Background: Minimally-invasive gastric fundoplication represents an important therapeutic option in patients with refractory reflux and symptomatic hiatal hernias. Preservation of esophageal and gastric function is a hallmark principle in ensuring optimal surgical outcomes. In this study, we evaluate the impact of fundoplication on esophageal transit and gastric emptying scintigraphy studies, and relate these functional findings […]
This is Video is about a 32 year old male with a relatively short history of Crohn’s disease manifested by an ileo-psoas abscess, partial intestinal obstruction, and an undiagnosed ileo-transverse colon fistula. The technical aspects of performing an ileocolic resection in complicated Crohn’s is demonstrated, including intracorporeal division of the fistula and drainage of the […]
Narrow-band imaging is one of the latest technological achievements of the digital endoscopy. The technique is using interference filter to light surfaces in narrow bands of red, green, and blue colour that visualizes the differences in mucosa colouring and enhances contrast between the mucosa surface and submucosa vascular network. The NBI makes easier differentiating between […]
Acute pancreatitis (AP) is one of the important problem of the urgent surgery, often registrated in surgical patients. The today’s situation occurs in treatment of patients with AP seemes to be far from satisfactory. One of the main problem of the contemporary surgery is to perform out the new ways of how to treat AP […]
Introduction: Laparoscopic cholecystectomy (LC) has become the mainstay for treatment of gallbladder disease. Although biliary injuries are well described in LC, these are mainly associated with common bile duct injuries. There are scant reports related to complications involving the accessory ducts of Luschka (ADL). Case presentations: We present three patients that presented with persistent abdominal […]
The patients after colorectal surgery undergo complex rehabilitation postoperatively. A standard model of the postoperative rehabilitation covered complete mobilization of the patient on the second postoperative day and oral feeding 4 – 5 days after surgery. With this model mean time of postoperative hospitalization ranged between 6 – 10 days and the risk of postoperative […]
Background: The presence of hiatal hernia has been considered a contraindication for LAGB, since more complications such as band slippage (BS) were advocated. Few data have been reported on simultaneous LAGB and HHR.Methods: Between 11/04 and 7/05 432 patients underwent LAGB. Patients with less than 3 months f/u were excluded (total group 417). Patients were […]
Introduction: Large endoscopic submucosal dissection (ESD) of superficial esophageal cancers often requires subsequent of balloon dilation operations to prevent post-operative esophageal constriction. We therefore have previously developed a novel method to transplant oral mucosal epithelial cell sheets using cell sheet engineering to promote wound healing after ESD (Gut, 1704-1720, 2006). Although we have demonstrated the […]
Introduction: The objective of this study is to evaluate the clinical results of the laparoscopic interposition of a segment of ileum into the proximal duodenum associated to a sleeve gastrectomy (II-DSG) in order to treat patients with Type 2 Diabetes Mellitus (T2DM) and BMI 21-29.Methods: The laparoscopic procedure was performed in 69 patients. 22 were […]
NOTES has been touted as the next step in minimally invasive surgery. As such, most of the effort to perform NOTES has been focused on reproducing surgical procedures in a manner similar to how they are accomplished laparoscopically. It seems, however, that a potential advantage for NOTES is to allow surgeons to perform operations in […]
Background: Early-stage esophageal cancer can be cured by surgical resection with low mortality and excellent five-year survival. Recently, however, endoscopic therapies have been proposed as an acceptable alternative. Endoscopic ultrasound (EUS) is typically used for pretreatment staging; the presence of muscularis propria invasion and/or nodal metastasis are a contraindication to endoscopic therapy. We hypothesized that […]
Laparoscopic adrenalectomy has become in last decade “gold standard” for treating of adrenal tumors with diameters smaller than 6 cm. In addition, one should note that larger tumors or potentially malignant tumors, once considered contraindications to a laparoscopic approach, can now be removed laparoscopically, with virtually no complication. In many surgical centers a tumor size […]
