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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
Stress impact on healthcare workers during the COVID-19 pandemic: preliminary results of a worldwide survey-based study
Bile duct injury (BDI) and laparoscopic cholecystectomy: is there a solution?
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 difficult case of laparoscopic cholecystectomy using a "non-lifting technique": a live educational procedure
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
Thoracoscopic thymectomy using a subxiphoid camera port
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
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