient lost 60% of her excess weight; however, she complained that the gastric band was no longer as efficient. Imaging studies allowed to identify the existence of a 50mL supragastric pouch. A gastroscopy reveals nothing unusual. Following this postoperative control, we decided to remove the patient’s gastric band as she was troubled by the superior gastric pouch. |
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Fully laparoscopic total coloproctectomy for intestinal polyposis J Leroy (France) / J Marescaux (France) 30:00 - 2010 Mar The objective of this film is to demonstrate a technique of coloproctectomy for disseminated polyposis in a young female patient who presented fairly massive bleedings. Her polyposis was discovered but did not have any known family history. Technical details and all steps of the dissection are clearly exposed. |
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Segmental colonic resection for cancer of the splenic flexure J Leroy (France) / J Marescaux (France) 26:00 - 2010 Feb The laparoscopic approach for the treatment of splenic flexure (SF) colon cancer is not standardized and is a challenging procedure. The aim of this video is to show the possible segmental and oncological resections of a tumor of the splenic flexure. |
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Laparoscopic left pancreatectomy with spleen preservation for a suspicion of IPMN B Dallemagne (France) / S Perretta (France) / L Soler (France) / J Marescaux (France) 20:00 - 2010 Feb Laparoscopic distal pancreatectomy is suitable for benign and premalignant neoplasms located in the body and tail of the pancreas. Spleen preservation following distal pancreatectomy is known to be safe. There are two distinct approaches to preserve the spleen during the dissection of the distal pancreas. The classic design is to identify, isolate, and preserve the splenic artery and vein. Alternatively, the splenic artery and vein are ligated with the pancreas, and perfusion of the spleen is assured by the short gastric vessels. Both are accepted as appropriate techniques to address a mass in the tail of the pancreas. This video demonstrates a left pancreatic resection with spleen preservation and ligation of the splenic artery and vein. |
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Laparoscopic Roux-en-Y gastric bypass (LRGBP) redo after laparoscopic sleeve gastrectomy in a morbidly obese woman M Vix (France) / J Marescaux (France) 09:30 - 2010 Feb With more and more bariatric procedures being performed, it is predictable that more patients will suffer from complications necessitating re-do surgery. We show the case of a laparoscopic sleeve gastrectomy being transformed into a laparoscopic Roux-en-Y gastric bypass. |
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Laparoscopic transhiatal esophagectomy for adenocarcinoma of the lower esophagus B Dallemagne (France) / S Perretta (France) / J Marescaux (France) 27:40 - 2010 Jan Conventional esophagectomy requires either a laparotomy with a transhiatal dissection or a laparotomy combined with thoracotomy and it is associated with significant morbidity and mortality. In the attempt to decrease morbidity, some surgeons have reported the application of minimally invasive technique of resection of the esophagus. De Paula was the first to report a large series of 48 patients undergoing a total laparoscopic transhiatal esophagectomy (LTH). LTH may be used to treat patients with either benign or malignant esophageal disease because the reconstructive result cervical esophagogastric anastomosis yields good functional outcomes. Here we show the case of a LTH for adenocarcinoma of the lower esophagus. |
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Laparoscopic sleeve gastrectomy: integral procedure M Vix (France) / J Marescaux (France) 25:00 - 2010 Jan This is the case of a 56-year-old woman with a BMI of 44. This patient wanted to have surgery for morbid obesity and after giving her explanations about the sleeve gastrectomy and gastric bypass, she preferred to have a sleeve gastrectomy. This is a real-time recorded video in which all aspects and tricks of a correct sleeve gastrectomy are clearly presented. |
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Collis Nissen for slipped fundoplication with recurrent GERD symptoms B Dallemagne (France) / J Marescaux (France) 17:00 - 2010 Jan Hiatal hernia recurrence is a dreaded postoperative complication after surgery for gastroesophageal reflux. This video presents a live surgery performed on a patient presenting with recurrent symptoms and dysphagia after previous Nissen fundoplication performed 5 years ago. All the preoperative work-up demonstrates the recurrent reflux, mixed ascites and alkaline reflux associated with an intrathoracic migration of the proximal stomach and probably a slippage of the valve on the upper part of the stomach. This patient has a manometry, which confirmed the weakness of the lower esophageal sphincter (LES) associated with some dysmotility disorders in the lower esophagus. |
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Laparoscopic left colectomy for cancer F Corcione (Italy) / J Marescaux (France) 24:33 - 2009 Dec The laparoscopic approach for colonic cancer has been shown to be feasible, safe and respects oncologic criteria for cancer surgery. In this video demonstration at the IRCAD Advanced Course in Laparoscopic Colorectal Surgery in November 2009, Prof. Francesco Corcione shows a laparoscopic left colectomy strictly respecting oncological principles. |
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Laparoscopic rectal resection for a large adenovillous tumor J Leroy (France) / J Marescaux (France) 29:09 - 2009 Dec The laparoscopic approach is currently accepted for the treatment of colorectal malignancy. This video demonstrates a laparoscopic rectal resection for a large adenovillous tumor using five trocars. The patient’s right arm is alongside the body. All the team stands to the right, one assistant between the patient’s legs. |
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Laparoscopic coloproctectomy for ulcerative colitis C Huscher (Italy) / J Marescaux (France) 27:40 - 2009 Dec Laparoscopic coloproctectomy for ulcerative colitis is a safe procedure and is associated with short-term benefits such as faster recovery and less pain. In this live video shot during the IRCAD Advanced Course in Laparoscopic Colorectal Surgery in November 2009, Prof. Cristiano Huscher shows a laparoscopic coloproctectomy for ulcerative colitis in a female patient. |
