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Laparoscopic left adrenalectomy for Conn's adenoma: three trocar technique
Conn's disease is a condition in which the adrenal glands produce too much aldosterone. Prevalence estimates for Conn's syndrome is about 0.03-1.2% of the population with hypertension.
Many patients with Conn's disease have a high blood pressure that is difficult to control. This increases the risk of stroke, heart disease and kidney failure. When Conn's disease is caused by a tumor (benign adrenal adenoma), surgical resection is advised. This video demonstrates the case of a woman presenting with Conn’s disease. The preoperative work-up demonstrated a tumor located on the left adrenal gland. The patient presented an elevated aldosteronemia and the CT-scan demonstrated a 2cm left adrenal tumor. The patient is placed in a full lateral position, on the right side.
D Mutter, L Soler, J Marescaux
Surgical intervention
10 years ago
1761 views
112 likes
0 comments
15:51
Laparoscopic left adrenalectomy for Conn's adenoma: three trocar technique
Conn's disease is a condition in which the adrenal glands produce too much aldosterone. Prevalence estimates for Conn's syndrome is about 0.03-1.2% of the population with hypertension.
Many patients with Conn's disease have a high blood pressure that is difficult to control. This increases the risk of stroke, heart disease and kidney failure. When Conn's disease is caused by a tumor (benign adrenal adenoma), surgical resection is advised. This video demonstrates the case of a woman presenting with Conn’s disease. The preoperative work-up demonstrated a tumor located on the left adrenal gland. The patient presented an elevated aldosteronemia and the CT-scan demonstrated a 2cm left adrenal tumor. The patient is placed in a full lateral position, on the right side.
Gastric bypass: surgical treatment of morbid obesity
Morbid obesity is a major health concern in so many countries. It is associated with severe life-threatening co-morbidities. Unfortunately, many studies have proven that non-surgical approaches to lose weight are doomed to fail. There is good evidence that bariatric surgery is the most enduring and efficacious means of tackling morbid obesity with regards to long-term weight loss.

Roux-en-Y gastric bypass is today one of the gold standard surgeries. It is based on several mechanisms: restriction, malabsorption, and changes in gut hormones secretions.
In this chapter, all aspects of this bariatric procedure such as anatomical details, indications, contraindications, surgical setting and technical details are carefully presented.
M Vix
Operative technique
11 years ago
7437 views
166 likes
0 comments
Gastric bypass: surgical treatment of morbid obesity
Morbid obesity is a major health concern in so many countries. It is associated with severe life-threatening co-morbidities. Unfortunately, many studies have proven that non-surgical approaches to lose weight are doomed to fail. There is good evidence that bariatric surgery is the most enduring and efficacious means of tackling morbid obesity with regards to long-term weight loss.

Roux-en-Y gastric bypass is today one of the gold standard surgeries. It is based on several mechanisms: restriction, malabsorption, and changes in gut hormones secretions.
In this chapter, all aspects of this bariatric procedure such as anatomical details, indications, contraindications, surgical setting and technical details are carefully presented.
Stepwise approach for laparoscopic reversal of Hartmann's procedure
Restoration of intestinal continuity following reversal of Hartmann's procedure is an operation associated with a lengthy hospital stay, protracted convalescence, and a high morbidity rate. The advantages of minimally invasive surgery such as rapid mobilization, less postoperative pain, early restoration of bowel function, and a rapid return to a normal diet, and reduced morbidity are very useful in this procedure. Furthermore, laparoscopic reversal of Hartmann's has a comparable operative time with the open technique when performed by experienced surgeons like in this case. This interesting video shows each step of the procedure clearly. Three ports are used and the colon is divided intra-abdominally.
J Leroy, F Costantino, J Marescaux
Surgical intervention
11 years ago
2491 views
117 likes
0 comments
10:05
Stepwise approach for laparoscopic reversal of Hartmann's procedure
Restoration of intestinal continuity following reversal of Hartmann's procedure is an operation associated with a lengthy hospital stay, protracted convalescence, and a high morbidity rate. The advantages of minimally invasive surgery such as rapid mobilization, less postoperative pain, early restoration of bowel function, and a rapid return to a normal diet, and reduced morbidity are very useful in this procedure. Furthermore, laparoscopic reversal of Hartmann's has a comparable operative time with the open technique when performed by experienced surgeons like in this case. This interesting video shows each step of the procedure clearly. Three ports are used and the colon is divided intra-abdominally.
