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

Video-assisted procedure for treatment of high and intermediate anorectal imperforations

This video shows how a laparoscopic-assisted colonic pull-through can be performed as part of the definitive operative cure of high and intermediate imperforate anuses.

P Mure

Surgical intervention

Video-assisted procedure for treatment of high and intermediate anorectal imperforations

This video shows how a laparoscopic-assisted colonic pull-through can be performed as part of the definitive operative cure of high and intermediate imperforate anuses.

Laparoscopic Collis-Nissen procedure for failed fundoplication

This video shows a laparoscopic Collis-Nissen gastroplasty in a patient with a previous Nissen fundoplication which was performed using an open approach.
Despite an extensive mobilization, it was not possible to achieve an adequate length of intra-abdominal esophagus. A short esophagus was diagnosed and the surgeon performs a Collis gastroplasty. The hiatus is repaired with interrupted non-absorbable sutures. A Nissen fundoplication is performed.
This patient had a previous Nissen fundoplication using an open approach. After extensive mobilization, the surgeons diagnose a short esophagus and perform a Collis gastroplasty. They repair the hiatus with interrupted non-absorbable sutures, and perform a Nissen fundoplication. Once they complete the dissection, the authors assess the length of the esophagus. The video shows the authors placing tape around the gastroesophageal junction at the level of the hiatus. The junction between the stomach and the esophagus is at the level of the hiatus, a sign evocative of a short esophagus.

B Dallemagne, C Solano

Surgical intervention

Laparoscopic Collis-Nissen procedure for failed fundoplication

This video shows a laparoscopic Collis-Nissen gastroplasty in a patient with a previous Nissen fundoplication which was performed using an open approach.
Despite an extensive mobilization, it was not possible to achieve an adequate length of intra-abdominal esophagus. A short esophagus was diagnosed and the surgeon performs a Collis gastroplasty. The hiatus is repaired with interrupted non-absorbable sutures. A Nissen fundoplication is performed.
This patient had a previous Nissen fundoplication using an open approach. After extensive mobilization, the surgeons diagnose a short esophagus and perform a Collis gastroplasty. They repair the hiatus with interrupted non-absorbable sutures, and perform a Nissen fundoplication. Once they complete the dissection, the authors assess the length of the esophagus. The video shows the authors placing tape around the gastroesophageal junction at the level of the hiatus. The junction between the stomach and the esophagus is at the level of the hiatus, a sign evocative of a short esophagus.

Laparoscopic treatment of acute small bowel obstruction: multiple cases of laparoscopic adhesiolysis

The video shows the laparoscopic management of three separate cases of acute small bowel obstruction secondary to adhesions. The difficulties and advantages of such an approach in this emergency scenario are discussed.
The author begins by inserting a trocar in the umbilicus. Upon exploration of the abdominal cavity, intestinal obstruction becomes clearly evident from the presence of dilated loops and flattened, collapsed loops. The author follows the collapsed loops until the transition zone is identified. The adhesions appear between the greater omentum and the mesentery. This band is divided. Further exploration leads to the finding of a second adhesion. This area shows no signs of occlusion. The author divides this adhesion. Exploration of the remainder of the small bowel continues to rule out further adhesions.

F Costantino, J Marescaux

Surgical intervention

Laparoscopic treatment of acute small bowel obstruction: multiple cases of laparoscopic adhesiolysis

The video shows the laparoscopic management of three separate cases of acute small bowel obstruction secondary to adhesions. The difficulties and advantages of such an approach in this emergency scenario are discussed.
The author begins by inserting a trocar in the umbilicus. Upon exploration of the abdominal cavity, intestinal obstruction becomes clearly evident from the presence of dilated loops and flattened, collapsed loops. The author follows the collapsed loops until the transition zone is identified. The adhesions appear between the greater omentum and the mesentery. This band is divided. Further exploration leads to the finding of a second adhesion. This area shows no signs of occlusion. The author divides this adhesion. Exploration of the remainder of the small bowel continues to rule out further adhesions.

Laparoscopic management of acute small bowel obstruction after laparoscopic gastric bypass

This video demonstrates the laparoscopic approach to a case of acute bowel obstruction that developed in a patient who had previously had a laparoscopic gastric bypass. It involves adhesiolysis and repair of an internal mesenteric hernia.

M Vix, J Marescaux

Surgical intervention

Laparoscopic management of acute small bowel obstruction after laparoscopic gastric bypass

This video demonstrates the laparoscopic approach to a case of acute bowel obstruction that developed in a patient who had previously had a laparoscopic gastric bypass. It involves adhesiolysis and repair of an internal mesenteric hernia.

Primary endorectal pull-through (ERPT) for the treatment of classic Hirschsprung’s disease: Georgeson procedure

This video demonstrates how to perform an endorectal pull-through for the correction of Hirschsprung's disease. Laparoscopy facilitates the sigmoid colon mobilization as well as the determination of the the proximal dissection margin (through sequential biopsy taking).

G Mattioli, V Jasonni

Surgical intervention

Primary endorectal pull-through (ERPT) for the treatment of classic Hirschsprung’s disease: Georgeson procedure

This video demonstrates how to perform an endorectal pull-through for the correction of Hirschsprung's disease. Laparoscopy facilitates the sigmoid colon mobilization as well as the determination of the the proximal dissection margin (through sequential biopsy taking).