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Transumbilical single port laparoscopic sigmoidectomy for diverticulosis J Leroy (France) / J Marescaux (France) 11:10 - 2009 Dec Transumbilical single incision laparoscopic sigmoidectomy is feasible by experienced laparoscopic surgeons using current available laparoscopic instruments and staplers. In this live video shot during the IRCAD Advanced Course in Laparoscopic Colorectal Surgery in November 2009, Prof. Leroy shows an extraordinary single port sigmoidectomy. |
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Difficult case of laparoscopic sleeve gastrectomy after removal of a gastric band for morbid obesity M Vix (France) / J Marescaux (France) 09:35 - 2009 Nov 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 the region of the lower end of the esophagus. This video shows a difficult case of laparoscopic sleeve gastrectomy two months after the removal of a gastric band that was placed 10 years ago. |
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Three-trocar laparoscopic sigmoidectomy and transanal extraction of the specimen for diverticular sigmoiditis J Leroy (France) / J Marescaux (France) 10:00 - 2009 Nov 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 trauma and morbidity may be reduced. In this case, two 12mm ports and one 5mm port are used. |
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Single port cholecystectomy: impact of instrumentation in getting the critical view of safety B Dallemagne (France) / J Leroy (France) / J Marescaux (France) 07:29 - 2009 Nov 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 necessity of correctly exposing the gallbladder, the second is to find the instrumentation that allows to perform the different dissection stages, ligature of the cystic duct and artery, but also to obtain an acceptable visualization of the Calot’s triangle. Various methods are proposed at the moment, along with different instruments: rigid, articulated, curved ones. In this video, we present two cholecystectomies, one is performed with conventional laparoscopic instruments, the other with curved instruments especially adapted for a unique trocar. |
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Comparison between floppy Nissen and Nissen Rossetti fundoplication: the significance of short gastric vessels division B Dallemagne (France) / S Perretta (France) / J Marescaux (France) 17:28 - 2009 Oct In this video, we present the surgical treatment of a typical gastroesophageal reflux disease in a young woman. She suffers from PPI tolerance, regurgitation with ENT symptoms, some asthma that usually is an indirect sign of very important regurgitation problems. That’s probably the best indication for anti-reflux surgery because everything can be controlled by medication. This is a very teaching video in which all technical details and all landmarks of the procedure are well illustrated. |
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Laparoscopic approach for symptomatic benign stricture following laparoscopic sigmoid resection J Leroy (France) / F Costantino (France) / J Marescaux (France) 17:10 - 2009 Oct Anastomotic stenosis and fistula after laparoscopic sigmoidectomy are a subject of interest in the literature. Most series reporting results on these complications are heterogeneous. In addition, the selection of patients for treatment vary considerably. The objective of this film is to show a complication, although exceptional, three months after a laparoscopic sigmoidectomy; this complication is a peri-anastomotic stenosis combined with potential rupture of the anastomosis, fistula and peri-anastomotic abscess. |
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Totally laparoscopic splenectomy for benign splenic cyst D Mutter (France) / L Soler (France) / J Marescaux (France) 08:34 - 2009 Oct Splenic cysts are rare lesions. Splenectomy is the treatment of choice. This video demonstrates a totally laparoscopic splenectomy. The procedure is performed with the patient placed in a supine position with a slight right lateral tilt. An open laparoscopy is carried out systematically. Four ports are used: one port to retract, two operating ports and another port to accommodate a 5mm scope with a high definition camera. |
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Laparoscopic resection of liver segments V and VIII for colorectal metastasis B Dallemagne (France) / D Mutter (France) / L Soler (France) / J Marescaux (France) 10:13 - 2009 Oct Laparoscopic liver resection in selected patients in highly specialized centers provides comparable oncological results to treatment with open liver resection for patients with colorectal liver metastases. In this video, we present the case of a patient who underwent the resection of two liver segments in the context of a colorectal pathology. Initially, this lesion was estimated as sitting in the liver’s segment IV, but using a specific software dedicated to reconstructions of CT-scan data, it was discovered that this lesion was situated across segment V and segment VIII. This reconstruction allows to obtain a perfect visualization of the different relationships between the vessels and also allows to guide the procedure and to simulate the operative maneuver. |
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Enucleation of a pancreatic nonfunctioning endocrine tumor localized with intraoperative US and augmented reality B Dallemagne (France) / L Soler (France) / J Marescaux (France) 09:54 - 2009 Sep 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 reconstruction is used during surgery to help the surgeon pinpoint the lesion accurately. A laparoscopic approach is used. |
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Laparoscopic coloanal anastomosis for the treatment of anastomotic stricture after partial TME J Leroy (France) / J Marescaux (France) 29:00 - 2009 Sep An anastomotic stricture is a common clinical finding. Its management can be difficult. Major corrective surgery is possible; however, it is technically challenging and not risk-free. The purpose of this video is to show the feasibility of a laparoscopic re-intervention on a stenosis following a colorectal anastomosis performed 2 years previously during the treatment of a PT3N0M0 mid-rectal cancer. |
