monthly focus

surgical intervention video

CIRURGIA INTERATIVA AO VIVO: demonstração totalmente abrangente da gastrectomia robótica guiada por fluorescência para câncer


实时交互式手术：全面展示机器人荧光引导胃癌切除术


In this live interactive surgery, Dr. Hyung demonstrates his experience with robotic fluorescence-guided gastrectomy for gastric cancer. In this case of an early distal gastric cancer, a distal gastrectomy with D1+ lymphadenectomy is performed showing the ICG fluorescence of regional lymph nodes. Billroth I reconstruction is performed with an intracorporeal anastomosis. 

LIVE INTERACTIVE SURGERY: fully comprehensive demonstration of robotic fluorescence-guided gastrectomy for cancer 

CIRUGÍA INTERACTIVA EN VIVO: demostración totalmente abarcadora de la gastrectomía robótica guiada por fluorescencia para cáncer


CHIRURGIE LIVE INTERACTIVE: démonstration complète de la gastrectomie robotique guidée par fluorescence pour traitement de cancer


LIVE хирургия: всеобъемлющая демонстрация робот-ассистированной флуоресцентной гастрэктомии по поводу рака

CIRURGIA INTERATIVA AO VIVO: reparo da hérnia paraesofágica: valor crítico da abordagem exterior ao saco


LIVE хирургия: лапароскопическая пластика параэзофагеальной грыжи 

CIRUGÍA INTERACTIVA EN VIVO: reparación de la hernia paraesofágica: valor crítico del abordaje exterior al saco


Paraesophageal hernia (PEH) repair is a challenging procedure. Repositioning of the herniated stomach and the reduction of the sac from the mediastinum is mandatory in order to decrease the risk of recurrence. The dissection and reduction of the sac must be performed following stepwise and precise dissection rules: it must be carried out outside of the sac, in an anatomical cleavage plane. Recurrence is also related to the type of crural repair performed, some authors advocating the systematic use of prosthetic or biological reinforcement. In this video, we present a PEH repair and cruroplasty protected with an absorbable mesh and contemporary Nissen fundoplication.

LIVE INTERACTIVE SURGERY: paraesophageal hernia repair: critical value of extrasaccular approach

活体互动手术：食管旁疝修补术：动脉外入路的临界值


CHIRURGIE LIVE INTERACTIVE: réparation d'une hernie para-oesophagienne: valeur critique de l'approche extrasacculaire


LIVE хирургия: лапароскопическое шунтирование желудка по Ру с пластикой случайной перфорации малого желудочка и культи желудка

实时交互式手术：腹腔镜Roux-en-Y胃旁路术（LRYGB），修复胃囊和胃残留物的偶然穿孔


This video shows a laparoscopic Roux-en-Y gastric bypass (LRYGB) procedure with the repair of an intraoperative incidental perforation of the gastric pouch and of the gastric remnant. 

LIVE INTERACTIVE SURGERY: Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) with repair of incidental perforation of gastric pouch and gastric remnant 

CHIRURGIE LIVE INTERACTIVE: Pontage gastrique Roux-en-Y laparoscopique avec réparation d'une perforation accidentelle de la poche gastrique et du gastric remnant


CIRUGÍA INTERACTIVA EN VIVO: Bypass Gástrico en Y de Roux laparoscópico (BGYRL) con reparación de la perforación incidental del pouch gástrico y del remanente gástrico


CIRURGIA INTERATIVA AO VIVO: Bypass Gástrico em Y de Roux laparoscópico (BGYRL) com reparo da perfuração incidental do pouch gástrico e do remanescente gástrico


A 65-year-old woman was referred to our hospital with complaints of dysphagia. She had a surgical history of cesarean section and cholecystectomy. Esophageal motility examination showed a normal lower esophageal sphincter (LES), and the absence of hiatal hernia and spasm in the distal part of the esophagus. The barium X-ray showed a bulky diverticulum in the middle thoracic esophagus and barium collecting inside the diverticulum without obstruction. The 3D-CT image also showed a giant diverticulum in the middle esophagus. The diverticulum was located below the azygos vein and carina of the bronchus and was sticking out from the middle esophagus in the contralateral side of the thoracic aorta. The diverticulum does not invade other organs. The patient was then proposed for an elective surgery, a thoracoscopic esophageal diverticulectomy and myotomy in a prone position.

