Percutaneous endoscopic gastrostomy (PEG) tube placement has become one of the mainstays for enteral nutrition in patients unable to tolerate oral feedings. Complications related to PEG tube placement are typically minor, however, major complications have been reported. One unique complication related to PEG placement involves the placement of the PEG transcolonic. Treatment strategies for managing transcolonic PEG placement vary as it is a rare complication and have not been well studied.
The Objective of this video is to present how a complex case of a Bismuth-Strasberg E2 biliary injury with an associated biliperitoneum was resolved with a pure laparoscopic two-stage approach starting at postoperative day 10. The surgical team involved in this case has over 10 years of advanced HBP laparoscopic experience.
Case: A 56-year-old female to whom a laparoscopic converted to open cholecystectomy for acute cholecystitis was performed. The patient was discharged at postoperative day 3
This is a video presentation of the repair of a large band slip into a giant paraesophageal hernia. Performance of this complex operation requires the utilization of both advanced Bariatric and Esophageal Surgery techniques. There is a paucity of videos demonstrating cases of this kind.
Paraesophageal hernias (PHH) constitute approximately 5% of all hiatal hernias. Surgical management of a symptomatic PHH requires reduction of the stomach, closure of the hiatus and fundoplication. Gastric ischemia is a rare complication and difficult to manage. Prevention is the key, however a strategy must be in place if this devastating injury occurs.
This video highlights the finding of gastric ischemia, intraoperative decision-making and subsequent management.
BACKGROUND. Endoscopic Plication by POSE (Primary Obesity Surgery Endoluminal) procedure is a new endoscopic restrictive procedure. It may be indicated in patients with Grade I or II Obesity. Short term results are promising, but long term results and its efficacy in morbid obese patients it is unknown.
METHODS. This video shows two failure of weight loss after a POSE procedure in morbid obese patients. We show how a revisional bariatric surgery either to Roux-en-Y Gastric Bypass (RYGB) or Sl
The rectal cancer surgery has a risk of nerve injury. Total mesorectal excision (TME) has been a gold standard for rectal cancer surgery since 1990s by Prof healed. In this technique is complete excision of mesorectal tissue within the intact envelop of fascia propia of the rectum. Also, preservation of autonomic nerve is warranted to avoid genitourinary complication and sexual dysfunction. In the present, laparoscopic treatment is more popular and has benefit to identify the autonomic nerve by
OBJECTIVES: Peroral endoscopic myotomy (POEM) has been shown to be a new effective minimally invasive laparoendoscopic approach to achalasia. However, long-term outcomes of this procedure are yet to be determined. This is a case of a 74-year-old woman who underwent a POEM with complete resolution of dysphagia, but presented three months later with increasing gastroesophageal reflux that proved to be refractory to PPI therapy. Barium swallow demonstrated the presence of moderate spontaneous reflu
This is a video of a laparoscopic gastric bypass in a morbidly obese male with unknown intestinal nonrotation at the time of surgery. In order to complete the operation, lysis of Ladd’s bands and other abnormal adhesions was required. Due to the abnormal anatomy of the individual an appendectomy was also performed.
Today we discuss a patient with heterotaxy syndrome who presented for sleeve gastrectomy. She had a prior cholecystectomy at which situs inversus was noted, so CT scan was obtained for operative planning. We see dextrocardia with a left sided liver noting a prominent right lobe. We see the right sided gastric body without the normal duodenal sweep; we also note right sided polysplenia.
This guided trocar placement with a mirror image approach: we placed the 12mm trocar in the left upper quadran
Major injury to the common bile duct is a well-known complication of a cholecystectomy procedure. Because of the altered anatomy, procedures of the fore-gut after biliary reconstruction present a surgical challenge. Open Roux-en-Y gastric bypass following Roux-en-Y pancreaticojejunstomy has previously been described by Timmermans, et al. We report a case of laparoscopic Roux-en-Y high divided gastric bypass after Roux-en-Y hepaticojejunostomy and describe the operative technique and follow up.