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General and digestive surgery

Find all the surgical interventions, lectures, experts opinions, debates, webinars and operative techniques per specialty.
Laparoscopic repair of a giant type III paraesophageal hernia with mesenteric-axial gastric volvulus
This video demonstrates a laparoscopic repair of a giant type III paraesophageal hernia with an associated mesenteric-axial gastric volvulus in a 61-year-old woman. Dissection of the hernia sac was difficult because the esophageal hiatus was not very enlarged and the overlying peritoneum was very thickened because of chronic hernia incarceration. Once the stomach was replaced into the peritoneal cavity, mediastinal mobilization of the esophagus up to the pulmonary vein was performed. After crural repair, a standard posterior fundoplication was performed, as the intra-abdominal esophageal length was adequate.
P Vorwald, M Posada, G Salcedo, R Restrepo, JR Torres
Surgical intervention
3 years ago
1678 views
53 likes
0 comments
13:44
Laparoscopic repair of a giant type III paraesophageal hernia with mesenteric-axial gastric volvulus
This video demonstrates a laparoscopic repair of a giant type III paraesophageal hernia with an associated mesenteric-axial gastric volvulus in a 61-year-old woman. Dissection of the hernia sac was difficult because the esophageal hiatus was not very enlarged and the overlying peritoneum was very thickened because of chronic hernia incarceration. Once the stomach was replaced into the peritoneal cavity, mediastinal mobilization of the esophagus up to the pulmonary vein was performed. After crural repair, a standard posterior fundoplication was performed, as the intra-abdominal esophageal length was adequate.
Small bowel volvulus over acute bowel invagination: laparoscopic management
Digestive angiodysplasia is a condition defined by an innate alteration of digestive wall vascular structures, which has been well-described since the development of endoscopy. Its cause is not well known and most occurrences are probably innate. Digestive angiodysplasias can be isolated or multiple. They most frequently affect the right colon, and more rarely the stomach, the duodenum and the small bowel. They are the most frequent cause of occult digestive hemorrhage (30 to 40% of cases) and can more rarely cause occlusive episodes through intestinal invagination, linked to a voluminous angiodysplasia lesion.
Here we describe the case of a girl treated for colonic angiodysplasia lesions. She was admitted to our intensive care unit for an occlusive syndrome. CT-scan helped to diagnose a small bowel invagination and decision is made to treat this patient laparoscopically.
More specifically, this 15-year-old girl has a history of strabismus repair in 2011 and right foot surgery for an arteriovenous angiodysplasia lesion. Angiodysplasia was diagnosed after an episode of abdominal pain and a rectorrhagia in 2010. Colonoscopy at this time allowed to find three lesions of 5 to 8mm in diameter. A yearly colonoscopy control is performed. The patient was admitted to the intensive care unit for an occlusive syndrome with abdominal pain. Abdominal ultrasonography suggested an invagination which was confirmed by injected CT-scan. Decision was made to perform a laparoscopic exploration for a disinvagination or a bowel resection.
J Leroy, L Marx, D Mutter, J Marescaux
Surgical intervention
5 years ago
1423 views
19 likes
0 comments
07:41
Small bowel volvulus over acute bowel invagination: laparoscopic management
Digestive angiodysplasia is a condition defined by an innate alteration of digestive wall vascular structures, which has been well-described since the development of endoscopy. Its cause is not well known and most occurrences are probably innate. Digestive angiodysplasias can be isolated or multiple. They most frequently affect the right colon, and more rarely the stomach, the duodenum and the small bowel. They are the most frequent cause of occult digestive hemorrhage (30 to 40% of cases) and can more rarely cause occlusive episodes through intestinal invagination, linked to a voluminous angiodysplasia lesion.
Here we describe the case of a girl treated for colonic angiodysplasia lesions. She was admitted to our intensive care unit for an occlusive syndrome. CT-scan helped to diagnose a small bowel invagination and decision is made to treat this patient laparoscopically.
More specifically, this 15-year-old girl has a history of strabismus repair in 2011 and right foot surgery for an arteriovenous angiodysplasia lesion. Angiodysplasia was diagnosed after an episode of abdominal pain and a rectorrhagia in 2010. Colonoscopy at this time allowed to find three lesions of 5 to 8mm in diameter. A yearly colonoscopy control is performed. The patient was admitted to the intensive care unit for an occlusive syndrome with abdominal pain. Abdominal ultrasonography suggested an invagination which was confirmed by injected CT-scan. Decision was made to perform a laparoscopic exploration for a disinvagination or a bowel resection.
Laparoscopic Tanner’s gastropexy for acute gastric volvulus
Acute gastric volvulus is a rare clinical entity defined as an abnormal rotation of the stomach of more than 180 degrees, creating a closed loop obstruction that can result in incarceration and/or strangulation. The most common causes of gastric volvulus in adults are diaphragmatic defects such as paraesophageal hernias. Historically, mortality rates of 30-50% have been reported for acute volvulus, with the major cause of death being strangulation, which can lead to necrosis and perforation. Emergent surgical intervention is indicated for acute gastric volvulus. The laparoscopic treatment requires considerable experience but it has the potential to decrease the morbidity associated with open procedures. In February 2009, a case of an organo-axial gastric volvulus with a giant hiatal hernia was published in WeBSurg. We would like to take advantage of this to present a case with a mesentero-axial type marking the difference of the pathophysiology.
J Torres Bermúdez, S del Valle Ruiz , J Lopez Espejo, G Sánchez de la Villa
Surgical intervention
8 years ago
3783 views
41 likes
0 comments
12:27
Laparoscopic Tanner’s gastropexy for acute gastric volvulus
Acute gastric volvulus is a rare clinical entity defined as an abnormal rotation of the stomach of more than 180 degrees, creating a closed loop obstruction that can result in incarceration and/or strangulation. The most common causes of gastric volvulus in adults are diaphragmatic defects such as paraesophageal hernias. Historically, mortality rates of 30-50% have been reported for acute volvulus, with the major cause of death being strangulation, which can lead to necrosis and perforation. Emergent surgical intervention is indicated for acute gastric volvulus. The laparoscopic treatment requires considerable experience but it has the potential to decrease the morbidity associated with open procedures. In February 2009, a case of an organo-axial gastric volvulus with a giant hiatal hernia was published in WeBSurg. We would like to take advantage of this to present a case with a mesentero-axial type marking the difference of the pathophysiology.