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Laparoscopic partial TME with side-to-end coloanal anastomosis in a female patient J Leroy (France) / J Marescaux (France) 18:00 - 2009 Sep The laparoscopic approach for rectal tumors is a technically demanding procedure, but it is safe and it has the feature of an oncologic procedure. The objective of this video is to demonstrate a standardized technique for the treatment of cancers of the upper rectum in a female patient. The therapeutic strategy includes a partial rectal resection with total mesorectal excision followed by a colorectal anastomosis on the inferior third of the rectum. |
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Three-trocar laparoscopic splenectomy for thrombocytopenia D Mutter (France) / J Marescaux (France) 14:10 - 2009 Sep 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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Laparoscopic TEP repair of a Nyhus type II left inguinal hernia in a male patient B Dallemagne (France) / J Marescaux (France) 14:10 - 2009 Sep This video shows the technical details of a laparoscopic TEP repair of a Nyhus type II left inguinal hernia in a male patient performed during an IRCAD-EITS course in Strasbourg. |
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Adenocarcinoma of colorectal junction: laparoscopic anterior rectal resection. Advantage of the Ligasure Advance® device J Leroy (France) / J Marescaux (France) 19:24 - 2009 Jul The purpose of this video is to show an anterior rectal resection technique for an adenocarcinoma of the rectosigmoid junction using the Ligasure Advance® device (Valleylab, Covidien, Boulder, CO).This video shows how this device can optimize efficiency and safety in the operating room and potentially reduce overall operating time. |
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Paraesophageal herniation of the colon: laparoscopic repair B Dallemagne (France) / S Perretta (France) / J Marescaux (France) 28:40 - 2009 Jul Large paraesophageal hernias (PEHs) occur most commonly in an elderly, debilitated patient population with existing co-morbid conditions. The surgical approach to paraesophageal hernias (PEHs) has changed with the advent of laparoscopic techniques. This video presents the case of a 72-year-old male patient referred to our unit for epigastric pain. In this patient, the endoscopy showed nothing specific concerning this pain. The barium swallow showed no abnormality, but just a lateralization of the esophagus. The CT-scan demonstrated a large hiatal hernia. The laparoscopic repair is presented here. |
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Laparoscopic partial TME for sessile polyp with intraoperative endoscopic control M Li (China) 25:16 - 2009 Jul Total mesorectal excision (TME) was described 20 years ago and is now recognized as the therapeutic gold standard for middle and lower third rectal cancers. This is the case of a 70-year-old man with a BMI of 24 presenting with multiple polyps of the sigmoid colon larger than 3cm at 10 to 30cm from the anal verge. He has no past surgical history and colonoscopy revealed 3 sessile polyps at 15, 20, and 30cm from the anal verge as well as a flat polyp at 10cm from the anal verge. The histological examination concluded in one adenomatous, one adenovillous with high-grade dysplasia and one hyperplastic lesion. A laparoscopic partial TME with intraoperative endoscopic control is performed. |
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Laparoscopic treatment of gastrogastric fistulas after gastric bypass M Vix (France) / D Mutter (France) / J Marescaux (France) 10:36 - 2009 Jul Gastrogastric fistula (GGF) is a rare complication that occurs after a divided Roux-en-Y gastric bypass (RYGBP). The incidence can be as high as 49% in patients who undergo non-divided or partially divided RYGBP. This is the case of a 33-year-old female patient who benefited of a gastric bypass 4 months earlier. After the procedure, the patient suffered from dysphagia. During preoperative work-up, a gastrogastric fistula was discovered. This video shows the laparoscopic treatment of the gastrogastric fistula. |
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Laparoscopic Collis gastroplasty and partial fundoplication for valve slippage B Dallemagne (France) / S Perretta (France) / J Marescaux (France) 25:00 - 2009 Jul Re-operative antireflux surgery represents a challenging and complex clinical undertaking requiring careful patient selection as well as a high level of technical expertise. The procedures themselves are associated with a high rate of morbidity. This video shows a laparoscopic Collis gastroplasty and partial fundoplication for the treatment of valve slippage. |
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Laparoscopic one trocar cholecystectomy: Gelport® technique D Mutter (France) / J Marescaux (France) 06:41 - 2009 Jul Single port access cholecystectomy is a new laparoscopic procedure using only one transumbilically placed port. This video shows a procedure performed using a Gelport® through a 2.5cm incision. This Gelport® is usually used to perform hand-assisted surgery. In this case, the incision used to introduce the hand was closed by a single suture and 3 ports are inserted in the gel. These 3 ports allow to insert a 5mm 30 degree optic and straight or angulated instruments into the abdomen. |
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Laparoscopic treatment for a symptomatic esophageal stenosis following Nissen repair B Dallemagne (France) / J Marescaux (France) 13:14 - 2009 Jun Laparoscopic fundoplication has revolutionized the surgical treatment of gastroesophageal reflux disease. Careful patient selection, identification of the short esophagus, and accurate construction of the fundoplication can lead to a decrease in the incidence of postoperative dysphagia. This is an interesting video in which a critical analysis in performing a redo operation is clearly given to each surgical step. |
