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Recently uploaded on WebSurg

Surgical intervention
20:59
How fluorescence can help to obtain the critical view of safety (CVS) during laparoscopic cholecystectomy: a live educational procedure broadcasted from IRCAD Taiwan
This live educational video broadcasted from IRCAD Taiwan shows the case of a 31-year-old woman admitted to hospital for chronic abdominal pain in the right upper quadrant for one month. Ultrasonography (US) demonstrated gallstones with a moderate thickening of the gallbladder wall. The patient had a BMI of 26 and she had a past surgical history of laparotomy for perforated appendicitis and thyroidectomy for papillary cancer.
This procedure highlights the benefits of intraoperative guidance with ICG fluorescence. In addition to a conventional preoperative intravenous (IV) injection, ICG fluorescence was used intraoperatively to understand and demonstrate the vascular anatomy of the hepatocystic triangle. During this procedure, technical points are discussed between Dr. M Lin, the operator, and Drs. B Dallemagne, HP Wong, W Huang.

How fluorescence can help to obtain the critical view of safety (CVS) during laparoscopic cholecystectomy: a live educational procedure broadcasted from IRCAD Taiwan

M Lin, B Dallemagne, HP Wong, W Huang, A Garcia
10 days ago
167
Surgical intervention
52:26
Stress impact on healthcare workers during the COVID-19 pandemic: preliminary results of a worldwide survey-based study
During an epidemic of a novel infectious disease, many healthcare workers may suffer from stress. Fear and fatigue can be overwhelming and cause severe psychological distress such as anxiety, depression, burnout, and hostility. The recent outbreak of COVID-19 may be a major source of stress for healthcare workers. The psychological monitoring of healthcare workers during the COVID-19 outbreak is essential since it may allow for the early detection and early management of distress and deliver timely support and stress management training recommendations. The preliminary results of a survey-based study were presented during this weekly fellows meeting session jointly organized by the IHU and IRCAD France (as of May 2020).

Stress impact on healthcare workers during the COVID-19 pandemic: preliminary results of a worldwide survey-based study

A Garcia, J Verde, S Perretta
14 days ago
60
Lecture
26:07
Bile duct injury (BDI) and laparoscopic cholecystectomy: is there a solution?
In this key lecture, Dr. Soper looks into bile duct injury (BDI) and laparoscopic cholecystectomy (LC), a very common operation for general surgeons.

Bile duct injury (BDI) and laparoscopic cholecystectomy: is there a solution?

N Soper
1 month ago
561
Surgical intervention
22:59
COVID-19 in surgical systems
In all fields of medicine, the COVID-19 pandemic has had an unprecedented impact on clinical practice, and this crisis has exposed a gap in surgical knowledge, skills, and performance.
This novel disease entity implies new patient and team safety issues and concerns in relation to surgery. The current recommendations of major surgical societies have stressed the importance of recognition and enforcement of protection measures against the virus.
Surgery during the COVID-19 pandemic was addressed during this April weekly fellows meeting session jointly organized by the IHU and IRCAD France, summarizing current practical recommendations and guidelines.

COVID-19 in surgical systems

A Garcia
1 month ago
1.6K
Surgical intervention
28:35
A difficult case of laparoscopic cholecystectomy using a "non-lifting technique": a live educational procedure
This unabridged video of a live educational surgery performed by Dr. Dallemagne during the last advanced Hepatobiliary and pancreatic surgery course at IRCAD France (November 7-9, 2019) very clearly demonstrates the stepwise execution of a laparoscopic cholecystectomy in the context of a chronic cholecystitis along with all its tips and tricks. This is the case of a 62-year-old man, who was admitted 2 months before surgery for an episode of acute cholecystitis. The patient was treated non-surgically and finally discharged. After multiple relapses of pain and discomfort in the right upper quadrant, surgery was planned and finally executed. Dr. Bernard Dallemagne’s surgical skills and experience and the beauty of the procedure in this challenging scenario, associated with a dynamic Questions & Answers (Q&A) and experts' comments from the auditorium, make this video a 'must see' for any surgeon who will perform a gallbladder procedure.