PURPOSE: To assess the effectiveness of laparoscopic radio frequency ablation therapy (Lap-RFA) for small hepatocellular carcinomas (HCCs) located beneath the diaphragm or on the surface of the liver. MATERIALS AND METHODS: Lap-RFA indication was as follows; smaller than 3cm in a diameter and less than three in the number, no vascular invasion, general condition available […]
Introduction With the increasing uptake of laparoscopic hernia repairs, there could be concern that the availability of this basic open training procedure will be less for the current cohort of trainees as consultants and experienced registrars are doing more hernia repairs laparoscopically. This study aimed to determine whether there was a reduction in trainee exposure […]
This study is a retrospective review of all patients treated with a robotic-assisted mininvasive surgery for visceral artery aneurysms (VAA) at a single Institution. Robotic surgery seems to offer an important alternative to the traditional treatment.Materials and Methods: between September 2001 and June 2007, 12 patients aged 41-78 (mean = 59.25) underwent minimally invasive robotic […]
The overall activity of robotic pancreatic surgery at Misericordia Hospital in Grosseto has been reviewed. From October 2000 to March 2007, has been performed 68 robotic pancreatic resections: 35 pancreatoduodenectomies (PD) (25Whipple, 10 Longmire procedures), 28distal pancreatectomies (DP) (13 spleen-preserving), 3 middle segment pancreatectomies and 2 insulinoma enucleations.The etiology of 35 PD were:11 ductal cancer, […]
Introduction: It is possible that outcomes after laparoscopic Nissen fundoplication are different when patients are operated upon for disparate indications, e.g., symptoms due to excessive acid reflux or obstruction. This study was undertaken to compare symptomatic outcomes between patients undergoing fundoplication for the disparate indications of excessive acid reflux vs. dysphagia. Methods: Laparoscopic Nissen fundoplications […]
Background: Laparoscopic surgery has created an obstacle to traditional teaching of surgical skills. To invest in a simulator is a large responsibility for a teaching institution. The LTS 2000-ISM60 is a computer enhanced video-laparoscopic training system. The purpose of this multicentric multi specialty study was to validate LTS according to laparoscopic experience level and level […]
Background: Endoluminal full thickness gastroplication has been shown to have significant and long lasting improvement of GERD symptoms and health related quality of life (HRQL) with very little patient morbidity. These treatments, however, are criticized for normalizing esophageal acid exposure in only 30 – 40% of patients treated. We hypothesize that there are objective criteria […]
Objective: Natural orifice transluminal endoscopic surgery has potential benefits for patients and clinicians. Many improved tools have been developed in the last few years, but access, navigation and orientation, especially in the upper abdomen for procedures such as diaphragmatic pacing and Nissen fundoplication, remain an unsolved challenge. NeoGuide has developed a computer-controlled multi-segmented endoscope with […]
Background: Conversion to open surgery occurred in 12-29% of the patients who underwent laparoscopic colorectal resection. This study aimed to evaluate the impact of conversion on the operative outcome and prognosis of patients who underwent laparoscopic resection for colorectal cancer.Methods: The prospectively collected data of 473 patients who underwent laparoscopic colectomy between May 2000 and […]
Introduction: Few studies have been designed to assess the performance of laparoscopic surgical staplers. This study analyzes the effect of staples and staple height on tissue perfusion. Methods: Staple lines created on live porcine small bowel segments using laparoscopic surgical staplers were tested for perfusion using visible light spectroscopy to assess tissue oxygenation. Perfusion measurements […]
Introduction:Double balloon enteroscopy (DBE) is a relatively new endoscopic technique to diagnose and treat small bowel disease. While it is becoming widely used, there are relatively few data regarding potential complications. Methods: We reviewed all DBE cases at an academic medical center from 2006-2007. 39 DBEs were identified and three patients had severe complications (7.7%) […]
IntroductionPost-operative nausea and vomiting (PONV) represents a serious and vexing problem after bariatric surgery. We hypothesized that liberal administration of IV fluid administration may influence PONV. Methods50 patients were recruited from a bariatric surgery clinic in an academic hospital. Patients were randomized to two groups of intra-operative IV fluid administration: Group A received 15ml/kg while […]