Мы используем файлы cookies, чтобы улучшить работу сайта. Продолжая просматривать наш сайт, вы соглашаетесь на использование файлов cookie.

Didier MUTTER

Hôpitaux Universitaires de Strasbourg
Strasbourg, Франция
MD, PhD, FACS
43K лайков
1 просмотр/-ов
259 комментариев
Фильтр
Очистить Хирургические специальности
Подробнее

Очистить Рубрики
Подробнее
Очистить Категории
Подробнее
Расположение: Список Таблица
Complicated laparoscopic cholecystectomy with bile leak: management strategy
Laparoscopic cholecystectomy may be rendered particularly complicated due to several conditions such as hepatomegaly or an advanced inflammatory state. Technical difficulties may be accountable for intraoperative complications, such as biliary leakage although surgeons comply with well-established safety guidelines such as the "critical view of safety" prior to the division of pedicular structures.
This is the case of a morbidly obese 69-year-old male patient who was operated on three months after an episode of cholangitis medically treated and managed with ERCP and endoscopic sphincterotomy with a favorable evolution.
During laparoscopic cholecystectomy, the cystic pedicle presents an inflammatory aspect, making the exposure and the surgical procedure particularly uneasy to perform in this obese patient.
During dissection, bile leakage was evidenced.
This video shows a therapeutic strategy to handle such a case, with the initial objective of preventing any common bile duct injury.
P Pessaux, G Philouze, D Mutter, J Marescaux, JB Bertin, S Osailan
Хирургические операции
12 дней назад
242 просмотров
4 лайков
1 комментарий
10:28
Complicated laparoscopic cholecystectomy with bile leak: management strategy
Laparoscopic cholecystectomy may be rendered particularly complicated due to several conditions such as hepatomegaly or an advanced inflammatory state. Technical difficulties may be accountable for intraoperative complications, such as biliary leakage although surgeons comply with well-established safety guidelines such as the "critical view of safety" prior to the division of pedicular structures.
This is the case of a morbidly obese 69-year-old male patient who was operated on three months after an episode of cholangitis medically treated and managed with ERCP and endoscopic sphincterotomy with a favorable evolution.
During laparoscopic cholecystectomy, the cystic pedicle presents an inflammatory aspect, making the exposure and the surgical procedure particularly uneasy to perform in this obese patient.
During dissection, bile leakage was evidenced.
This video shows a therapeutic strategy to handle such a case, with the initial objective of preventing any common bile duct injury.
Laparoscopic cholecystectomy: cystic duct stone management
This video demonstrates a laparoscopic cholecystectomy in a 69-year-old woman who had multiple episodes of biliary colic. Ultrasonography and MRI showed the presence of multiple gallbladder stones. MRI also showed a folded gallbladder infundibulum over the cystic duct, which is enlarged and contains a stone. The common bile duct is otherwise perfectly thin and free of stones. In this video, one can observe a stepwise cholecystectomy technique, with exposure, dissection of the serosa and of Calot’s triangle. Cystic artery division is first performed in order to allow complete cystic duct dissection obtaining the critical view of safety. The dissection of the dilated cystic duct is thoroughly demonstrated. A small stone is pushed back into the gallbladder; the cystic duct is opened and checked for residual stones, and the cystic duct convergence with the common bile duct is evidenced prior to clip positioning and duct division.
M Ignat, M Wehr, B Seeliger, D Mutter, J Marescaux
Хирургические операции
3 месяцев назад
2677 просмотров
10 лайков
2 комментариев
10:44
Laparoscopic cholecystectomy: cystic duct stone management
This video demonstrates a laparoscopic cholecystectomy in a 69-year-old woman who had multiple episodes of biliary colic. Ultrasonography and MRI showed the presence of multiple gallbladder stones. MRI also showed a folded gallbladder infundibulum over the cystic duct, which is enlarged and contains a stone. The common bile duct is otherwise perfectly thin and free of stones. In this video, one can observe a stepwise cholecystectomy technique, with exposure, dissection of the serosa and of Calot’s triangle. Cystic artery division is first performed in order to allow complete cystic duct dissection obtaining the critical view of safety. The dissection of the dilated cystic duct is thoroughly demonstrated. A small stone is pushed back into the gallbladder; the cystic duct is opened and checked for residual stones, and the cystic duct convergence with the common bile duct is evidenced prior to clip positioning and duct division.
Right and left adrenalectomy by transperitoneal approach
In this video, Professor Didier Mutter demonstrates different approaches for laparoscopic adrenalectomy. For a precise and fast dissection, the quality of camera and instruments is essential. Vascular landmarks are of paramount importance, Sometimes, there is a duplication of the adrenal vein, and any mistake in dissection can cause difficulty to control bleeding. 3D reconstruction helps to identify some original anatomical variations. In this lecture, Professor Mutter also discusses the robotic approach used to perform an adrenalectomy with 3D reconstruction for vascular exploration in order to prevent renal vascular damage. The laparoscopic approach is the gold standard for all types of glands. In some complicated cases, the procedure is converted to an open procedure. This does not mean that the technique has failed.
D Mutter
Лекции
2 лет назад
3104 просмотров
291 лайков
1 комментарий
18:17
Right and left adrenalectomy by transperitoneal approach
In this video, Professor Didier Mutter demonstrates different approaches for laparoscopic adrenalectomy. For a precise and fast dissection, the quality of camera and instruments is essential. Vascular landmarks are of paramount importance, Sometimes, there is a duplication of the adrenal vein, and any mistake in dissection can cause difficulty to control bleeding. 3D reconstruction helps to identify some original anatomical variations. In this lecture, Professor Mutter also discusses the robotic approach used to perform an adrenalectomy with 3D reconstruction for vascular exploration in order to prevent renal vascular damage. The laparoscopic approach is the gold standard for all types of glands. In some complicated cases, the procedure is converted to an open procedure. This does not mean that the technique has failed.