Introduction: Median arcuate ligament syndrome is a rare disorder resulting from compression of the celiac artery and associated nervous fibers by the insertion of the diaphragmatic muscle fibers. The first median arcuate ligament release was performed in 1963. The largest series gathered involving open operative intervention was 15 patients. The syndrome includes weight loss, posprandial abdominal pain, nausea, vomiting and food fear. Radiographic compression of the MAL is found in 20% of patie
After successful implementation in other surgical fields, robotic colorectal surgery has gained considerable interest. It may help to overcome steep learning curves and benefit even more from minimally invasive surgery, especially in rectal resections.
We present a 50 year old man diagnosed of rectal cancer 7.5 cm from the anal verge. Stadification was T2N0 by MRI. A low anterior resection with side-to-end anastomosis was performed transanally with a single port device, and transabdominally wit
Laparoscopic cholecystectomy is a common procedure. The incidence of major bile duct injury is greater than in open cholecystectomy. The critical view of safety is a secure method of ductal identification. When this is not acheivable, total cholecystectomy should not be performed and a bail-out procedure should be utilized. Once such procedure is a subtotal cholecystectomy with two subtypes depending on whether the gallbladder is “reconstituted” or “fenestrated.” We report a case of recurre
This video outlines the experience we have had at UC San Diego performing 74 cases with indocyanine green (ICG) intraoperative fluorescence imaging. We’ve put together selected cases to show and discuss the wide variety of surgical applications for this exciting technique including: robotic-assisted transhiatal esophagectomy, laparoscopic sleeve gastrectomy, laparoscopic adrenalectomy, parathyroidectomy, laparoscopic cholecystectomy, exploratory laparotomy, and subtotal gastrectomy.
Laparoscopic adrenalectomy has long been accepted as an acceptable way to remove adrenal masses. Most tumors excised are small functional tumors, or masses larger than four to six centimeters.
We present the case of a 67-year-old male with a 13.5 centimeter non-functioning adrenal tumor. He presented initially with incidental elevated liver function tests on routine labs. His workup revealed a 13.5cm heterogenous cavernous right adrenal mass. Extensive endocrine workup did not find a functional