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Laparoscopic sleeve gastrectomy in a female patient with a BMI of 42 M Vix (France) / J Marescaux (France) 16:00 - 2009 Jun Laparoscopic sleeve gastrectomy (LSG) was initially introduced for super-obese patients in a two-step concept in order to reduce the perioperative risk. Presently, it is proposed as one of the effective standard procedures for surgical treatment of morbid obesity. This video shows a laparoscopic sleeve gastrectomy in a female patient with a BMI of 42. |
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Three port technique for laparoscopic left colectomy C Huscher (Italy) / J Marescaux (France) 24:00 - 2009 May With advancing surgical technology and technique, truly minimally invasive surgical procedures are feasible. Three port laparoscopic colectomy should offer minimal scarring without compromising the surgical outcome. This video demonstrates the technical details in performing the three port colectomy in a 40-year-old man with a BMI of 29, with several episodes of diverticulitis of the left colon. |
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Laparoscopic sigmoidectomy following inadequate endoscopic resection margins of pedunculated polyp F Corcione (Italy) / J Marescaux (France) 19:24 - 2009 May The value and efficacy of laparoscopic colorectal surgery has been validated by large multicenter, randomized, controlled trials. This video shows a laparoscopic sigmoidectomy in a 74-year-old woman who underwent an incomplete endoscopic resection of a T1 adenocarcinoma tumor. Four trocars are used: two of 10mm and two of 5mm. |
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Standardized laparoscopic sigmoidectomy for diverticulitis in an obese male patient using the triple stapling technique J Leroy (France) / J Marescaux (France) 21:19 - 2009 May Obesity is a modern-day phenomenon that is increasing throughout the world. Laparoscopic colorectal surgery is clearly more technically demanding in the obese patient. Apart from this, however, it is not associated with any increased risk of postoperative complications. This is the case of a 52-year-old man with a BMI of 30 who was admitted several times to the hospital because of diverticulitis. The video demonstrates the technical details in performing the laparoscopic sigmoidectomy using the triple stapling technique. |
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Totally laparoscopic TME for middle rectal cancer with a side-to-end colorectal anastomosis J Leroy (France) / J Marescaux (France) 29:55 - 2009 May Over the last decade, the surgical treatment of rectal cancer has witnessed various improvements. Total mesorectal excision (TME) became the standard procedure. The surgical quality of the TME has a high effect on prognosis. This is the case of a 60-year-old woman with a BMI of 38 in whom a totally laparoscopic TME for middle rectal cancer with a side-to-end colorectal anastomosis is performed. |
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Laparoscopic TAPP procedure for bilateral inguinal hernia J Leroy (France) / J Marescaux (France) 18:00 - 2009 Apr This video demonstrates the trans-abdominal preperitoneal (TAPP) approach to bilateral inguinal hernia in a male patient with a BMI of 55. The surgeon performs the repair using a non-woven, non-absorbable polypropylene mesh. The author uses a 3-trocar approach: the first one is a 12mm supra-umbilical port (i.e., the trocar for the scope), and two 5mm ports on the right and on the left approximately at the crossing between the umbilical line and the mid-clavicular line. A clear explanation of all surgical landmarks is offered. The main objectives when doing a TAPP dissection are well exposed. |
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Laparoscopic Roux-en-Y gastric bypass after vertical banded gastroplasty F Costantino (France) / M Vix (France) / J Marescaux (France) 16:04 - 2009 Apr 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. |
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Totally laparoscopic TME in a male patient with a side-to-end mechanical anastomosis J Leroy (France) / J Marescaux (France) 19:22 - 2009 Apr Total mesorectal excision (TME) of the rectum has been advocated as the gold surgical treatment of the middle and low third rectal cancer. This video clearly demonstrates a totally laparoscopic TME in a male patient with a side-to-end anastomosis according to the principle of TME as described by Professor Heald in open surgery. |
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Laparoscopic splenopancreatectomy assisted by augmented reality for pancreatic cancer D Mutter (France) / J Marescaux (France) / L Soler (France) 18:16 - 2009 Apr Soper et al. in 1994 were able to establish the safety and efficacy of laparoscopic distal pancreatectomy in an animal model, with no evidence of pancreatic leaks or fistulas. Later, in 1996, Cuschieri et al. described the technique they used to perform laparoscopic distal 70–80% pancreatectomy with en-bloc splenectomy in a group of five patients with intractable pain due to chronic pancreatitis. The authors demonstrated that this operation can be performed laparoscopically within an acceptable operating time and without major complications with advantages that include smaller incisions, less pain, and shorter postoperative recovery. Identification of anatomical landmarks is crucial for this kind of procedure expecially when treating cancer. Augmented reality is a new tool to improve oncological safety, confirming the ideal dissection plane and anatomical landmarks, and to maximize functional preservation. The objective of this video is to demonstrate how to perform a splenopancreatectomy with removal of pancreatic cancer while keeping sufficient safety margins. Augmented reality is used in order to clearly identify the position of the anatomical landmarks: the splenic vein and artery, as well as the exact position of the tumor so that a sufficient resection margin can be identified. |
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Laparoscopic sigmoidectomy for cancer in a female patient: a gold standard technique J Leroy (France) / J Marescaux (France) 19:00 - 2009 Apr This video clearly demonstrates the technical details (exposure, vascular approach, colorectal dissection and anastomosis) to correctly perform a laparoscopic sigmoidectomy for cancer in a female patient. |
