Laparoscopic Splenectomy for Management of Refractory ITP After Previous Open Splenectomy
Michael T Fastiggi, MD, L Katz, MD, Philip George, MD. Mount Sinai Medical CenterIntroduction: Splenectomy is usually an effective treatment for medically refractory idiopathic thrombocytopenic purpura. However, some patients develop recurrent thrombocytopenia. At least one third of these cases are attributable to an accessory spleen. Discussion: In recurrent thrombocytopenia after splenectomy, an accessory spleen should… Continue Reading
Laparoscopic Transgastric GIST Resection
Colette S Inaba, MD, Michael Tran, MD, Brian R Smith, MD. University of California IrvineThis video demonstrates a transgastric resection of a gastrointestinal stromal tumor. Cuffed trocars are used to gain laparoscopic entry into the lumen of the stomach. The tumor is dissected using an energy device and the resulting gastric defect is repaired using… Continue Reading
- Topic:
- Foregut
Median Arcuate Ligament Syndrome, Case Series and Review of the Literature
Jesse Conner, MD, Joshua Gierman, MD, Laura Fischer, MD. Oklahoma University Health Science CenterIntroduction: Median arcuate ligament syndrome is a rare cause of abdominal pain. Symptoms include vague epigastric pain, post prandial pain, nausea, vomiting, and weight loss. The pathophysiology has been thought to be secondary to compression of the celiac artery by a thick… Continue Reading
- Topic:
- Foregut
Minimally Invasive Robot-Assisted Left Lateral Segmentectomy for Recurrent Intrahepatic Lithiasis
Subhashini Ayloo, MD, MPH, Jacob Schwartzman, MD. Rutgers, New Jersey Medical SchoolObjective: To demonstrate the safety and feasibility of robot-assisted left lateral segmentectomy for recurrent cholangitis due to recurrent intrahepatic lithiasis in a previously Roux-en-Y hepaticojejunostomy patient. A 46 year old man with previous hepaticojejunostomy for common bile duct stones and intrahepatic ductal stones presents with… Continue Reading
- Topic:
- Robotics
Minimally Invasive Surgery: Colonoscopic Assisted Transanal Endoscopic Microsurgery for Local Resection of a Large Sigmoid Polyp
Kevin M Izquierdo, MD, Beverly Ng, MD, John H Marks, MD. Lankenau Medical CenterThis video demonstrates a novel approach to perform endoluminal surgery for a 3cm polyp in the distal sigmoid colon using a combined rigid and flexible endoscopic approach. The patient is a 56-year-old male who presented with symptoms of intermittent rectal bleeding for… Continue Reading
PURE LAPAROSCOPIC LEFT LATERAL SECTIONECTOMY FOR GIANT HEMANGIOMA OF LEFT LATERAL SEGMENT OF LIVER
Srikanth Gadiyaram, Dr, Kumar Parth, Dr, Gaurav Singh, Dr, Yashas H Ramegowda, Dr. Sahasra Hospitals, Centre of Excellence for Gastroenterology, Bangalore, IndiaBackground: Laparoscopic resection has become standard of care for left lateral sectionectomy (LLS), however, there could be technical challenges in laparoscopic resection while dealing with giant tumors. In a medline search we did not… Continue Reading
Rectopexy with Magnet Retraction
Estefania Roldan, Leonard K Welsh, MD, Gerardo Davalos, MD, Ramon Diaz, MD, Dana Portenier, MD, Daniel Guerron, MD, Billy Lan, MD. Duke University Medical CenterLaparoscopic rectopexy for rectal prolapse is often complicated by the narrow working space of the pelvis as the sigmoid colon and uterus often obstruct visualization. Many approaches for effective retraction have… Continue Reading
- Topic:
- Colorectal
Revisional Bariatric Surgery for Weight Regain and Eroded Mesh Following Previous Open Roux-en-Y Gastric Bypass
