Chopstick Surgery: A Novel Technique Enables Use of the Da Vinci Robot to Perform Single Incision Laparoscopic Surgery (SILS)
INTRODUCTION: Single incision laparoscopic surgery (SILS) is limited by the coaxial arrangement of the instruments. A surgical robot with “wristed” instruments could overcome this limitation but the “arms” collide when working coaxially. This video demonstrates a new technique of “chopstick surgery” which enables use of the robotic arms through a single incision without collision.METHODS: Experiments… Continue Reading
- Topic:
- Robotics
Early Re-exploration Following Incisional Hernia with Biologic Graft
Introduction:Biologic grafts have been used for the repair of complex abdominal wall defects. Although much is known about the remodeling process, their propensity to form adhesions in humans has not been well studied yet. We present a case of early re-exploration after a complex incisional hernia repaired with bovine pericardium graft.Methods:A 61 year-old man with… Continue Reading
- Topic:
- Outcomes and Quality
Hand Assisted Laparoscopic Surgery for Massive Splenomegaly
The patient is a 57 yo male with history of chronic lymphocytic leukemia for fifteen years and splenomegaly. Patient had a palpable spleen below the level of the umbilicus. His preoperative white blood cell count was 46000 and lymphocyte count was 40000. A Hand port was placed in the upper midline. The patient was in… Continue Reading
- Topic:
- Solid Organ and Endocrine
Hand Assisted Laparoscopy for Wandering Spleen
This is a case presentation of a patient with a wandering spleen. The patient is an 18 year old female who suffered from a malarial infection at age five. A CT scan at that time documented her spleen was located in the normal anatomical position. When the patient was 18 years old, she underwent an… Continue Reading
- Topic:
- Minimally Invasive Other
Incisionless Weight Loss Surgery. a Novel Gastric Restrictive Procedre Using the Transoral Gastroplasty Technique
The standard operations for weight loss surgery in this country are the Roux-en-y gastric bypass and the adjustable gastric band. Both of these operations are performed laparoscopically. Although the incisions used in minimally invasive surgery are small compared to open surgery, they still require cutting of the anterior abdominal wall. We present one of the… Continue Reading
- Topic:
- Metabolic / Obesity
Laparoendoscopic Single Site Heller Myotomy and Anterior Fundoplication
Laparoendoscopic Single Site (LESS) surgery continues the evolutionary arc from “open” to laparoscopic to “minimal scar” surgery, facilitating improved patient recovery and improved cosmesis. Promises of patient acceptance of LESS surgery are high and will drive investment of resources to promptly develop safe and effective LESS surgery procedures for clinical application. This video demonstrates LESS… Continue Reading
- Topic:
- Esophageal / Gastric Surgery
Laparoscopic Adjustable Gastric Banding in a Patient with Previous Gastric Bypass Surgery
Introduction: We present a case of laparoscopic adjustable gastric banding (LAGB) in a patient with previous Roux -en- Y gastric bypass (RYGB).Methods: 39 year old morbidly obese woman (BMI 44 kg/m²) referred for evaluation for revisional bariatric surgery. She underwent open RYGB in 2000. She lost 250 lbs after her surgery but slowly she regained… Continue Reading
- Topic:
- Metabolic / Obesity
Laparoscopic Collis-nissen Fundoplication in a Patient with Tracheoesophageal Fistula Repair with Recurrent Hiatal Hernia and Gastroesophageal Reflux
INTRODUCTION: A 6 year old with a history of a tracheosophageal fistula presents with a history problematic for recurrent hiatal hernias and severe gastroesophageal reflux. He underwent a laparoscopic Nissen fundoplication at 3 months of age. He had continued reflux and strictures and underwent a revision Nissen fundoplication with repair of a hiatal hernia at… Continue Reading
- Topic:
- Esophageal / Gastric Surgery
Laparoscopic Common Bile Duct Exploration and Laser Lithotripsy: A Novel Approach to Management of Common Bile Duct Stones
Introduction: Common bile duct stones (CBDS) are found in approximately 10% of patients who undergo cholecystectomy. Symptomatic common bile duct stones are a source of significant morbidity as they may cause obstructive jaundice, cholangitis, biliary cirrhosis and pancreatitis. Endoscopic retrograde cholangiopancreatography (ERCP) has been a mainstay of treatment for common bile duct stones. Laparoscopic common… Continue Reading
Laparoscopic Completion Proctocolectomy and Ipaa
The patient is a 21 year old female status post laparoscopic subtotal colectomy with end ileostomy 7 months earlier for fulminant ulcerative colitis. She has been off steroids for 2 months. She presents now for elective takedown of end ileostomy, completion proctocolectomy, and J-pouch reconstruction. This video demonstrates the laparoscopic completion proctocolectomy and ileal pouch… Continue Reading
- Topic:
- Colorectal
Laparoscopic Distal Pancreatectomy and Splenectomy for Splenic Artery Aneurysm
Introduction: Large splenic artery aneurysms are rare, but comprise 60% of all visceral artery aneurysms. Most are found incidentally and rupture in the non-pregnant patient carries an approximate 25% mortality rate. Historically these have been managed with an open surgical approach for resection.Methods: We present the case of a 45 year old male with a… Continue Reading
- Topic:
- Solid Organ and Endocrine
Laparoscopic Distal Pancreatectomy with Spleen Preservation
Spleen sparing distal pancreatectomy is usually performed for small or benign looking tumors of the body and tail of the pancreas. Such tumors include neuroendocrine pancreatic tumors, intraductal papillary mucinous neoplasm and other cystic lesions.The procedure of distal pancreatectomy with spleen preservation may be challenging and technically difficult when performed in the open fashion, let… Continue Reading
- Topic:
- Solid Organ and Endocrine
Laparoscopic Grynfeltt Hernia Repair
BACKGROUNDLumbar hernias are rare. Laparoscopic lumbar hernia repair was first described in 1996 by Burick and Parascandola. In 2005, the first publication comparing open versus laparoscopic lumbar hernia repair was published by Moreno-Egea of Spain. Various techniques have been described during this time period. Given their posterior nature and relationship to critical vascular, neurological and… Continue Reading
- Topic:
- Abdominal Wall Hernias
Laparoscopic Intervention for Massive, Rapidly Progressive Pancreatic Pseudocyst Disease with Endocrine and Exocrine Dysfunction
Introduction: Therapeutic interventions for pancreatic pseudocyst disease are most often based on symptoms, lesion size, and in particular duration of the lesion. Conventional wisdom typically avoids early surgical therapy for “immature” pseudocysts, citing concerns of cyst wall thickness, durability, and ability to hold suture material for a secure anastomosis. We present a case of a… Continue Reading
- Topic:
- HPB
Laparoscopic Management of Spigelian Hernias
Spigelian Hernias were first described by Josef Klinkosch in 1764 and named after Adriaan von Spieghel the Flemish anatomist who was the first to describe the linea semilunaris. Spigelian Hernias are the most common of the lateral ventral hernias but only account for 1%-2% of all hernias. These hernias most commonly present between the 4th… Continue Reading
- Topic:
- Abdominal Wall Hernias