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Laparoscopic proctectomy with ileoanal anastomosis for inflammatory bowel disease J Leroy (France) / J Marescaux (France) 13:54 - 2009 Mar Total coloproctectomy with ileal pouch-anal anastomosis is the operation of choice for ulcerative colitis. The objective of this video is to demonstrate the technique used to perform a laparoscopic coloproctectomy for the treatment of inflammatory bowel disease (and particularly, ulcerative colitis) and to show the ileoanal anastomosis (with creation of an ileal J-pouch) that follows a total colectomy resection. In this case, only sample exteriorization and ileal J-pouch formation are performed using the temporary ileostomy opening situated in the right flank. All other steps are performed entirely laparoscopically. The dissection is carried out using the 10mm Ligasure Atlas device. |
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Laparoscopic re-operation for severe dysphagia following fundoplication and prosthetic reinforcement of the hiatus B Dallemagne (France) / S Perretta (France) / J Marescaux (France) 18:24 - 2009 Mar Complications related to prosthetic hiatoplasty for hiatal hernia repair are more common than previously reported with no apparent relationship between mesh type and mesh configuration. The aim of this video is to show a case of mesh repair complication. A 50-year-old woman presented with severe dysphagia and important weight loss one year after redo laparoscopic Nissen fundoplication with prosthetic crural repair. At re-operation, important esophageal stenosis and angulation was found arising from the key-hole-shaped polypropylene mesh with pseudodiverticular dilatation of the distal esophagus. The esophagus was freed from the dense fibrotic capsule surrounding the prosthesis and a myotomy was performed. |
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Laparoscopic sigmoidectomy for acute diverticulitis: medial approach with extensive IMV dissection F Corcione (Italy) / J Marescaux (France) 17:30 - 2009 Feb Colonic diverticulosis is an increasingly common condition in Western societies. Sigmoid colectomy for diverticulitis can be technically challenging because of severe inflammation in the left lower quadrant and pelvis. We here present a standard elective sigmoidectomy, after episodes of diverticulitis treated medically. |
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Laparoscopic right colectomy in an obese patient with a dysplastic adenoma C Huscher (Italy) / J Marescaux (France) 13:00 - 2009 Feb This video demonstrates a laparoscopic three-port right hemicolectomy in an obese patient with a dysplastic adenoma. A stepwise approach including landmark identification is undertaken during the procedure. The specimen is extracted through a small laparotomy, which will be protected by a plastic bag. An extracorporeal mechanical side-to-side anastomosis using a 60mm Endo-GIA is made and the mesenteric window is closed using a monofilament 2/0 running suture. This video is a good demonstration of key anatomic landmarks, surgical planes, and surgical approach to a right hemicolectomy. |
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Laparoscopic antrectomy and vagotomy for stenotic pyloric peptic ulcer B Dallemagne (France) / S Perretta (France) / J Marescaux (France) 12:15 - 2009 Feb Peptic ulcer disease is the major cause of benign gastro-duodenal obstruction or gastric outlet obstruction (GOO) in the adult population. Patients often present with abdominal pain and distension, vomiting, dehydration, and weight loss. Previous studies have demonstrated that the incidence of GOO varies from 5% to 10% of all hospital admissions for ulcer-related complications. Today surgeons are performing fewer elective ulcer surgeries, as H2 receptor blockers and the eradication of Helicobacter pylori represent a major step in the treatment of this disease. Nevertheless, patients with complications and those resistant to medical therapy can be offered surgical options. When surgery is required, a laparoscopic approach is possible with its well-known advantages. Surgical procedures include highly selective vagotomy with some form of pyloroplasty, truncal vagotomy and antrectomy, and truncal vagotomy with gastroenterostomy. Proponents of highly selective vagotomy advocate an acceptably low recurrence rate (0 to 5% at follow-up of 24 to 90 months) and a relative paucity of post-gastrectomy sequelae. Those recommending vagotomy and antrectomy stress the superiority of the acid-reducing procedure, the virtual absence of recurrent ulceration, and the rarity of postoperative symptoms other than post-vagotomy diarrhea, which is usually a self-limited process. Finally, truncal vagotomy with gastroenterostomy avoids what can be a treacherous duodenal stump, but can result in higher ulcer recurrence rates. We present the case of a young male patient not compliant to medical treatment who was referred to us for gastric outlet obstruction. The selected approach consisted in a laparoscopic Billroth II antrectomy and vagotomy using four ports. |
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Laparoscopic enucleation of a pancreatic insulinoma B Dallemagne (France) / S Perretta (France) / J Marescaux (France) 19:00 - 2009 Jan Insulinoma is the most common pancreatic endocrine neoplasm. Treatment is by excision. In the pre-laparoscopic era, the enucleation was performed by laparotomy, but surgeons have shown that it can be performed laparoscopically. Preoperative localization is important in planning port placement and in guiding laparoscopic ultrasonography if necessary. When enucleation is performed, the pancreatectomy provides no oncologic advantage. |
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Laparoscopic stepwise repair of a giant hiatal hernia B Dallemagne (France) / S Perretta (France) / M Asakuma (France) / J Marescaux (France) 20:00 - 2009 Jan The laparoscopic approach is considered the technique of choice for the repair of large hiatal hernia leading to low morbidity and mortality rates. We describe our approach for the laparoscopic repair of giant hiatus hernia. This entails full dissection of the hernia sac from the mediastinum, hiatal repair and the construction of a fundoplication. |
