Background: The extent of liver resection is best tailored to the patient’s status, and performing anatomical liver resection while preserving the liver volume as much as possible is the optimal strategy. This video shows the technical methods used for a laparoscopic anatomical segmentectomy of combined segment 3 (S3) and segment 4 (S4).
Patient and methods: A 63-year-old woman underwent a laparoscopic left hemicolectomy for cancer of the descending colon. Three years after surgery, follow-up a
Background: The most common variation of the hepatic artery is a replaced right hepatic artery (RHA) arising from the superior mesenteric artery (SMA). Recognition of anatomic abnormalities is fundamental during surgery, especially in complex procedures, such as pancreaticoduodenectomies. We herein report a case of robotic pancreaticoduodenectomy with preservation of a replaced RHA in a patient diagnosed with pancreatic cancer.
Case description: A 59-year-old female was referred to our departm
Background: Cystogastrostomy has been the procedure of choice for large, symptomatic pancreatic pseudocysts. Multiple methods have been developed for creating cystogastrostomies. These include traditional open techniques, laparoscopic approaches, and endoscopic drainage procedures. This video presents a novel method for a combined laparoscopic and endoscopic approach to pancreatic pseudocyst drainage.
The patient is a 48 year-old Caucasian female. She has a past surgical history significa
We present an interesting case where a 78 year-old Indian gentleman presented with both gastric and sigmoid colon primaries. Pre-operative histology revealed adenocarcinoma for both.
He underwent laparoscopic total gastrectomy, D2 lymphadenectomy, en bloc distal pancreatectomy, splenectomy and high anterior resection. Intra-operatively, the gastric tumour was noted to be invading posteriorly necessitating the distal pancreactectomy and splenectomy. Operative duration was 7 hours and 45 minutes.
Type 3 choledochal cyst or choledochocele is the rarest form and accounts for 5% of all bile duct cysts. These cysts are located within the duodenal wall and the mucosal histology further differentiates them between choledochocele and duodenal duplication cysts. The challenge in the approach is related to the proximity to the ampulla and the impact on the pancreaticobiliary drainage. To date, there is only one case described of a closed choledococele when the ampulla opens within the cyst cavity