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Luc SOLER

IRCAD-EITS
Strasbourg, Франция
PhD
3.6K лайков
162.6K просмотров
17 комментариев
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Расположение: Список Таблица
Segment III hepatocellular carcinoma (HCC) and major liver cirrhosis: laparoscopic resection
Laparoscopy for liver resection is a highly specialized surgical field because liver surgery presents severe technical difficulties, such as control of bleeding and risk of gas embolism. This video presents the case of a 60-year-old patient presenting with significant liver cirrhosis. During follow-up, a 3cm HCC located in the left liver was diagnosed. CT-scan was reconstructed in order to precisely define the landmarks regarding position of the tumor to the vessels. A laparoscopic approach was decided upon. As expected, a major liver cirrhosis is diagnosed. A parenchyma preserving hepatectomy is performed.
D Mutter, L Soler, J Marescaux
Хирургические операции
9 лет назад
1679 просмотров
45 лайков
1 комментарий
05:42
Segment III hepatocellular carcinoma (HCC) and major liver cirrhosis: laparoscopic resection
Laparoscopy for liver resection is a highly specialized surgical field because liver surgery presents severe technical difficulties, such as control of bleeding and risk of gas embolism. This video presents the case of a 60-year-old patient presenting with significant liver cirrhosis. During follow-up, a 3cm HCC located in the left liver was diagnosed. CT-scan was reconstructed in order to precisely define the landmarks regarding position of the tumor to the vessels. A laparoscopic approach was decided upon. As expected, a major liver cirrhosis is diagnosed. A parenchyma preserving hepatectomy is performed.
Laparoscopic left adrenalectomy for Conn's adenoma: three trocar technique
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.
D Mutter, L Soler, J Marescaux
Хирургические операции
9 лет назад
1620 просмотров
110 лайков
0 комментариев
15:51
Laparoscopic left adrenalectomy for Conn's adenoma: three trocar technique
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.
Laparoscopic splenopancreatectomy assisted by augmented reality for pancreatic cancer
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.
D Mutter, J Marescaux, L Soler
Хирургические операции
10 лет назад
1333 просмотров
40 лайков
0 комментариев
18:27
Laparoscopic splenopancreatectomy assisted by augmented reality for pancreatic cancer
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.
Minimally invasive video-assisted parathyroidectomy for primary hyperparathyroidism
In recent years, the advances in preoperative localization studies, the availability of intraoperative parathyroid hormone (PTH) assay and the introduction of cervicoscopy revolutionized the surgical treatment of primary hyperparathyroidism (PHPT).
Minimally invasive video-assisted parathyroidectomy (MIVAP) is an efficacious and feasible procedure with the same complication rate as conventional surgery and has significant advantages in terms of cosmetic results, postoperative pain, recovery, and patient satisfaction. MIVAP should be considered a valid and validated option for the treatment of sporadic primary hyperparathyroidism, especially in case of a suspected single adenoma. This video demonstrates a minimally invasive approach for the excision of a right superior parathyroid adenoma in an inter-crico-thyroid position in a 65-year-old female patient.
M Vix, L Soler, J Marescaux
Хирургические операции
10 лет назад
1514 просмотров
29 лайков
0 комментариев
04:46
Minimally invasive video-assisted parathyroidectomy for primary hyperparathyroidism
In recent years, the advances in preoperative localization studies, the availability of intraoperative parathyroid hormone (PTH) assay and the introduction of cervicoscopy revolutionized the surgical treatment of primary hyperparathyroidism (PHPT).
Minimally invasive video-assisted parathyroidectomy (MIVAP) is an efficacious and feasible procedure with the same complication rate as conventional surgery and has significant advantages in terms of cosmetic results, postoperative pain, recovery, and patient satisfaction. MIVAP should be considered a valid and validated option for the treatment of sporadic primary hyperparathyroidism, especially in case of a suspected single adenoma. This video demonstrates a minimally invasive approach for the excision of a right superior parathyroid adenoma in an inter-crico-thyroid position in a 65-year-old female patient.
Laparoscopic left adrenalectomy for Conn's disease: virtual reality and exposure for vascular approach
This is a very detailed and didactic video demonstrating laparoscopic left adrenalectomy. All the critical steps are presented clearly and the surgical approach is explained at each stage. All the dissection is performed with only a hook cautery and atraumatic graspers. This is an excellent video for laparoscopic surgeons interested in learning adrenalectomy.