Laparoscopic radical antegrade pancreatosplenectomy
Benign inflammatory lesions, cystic neoplasms, and neuro-endocrine tumours in the body and tail of the pancreas are considered good indications for laparoscopic distal pancreatectomy and/or en-bloc pancreatosplenectomy. Laparoscopic resection of malignant neoplasms has raised concern about the radicality of resection and oncological outcomes.
This video demonstrates the technique of laparoscopic radical antegrade pancreatosplenectomy (lap-RAP), which achieves a radical resection with clear circumferential margins. The resection proceeds from right to left to include a coeliac lymphadenectomy, early division of the splenic artery, splenic vein and neck of pancreas, and medial to lateral mobilization of the pancreas posterior to Gerota's fascia to ensure an adequate posterior oncological clearance.
Lap-RAP extends the benefits of laparoscopic pancreatectomy to include malignant lesions in the body and tail of the pancreas.
This video is recommended for experienced laparoscopic surgeons.
I Tait, FM Polignano, GD Adamson
Surgical intervention
11 years ago
3343 views
93 likes
0 comments
09:51
Laparoscopic radical antegrade pancreatosplenectomy
Benign inflammatory lesions, cystic neoplasms, and neuro-endocrine tumours in the body and tail of the pancreas are considered good indications for laparoscopic distal pancreatectomy and/or en-bloc pancreatosplenectomy. Laparoscopic resection of malignant neoplasms has raised concern about the radicality of resection and oncological outcomes.
This video demonstrates the technique of laparoscopic radical antegrade pancreatosplenectomy (lap-RAP), which achieves a radical resection with clear circumferential margins. The resection proceeds from right to left to include a coeliac lymphadenectomy, early division of the splenic artery, splenic vein and neck of pancreas, and medial to lateral mobilization of the pancreas posterior to Gerota's fascia to ensure an adequate posterior oncological clearance.
Lap-RAP extends the benefits of laparoscopic pancreatectomy to include malignant lesions in the body and tail of the pancreas.
This video is recommended for experienced laparoscopic surgeons.
Laparoscopic gastric bypass in a patient with a BMI of 51
This video demonstrates the bariatric procedure of Roux-en-Y gastric bypass, with the Roux limb in the ante-colic position. The jejunojejunostomy is performed with a linear stapler, while the gastrojejunostomy is carried out with a circular stapler; the anvil having been passed down from the mouth into the stomach, attached to the end of a nasogastric tube. This video is suitable for bariatric surgeons.
The authors identify the duodenojejunal flexure (ligament of Treitz). They measure a biliary loop of 75cm, shelving that to the left and temporarily attaching it to the stomach before marking it. They then measure a 150cm alimentary limb and place it in the right side of the abdomen, and attach it with a suture to the end of the biliary loop. They create a minimal opening in the two loops with a cautery hook to allow passage of the linear stapler, using 2.5mm staples. They close the opening through which the linear stapler is introduced with an absorbable 2/0 braided running suture. The procedure continues with the closure of the mesenteric defect.
M Vix, J Marescaux
Surgical intervention
12 years ago
290 views
57 likes
0 comments
15:14
Laparoscopic gastric bypass in a patient with a BMI of 51
This video demonstrates the bariatric procedure of Roux-en-Y gastric bypass, with the Roux limb in the ante-colic position. The jejunojejunostomy is performed with a linear stapler, while the gastrojejunostomy is carried out with a circular stapler; the anvil having been passed down from the mouth into the stomach, attached to the end of a nasogastric tube. This video is suitable for bariatric surgeons.
The authors identify the duodenojejunal flexure (ligament of Treitz). They measure a biliary loop of 75cm, shelving that to the left and temporarily attaching it to the stomach before marking it. They then measure a 150cm alimentary limb and place it in the right side of the abdomen, and attach it with a suture to the end of the biliary loop. They create a minimal opening in the two loops with a cautery hook to allow passage of the linear stapler, using 2.5mm staples. They close the opening through which the linear stapler is introduced with an absorbable 2/0 braided running suture. The procedure continues with the closure of the mesenteric defect.