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Laparoscopic esophageal diverticulectomy and myotomy B Dallemagne (France) / S Perretta (France) / J Marescaux (France) 10:00 - 2009 Jan Open trans-thoracic surgery represents the traditional approach for the treatment of symptomatic esophageal diverticula. However, it should be noted that minimally invasive techniques, including the laparoscopic trans-hiatal approach has been reported with success. We present the case of a patient suffering from dysphagia and regurgitation due to an esophageal diverticulum, successfully treated through a laparoscopic approach. |
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Use of absorbable tacker for Nyhus IIIa left inguinal hernia D Mutter (France) / J Marescaux (France) 05:00 - 2008 Dec We present the case of an inguinal hernia in a male patient, treated laparoscopically through a TAPP approach. The use of innovative absorbable tackers and its advantages are shown and thoroughly explained. |
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Laparoscopic TME dissection with monopolar cautery J Leroy (France) / J Marescaux (France) 26:46 - 2008 Dec 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. |
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Intraoperative diagnosis of short esophagus in a patient with Barrett's metaplasia B Dallemagne (France) / S Perretta (France) / J Marescaux (France) 12:40 - 2008 Dec Patients who have Barrett’s esophagus are considered at risk for having a short esophagus. Routine intraoperative endoscopy and liberal addition of a Collis gastroplasty is a key factor to prevent recurrences. |
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Laparoscopic ileocolectomy for caecal perforated diverticulum using the Ligasure Advance® J Leroy (France) / J Marescaux (France) 20:51 - 2008 Nov This patient presents with a perforation of a caecal diverticulum. The right parietocolic ridge is dissected, using the monopolar tip of the Ligasure Advance device. Hemostasis can be performed with the same instrument, using the bipolar sealing part. A classic ileocolectomy is carried out and a totally intracorporeal latero-lateral anastomosis is performed. |
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Laparoscopic sigmoidectomy for acute diverticulitis (Hinchey stage IIb) J Leroy (France) / J Marescaux (France) 16:37 - 2008 Nov 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. |
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Combined endoscopic and laparoscopic transgastric single port (TriPort) access for a gastric tumor J Leroy (France) / B Dallemagne (France) / D Mutter (France) / J Marescaux (France) 04:11 - 2008 Nov Intragastric tumors represent a challenging pathology to treat with a minimally invasive approach because of their position and size. The possibility to combine both endoscopy and intragastric endoscopic surgery is of great value in these cases. This video shows such a combined endoscopic and laparoscopic approach to treat a stromal gastric tumor of the cardia. The endoscopy allows to choose a perfect position of laparoscopic access, depending on the tumor location. Furthermore, it provides the vision at the beginning of the intervention. After ablation of the tumor, a Triport is inserted into the stomach to close the gastric mucosa, allowing multiple transgastric access through a single gastrotomy. |
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Single port site cholecystectomy for symptomatic cholelithiasis D Mutter (France) / J Marescaux (France) 06:07 - 2008 Nov 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. |
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Laparoscopic approach for a T3 cancer of the colorectal junction J Leroy (France) / J Marescaux (France) 18:50 - 2008 Nov This video shows a standard oncological laparoscopic approach for T3 cancer of the colorectal junction. In this case, the patient presents a big tumor with a clinical sub-occlusion. A low anterior resection is performed by a medial to lateral approach, with a primary inferior mesenteric artery control. Splenic flexure mobilization was not necessary in this case. An end-to-end colo-anal anastomosis ends the procedure. |
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Laparoscopic treatment of GERD in an obese patient B Dallemagne (France) / J Marescaux (France) 15:19 - 2008 Oct 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. |
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Laparoscopic total colectomy for disseminated polyposis in an obese male patient (BMI=32) J Leroy (France) / J Marescaux (France) 23:00 - 2008 Oct This video presents the case of an obese male patient with rectorrhagia caused by disseminated polyposis. A stepwise approach is applied. The landmarks are identified in a detailed way. |
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Laparoscopic treatment of a non-congenital diaphragmatic hernia B Dallemagne (France) / S Perretta (France) / J Marescaux (France) 05:05 - 2008 Oct A step-by-step approach is explained for the laparoscopic management of a diaphragmatic hernia in a patient with a past surgical history of Nissen fundoplication. Preoperative and postoperative CT-scans are shown. |
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A world premiere: Single port sigmoidectomy for diverticulosis in humans J Leroy (France) / J Marescaux (France) 05:46 - 2008 Oct This video shows a unique procedure during which a sigmoidectomy was performed with a single trocar and entirely through the umbilicus. The principles applied to benign colonic resections are respected. An original colo-colonic anastomosis is presented with the use of external magnets to aid in with the totally intracorporeal anastomosis. The postoperative cosmetic results are shown. |
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Laparoscopic gastric bypass for a young woman with a BMI of 44 D Varela (France) / J Marescaux (France) 16:30 - 2008 Oct This video presents the key steps to a gastric bypass procedure. This video is recommended for advanced laparoscopic surgeons. |
 Descarga gratuita |
Laparoscopic TME in a female patient J Leroy (France) / J Marescaux (France) 21:54 - 2008 Sep This video shows a TME resection performed live at an EITS Course in Laparoscopic Colorectal Surgery. It shows the technical steps and relevant anatomy in a difficult case as the patient has a past surgical history and is predisposed to bleeding. |
