Monthly publications : October 2007 | WebSurg, the online university of IRCAD

Rolling (paraesophageal) hiatal hernia treatment in an 80-year-old male patient

This is a 'live' surgical video demonstrating a hiatal hernia repair by Dr. Bernard Dallemagne. Every step of the operation is discussed with the expert panel and workshop participants. This video is recommended to upper GI surgeons.

B Dallemagne, J Marescaux

Surgical intervention

Rolling (paraesophageal) hiatal hernia treatment in an 80-year-old male patient

This is a 'live' surgical video demonstrating a hiatal hernia repair by Dr. Bernard Dallemagne. Every step of the operation is discussed with the expert panel and workshop participants. This video is recommended to upper GI surgeons.

Laparoscopic Heller procedure for achalasia

This is a 'live' surgery performed by Dr. B Dallemagne demonstrating the key steps in performing a Heller procedure. Minimal dissection is carried out to expose the anterior surface of the esophagus, after which the myotomy is delicately performed with scissors. This video is recommended to upper GI surgeons.
Barium swallow showed the classic sign of achalasia at the level of the cardia in this elderly woman with gastroesophageal reflux disease. CT-scan of the chest showed a large sigmoid-like esophagus. Mobilization of the esophagus begins with the authors opening only the anterior aspect of the hiatus to gain access to the esophagus. They dissect the upper part of the esophagus and expose the azygos vein on the right, clearing the gastroesophageal junction on the gastric side of the cardia. They continue by opening the hypertrophic musculature to enable swallowing, then continue with a Heller myotomy.

B Dallemagne, J Marescaux

Surgical intervention

Laparoscopic Heller procedure for achalasia

This is a 'live' surgery performed by Dr. B Dallemagne demonstrating the key steps in performing a Heller procedure. Minimal dissection is carried out to expose the anterior surface of the esophagus, after which the myotomy is delicately performed with scissors. This video is recommended to upper GI surgeons.
Barium swallow showed the classic sign of achalasia at the level of the cardia in this elderly woman with gastroesophageal reflux disease. CT-scan of the chest showed a large sigmoid-like esophagus. Mobilization of the esophagus begins with the authors opening only the anterior aspect of the hiatus to gain access to the esophagus. They dissect the upper part of the esophagus and expose the azygos vein on the right, clearing the gastroesophageal junction on the gastric side of the cardia. They continue by opening the hypertrophic musculature to enable swallowing, then continue with a Heller myotomy.

Transabdominal pre-peritoneal (TAPP) repair of Amyand's hernia in a 72-year-old man

This video demonstrates the unusual case of an Amyand's hernia, where the appendix is found in the right inguinal hernia sac. The patient underwent 2 previous open inguinal hernia repairs, making the procedure more challenging. This video is recommended to general surgeons.

P Arora

Surgical intervention

Transabdominal pre-peritoneal (TAPP) repair of Amyand's hernia in a 72-year-old man

This video demonstrates the unusual case of an Amyand's hernia, where the appendix is found in the right inguinal hernia sac. The patient underwent 2 previous open inguinal hernia repairs, making the procedure more challenging. This video is recommended to general surgeons.

Splenectomy by laparoscopic posterior lateral approach for idiopathic thrombocytopenic purpura (ITP): selective vascular control

This video demonstrates an alternative approach to perform splenectomy by commencing with the dissection of the postero-lateral aspect. In this way, the splenic artery and vein are ligated first at the hilum before division of the short gastric arteries. This video is recommended to general surgeons.

D Mutter

Surgical intervention

Splenectomy by laparoscopic posterior lateral approach for idiopathic thrombocytopenic purpura (ITP): selective vascular control

This video demonstrates an alternative approach to perform splenectomy by commencing with the dissection of the postero-lateral aspect. In this way, the splenic artery and vein are ligated first at the hilum before division of the short gastric arteries. This video is recommended to general surgeons.

Laparoscopic TME for rectal cancer in a male patient: an ideal case to start

This video shows Dr. Joel Leroy performing an anterior resection. All the critical steps are described in detail. This video is suitable for surgeons performing laparoscopic colorectal surgery.

J Leroy, J Marescaux

Surgical intervention

Laparoscopic TME for rectal cancer in a male patient: an ideal case to start

This video shows Dr. Joel Leroy performing an anterior resection. All the critical steps are described in detail. This video is suitable for surgeons performing laparoscopic colorectal surgery.