LIVE INTERACTIVE SURGERY: thoracoscopic esophageal diverticulectomy and myotomy

CIRURGIA INTERATIVA AO VIVO: diverticulectomia esofágica toracoscópica e miotomia 


CIRUGÍA INTERACTIVA EN VIVO: diverticulectomía esofágica toracoscópica y miotomía 


LIVE хирургия: торакоскопическая дивертикулэктомия пищевода и миотомия

实时交互式手术：胸腔镜食管憩室切除术和肌切开术


CHIRURGIE LIVE INTERACTIVE: diverticulectomie et myotomie oesophagienne par thoracoscpie 


We present the clinical case of a 50-year-old patient managed for a left direct symptomatic reducible inguinal hernia, with a palpable impulse on examination. The patient’s history included a left indirect inguinal hernia repair in his childhood.



The procedure begins conventionally with an open laparoscopy with the introduction of a supra-umbilical port. The exploration confirms the presence of a left hernia and rules out the diagnosis of right hernia. Dissection starts with a horizontal peritoneal incision, which allows to progressively parietalize all elements of the cord, making sure to stay in contact with the peritoneum. Dissection of the previously operated hernia dating back to the patient’s childhood is slightly more painstaking and constraining due to the presence of adhesion-related scars. However, the parietalization of the peritoneum is carried on without any particular problem, and considering that it is a direct hernia, the deferent duct is very easily identified and parietalized. Reduction of the direct hernia is performed easily with the reintroduction of the transversalis fascia. Given the small size of the hernia, the fascia will not be exteriorized.



After complete lowering, a 15 X 15cm polypropylene mesh (Parietene™) is recut to a 13 X 12cm size with external trimming. The mesh is positioned in order to cover all direct and internal hernial orifices. It is only fixed to Cooper’s ligament, to the anterior superior iliac spine, and to the anterior abdominal wall so as to prevent any early mobilization postoperatively. Reperitonization is then performed with peritoneal fixation using absorbable staples (of the AbsorbaTack™ type). Exsufflation is achieved under visual guidance.



The entire procedure is performed as an outpatient surgery. The patient was admitted to our unit just before the intervention. He is discharged a few hours later. 

LIVE INTERACTIVE SURGERY: left direct inguinal hernia: laparoscopic TAPP approach

CHIRURGIE LIVE INTERACTIVE: hernie inguinale directe gauche: approche laparoscopique TAPP


CIRUGÍA INTERACTIVA EN VIVO: hernia inguinal izquierda directa: abordaje TAPP laparoscópico


实时交互式手术：直接腹股沟疝：腹腔镜TAPP手术


LIVE хирургия: левосторонняя паховая грыжа, лапароскопический ТАРР подход

CIRURGIA INTERATIVA AO VIVO: hérnia inguinal direta esquerda: abordagem TAPP laparoscópica


To achieve a safe tension-free anastomosis during a laparoscopic left colonic resection, complete splenic flexure mobilization is mandatory. In this live interactive surgery, Dr. Salvador Morales-Conde performed a laparoscopic left colectomy with complete splenic flexure mobilization for diverticular disease showing his technical tips in each surgical step. 

LIVE INTERACTIVE SURGERY: laparoscopic left colonic resection with complete mobilization of the splenic flexure for diverticular disease

CIRUGÍA INTERACTIVA EN VIVO: resección laparoscópica del colon izquierdo con mobilización completa de la flexura esplénica para enfermedad divertículo


CIRURGIA INTERATIVA AO VIVO: ressecção laparoscópica do cólon esquerdo com mobilização completa da flexura esplênica para doença diverticular


实时交互式手术：腹腔镜左侧结肠切除术，完全动员脾曲挠进行憩室病


CHIRURGIE LIVE INTERACTIVE: résection laparoscopique du colon droit avec mobilisation complète de l'angle colique gauche pour maladie diverticulaire


