Vamsi K Aribindi, MD1, Veeshal H Patel, MD2, Scott V Weiner, MD3, Phillip Kim, MD, MBA4, Rebecca C Gologorsky, MD3, Oliver A Guevarra3, Carissa E Chu, MD3, Marshall L Stoller, MD3, Harrison R Michael, MD3. 1Baylor College of Medicine; University of California, San Francisco, 2University of Washington; University of California, San Francisco, 3University of California, San Francisco, 4New York Presbyterian Hospital Columbia University Medical Center; University of California, San Francisco
In this video, laparoscopic delivery of magnets for intestinal anastomosis is shown. The operation is an ileal conduit performed for neurogenic bladder secondary to paralysis. The plan was for a laparoscopic bowel resection and anastomosis using the magnets, followed by planned conversion to open to finish the operation. First, the right colon is mobilized medially in preparation for the ileal conduit. Then, a portion of the ileum to be used is identified. This portion is marked and secured at either end by vessel loops. An enterotomy is made at the distal end of the marked portion of the ileum and the magnets are introduced, one at a time. They are first brought into the body through a laparoscopic port hole with the port removed, and then placed into the bowel and milked into place. The portion of ileum was then stapled off, and the site of the enterotomy was also stapled off and removed. A technical mishap with the magnets coming together prematurely was then corrected, and the bowel is slid into correct alignment for the anastamosis. However, once the anastomosis was completed and magnets positioned, due to the abnormally small caliber of the patient’s bowel relative to the magnets and known paralytic ileus, the decision was made to convert to a stapled anastomoses. Nonetheless, the technical success of the procedure is shown here.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95330
Program Number: V415
Presentation Session: Video Loop Day 4
Presentation Type: VideoLoop