Julie A Stortz, MD, Russell B Hawkins, MD, Alexander L Ayzengart, MD, MPH, Jeffrey E Friedman, MD. University of FloridaBackground: Revisional bariatric surgery has become increasingly prevalent due to the rising number of bariatric procedures to treat morbid obesity. Here we describe a case in which a patient required reoperation following Roux-en-Y gastric bypass (RYGB)… Continue Reading
REVISIONAL RYGB: REMNANT GASTRECTOMY, RE-DO GASTROJEJUNOSTOMY, AND CLOSURE OF GASTRO-GASTRIC FISTULA
Rene Aleman, MD, Mauricio Sarmiento-Cobos, MD, Kandace Kichler, MD, Matthew Lange, MD, Federico Serrot, MD, Samuel Szomstein, MD, FACS, FASMBS, Emanuele Lo Menzo, MD, PhD, FACS, FASMBS, Raul J Rosenthal, MD, FACS, FASMBS. Cleveland Clinic FloridaRevisional surgery after primary RYGB in the presence of a gastro-gastric fistulae requires surgical repair with or without remnant gastrectomy.… Continue Reading
Robot-Assisted Laparoscopic Repair of Hepatic Duct Stricture
Subhashini Ayloo, MD, MPH, Jacob Schwartzman, MD. Rutgers, New Jersey Medical SchoolObjective: To demonstrate the safety and feasibility of minimally invasive robot-assisted repair of an indeterminate hepatic duct stricture. Materials and Methods: A 57 year old woman presents with abdominal pain, obstructive jaundice, and elevated LFTs. Diagnostic imaging showed cholelithiasis, choledocholithiasis and a CHD stricture. … Continue Reading
- Topic:
- Biliary
Robotic-assisted Conversion of Slipped Nissen Fundoplication to Toupet Fundoplication and Hiatal Hernia Repair
Joseph R Broucek, MD, Enrique Elli, MD, FACS. Mayo Clinic - FloridaFailure rates of laparoscopic Nissen fundoplication occur in the range of 2-17%. The most common recurrent symptoms include reflux and regurgitation. If the patient fails medical therapy, revisional surgery is known to be successful in more than 90% of cases. This is a case… Continue Reading
- Topic:
- Foregut
Robotic Cholecystectomy with variant anatomy on DaVinci Xi
Abraham Krikhely, MD, FACS, Abby Wong, MD. Columbia Univeristy Medical CenterThis is an interesting case of variable anatomy encountered during robotic cholecystectomy performed in a 48 year old female with biliary colic and GERD after sleeve gastrectomy. This was done at the same setting as the robotic revision to a gastric bypass from prior sleeve gastrectomy and the… Continue Reading
- Topic:
- Robotics
Robotic Heller Myotomy and Roux-en-y Gastric Bypass
Zeyad Loubnan, MD, Elissa Davila-Shiau, BA, Manish Parikh, MD, Akuezunkpa Ude Welcome, MD. NYU School of MedicineThis is a video of a 31 year old male with achalasia and severe obesity (Body Mass Index = 41). The patient reported a history of endoscopic balloon dilation 20 years prior and was having recurrent dysphagia. Manometry confirmed… Continue Reading
Robotic Median Arcuate Ligament Release
Desmond T Huynh, MD, Miguel Burch, MD, Kevin Shamash, Richard Van Allan, Daniel Shouhed, MD. Cedars-Sinai Medical CenterMedian Arcuate Ligament Syndrome (MALs) is a rare vascular condition in which the median arcuate ligament compresses the celiac trunk which presents as a constellation of symptoms including nausea, vomiting, weight loss, and post-prandial epigastric pain. The treatment… Continue Reading
- Topic:
- Foregut
Robotic Repair of Small Bowel Obstruction From Internal Hernia After Recent Bilateral TAPP Repair Of Inguinal Hernias
Osvaldo Zumba, MD, Jordan Dozier, MD, George Mazpule, MD, Stephen G Pereira, MD, Adam Rosenstock. Hackensack University Medical CenterRobotic TAPP (Transabdominal Preperitoneal) has emerged as a viable option for the treatment of inguinal hernias. Compared to both the laparoscopic and open approach, the robotic repair offers less pain, similar recurrence rates, and less technical challenge. … Continue Reading
- Topic:
- Robotics