LIVE хирургия: лапароскопическая левосторонняя резекция толстой кишки с полной мобилизацией селезёночного изгиба по поводу дивертикулярной болезни

video lecture

In this authoritative lecture, Dr. Michel Vix highlighted the indications related to metabolic and morbid obesity surgery. He presented key anatomical landmarks and operating room (OR) set-up depending on every patient. He briefly described the main principles of port placement and pneumoperitoneum, and demonstrated maneuvers, indications, and main key steps of morbid obesity procedures including LAGB, SBPD-DS, Scopinaro, RYGB, Mini Gastric Bypass, and Sleeve Gastrectomy, along with their technical aspects, mortality, morbidity, effectiveness, and results using different studies and meta-analyses. He also demonstrated the main principles and key steps of new trends and approaches in bariatric and metabolic surgery with  complications and technical therapeutic aspects.

Bariatric and metabolic surgery

Nesta palestra de especialista, o Dr. Michel Vix destaca as indicações relacionadas à cirurgia metabólica e da obesidade mórbida. Apresenta os pontos-chave de referência anatômicos e a configuração da sala de cirurgia dependendo de cada paciente. Descreve brevemente os princípios gerais da colocação dos portais e do pneumoperitônio e demonstra as manobras, indicações e passos-chave principais dos procedimentos de obesidade mórbida incluindo a banda gástrica laparoscópica ajustável, a derivação biliopancreática ou cirurgia de Scopinaro, o BGYR, o Minibypass Gástrico e a Gastrectomia Vertical, com seus aspectos técnicos, morbimortalidade, eficácia e resultados usando diferentes estudos e metanálises. Também demonstra os princípios gerais e os passos-chave das novas tendências e abordagens da cirurgia bariátrica e metabólica com complicações e aspectos terapêuticos técnicos.


Cirurgia bariátrica e metabólica

Chirurgie bariatrique et métabolique


Бариатрическая и метаболическая хирургия


Хирургия селезёнки: лапароскопическая спленэктомия: симптомы и методы


Chirurgie de la rate : splénectomie laparoscopique : indications et technique


In this key lecture, Professor Antonio D'Urso outlines the basic principles of laparoscopic splenectomy using a range of specific instruments suited for different technical cases. The main principles for accessory and large spleen management are demonstrated including a brief description of stepwise dissection maneuvers along with complications. Professor D'Urso also gave an overview of robotic splenectomy. 

Splenic surgery: laparoscopic splenectomy: indications and technique

Nesta palestra magistral, o Professor Antonio D'Urso destaca os princípios básicos da esplenectomia laparoscópica usando uma gama de instrumentos específicos e adequados para diversos casos técnicos. Os princípios gerais para o manejo do baços grandes e acessórios são demonstrados, incluindo uma breve descrição do passo a passo das manobras de dissecção junto com as complicações. O Professor D'Urso também apresenta um panorama da esplenectomia robótica.


Cirurgia esplênica: esplenectomia laparoscópica: indicações e técnica

In this key lecture, Professor Morales-Conde provided a brief historical coverage of colorectal surgery with different approaches and technologies. The main objective was to make the procedure minimally invasive, safer, and more reproducible. He demonstrated the basic principles and maneuvers of port placement, splenic flexure resection, total colectomy, and intracorporeal vs. extracorporeal anastomosis with different meta-analyses and videos. He highlighted the main aspects of splenic flexure mobilization and also described future approaches, innovation, and new trends in colorectal surgery with their clinical significance.

Colorectal surgery

Колоректальная хирургия


Nesta palestra magistral, o Professor Morales-Conde proporcionou uma breve cobertura histórica da cirurgia colorretal com diferentes abordagens e tecnologias.O objetivo principal foi tornar o procedimento minimamente invasivo, mais seguro e mais reproduzível.Ele demonstrou os princípios básicos e as manobras de colocação dos portais, ressecção da flexura esplênica, colectomia total e anastomose intra vs. extracorpórea com diversas metanálises e vídeos.Destacou os aspectos principais da mobilização da flexura esplênica e também descreveu as abordagens futuras, a inovação e as novas tendências na cirurgia colorretal com sua significação clínica.


