INTRODUCTION: Recommendations for assessing learning curves in surgery were published in 2001. This study aims to assess systematically all published learning curve studies in laparoscopic surgery, and determine the impact of these recommendations on the quality of the publication.METHODS AND PROCEDURES: A systematic review was performed on all studies from 1996 assessing learning curves in […]
LAPAROSCOPIC VERSUS OPEN LIVER RESECTION FOR HEPATOCELLULAR CARCINOMA: A COMPARATIVE STUDYIbrahim DAGHER, Giuseppe DI GIURO, Panagiotis LAINAS, Helene AGOSTINI, Alessio CARLONI, Dominique FRANCODepartment of General Surgery, Antoine Béclère Hospital, AP-HP, Clamart, F-92140, France; Univ Paris-Sud, Orsay, F-91405, France. Objective of the study: Laparoscopic liver resection for hepatocarcinoma, especially in cirrhotic patients, has recently been developed […]
The relevance of using fluroscopy as a routine in gastric banding control Hypothesis: using fluroscopy as a routine in performing gastric banding controls will enable early detection of possible complications and will optimize the adjustment of the band.Method: 100 patients were strictly followed up in our center for LGB control. All controls were done routinely […]
INTRODUCTION: There is no clear consensus on the effect of computer games on laparoscopic surgical performance, this maybe due to the type of games used. This study aims to compare two high fidelity computer games, and their effect on the learning curve in laparoscopic surgery.METHODS AND PROCEDURES: 31 laparoscopic naïve subjects were randomly assigned to […]
Single Port Appendectomy has been described. One of the problems of single port surgery is that there are limited valves for insertion of instruments and that the instruments tend to clash with the camera outside as the point of ingress is the same. Caddedu and colleagues have been working on a magnetic camera that can […]
Introduction: We hypothesize that gender, BMI and preoperative chemoradiation may influence the ability to perform a hand-assisted laparoscopic (HAL) resection for patients with rectal cancer.Methods: We performed retrospective analysis of patients who underwent HAL resection of rectal cancer. Four trocars and a standard 7 cm incision length were used. We abstracted clinical and pathological variables […]
Introduction: This is a unique case of a pheochromocytoma secreting both ACTH and CRH. Pheochromocytomas secreting either CRH or ACTH have been reported in the literature and are a rare cause of Cushing’s syndrome. To date, there are no reports of a pheochromocytoma producing both hormones. Background: A 38-yr-old previously healthy female presented with a […]
IntroductionMorbid Obesity is the leading public health epidemic of the industrialized world with bariatric surgery as the only effective and enduring treatment for this disease. Gastric Bypass is known to be very effective for weight loss and can also improve obesity related comorbidities like joint disease. Joint disease may be difficult to assess without radiographs. […]
IntroductionMorbid Obesity is the leading public health epidemic of the industrialized world with bariatric surgery as the only effective and enduring treatment for this disease. Gastric Bypass is known to be very effective for weight loss but can have complications like marginal ulcers or strictures. We hypothesized that gastric bypass patients with ulcers/strictures have differing […]
INTRODUCTIONEndoscopic balloon dilation has been shown to be an effective treatment for gastrojejunal (GJ) strictures after Roux-en-Y gastric bypass (RYGB). We hypothesize the number of necessary interventions is influenced by the time interval since RYGB. This is a retrospective review examining the relationship between the interval from RYGB to balloon dilation in patients with stricture.MATERIALS […]
Introduction: With the incidence of morbid obesity in the United States increasing at a rapid rate, bariatric surgical practices have continued to flourish. Recent years have seen the establishment by various professional organizations of credentialing processes, centers-of-excellence programs and fellowship training positions. Many of these processes grant privileges to bariatric surgeons based on case volume, […]
Introduction: Surgical weight loss has been shown to effectively lead to improvements of obesity associated comorbid conditions. The goal of our study was to compare the timing of comorbidity resolution between laparoscopic roux-en-y gastric bypass (LRYGB) and laparoscopic adjustable gastric banding (LAGB).Methods: All patients (n=476) undergoing LRYGB or LAGB at our institution over a 2 […]