A difficult case of laparoscopic cholecystectomy using a "non-lifting technique": a live educational procedure

B Dallemagne, J Verde, D Mutter, J Marescaux
1 month ago
2.4K
Surgical intervention
41:41
Addressing the challenges of a complicated laparoscopic cholecystectomy for cholecystitis: a live educational procedure
In this live educational video, Professor Didier Mutter provides a precise description of the most important anatomical landmarks related to cholecystectomy performed for cholecystitis. The video features a noteworthy case of fibrotic gallbladder surrounded by inflammation managed with cholecystectomy. In spite of anatomical difficulties, Professor Mutter shows how to perform a "critical view of safety", the systematization of which should be dogmatic, with complete extraction of all gallstones, in the learning process of cholecystectomy.
The author performs an outstanding standardized surgery, explaining the techniques and maneuvers to be performed in order to obtain success.

Addressing the challenges of a complicated laparoscopic cholecystectomy for cholecystitis: a live educational procedure

D Mutter, R Canales Cama, J Marescaux
1 month ago
2.7K
Surgical intervention
08:10
Thoracoscopic thymectomy using a subxiphoid camera port
Thoracoscopic thymectomy is currently considered the approach of choice for the treatment of thymic conditions, including myasthenia gravis (MG). It has demonstrated advantages over open approaches, because it reduces postoperative pain, hospital stay, blood loss, promotes early patient discharge, and provides cosmetic improvement. The use of a subxiphoid access, either as a single port or camera-assistant port, grants even greater benefits as it allows the following: visualization of the phrenic nerve to the contralateral phrenic nerve, reaching all the thymus poles and the lower limit of the thyroid gland, peritracheal fat and aortopulmonary window, pericardial dissection and bilateral epiphrenic fat removal. In addition, it facilitates bilateral exploration through a pleural opening without the need to place another trocar on the left, and the use of carbon dioxide throughout the surgery, thereby avoiding sternal retraction. The dissection through the correct planes, and the systematization of the operative technique might reduce time and improve outcomes.

Thoracoscopic thymectomy using a subxiphoid camera port

I Sastre, M España, R Ceballos, M Bustos
2 months ago
1.1K
Surgical intervention
13:07
Laparoscopic central pancreatectomy for renal cell carcinoma metastasis
Authors present the case of a laparoscopic central pancreatectomy in a patient with a clear cell renal cell carcinoma metastatic lesion to the pancreatic neck.
A 71-year old female patient was admitted with a pancreatic neck lesion detected by abdominal ultrasound performed for mild epigastric pain she has been suffering from for 3 months prior to admission. Her past medical history is significant for right nephrectomy performed 25 years ago. The patient stated that she had an acquired cystic kidney disease, but no medical records were available to confirm that. A multidisciplinary investigation was performed. Pancreatic protocol CT-scan revealed a 2.5cm hyper-enhancing round-shaped tumor, located within the pancreatic neck. The patient had no carcinoid syndrome, and levels of PNET specific markers (Chromogranin A, NSE, Insulin, 5-HIIA) were not elevated. CA 19-9 and CEA levels were also normal. The tumor was [111In]-octreotide negative on octreotide scan. As a result, a non-functioning pancreatic neuroendocrine tumor was suspected considering its CT-scan characteristics.
A laparoscopic pancreatic enucleation was planned with possible central pancreatectomy in case the enucleation would turn out to be unfeasible. The attempt to perform enucleation failed due to intensive bleeding from an intrapancreatic vessel, unclear borders of the tumor, and high risk of postoperative pancreatic fistula formation. It was decided to continue the surgery with central pancreatectomy.
The postoperative course was complicated by a postoperative pancreatic fistula (POPF) grade B (according to the ISGPF classification), which was managed successfully using interventional percutaneous drainage. Final histopathological examination revealed a clear cell renal cell carcinoma (RCC) metastatic lesion to the pancreas. A CT-scan performed 2 years after the surgery revealed no signs of disease progression. The pancreaticojejunostomy shows no signs of obstruction. The patient has neither exocrine nor endocrine pancreatic insufficiency.
The purpose of the video is to demonstrate the feasibility of laparoscopic central pancreatectomy, which is an organ-preserving procedure and is accompanied with better long-term results.

Laparoscopic central pancreatectomy for renal cell carcinoma metastasis

P Agami, M Baychorov, R Izrailov, I Khatkov
2 months ago
1.6K

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