Iheule NEWME

This video demonstrates a rare case of single port laparoscopic cholecystectomy in a patient with situs inversus totalis using the E.K. glove port as the access port. There are only four reported cases in the literature of single port laparoscopic cholecystectomy in situs inversus totalis. The procedure was uneventful, demonstrating that this approach may also be an option for this kind of rare surgery.
Reference:
E Khiangte, I Newme, P Phukan, S Medhi. Improvised transumbilical glove port: a cost-effective method for single port laparoscopic surgery. Indian J Surg 2011;73:142–5.

The objective of this video is to demonstrate the laparoscopic treatment of a choledochal cyst in a 24-year-old woman. The Roux-en-Y construction is carried out extracorporeally using the E.K. port as the wound protector and the hand-sewn hepatico-jejunostomy is performed intracorporeally.

The objective of this video is to illustrate the potential difficulties that may be encountered during the dissection of Calot’s triangle in the management of acute cholecystitis performed through a single port. The video demonstrates when to convert and how to manage hemorrhage in single port cholecystectomy.

In this video we demonstrate the laparoscopic single-port treatment of a left ovarian dermoid cyst in a 40-year-old patient using the E.K. Glove port. Every effort is made to enucleate the cyst without perforation.

This video demonstrates the single port laparoscopic treatment of a right indirect inguinal hernia in a 21-year-old male patient using the E.K. Glove port. This video will show the polypropylene mesh fixation and the repair of the peritoneal flaps performed exclusively by hand suturing.

This video demonstrates the single-port laparoscopic treatment of a left indirect inguinal hernia in a male patient aged 50 using the E.K. glove port. The peritoneal dissection, the separation of the hernia sac and placement of the polypropylene mesh are demonstrated. Single-port intracorporeal suturing of the peritoneal flap is also shown in the video.

One of the main drawbacks of single port cholecystectomy, which cripples the surgeon is the gallbladder fundus retraction. Here, we demonstrate the different cost-effective methods we employ for fundus retraction in single port cholecystectomy.

This video shows a female patient of 62 years, presenting with acute upper abdominal pain with fever and vomiting for five days. Clinically, she presented with features of acute cholecystitis.
Blood examination revealed leukocytosis with normal liver function tests. Abdominal ultrasonography showed edema of the gallbladder wall with pericholecystic collection, cholelithiasis and signs of acute cholecystitis.
Under antibiotic cover, the patient was subjected for single-port laparoscopic cholecystectomy using the EK glove port. Due to dense and stubborn adhesions, the procedure was converted to conventional 3-port surgery.
The duodenum was found adherent to the infundibulum of the gallbladder with a fish bone and pus within it. A 3.3cm long fish bone perforated the duodenum, produced abscess and mimicked acute cholecystitis.
The fish bone was extracted, perforation was repaired and cholecystectomy was performed.

Single port laparoscopic surgery has emerged to enhance the cosmetic benefits and to decrease morbidity in minimally invasive surgery. However, this technique requires a specialized multichannel port (to introduce the laparoscope and instruments) which is very costly and not affordable for the majority of the population. We have improvised a single port access system using readily available materials like surgical gloves, the rigid plastic ring, the inner flexible ring and conventional laparoscopic trocars (the EK Port) with no added cost for the patient. This also eliminates the need for an Alexis® wound retractor. We have performed about 130 single port surgeries since September 2009 using this technique without any complications.

This video features a 62-year-old diabetic male patient who is not undergoing any treatment. He has sufferont from vague upper abdominal pain for one month. He has a past history of acute upper abdominal pain which was managed conservatively.
Abdominal ultrasonography demonstrates cholelithiasis with signs of chronic cholecystitis. Blood examination reveals hyperglycemia with normal liver function tests.
After controlling the hyperglycemic status, the patient is subjected to a laparoscopic cholecystectomy. There is evidence of gallbladder perforation, as the gallbladder is sealed off by the omentum. The gallbladder presents a large amount of calculi which are visible through the thin wall of the gallbladder, and some calculi almost protruding out through the wall.
The laparoscopic cholecystectomy is performed successfully with caution not to soil the peritoneum.