Abstract Background: Laparoscopic Roux-en-Y gastric (RYGB) bypass is the most common Bariatric procedure performed in the US. Postoperative gastrointestinal bleeding occurs in approximately 1% of all procedures. We report our experience with the rare complication of intraluminal gastrointestinal hemorrhage leading to an obstructing intraluminal blood clot at the jejunojejunostomy (JJ) following RYGB. Methods: Two cases […]
.Introduction: Chronic pain is the most common complication following hernia repair. Thus far, the presence of preoperative pain has been of unclear significance as a predictor of postoperative pain. Methods: A query of the International Hernia Mesh Registry was performed to include all inguinal and ventral hernia repairs within the registry. Patients with preoperative pain […]
Background: In a group of 74 patients where computed tomography (CT) showed locally extending but not metastatic pancreatic cancer, we have demonstrated (Surg Endosc 2005;19:638-42) that 1/3 will have occult metastatic disease using diagnostic laparoscopy and peritoneal lavage for cytology (DL-PLC). Using a larger cohort, we asked if there are predictive factors that increase the […]
INTRODUCTION: Upper endoscopy (UE) is essential in the diagnosis and treatment of complications after Roux-en-Y gastric bypass (RYGB). Patients who have undergone RYGB present with a variety of functional (nausea, pain, and reflux) as well as obstructive (vomiting and dysphagia) symptoms. The primary aim of this study was to correlate symptoms and endoscopic findings with […]
Introduction: Mandatory repair of paraesophageal hernias is no longer standard of care with a reported risk of strangulation of 1% per year. Methods of repair vary with regard to surgical approach and technique. We report our experience with laparoscopic paraesophageal hernia repair, using a variety of techniques for repair based on patient comorbidities, age, crural […]
Background: We have previously shown that laparoscopic (LAP) colectomy can be accomplished safely for the curative treatment of benign and malignant colorectal disease. Hand-assisted (HA) laparoscopic surgery appears to be an effective treatment for colorectal disease as well. Here, we perform a comparative analysis of clinical outcomes for open, LAP, and HA segmental colonic resection.Study […]
Introduction: Upper gastrointestinal (GI) leaks are one of the most important postoperative complications following bariatric surgery. Standard treatment has been a combination of surgical or percutaneous drainage, parenteral nutrition and antibiotics. The endoscopic approach using flexible stents has been recently proposed as an alternative of treatment. Methods and procedures: Restrospective analysis of all patients who […]
Percutaneous endoscopic gastrostomy (PEG) tubes have revolutionized patient care. The procedure has relatively few complications and can provide an incredible benefit for patients. However, complications may arise and cause severe morbidity and sometimes mortality. We present a case of a 39 year old male who came to our institute after suffering severe head trauma from […]
Background:Since the first surgical procedure of this type in 1997, single incision surgery for biliary tract disease has been slow to gain popularity. Recent descriptions of SILSTM and SPATM have shown great potential to revolutionize minimally invasive procedures. The average general surgeon still has to face a significant learning curve and to decide how to […]
Morbid obesity continues to be a major obstacle in patients undergoing laparoscopic colon surgery. A review of the surgical literature repeatedly demonstrates morbid obesity to be one of the most common causes of conversion in patients undergoing laparoscopic colectomy. Particular troublesome is the fact that it is these patients who perhaps could benefit the most […]
Background: Fundamentals of Laparoscopic Surgery (FLS) is a validated program developed by the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) to educate and assess competency in Minimally Invasive Surgery (MIS).This study reports the first malpractice carrier sponsored FLS course for surgeons-in-practice underwritten by the Controlled Risk Insurance Company of Harvard’s Risk Management Foundation (CRICO/RMF). […]
OBJECTIVE:Laparoscopy has provided a means to assist in the decision-making process for patients with acute abdominal pain. Conditions such as appendicitis, diverticulitis, cholecystitis, small bowel obstruction, perforated viscous, endometriosis, and ovarian cysts can now be safely diagnosed and treated via laparoscopy. With Natural Orifice Transluminal Endoscopic Surgery(NOTES) considered as the next frontier in minimally invasive […]