Transgastric Endoscopic Cholangiopancreatography: a Case Series and Description of Technique. Peter M. Bertin DO, Kirpal Singh MD, Maurice E. Arregui MD FACS. St Vincent Indianapolis, IN Purpose: Roux-en-Y gastric bypass excludes the biliary and pancreatic tree from traditional endoscopic evaluation and treatment. As the number of former bypass patients accrues, the need to assess and […]
Introduction: Acute care surgery for peritonitis and perforated ulcer has traditionally been performed open, but in select circumstances may be safely performed laparoscopically with good outcomes. Methods: A retrospective chart review of emergent cases in an academic medical center involving acute abdomen from 2007 to 2008 included three perforated duodenal ulcers and one marginal ulcer […]
Introduction: Unexpected findings during laparoscopic Roux-en-Y gastric bypass (LRYGB) are frequent and consist mainly of peritoneal adhesions, hernias, organomegaly, gallstones and adnexal cysts. These findings are relatively frequent and their management remains a part of every day bariatric practice. Unexpected and unusual intraoperative findings are only sporadically encountered during LRYGB. Management and clinical decision making […]
Before natural orifice translumenal endoscopic surgery (NOTES) can be safely introduced for human use in the United States, several technical and physiologic factors need to be elucidated. Among these are the host systemic and peritoneal responses to inflammation. The inflammatory response to laparoscopy (LAP) has been well characterized, and has been shown to favorably alter […]
Introduction: Despite the subjectivity of the method, endoanal ultrasonography (EAUS) is the gold standard to evaluate the external (EAS) and Internal (IAS) anal sphincters. Differentiating a sphincter defect from normal anatomic variation is challenging. We developed a new standardized protocol to evaluate the anal sphincter complex and establish normal values of lengths and thickness of […]