 Descarga gratuita |
Laparoscopic right colectomy for cancer: vascular problem during the anastomosis B Salky (United states) 27:50 - 2008 Sep This video presents the case of a right colectomy, with an intraoperative complication of the anastomosis, requiring a redo of the ileocolic isoperistaltic anastomosis. |
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Laparoscopic cholecystectomy using micro-instrumentation including monopolar and bipolar 2mm cautery D Mutter (France) / J Marescaux (France) 09:27 - 2008 Sep This video demonstrates the feasibility and the challenges of a laparoscopic cholecystectomy using micro-instrumentation in an uncomplicated cholelithiasis. |
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Laparoscopic resection of a hepatocellular carcinoma within segment IVa of the liver D Mutter (France) / J Marescaux (France) / L Soler (France) 08:00 - 2008 Sep This video presents the case of a female patient with an ethylic cirrhosis, diagnosed with a hepatocellular carcinoma located in segment IVa of the liver. The laparoscopic approach helps preserve liver function in patients with precarious liver conditions. |
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Laparoscopic treatment of an appendicular mucocele J Leroy (France) / J Marescaux (France) 05:00 - 2008 Sep This video shows the laparoscopic treatment of an appendicular mucocele in a female patient who had had a hysterectomy. |
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Totally laparoscopic reversal of Hartmann's procedure J Leroy (France) / J Marescaux (France) 15:00 - 2008 Sep This video presents a totally laparoscopic reversal of Hartmann’s procedure in a patient with a surgical history of laparotomy for colorectal surgery. |
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Laparoscopic Nissen fundoplication: a stepwise standard approach B Dallemagne (France) / J Marescaux (France) 13:10 - 2008 Sep This video demonstrates all the important technical steps for a standard construction of a Nissen's fundoplication. |
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TME with LigaSure Advance®: coloanal anastomosis on the J-pouch after failed closure of the rectal stump J Leroy (France) / J Marescaux (France) 24:42 - 2008 Sep This video presents a TME with creation of a J-pouch for a coloanal anastomosis. A thorough description of the operative steps is presented. This video is recommended for digestive surgeons. |
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Laparoscopic TAPP repair for a right Nyhus type IVa inguinal hernia in a male patient J Leroy (France) / J Marescaux (France) 10:32 - 2008 Jul This edit of a case performed at a recent EITS Laparoscopic Course demonstrates the TAPP technique for a right inguinal hernia. As well as the technical steps, the relevant anatomy is expertly demonstrated. |
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Large type III hiatal hernia repair with a biological diaphragmatic mesh and partial posterior fundoplication B Dallemagne (France) / J Marescaux (France) 18:55 - 2008 Jun This video presents the management of a giant hiatal hernia by a laparoscopic Toupet fundoplication. We use a combination of pledgets and sutures as well as a mesh to close the crural defect. We recommend this video for advanced upper GI surgeons. |
| Endocrina (5) | |
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12cm right pheochromocytoma: not a contraindication to a laparoscopic approach D Mutter (France) / L Soler (France) / J Marescaux (France) 17:00 - 2010 Feb Laparoscopic adrenalectomy is now accepted as the procedure of choice for the resection of benign adrenocortical tumors. This video shows the laparoscopic approach for a 12cm right pheochromocytoma, demonstrating that the size is not a contraindication for laparoscopy. |
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Importance of intraoperative identification of the vascular supply in a large (14cm) right pheochromocytoma D Mutter (France) / L Soler (France) / J Marescaux (France) 19:00 - 2009 Nov Laparoscopic adrenalectomy for large masses is a technically demanding procedure that should be undertaken by experienced laparoscopic surgeons familiar with retroperitoneal anatomy. In case of very large tumors, a primary vascular approach must prevail over any other types of dissection. This video shows the case of a patient presenting with a voluminous non-secreting adrenal tumor (with a diameter of 14cm) in which a primary laparoscopic approach is decided upon as performed conventionally. |
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Laparoscopic left adrenalectomy for Conn's adenoma: three trocar technique D Mutter (France) / L Soler (France) / J Marescaux (France) 14:00 - 2009 Jun Conn's disease is a condition in which the adrenal glands produce too much aldosterone. Prevalence estimates for Conn's syndrome is about 0.03-1.2% of the population with hypertension. Many patients with Conn's disease have a high blood pressure that is difficult to control. This increases the risk of stroke, heart disease and kidney failure. When Conn's disease is caused by a tumor (benign adrenal adenoma), surgical resection is advised. This video demonstrates the case of a woman presenting with Conn’s disease. The preoperative work-up demonstrated a tumor located on the left adrenal gland. The patient presented an elevated aldosteronemia and the CT-scan demonstrated a 2cm left adrenal tumor. The patient is placed in a full lateral position, on the right side. |
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Left pheochromocytoma: laparoscopic vascular approach D Mutter (France) / J Marescaux (France) 11:43 - 2009 Mar Since it was first performed in 1992, laparoscopy has clearly become the procedure of choice for the removal of most functioning and non-functioning adrenal tumors. Compared with those who underwent a standard open approach, patients undergoing a laparoscopic adrenalectomy have demonstrated decreased perioperative morbidity, shorter hospital stay, and faster functional recovery. This video demonstrates how to perform a laparoscopic adrenalectomy showing the surgical landmarks for a correct vascular approach in a stepwise fashion. |