Micro-instrumentation for minimally invasive cholecystectomy: surgical technique

This video demonstrates an esthetic cholecystectomy using 2mm micro-instruments. The key steps and difficulties of this procedure are shown in detail by Professor Didier Mutter. This video is recommended to general surgeons.
The authors use 2mm micro-instruments in this 25-year-old woman with symptomatic cholelithiasis. They dissect in the avascular plane between Glisson’s capsule and the gallbladder. Dissection with the micro-instruments is more time-consuming than with conventional instruments because the 2mm instruments have two drawbacks: flexibility, and being situated inside the abdomen with little of the instrument on the outside. After the dissection, the authors remove the 2 cameras and introduce the extraction bag through the umbilicus. They then reinsert the 10mm camera to check the operative field and help guide removal of the trocars. This step helps to minimize postoperative hemorrhage. Cosmesis is enhanced with three 2mm incisions and one 10mm incision deep in the umbilicus.

D Mutter, J Marescaux

Surgical intervention

Micro-instrumentation for minimally invasive cholecystectomy: surgical technique

This video demonstrates an esthetic cholecystectomy using 2mm micro-instruments. The key steps and difficulties of this procedure are shown in detail by Professor Didier Mutter. This video is recommended to general surgeons.
The authors use 2mm micro-instruments in this 25-year-old woman with symptomatic cholelithiasis. They dissect in the avascular plane between Glisson’s capsule and the gallbladder. Dissection with the micro-instruments is more time-consuming than with conventional instruments because the 2mm instruments have two drawbacks: flexibility, and being situated inside the abdomen with little of the instrument on the outside. After the dissection, the authors remove the 2 cameras and introduce the extraction bag through the umbilicus. They then reinsert the 10mm camera to check the operative field and help guide removal of the trocars. This step helps to minimize postoperative hemorrhage. Cosmesis is enhanced with three 2mm incisions and one 10mm incision deep in the umbilicus.

Laparoscopic resection of the 1st portion of duodenum for a gastrointestinal stromal tumor (GIST)

This video demonstrates a laparoscopic resection of the first part of the duodenum. A distal gastrectomy is performed concurrently and GI continuity is restored by a Roux-en-Y gastro-jejunostomy. This video is recommended for upper GI surgeons.

F Corcione

Surgical intervention

Laparoscopic resection of the 1st portion of duodenum for a gastrointestinal stromal tumor (GIST)

This video demonstrates a laparoscopic resection of the first part of the duodenum. A distal gastrectomy is performed concurrently and GI continuity is restored by a Roux-en-Y gastro-jejunostomy. This video is recommended for upper GI surgeons.

Laparoscopic resection of the 3rd and 4th portion of duodenum for a gastrointestinal stromal tumor (GIST)

This video demonstrates the rather difficult procedure of laparoscopic resection of the distal duodenum. The duodenum is dissected from both above and below the transverse mesocolon. A hand-sewn duodenojejunal anastomosis restores bowel continuity. This video is recommended for upper GI surgeons.
The patient is in the dorsal position with arms outstretched and legs abducted. The surgeon stands between the patient’s legs. Mobilization begins with adhesiolysis and then moves onto dissection of the duodenum with a Kocher's maneuver. The author completely mobilizes the third portion of duodenum. Once the surgeon identifies the third and fourth portions of the duodenum, ultrasound helps define the resection margins, initially marked with metallic clips. The procedure continues with division of the ligament of Treitz and resection of the first jejunal loop with a vascular stapler.

F Corcione

Surgical intervention

Laparoscopic resection of the 3rd and 4th portion of duodenum for a gastrointestinal stromal tumor (GIST)

This video demonstrates the rather difficult procedure of laparoscopic resection of the distal duodenum. The duodenum is dissected from both above and below the transverse mesocolon. A hand-sewn duodenojejunal anastomosis restores bowel continuity. This video is recommended for upper GI surgeons.
The patient is in the dorsal position with arms outstretched and legs abducted. The surgeon stands between the patient’s legs. Mobilization begins with adhesiolysis and then moves onto dissection of the duodenum with a Kocher's maneuver. The author completely mobilizes the third portion of duodenum. Once the surgeon identifies the third and fourth portions of the duodenum, ultrasound helps define the resection margins, initially marked with metallic clips. The procedure continues with division of the ligament of Treitz and resection of the first jejunal loop with a vascular stapler.

How do you assess preoperatively deep endometriotic patients?

What are your treatment options for severe endometriosis?

