A Comparison of Permanent and Nonpermanent Staple Line Buttressing Materials for Linear Staple Lines During Laparoscopic Roux-en-Y Gastric Bypass (lgbp)
Objective: This study analyzed our experience with 3 different buttressing materials for creating the gastric division during LGBP.Methods: From June 2001 to October 2006, 1451 consecutive patients undergoing LGBP had buttressing material used for the staple creation of the gastric pouch. Permanent bovine pericardial strips, Peristrips Dry® (PSD) was used in 926 cases, Seamguards® (SG),… Continue Reading
Introduction: Laparoscopic vagal preserving oesophagectomy is a recognised treatment option for high grade dysplasia of the oesophagus. A jejunal interposition, as described by Alvin Merendino in 1955, aims to substitute the lower oesophageal sphincter, thereby treating physiological disorders such as reflux oesophagitis. Methods: We aimed to combine these procedures in the treatment of an otherwise… Continue Reading
OBJECTIVE: To demonstrate the feasibility of longitudinal mentoring and telementoring of community surgeons in laparoscopic colon surgery.METHODS: A formal mentoring protocol was established between a university centre and surgeons at a local 134 bed community hospital 60km away. The community surgeons (CS) attended a didactic course on laparoscopic colon surgery before attending surgery at the… Continue Reading
Background: The purpose of this study is to clarify of the safety and the feasibility of the short-term and long-term results of the laparoscopic surgery for patients with rectal cancer from the accumulated data of 28 leading hospitals in Japan.Methods: From May 1994 to February 2006, this study group comprised 1057 patients with rectal cancer… Continue Reading
A new flexible endoscopic suturing method with laparoscopic protection for safer full-thickness attachment to the gastro-intestinal tract
Background: There are some difficulties associated with placing multiple stitches or tissue anchors at flexible endoscopy in order to achieve long term attachment of devices within the gastrointestinal tract. Precision stitching of an object to the wall of the gut requires accurate penetration of the device attachment points, and knowledge that the anchor has been… Continue Reading
A Paradigm Shift in Ventral Hernia Repair. Laparoscopic Component Separation During Laparoscopic Ventral Hernia Repair.
Component separation is an important technique in the repair of ventral hernias because it allows restoration of the normal anatomic relationship of the rectus muscles while maintaining a tension-free repair. Our group has previously reported on fully laparoscopic component separation as an important tool in the repair of ventral hernias. This technique allows for protection… Continue Reading
A Randomized Controlled Trial of Laparoscopic Nissen Fundoplication (LNF) versus Proton Pump Inhibitors for Treatment of Patients with Chronic Gastro-Esophageal Reflux Disease (GERD)
Objective: In patients with GERD who were stable and symptomatically controlled on long-term medical therapy we performed an RCT to compare ongoing optimized medical therapy with LNF.Methods: 201 patients were eligible for randomization, 104 gave informed consent (age mean 42.9, sd11; male 55 female 49) and 2 withdrew from the study immediately after randomization. Patients… Continue Reading
Accuracy and Role of Surgeon-performed Intraoperative Ultrasound in Minimally Invasive Open Parathyroidectomy
Objective: Assessment of the accuracy and the role of surgeon-performed ultrasound in comparison to expert radiology-performed ultrasound, sestamibi scanning and histologic findings.Patients and Methods: From January 2006 to December 2007 we prospectively evaluated forty two consecutive patients undergoing parathyroidectomy for primary hyperparathyroidism. One surgeon who was unaware of the preoperative imaging studies did all ultrasound… Continue Reading
Background: Minimally invasive surgery is rapidly evolving with the promise of new endolumenal and translumenal surgical procedures performed with few or no external incisions. We describe our early human experience with a flexible platform technology that provides stable access and visualization, force transmission, two-handed tissue manipulation and durable tissue approximation. The EndoSurgical Operating System (EOS),… Continue Reading
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… Continue Reading
Background: Gastric carcinoid tumors are rare and little is known about the long term prognosis of these tumors, since no staging system currently exists. The aim of this study was to create a predictive staging system to accurately estimate prognosis. Methods: A retrospective review of 15,983 carcinoid patients from the SEER database identified 1,543 patients… Continue Reading
Anti-reflux Surgery Is Not Totally Effective Against Esophageal Adenocarcinoma, Despite the Regression or Disappearance of Barrett’s Esophagus in Most Cases – A Study of 80 Barret’s Patients.
BACKGROUND: Barrett’s Esophagus (BE) is a complication of gastroesophageal reflux disease (GERD) and can be a pre-malignant condition. laparascopic anti-reflux surgeries (LARS) significantly correct physiological and anatomical abnormalities in patients with GERD; nevertheless, there is no consensus about its effectiveness in preventing malignant transformation in patients with BE. The impact of LARS on those suffering… Continue Reading
Assessment of the Clinical Utility of Routine Barium Esophagram After Laparoscopic Anterior Esophageal Myotomy for Achalasia
Introduction: The purpose of this study is to evaluate the clinical utility of routine barium esophagram (BAS) after laparoscopic anterior esophageal myotomy for achalasia.Methods: Records of 260 consecutive patients (pts) undergoing laparoscopic anterior esophageal myotomy for achalasia from 5/96-8/07 were reviewed from a prospective, IRB-approved database. All radiographic reports and perioperative records were reviewed. Data… Continue Reading
C-reactive protein concentrations before and after gastric bypass surgery inversely correlate with omental gene expression of adiponectin.
Adipose tissue is a key regulator of C-reactive protein (CRP), an inflammatory marker linked to atherosclerosis. Adiponectin, the most abundant adipokine is also an importantl factor involved in the inflammatory state of obesity. The aim of the study was to assess the impact of gastric bypass surgery (GBS) on the CRP levels and its relation… Continue Reading
Background: Kidneys harvested by laparoscopic donor nephrectomy regain normal function slightly later than laparotomy-harvested organs. Several factors affect the organs after laparoscopic recruitment, which could explain the relatively prolonged period of recovery. We investigate the role of CO2-induced pneumoperitoneum (PNP) on organ dysfunction as expressed by cell apoptosis.Methods: CO2-PNP was established in 24 anesthetized Wistar… Continue Reading