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Carlos VEIGA

University of Minho
Braga, Portugal
MD
85 likes
3.2K views
1 comment
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Laparoscopic gastrostomy in a patient with esophageal squamous cell carcinoma
Percutaneous endoscopic gastrostomy (PEG) and self-expanding endoscopic prosthesis are considered to be the "gold standard" for patients with neurological or oncologic diseases, which do not allow feeding per os. When they fail, surgical gastrostomy is considered. Recent data suggest that the laparoscopic approach may be better regarding early complications as compared to PEG.
We present the case of an 81-year-old male patient diagnosed with squamous cell carcinoma of the esophagus. The patient presented with total dysphagia. The attempt of placing a self-expanding endoscopic prosthesis was unsuccessful. The patient was then proposed for the placement of a feeding laparoscopic gastrostomy. The postoperative period was uneventful and the patient was discharged on day two.
Surgical gastrostomy is associated with frequent complications, such as erythema, chronic suppuration, migration and complications associated with surgical access. Laparoscopic access and technical details of the procedure allowed to reduce such complications and to perform the main steps under direct visual control, making it very safe and easily reproducible.
A Gomes, D Luis, T Carneiro, C Veiga
Surgical intervention
3 years ago
1879 views
56 likes
1 comment
06:40
Laparoscopic gastrostomy in a patient with esophageal squamous cell carcinoma
Percutaneous endoscopic gastrostomy (PEG) and self-expanding endoscopic prosthesis are considered to be the "gold standard" for patients with neurological or oncologic diseases, which do not allow feeding per os. When they fail, surgical gastrostomy is considered. Recent data suggest that the laparoscopic approach may be better regarding early complications as compared to PEG.
We present the case of an 81-year-old male patient diagnosed with squamous cell carcinoma of the esophagus. The patient presented with total dysphagia. The attempt of placing a self-expanding endoscopic prosthesis was unsuccessful. The patient was then proposed for the placement of a feeding laparoscopic gastrostomy. The postoperative period was uneventful and the patient was discharged on day two.
Surgical gastrostomy is associated with frequent complications, such as erythema, chronic suppuration, migration and complications associated with surgical access. Laparoscopic access and technical details of the procedure allowed to reduce such complications and to perform the main steps under direct visual control, making it very safe and easily reproducible.
Pure NOTES total transanal caudal-to-cranial low rectal resection
A 37-year-old female patient underwent a pure NOTES transanal rectal resection without transabdominal laparoscopic assistance for a rectal lesion located 5cm away from the anal verge (cT2N0M0 adenocarcinoma). All oncologic principles were fulfilled.
A GelPOINT Path Transanal® access platform was used. The procedure was achieved with no-flexible cameras and straight laparoscopic instruments. An Ultracision® device was used for dissection. A circular stapler with a long anvil was selected because it helped to achieve the anastomosis.
No complications were observed and the patient was discharged home on the third postoperative day.
P Leão, A Goulart, N Marcos, C Veiga, H Cristino
Surgical intervention
3 years ago
1332 views
29 likes
0 comments
15:43
Pure NOTES total transanal caudal-to-cranial low rectal resection
A 37-year-old female patient underwent a pure NOTES transanal rectal resection without transabdominal laparoscopic assistance for a rectal lesion located 5cm away from the anal verge (cT2N0M0 adenocarcinoma). All oncologic principles were fulfilled.
A GelPOINT Path Transanal® access platform was used. The procedure was achieved with no-flexible cameras and straight laparoscopic instruments. An Ultracision® device was used for dissection. A circular stapler with a long anvil was selected because it helped to achieve the anastomosis.
No complications were observed and the patient was discharged home on the third postoperative day.