monthly focus

surgical intervention video

In this live educational video, Dr. Dallemagne performs a laparoscopic stapled excision of a gastric gastrointestinal stromal tumor (GIST) located in the lesser curvature of the stomach of an 84-year-old male patient with anemia and melena due to recurrent tumoral bleeding. 

Laparoscopic stapled excision of a gastric GIST: a live educational procedure

Excision laparoscopique par agrafage de GIST gastrique : une procédure didactique en direct

Fundoplicature de Nissen assistée par gastroscopie laparoscopique : une procédure didactive en direct

In this live educational video, Dr. Perretta and Dr. Dallemagne jointly perform a gastroscopy-assisted laparoscopic Nissen fundoplication in a 28-year-old female patient with severe gastroesophageal reflux disease (GERD) and a history of lung transplantation due to cystic fibrosis.

Laparoscopic gastroscopy-assisted Nissen fundoplication: a live educational procedure

Résection endo-laparoscopique par voie d’abord transgastrique d'une tumeur stromale sous-muqueuse gastrique près de la jonction œsophagogastrique

Treatment of gastrointestinal stromal tumors (GIST) of the stomach has improved since laparoscopic procedures are widely performed. However, the minimally invasive resection of submucosal lesions still represents a challenge due to the difficulty in estimating their limits (1). Additionally, tumors located at the esophagogastric junction are considered difficult to access, as previous studies have reported technical limitations using the traditional laparoscopic approach (3). Thanks to the development of laparoscopy and digestive endoscopy, multiple laparo-endoscopic surgeries (LES) for GIST have recently been developed. These procedures are considered safe and feasible with regards to short-term surgical complications and long-term oncological results (2). 

References: 

(1). Lyu Z, Yang Z, Wang J, Hu W, Li Y. Totally Laparoscopic transluminal resection for gastrointestinal stromal tumors located at the cardiac region. Ann Surg Oncol 2018;25:2218-9. 

(2). Barajas-Gamboa JS, Acosta G, Savides TJ, Sicklick JK, Fehmi SM, Coker AM, Green S, Broderick R, Nino DF, Harnsberger CR, Berducci MA, Sandler BJ, Talamini MA, Jacobsen GR, Horgan S. Laparo-endoscopic transgastric resection of gastric submucosal tumors. Surg Endosc 2015;29:2149-57. 

(3). Wang H, Cao L, Zheng K, Zhao Y. Laparoscopic endoscopic cooperative surgery for gastrointestinal stromal tumors. Surg Laparosc Endosc Percutan Tech 2018;28:354-8. 

Endo-laparoscopic cooperative transgastric resection of a gastric submucosal GIST near the esophagogastric junction

video lecture

In this key lecture, Dr. Richard van Hillegersberg focuses on robot-assisted minimally invasive esophagectomy (RAMIE).

Robot-assisted minimally invasive esophagectomy (RAMIE)

Oesophagectomie mini-invasive assistée par robot

In this key lecture, Dr. Chao outlines robotic esophagectomy.

Robotic esophagectomy

Oesophagectomie robotisée

Gastrectomie totale robotisée avec lymphadénectomie D1 + pour tumeur de la jonction œsophagogastrique de Siewert type II : une procédure didactique en direct

In this live educational video, Dr. WJ Hyung presents the case of a 77-year-old male patient with a past medical history of chronic renal failure, myocardial infarction, and a previous lower abdominal surgery. His esophagogastric cancer diagnosis was based on the presence of an anemic syndrome. Esophagogastroduodenoscopy (EGD) revealed a Siewert type II tumor. Echo-endoscopy showed a T1b N0 tumor. During the extensive tumor staging, the presence of a metastatic disease was ruled out.

The video evaluates the surgical steps of robotic total gastrectomy with D1 plus lymphadenectomy. Intraoperative endoscopy was used to assess the proximal site of resection, tumor location, and esophagojejunostomy integrity 

During the procedure, essential points are stressed such as the importance of an accurate classification for esophagogastric junction tumors, and currently the evidence supports gastrectomy instead of esophagectomy in Siewert type II tumors due to higher survival rates.

Major technical factors such as robotic trocar placement, omentectomy type, lymphadenectomy types are highlighted as well as the energy sources used for dissection and vessel ligature. Robotic anastomosis is also discussed.

Focus on esophagogastric surgery

Laparoscopic stapled excision of a gastric GIST: a live educational procedure

Endo-laparoscopic cooperative transgastric resection of a gastric submucosal GIST near the esophagogastric junction

Robotic esophagectomy

Robot-assisted minimally invasive esophagectomy (RAMIE)