Key landmarks in this step are the splenic, adrenal, and renal veins—and the three main arterial pedicles of the latter that supply the left adrenal gland. The steady mobilization of the pancreas with retraction to the left with the spleen allows the authors to identify the renal vein, clear identification of which is essential. Steady dissection of the superior border of the renal vein enables positive identification of the adrenal vein. The authors dissect it circumferentially from the superior border of the renal vein up to the origin of the phrenic vein.
D Mutter, J Marescaux, L Soler
Хирургические операции
12 лет назад
3190 просмотров
67 лайков
0 комментариев
14:22
Laparoscopic left adrenalectomy for Conn's disease: virtual reality and exposure for vascular approach
This is a very detailed and didactic video demonstrating laparoscopic left adrenalectomy. All the critical steps are presented clearly and the surgical approach is explained at each stage. All the dissection is performed with only a hook cautery and atraumatic graspers. This is an excellent video for laparoscopic surgeons interested in learning adrenalectomy.

Key landmarks in this step are the splenic, adrenal, and renal veins—and the three main arterial pedicles of the latter that supply the left adrenal gland. The steady mobilization of the pancreas with retraction to the left with the spleen allows the authors to identify the renal vein, clear identification of which is essential. Steady dissection of the superior border of the renal vein enables positive identification of the adrenal vein. The authors dissect it circumferentially from the superior border of the renal vein up to the origin of the phrenic vein.
Laparoscopic spleno-pancreatectomy for cancer
Laparoscopic spleno-pancreatic resection performed for adenocarcinoma in the tail of the pancreas. This case demonstrates how a complex resection can be undertaken laparoscopically using a stepwise approach. Difficulty was encountered with division of the pancreas and the management of this problem is discussed.

The surgeon stands between the patient's legs with the table in the reverse Trendelenburg position. The authors place three 10-mm ports across the upper abdomen with additional 5-mm ports in the left subcostal epigastric area. The camera is placed in the supraumbilical port. The laparascopic approach provides superior visualization, and tactile assessment of the pancreas. Mobility of the tumor is important to determine feasibility of resection. Laparoscopic ultrasound can delineate the tumor and surrounding structures.
B Dallemagne, L Soler, J Marescaux
Хирургические операции
12 лет назад
5805 просмотров
24 лайков
0 комментариев
14:35
Laparoscopic spleno-pancreatectomy for cancer
Laparoscopic spleno-pancreatic resection performed for adenocarcinoma in the tail of the pancreas. This case demonstrates how a complex resection can be undertaken laparoscopically using a stepwise approach. Difficulty was encountered with division of the pancreas and the management of this problem is discussed.

The surgeon stands between the patient's legs with the table in the reverse Trendelenburg position. The authors place three 10-mm ports across the upper abdomen with additional 5-mm ports in the left subcostal epigastric area. The camera is placed in the supraumbilical port. The laparascopic approach provides superior visualization, and tactile assessment of the pancreas. Mobility of the tumor is important to determine feasibility of resection. Laparoscopic ultrasound can delineate the tumor and surrounding structures.
Virtual reality applied to video-assisted left superior parathyroidectomy
This video demonstrates how virtual reality is applied to video-assisted left superior parathyroidectomy. The virtual reconstruction is done from a preoperative contrast CT scan. The anatomy is then recreated layer by layer starting from the skin to the bone. Every anatomical structure can be removed or added back, in order to visualize areas that are normally not easily accessible and therefore difficult to identify. The relation with the adjacent vascular structures, arteries and veins, can also be very precisely established. A two cm horizontal neck incision is made below the sternal notch. The surgeons demonstrates a careful dissection of the anterior and lateral aspect of the thyroid. This manoeuvre allows to easily reach the area that had been previously virtually reconstructed. Once the gland is freed from its attachment the vascular pedicle is identified, isolated and clipped.
J Marescaux, M Vix, L Soler
Хирургические операции
12 лет назад
457 просмотров
2 лайков
0 комментариев
03:49
Virtual reality applied to video-assisted left superior parathyroidectomy
This video demonstrates how virtual reality is applied to video-assisted left superior parathyroidectomy. The virtual reconstruction is done from a preoperative contrast CT scan. The anatomy is then recreated layer by layer starting from the skin to the bone. Every anatomical structure can be removed or added back, in order to visualize areas that are normally not easily accessible and therefore difficult to identify. The relation with the adjacent vascular structures, arteries and veins, can also be very precisely established. A two cm horizontal neck incision is made below the sternal notch. The surgeons demonstrates a careful dissection of the anterior and lateral aspect of the thyroid. This manoeuvre allows to easily reach the area that had been previously virtually reconstructed. Once the gland is freed from its attachment the vascular pedicle is identified, isolated and clipped.