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Laparoscopic resection of a right pheochromocytoma: anatomical variation of the main adrenal vein D Mutter (France) / J Marescaux (France) 08:30 - 2009 Feb Laparoscopic adrenalectomy has now become the new "gold standard" for the surgical treatment of most adrenal lesions. Here we show a film of right adrenalectomy for pheochromocytoma, demonstrating the conventional "no touch technique" where the dissection takes place around the gland without really manipulating it. The film also demonstrates the anatomical landmarks as well as the principles and sequence of vascular control. |
| Ginecología (4) | |
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Laparoscopic restaging for ovarian cancer with pelvic and lumbo-aortic lymphadenectomy A Wattiez (France) / I Miranda-Mendoza (Chile) / J Nassif (France) / E Kovoor (France) / M Hummel (France) 22:00 - 2009 Sep Ovarian cancer usually affects women over age 50, but it can also occur in younger women. Its cause is unknown and is hard to detect early. We present a short video describing the technique of laparoscopic restaging for ovarian cancer with pelvic and lumbo-aortic lymphadenectomy. |
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Laparoscopic hysterectomy with adnexectomy A Wattiez (France) / E Kovoor (France) / J Nassif (France) / I Miranda-Mendoza (Chile) 22:49 - 2009 Jul This video demonstrates the technique of a total laparoscopic hysterectomy with adnexectomy. Our patient is a 44-year-old lady with Tamoxifen-induced endometrial hyperplasia, which failed to respond to medical treatment. Umbilical incision is made on the left internal border to give a more aesthetic scar. Direct entry is performed. The assistant helps to lift the abdomen while the surgeon directs the trocar perpendicularly towards the rectus sheath first, then directs it towards the pelvis. The midline port is inserted: this should be at a slightly higher level than the lateral ports for better ergonomics. The uterine manipulator has a rotating ceramic valve for opening the vagina and a set of rings to maintain the pneumoperitoneum. The procedure is started by coagulating and cutting the round ligament on the left and opening the broad ligament. The broad ligament is opened parallel to the infundibulopelvic ligament for adnexectomy and a window is made over the grey area. The posterior leaf of the broad ligament is opened towards the left uterosacral ligament. The anterior leaf of the broad ligament is opened towards the vagina by dissecting the space and coagulating and cutting the tissues in between. The dissection is continued until the uterine artery is reached. The left infundibulopelvic ligament is coagulated and cut. The same procedure is done on the other side. Bladder dissection is performed with the help of the assistant holding up the bladder and entering the vesicovaginal space. The bladder is dissected away, beyond the valve of the manipulator. The left uterine artery is coagulated and cut. The left uterosacral ligament is coagulated and cut. The right uterine vessels are coagulated and cut followed by the uterosacral ligament. The vagina is now cut against the valve of the manipulator using a monopolar hook. Bleeding points are coagulated with a bipolar forceps. The vagina is sutured in two layers using extracorporeal knots. The procedure is now complete and hemostasis is confirmed. This patient had a favourable postoperative outcome and was discharged on postoperative day 1. |
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Laparoscopic total hysterectomy and bilateral pelvic lymphadenectomy for endometrial cancer A Wattiez (France) / J Nassif (France) / C Zacharopoulou (France) 25:00 - 2008 Nov 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. |
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Laparoscopic total hysterectomy for multiple uterine myomas A Wattiez (France) / J Nassif (France) / C Zacharopoulou (France) 24:00 - 2008 Oct In this video, we present the case of a 49-year-old patient with menorrhagia caused by multiple uterine myomas. The technical aspects of a laparoscopic hysterectomy in the case of large uteri is also exposed. The video also presents tips and tricks to deal with such cases. |
| Urología (3) | |
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Laparoscopic surgical sacral colpopexy for genitourinary prolapse after hysterectomy E Mandron (France) 28:40 - 2009 Sep Laparoscopic promontofixation is a feasible and highly effective technique that offers good long-term results. In this video, a sacral colpopexy with double promontofixation using a double mesh, anterior and posterior mesh is presented in a patient who had a previous hysterectomy. |
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Laparoscopic treatment for genitourinary prolapse E Mandron (France) / C Saussine (France) / J Marescaux (France) 20:26 - 2009 Mar Nowadays, there is a consensus upon treating genitourinary prolapse with mesh placement. Anterior and posterior mesh placement can be done by a transvaginal or an abdominal approach. Such a laparoscopic approach should be considered as a gold standard in terms of anatomical and functional long-term results. We present a case of laparoscopic prolapse treatment with double anterior and posterior sacral mesh fixation. |
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Laparoscopic treatment of genitourinary prolapse E Mandron (France) / C Saussine (France) 23:32 - 2008 Dec Pelvic organ prolapse is a common condition affecting many adult women today. Knowledge of the anatomy of the pelvis is essential to understanding prolapse; for this, the challenge to the pelvic surgeon is to recreate normal anatomy while maintaining normal function. We present a case of a genitourinary prolapse treated through a laparoscopic approach. |
| © Aviso de Copyright - IRCAD - Todos los derechos reservados Estos vídeos y sus contenidos son de exclusiva propiedad del IRCAD y están protegidos por la ley francesa y por los tratados internacionales. Queda terminantemente prohibido copiar, modificar, retransmitir o recodificar estos vídeos sin la autorización escrita del departamento de relaciones públicas del IRCAD. |
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