Laparoscopic management of a right lateral rectal cystic tumor in a 43-year-old female patient

This video shows the surgical management of a patient with a lateral pararectal cystic tumour (benign) and explains the surgical approach to retrorectal tumours in general.

J Leroy

Surgical intervention

Laparoscopic management of a right lateral rectal cystic tumor in a 43-year-old female patient

This video shows the surgical management of a patient with a lateral pararectal cystic tumour (benign) and explains the surgical approach to retrorectal tumours in general.

Laparoscopic gastric bypass after failed Mason procedure

This video shows a redo gastric bypass in a patient who had previously failed to lose weight after a Mason procedure. The correction of the culprit gastrogastric fistula is demonstrated as well as the performance of the subsequent 'gold standard' operation.
This video shows a re-do gastric bypass in a patient who had previously failed to lose weight after a Mason procedure. The correction of the gastrogastric fistula is demonstrated as well as the performance of the subsequent “gold standard” operation. Once the fistula is fully isolated, the authors divide it using a 60mm Endo-GIA. The video shows the tract of the fistula has completely skeletonized. The gastrogastric fistula is clearly visible.

M Vix, D Varela, J Marescaux

Surgical intervention

Laparoscopic gastric bypass after failed Mason procedure

This video shows a redo gastric bypass in a patient who had previously failed to lose weight after a Mason procedure. The correction of the culprit gastrogastric fistula is demonstrated as well as the performance of the subsequent 'gold standard' operation.
This video shows a re-do gastric bypass in a patient who had previously failed to lose weight after a Mason procedure. The correction of the gastrogastric fistula is demonstrated as well as the performance of the subsequent “gold standard” operation. Once the fistula is fully isolated, the authors divide it using a 60mm Endo-GIA. The video shows the tract of the fistula has completely skeletonized. The gastrogastric fistula is clearly visible.

Transvaginal hybrid NOTES sleeve gastrectomy

This video shows the formatting of gastric sleeve surgery via a hybrid NOTES technique in a porcine model. A transvaginal approach is used along with one single transabdominal trocar with additional retraction aided by both an intraluminal gastroscope and an intragastric magnet (anchored by a second extracorporeally).

M Vix, C Solano, M Asakuma

Surgical intervention

Transvaginal hybrid NOTES sleeve gastrectomy

This video shows the formatting of gastric sleeve surgery via a hybrid NOTES technique in a porcine model. A transvaginal approach is used along with one single transabdominal trocar with additional retraction aided by both an intraluminal gastroscope and an intragastric magnet (anchored by a second extracorporeally).

Intraperitoneal laparoscopic pyeloplasty

This video shows how to perform an intraperitoneal pyeloplasty laparoscopically for the excision of a dysfunctional ureteropelvic junction.

C Saussine

Surgical intervention

Intraperitoneal laparoscopic pyeloplasty

This video shows how to perform an intraperitoneal pyeloplasty laparoscopically for the excision of a dysfunctional ureteropelvic junction.

What is the benefit of colonic specimen extraction through the rectum? Do you believe this has led to NOTES sigmoidectomy?

Credentialing the surgeon in new procedures: it is possible to promote both safety and innovation?

Are there any special advantages of using minimally invasive surgery in pediatric urology?

What are the latest developments in laparoscopic surgery in pediatric urology?

What is the future of laparoscopic surgery in pediatric urology?

What is the future of robotics in pediatric urology?

What are the problems caused by pre-transplantation nephrectomy?

How important is laparoscopy in the diagnostic and therapeutic management of sexual development disorders (DSD)?

What kind of gonads do group 3 DSD patients have?

How important is laparoscopy for the installation of a peritoneal dialysis?

What has videosurgery brought to your everyday practice?

If you had to choose a videoscopic assisted surgery, which one would it be?

What are your results like when comparing laparotomy and laparoscopy for choledochal cyst surgery?

You do a lot of thoracoscopy. What are the necessary indications?

Nowadays, colorectal surgery for cancer is still under evaluation. Can it be performed using a minimally invasive approach?

What are the advantages of totally laparoscopic approaches for the treatment of colorectal cancers?

Although Scientific Societies have not validated the laparoscopic approach for colorectal cancer, it appears that it is well standardized and gives good results. Are there any constraints for the procedure (obese patient, tumor stage, team and equipment)?

How do you teach your residents? What is the evolution of the learning curve and what are the factors that indicate that the fellow is ready to perform the operation?

What kind of advice would you give to a novice surgeon?

In America, what are the guidelines and recommendations for the laparoscopic treatment of colorectal cancers?

Nowadays, colorectal surgery for cancer is still under evaluation. Can it be performed using a minimally invasive approach?

M Walz

In your opinion, what are the essential steps for the training of surgeons?

M Walz

In this respect, what do you think of our EITS educational course programs?

M Walz

What do you think of the totally NOTES sigmoidectomy (combined transgastric and transrectal route) and what is your opinion of NOTES generally speaking?

In Germany, what are the guidelines and recommendations for the laparoscopic treatment of colorectal cancers?

M Walz

Colorectal surgery: you were a pioneer of the open approach, a firm supporter of the laparoscopic approach; what is now your opinion of NOTES?