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
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
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.
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.