Through a 12mm incision at the umbilicus, four low profile 5mm trocars were utilized in a single multi-trocar port. Pneumoperitoneum was established. Short gastric vessels were divided and gastric mobilization was achieved using LESS techniques. Utilizing an ultrasonic dissector the tumor was excised from the fundus and placed into an extraction bag. The resulting gastrotomy was initially closed with 0 polyester stay sutures. This allowed us to fire an Endo-GIA stapling device to obtain both an
This is the case of a 39 year-old male who was diagnosed with median arcuate ligament syndrome (MALS) at an outside hopital and underwent a laparoscopic median arcuate ligament release. He recovered well from his surgery, however his symptoms persisted. He presented to our institution for a second opinion. He underwent repeat imaging which showed a persistent high grade stenosis of the celiac origen.
After a long discussion with the patient, the decision was made to attept to revise the release
Case 92 yo female, antiaggregated history of coughing, regurgitation and repetitive pneumonia. Emergency room with a 3day history of abdominal pain and vomiting. Abdomen distended and tympanic. Abdominal radiography small bowel obstruction. Chest radiography revealed air-fluid levels on the right side of the chest. CT-scan demonstrated a right anterior diaphragmatic hernia, with large bowel in the thorax and evidence of proximal bowel obstruction.
Incarcerated strangulated diaphragmatic herni
Surgical options for morbid obesity have expanded greatly over the last several decades with the popularization of laparoscopic gastric banding (LGB) and laparoscopic sleeve gastrectomy (LSG). A more recent addition, laparoscopic greater curve plication (LGCP), is a restrictive procedure that has risen in popularity, although it is still considered investigational by the American Society of Metabolic and Bariatric Surgery guidelines. The purported benefits of LGCP include a reduction in staple l
Gastrocutaneous fistulas may persist after removal of a gastrostomy feeding tube. Closure of the tract traditionally consists of open surgical treatment with associated morbidity. More recently, methods such as endoscopic clip placement, biologic fibrin glue, or complex percutaneous endoscopic suturing methods have been developed. In our video, we would like to demonstrate a treatment option that consists of simple endoscopic suture closure of the fistula with added benefits of same day surgery,