ReliaTack™ Articulating Reloadable Fixation Device

A fixation device with one-of-a-kind articulating technology, interchangeable reloads, and screw-like tack designs for hernia repair.

ReliaTack™ Articulating Reloadable Fixation Device

A fixation device with one-of-a-kind articulating technology, interchangeable reloads, and screw-like tack designs for hernia repair.

Instrument

What are the colorectal and urological complications following surgery for rectovaginal endometriosis?

To resect or not to resect rectovaginal endometriosis? What should be done really?

To resect or not to resect the bowel in case of endometriosis? What is the apter decision?

How do you treat ureteric injuries?

F Zullo

What are your rules for preventing those injuries?

F Zullo

What is the place of laparoscopy in the treatment of kidney tumors?

A Rane

Does the laparoscopic approach comply with the carcinologic principles of radical nephrectomy for cancer?

A Rane

Is tumor size a contraindication to laparoscopic radical nephrectomy? Are there any other limiting criteria?

A Rane

What are the benefits of the transperitoneal approach compared with the retroperitoneal approach in the treatment of kidney tumors?

A Rane

What are the benefits of laparoscopy compared with open surgery?

A Rane

VITOM® 3D- 3D Visualization for Microsurgery and Open Surgery

Cameras, light sources and documentation

VITOM® 3D- 3D Visualization for Microsurgery and Open Surgery

Cameras, light sources and documentation

Unit

What is the place of robotics in the treatment of kidney tumors?

A Rane

What is the place of hand-assisted techniques in the treatment of kidney tumors?

A Rane

What is the place of laparoscopy in the treatment of kidney tumors?

Does the laparoscopic approach comply with the carcinologic principles of radical nephrectomy for cancer?

Is tumor size a contraindication to laparoscopic radical nephrectomy?

Are there any other limiting criteria contraindicating laparoscopic radical nephrectomy?

What are the benefits of the transperitoneal approach compared with the retroperitoneal approach in the treatment of kidney tumors?

What are the benefits of laparoscopy compared with open surgery?

What is the place of robotics in the treatment of kidney tumors?

What is the place of hand-assisted techniques in the treatment of kidney tumors?

LigaSure™ Small Jaw Open Sealer/Divider

A multifunctional tissue sealing system, featuring an integrated cutting mechanism for use in open procedures.

LigaSure™ Small Jaw Open Sealer/Divider

A multifunctional tissue sealing system, featuring an integrated cutting mechanism for use in open procedures.

Vessel sealing

What is the place of laparoscopy in the treatment of kidney tumors?

Does the laparoscopic approach comply with the carcinologic principles of radical nephrectomy for cancer?

Is tumor size a contraindication to laparoscopic radical nephrectomy? Are there any other limiting criteria?

What are the benefits of the transperitoneal approach compared with the retroperitoneal approach in the treatment of kidney tumors?

What are the benefits of laparoscopy compared with open surgery?

What is the place of robotics in the treatment of kidney tumors?

What is the place of hand-assisted techniques in the treatment of kidney tumors?

What is the place of robotics in the treatment of kidney tumors?

How about ergonomics with the robot?

Hands-on hints: transgastric route

In this video, a technique for the creation and closure of a gastrostomy to facilitate transgastric peritoneoscopy is demonstrated. It includes discussion of all the key steps of the procedure.

B Dunkin

Surgical intervention

Hands-on hints: transgastric route

In this video, a technique for the creation and closure of a gastrostomy to facilitate transgastric peritoneoscopy is demonstrated. It includes discussion of all the key steps of the procedure.

RoTalock™ Trocars - The new Self-Retaining Trocar Especially Developed for Neonatal and Pediatric Laparoscopic Surgery

instrument

NOTES sigmoidectomy in a pig model: a stepwise approach

This video demonstrates a number of different NOTES techniques for performing sigmoidectomy in a porcine model. The principal trans-gastric approach is combined with a trans-vaginal, trans-rectal and laparoscopic approach in 3 different animals. Different methods of vascular dissection and colonic division are discussed.

J Leroy, S Perretta, A Forgione, B Dallemagne, J Marescaux

Surgical intervention

NOTES sigmoidectomy in a pig model: a stepwise approach

This video demonstrates a number of different NOTES techniques for performing sigmoidectomy in a porcine model. The principal trans-gastric approach is combined with a trans-vaginal, trans-rectal and laparoscopic approach in 3 different animals. Different methods of vascular dissection and colonic division are discussed.