Monthly publications : February 2007 | WebSurg, the online university of IRCAD

Minimally invasive video-assisted thyroidectomy

This is a video in real time demonstrating the minimally invasive approach to a right hemithyroidectomy performed via a 1.5 cm incision in the suprasternal region of the neck. A video-endoscope is used to provide a magnified view and specialised instruments are used for the dissection of the gland.

P Miccoli

Surgical intervention

Minimally invasive video-assisted thyroidectomy

This is a video in real time demonstrating the minimally invasive approach to a right hemithyroidectomy performed via a 1.5 cm incision in the suprasternal region of the neck. A video-endoscope is used to provide a magnified view and specialised instruments are used for the dissection of the gland.

Laparoscopic redo fundoplication after Enteryx® injection

This video presents a Toupet fundoplication procedure performed for a patient who had recurrent gastro-esophageal reflux 3 years after endoscopic injection of the inert polymer ‘Enteryx’ into the gastro-esophageal junction (GEJ). The polymer can be seen around the GEJ, leading to extensive inflammatory adhesions in the hiatal region.

D Mutter, B Dallemagne, C Bailey, J Marescaux

Surgical intervention

Laparoscopic redo fundoplication after Enteryx® injection

This video presents a Toupet fundoplication procedure performed for a patient who had recurrent gastro-esophageal reflux 3 years after endoscopic injection of the inert polymer ‘Enteryx’ into the gastro-esophageal junction (GEJ). The polymer can be seen around the GEJ, leading to extensive inflammatory adhesions in the hiatal region.

Inguinal hernia repair: Total Extraperitoneal approach (TEP)

This is live video recorded during a surgical course demonstrating the total extra-peritoneal (TEP) approach to repair of a right indirect inguinal hernia.

Access to the pubis is gained on the midline. After taking down the adhesions, the authors visualize the pelvic bone. Moving laterally, they see the bladder and hernia, then the spermatic cord comes into view. The indirect hernia appears at 1 o’clock, the epigastric vessels serving as the landmark. The authors continue with reduction of the hernia sac.

B Dallemagne, S Perretta, J Marescaux

Surgical intervention

Inguinal hernia repair: Total Extraperitoneal approach (TEP)

This is live video recorded during a surgical course demonstrating the total extra-peritoneal (TEP) approach to repair of a right indirect inguinal hernia.

Access to the pubis is gained on the midline. After taking down the adhesions, the authors visualize the pelvic bone. Moving laterally, they see the bladder and hernia, then the spermatic cord comes into view. The indirect hernia appears at 1 o’clock, the epigastric vessels serving as the landmark. The authors continue with reduction of the hernia sac.

Anterior resection with TME for T2 rectal cancer of the upper rectum in a female patient

This detailed video demonstrates Dr. Joel Leroy performing a high anterior resection for a T2 rectal cancer. The surgery commences in the usual fashion with a high ligation of the inferior mesenteric artery, followed by excision of the rectum including the total mesorectal package. All the steps are presented clearly, including the vascular dissection, lateral colonic mobilisation and the laparoscopic approach for total mesorectal excision (TME).

J Leroy

Surgical intervention

Anterior resection with TME for T2 rectal cancer of the upper rectum in a female patient

This detailed video demonstrates Dr. Joel Leroy performing a high anterior resection for a T2 rectal cancer. The surgery commences in the usual fashion with a high ligation of the inferior mesenteric artery, followed by excision of the rectum including the total mesorectal package. All the steps are presented clearly, including the vascular dissection, lateral colonic mobilisation and the laparoscopic approach for total mesorectal excision (TME).

Acute cholecystitis management and technical tips

This video demonstrates the laparoscopic approach to cholecystectomy for acute cholecystitis. Key points such as gallbladder decompression, adhesiolysis and exposure of the operative field and dissection of Calot’s triangle during acute inflammation are described in detail.

D Mutter, J Marescaux

Surgical intervention

Acute cholecystitis management and technical tips

This video demonstrates the laparoscopic approach to cholecystectomy for acute cholecystitis. Key points such as gallbladder decompression, adhesiolysis and exposure of the operative field and dissection of Calot’s triangle during acute inflammation are described in detail.

Rectovaginal nodule excision and measures for prevention of fistula formation

A step by step strategy procedure of rectovaginal nodule excision, including technique of ureterolysis, technique of "shaving" the nodule, closure of vaginal and rectal defects and omentoplasty for fistula prevention. At the end of procedure, a safety test to detect incomplete rectal closure is performed.

A Wattiez

Surgical intervention

Rectovaginal nodule excision and measures for prevention of fistula formation

A step by step strategy procedure of rectovaginal nodule excision, including technique of ureterolysis, technique of "shaving" the nodule, closure of vaginal and rectal defects and omentoplasty for fistula prevention. At the end of procedure, a safety test to detect incomplete rectal closure is performed.

Laparoscopic hysterectomy with pelvic lymphadenectomy for cervical cancer

Step by step procedure of hysterectomy for early stage cervical cancer. The technique of pelvic nodes dissection, including the landmarks and margins (limits) of laparoscopic lymphadenectomy is shown. The specific movements for dissection of pelvic vessels and how to perform ureteric dissection is shown, accompanied by commentaries.

A Wattiez

Surgical intervention

Laparoscopic hysterectomy with pelvic lymphadenectomy for cervical cancer

Step by step procedure of hysterectomy for early stage cervical cancer. The technique of pelvic nodes dissection, including the landmarks and margins (limits) of laparoscopic lymphadenectomy is shown. The specific movements for dissection of pelvic vessels and how to perform ureteric dissection is shown, accompanied by commentaries.