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Monthly publications

#January 2008
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Minimally invasive video-assisted right parathyroidectomy: lateral approach, variation of Miccoli's technique
This video demonstrates how a slight modification of the standard video-assisted approach for parathyroidectomy can improve the visualization of the operative field.
A slight modification of the standard video-assisted approach for parathyroidectomy can improve visualization of the operative field. Cervical US confirmed the presence of a right superior parathyroid adenoma. The authors make a 2.5cm transverse neck incision 1cm above the sternal notch. In exposing the operative field, they divide the platysma and control the anterior jugular veins. They then dissect and retract the omohyoid muscle to quickly and precisely access the jugulocarotid groove.
F Costantino, M Vix, J Marescaux
Surgical intervention
10 years ago
874 views
20 likes
0 comments
08:20
Minimally invasive video-assisted right parathyroidectomy: lateral approach, variation of Miccoli's technique
This video demonstrates how a slight modification of the standard video-assisted approach for parathyroidectomy can improve the visualization of the operative field.
A slight modification of the standard video-assisted approach for parathyroidectomy can improve visualization of the operative field. Cervical US confirmed the presence of a right superior parathyroid adenoma. The authors make a 2.5cm transverse neck incision 1cm above the sternal notch. In exposing the operative field, they divide the platysma and control the anterior jugular veins. They then dissect and retract the omohyoid muscle to quickly and precisely access the jugulocarotid groove.
Laparoscopic right adrenalectomy for Conn's adenoma using ultrasonic shears
This video very clearly displays all the salient points of the performance of a right adrenalectomy with particular emphasis on the control of the vascular supply.
After controlling the venous landmarks, the authors move to control the main arteries of the adrenal gland. The authors identify the medial and superior pedicles and completely dissect them, gaining control with a one-clip application. The medial pedicle is only 1cm from the aorta. Severe bleeding may ensue, so they control the superior pedicle originating from the diaphragmatic artery with a clip. Identifying these arteries allows the authors to perform a complete removal of the adrenal gland and its surrounding fat. They clearly identify the renal artery, the renal vein just above it, and the inferior pedicle, which is also controlled with a simple clip application. At this point, the gland can be completely mobilized medially and inferiorly.
D Mutter, J Marescaux
Surgical intervention
10 years ago
1814 views
104 likes
12 comments
07:37
Laparoscopic right adrenalectomy for Conn's adenoma using ultrasonic shears
This video very clearly displays all the salient points of the performance of a right adrenalectomy with particular emphasis on the control of the vascular supply.
After controlling the venous landmarks, the authors move to control the main arteries of the adrenal gland. The authors identify the medial and superior pedicles and completely dissect them, gaining control with a one-clip application. The medial pedicle is only 1cm from the aorta. Severe bleeding may ensue, so they control the superior pedicle originating from the diaphragmatic artery with a clip. Identifying these arteries allows the authors to perform a complete removal of the adrenal gland and its surrounding fat. They clearly identify the renal artery, the renal vein just above it, and the inferior pedicle, which is also controlled with a simple clip application. At this point, the gland can be completely mobilized medially and inferiorly.
Dealing with vascular variation: laparoscopic cholecystectomy
This video describes the technique of laparoscopic cholecystectomy for symptomatic cholelithiasis with intraoperative cholangiography.
The key steps are presented: exploration, exposure, dissection of Calot’s triangle, intraoperative cholangiography, clipping and division, gallbladder bed dissection.
This technique is well standardized for the management of this condition.
The authors use intraoperative cholangiography for symptomatic cholelithiasis. To dissect Calot’s triangle, the authors first place grasping forceps through the epigastric trocar to grasp the gallbladder’s fundus and retract it cephalad and toward the patient’s right shoulder. They use a second grasping forceps on the infundibulum and retract the gallbladder laterally and caudally, thus opening Calot’s triangle. They start the dissection close at the junction of the infundibulum with the cystic duct, then incise the anterior and posterior peritoneal leaflets to access the vascular and biliary elements of Calot’s triangle. They then skeletonize the cystic duct and cystic artery.
D Mutter, J Marescaux, C Solano
Surgical intervention
10 years ago
3202 views
126 likes
0 comments
09:14
Dealing with vascular variation: laparoscopic cholecystectomy
This video describes the technique of laparoscopic cholecystectomy for symptomatic cholelithiasis with intraoperative cholangiography.
The key steps are presented: exploration, exposure, dissection of Calot’s triangle, intraoperative cholangiography, clipping and division, gallbladder bed dissection.
This technique is well standardized for the management of this condition.
The authors use intraoperative cholangiography for symptomatic cholelithiasis. To dissect Calot’s triangle, the authors first place grasping forceps through the epigastric trocar to grasp the gallbladder’s fundus and retract it cephalad and toward the patient’s right shoulder. They use a second grasping forceps on the infundibulum and retract the gallbladder laterally and caudally, thus opening Calot’s triangle. They start the dissection close at the junction of the infundibulum with the cystic duct, then incise the anterior and posterior peritoneal leaflets to access the vascular and biliary elements of Calot’s triangle. They then skeletonize the cystic duct and cystic artery.
Full thoracoscopic lingulectomy
This video illustrates the case of a 54-year-old female patient presenting with a 2cm tumor of the lingula. Percutaneous biopsy under CT-scan guidance revealed a carcinoid tumor. Imaging and DOPA PET scan did not demonstrate any other localization of the disease.

The patient was treated with a lingulectomy and lymphadenectomy performed via a totally endoscopic approach. The specimen was retrieved through one of the port that was enlarged at the end of the procedure. She was discharged 4 days later. Pathological examination confirmed the carcinoid tumor. All 18 removed lymph nodes were benign.

This technique is presented in the book :
D. Gossot Atlas of endoscopic major pulmonary resections
(2010) Springer-Verlag France
www.springer.com/978-2-287-99776-1
D Gossot
Surgical intervention
10 years ago
518 views
21 likes
0 comments
05:14
Full thoracoscopic lingulectomy
This video illustrates the case of a 54-year-old female patient presenting with a 2cm tumor of the lingula. Percutaneous biopsy under CT-scan guidance revealed a carcinoid tumor. Imaging and DOPA PET scan did not demonstrate any other localization of the disease.

The patient was treated with a lingulectomy and lymphadenectomy performed via a totally endoscopic approach. The specimen was retrieved through one of the port that was enlarged at the end of the procedure. She was discharged 4 days later. Pathological examination confirmed the carcinoid tumor. All 18 removed lymph nodes were benign.

This technique is presented in the book :
D. Gossot Atlas of endoscopic major pulmonary resections
(2010) Springer-Verlag France
www.springer.com/978-2-287-99776-1