Cirurgia colorretal

Chirurgie colorectale


In this key lecture, Dr. Dallemagne provides a brief overview of basic rules for a safe laparoscopic cholecystectomy. He demonstrates the incidence, different causes, and impact of biliary injuries in open, laparoscopic, and single port surgery. He describes the main criteria of dissection with the principle of critical view of safety and highlights the Tokyo and SAGES guidelines in relation to the optimal surgical timing. He mentions the recommended surgical techniques, main maneuvers of the technique with modified cholecystectomy, and when the decision to convert is made depending on complications. He also presents alternative methods for the intraoperative imaging of bile ducts, including the role of cholangiography, near-infrared and fluorescence-guided cholecystectomy.

Laparoscopic cholecystectomy: basic rules

Nesta palestra magistral, o Dr. Dallemagne proporciona um breve panorama das regras básicas para uma colecistectomia laparoscópica segura.Demonstra a incidência, as diferentes causas e o impacto das lesões biliares na cirurgia aberta, laparoscópica e de portal único.Descreve os principais critérios de dissecção com o princípio da visão crítica de segurança e destaca as diretrizes de Tóquio e da SAGES em relação ao tempo ótimo de cirurgia.Menciona as técnicas cirúrgicas recomendadas, as principais manobras da técnica com colecistectomia modificada e quando a decisão de converter é feita dependendo das complicações.Também apresenta métodos alternativos para as imagens intraoperatórias dos ductos biliares, incluindo o papel da colangiografia e da colecistectomia guiada por infravermelho próximo e fluorescência.


Colecistectomia laparoscópica: regras básicas

Лапароскопическая холецистэктомия: базовые правила


Règles de base : cholécystectomie laparoscopique


This two-part presentation outlines the principles and methods of functioning of the main medico-technical devices required to perform laparoscopic surgery.  

The first part deals with the laparoscopic unit components including the insufflator, light sources, the evolution of cameras and screens, as well as scopes used in laparoscopic surgery. For each component, operating principles, technological developments, malfunctions and their management are discussed.

The second part presents operating modalities based on novel innovative energy technologies which are used to control tissues. Their operating modalities, specific risks and prevention means are envisaged. This relates in the first place to the evolution of the use of high frequency currents delivering monopolar and bipolar currents within tissues. New ways of management of these currents with tissue vessel-sealing processes are also discussed. Finally, the principles, use and risks of the new means of dissection and tissue sealing with ultrasonic devices are addressed.

The operating principles and the specific risks of all these systems are not well known to surgeons. In case they are not correctly used, they represent new risks and surgeons should be aware of it. 

In conclusion, ergonomic choices of conventional instrumentation in minimally invasive surgery are outlined.  



Laparoscopic equipment and instrumentation in 2017

Esta apresentação em duas partes destaca os princípios e métodos de funcionamento do principais dispositivos médico-técnicos requeridos para realizar a cirurgia laparoscópica.A primeira parte lida com os componentes da unidade laparoscópica incluindo o insuflador, as fontes de luz, a evolução das câmeras e telas, bem como as óticas usadas na cirurgia laparoscópica.Para cada componente, os princípios cirúrgicos, desenvolvimentos técnicos, mal funcionamentos e seu manejo são discutidos.A segunda parte apresenta as modalidades operacionais baseadas nas tecnologias inovadoras de energia que são usadas para controlar os tecidos.Suas modalidades operacionais, riscos específicos e meios de prevenção são considerados.Isso se relaciona em primeiro lugar com a evolução do uso de correntes de alta frequência que fazem chegar correntes monopolares e bipolares dentro dos tecidos.Novos modos de manejo dessas correntes com processos de selagem de vasos nos tecidos são também discutidos.Finalmente, os princípios, o uso e os riscos dos novos meios de dissecção e selagem de vasos com dispositivos ultrassônicos são abordados.Os princípios operacionais e os riscos específicos de todos esses sistemas não são bem conhecidos pelos cirurgiões.Caso não sejam corretamente usados, representam novos riscos, e os cirurgiões devem estar cientes disso.Em conclusão, destacam-se as escolhas ergonômicas da instrumentação convencional na cirurgia minimamente invasiva.


Focus on Laparoscopic General Surgery