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Monthly publications

#June 2010
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Totally laparoscopic total gastrectomy for stage IIIA (cT3 cN1 cM0) advanced gastric carcinoma
A 66-year-old man was admitted to our hospital with complaints of epigastric pain. His hemoglobin level was 9.3g/dL. Endoscopy of the upper gastrointestinal tract (EGD) showed an advanced gastric carcinoma that had invaded the middle and lower third of the stomach. A biopsy specimen revealed a moderately differentiated adenocarcinoma. Abdominal computed tomography (CT) showed that the tumor had invaded the stomach wall. Enlarged lymph nodes were present only around the lesser curvature (regional lymph nodes No. 3). The patient was diagnosed with stage IIIA (cT3 cN1 cM0) advanced gastric carcinoma according to the Japanese classification of gastric carcinoma1. The patient was then taken to the operating room for exploratory laparoscopy and laparoscopic total gastrectomy with D2 lymphadenectomy. The operation time was 260 minutes. No further evidence of intra-abdominal disease or liver involvement was noted. The patient did well postoperatively and was subsequently discharged home on postoperative day 9. Four metastatic lymph nodes/twenty eight regional lymph nodes were found; so the pathological findings confirmed stage IIIA. The patient is disease-free at 10 months. Japanese Classification of Gastric Carcinoma - 2nd English Edition. Gastric Cancer 1998;1:10-24.
G Pignata, M Barone, U Bracale, E Gianetta, F Badessi
Surgical intervention
8 years ago
5298 views
33 likes
1 comment
26:02
Totally laparoscopic total gastrectomy for stage IIIA (cT3 cN1 cM0) advanced gastric carcinoma
A 66-year-old man was admitted to our hospital with complaints of epigastric pain. His hemoglobin level was 9.3g/dL. Endoscopy of the upper gastrointestinal tract (EGD) showed an advanced gastric carcinoma that had invaded the middle and lower third of the stomach. A biopsy specimen revealed a moderately differentiated adenocarcinoma. Abdominal computed tomography (CT) showed that the tumor had invaded the stomach wall. Enlarged lymph nodes were present only around the lesser curvature (regional lymph nodes No. 3). The patient was diagnosed with stage IIIA (cT3 cN1 cM0) advanced gastric carcinoma according to the Japanese classification of gastric carcinoma1. The patient was then taken to the operating room for exploratory laparoscopy and laparoscopic total gastrectomy with D2 lymphadenectomy. The operation time was 260 minutes. No further evidence of intra-abdominal disease or liver involvement was noted. The patient did well postoperatively and was subsequently discharged home on postoperative day 9. Four metastatic lymph nodes/twenty eight regional lymph nodes were found; so the pathological findings confirmed stage IIIA. The patient is disease-free at 10 months. Japanese Classification of Gastric Carcinoma - 2nd English Edition. Gastric Cancer 1998;1:10-24.
Laparoscopic pericystectomy for an 8cm hepatic hydatid cyst with 3D reconstruction
This is the case of a female patient presenting with epigastric pain. An 8cm liver cyst is identified on the examination. Given her previous medical and clinical history, the patient has a hydatid cyst. Serologic tests remain negative. This hydatid cyst is no longer active. Surgery is indicated given the symptomatology and the patient’s strong desire for the intervention. Indications for the surgical resection of non-active hydatid cysts remain rare. They mainly concern big cysts that may generate typical clinical signs of pain, heaviness and epigastric impairment. A standard pericystectomy performed in a stepwise manner should allow to resect this cyst without any resection of the liver parenchyma.
D Mutter, L Soler, J Marescaux
Surgical intervention
8 years ago
20213 views
94 likes
0 comments
08:03
Laparoscopic pericystectomy for an 8cm hepatic hydatid cyst with 3D reconstruction
This is the case of a female patient presenting with epigastric pain. An 8cm liver cyst is identified on the examination. Given her previous medical and clinical history, the patient has a hydatid cyst. Serologic tests remain negative. This hydatid cyst is no longer active. Surgery is indicated given the symptomatology and the patient’s strong desire for the intervention. Indications for the surgical resection of non-active hydatid cysts remain rare. They mainly concern big cysts that may generate typical clinical signs of pain, heaviness and epigastric impairment. A standard pericystectomy performed in a stepwise manner should allow to resect this cyst without any resection of the liver parenchyma.
Arthroscopic removal of volar ganglia
Arthroscopic removal of volar ganglia is a reasonable and safe approach, which requires understanding of specific technical gestures. The main indication being esthetic, the use of wrist arthroscopy is perfect. This video will show you how to perform this reliable procedure in a safe way. This young woman has a small volar ganglion, causing pain by creating pressure difference in the radiocarpal joint. Removing this kind of volar ganglion can be satisfied only by the radiocarpal joint. We will use a 3-4 portal for the scope and a 1-2 instrumental portal. Locating the origin of the ganglion can be assisted by external manipulation. It is usually located between the scapho radio-capitate ligaments and long radiolunate ligaments. Ganglion removal is carried out from the inside of the joint using a shaver. The operation may be considered completed when the anterior capsulectomy is performed and, possibly when we see the tendons. It is not necessary to close the portals, a simple dressing will be applied, and the patient may be able to totally use her hand and wrist the same day.
C Mathoulin, P Liverneaux
Surgical intervention
8 years ago
970 views
21 likes
0 comments
07:44
Arthroscopic removal of volar ganglia
Arthroscopic removal of volar ganglia is a reasonable and safe approach, which requires understanding of specific technical gestures. The main indication being esthetic, the use of wrist arthroscopy is perfect. This video will show you how to perform this reliable procedure in a safe way. This young woman has a small volar ganglion, causing pain by creating pressure difference in the radiocarpal joint. Removing this kind of volar ganglion can be satisfied only by the radiocarpal joint. We will use a 3-4 portal for the scope and a 1-2 instrumental portal. Locating the origin of the ganglion can be assisted by external manipulation. It is usually located between the scapho radio-capitate ligaments and long radiolunate ligaments. Ganglion removal is carried out from the inside of the joint using a shaver. The operation may be considered completed when the anterior capsulectomy is performed and, possibly when we see the tendons. It is not necessary to close the portals, a simple dressing will be applied, and the patient may be able to totally use her hand and wrist the same day.
Laparoscopic total hysterectomy and unilateral adnexectomy with resection of urinary bladder nodule for endometriosis
This video demonstrates the technique of a total laparoscopic hysterectomy with unilateral adnexectomy and the excision of a vesical endometriotic nodule.
This patient is a 46-year-old lady with a previous surgical history of one laparotomy for a hemoperitoneum (endometriotic ovarian cyst rupture) and 6 laparoscopies because of endometriosis, the last one 3 years ago with a segmental sigmoid resection. After this last surgery, the patient starts to complain of dysmenorrhea, chronic pelvic pain and dysuria. She has never had any urinary infection.
Because of urinary stress incontinence, she had botulinic toxin injection and underwent a cystoscopy, which revealed a bladder nodule.
A Wattiez, S Barata, AM Furtado Lima, P Trompoukis, B Gabriel, J Nassif
Surgical intervention
8 years ago
357 views
29 likes
1 comment
10:14
Laparoscopic total hysterectomy and unilateral adnexectomy with resection of urinary bladder nodule for endometriosis
This video demonstrates the technique of a total laparoscopic hysterectomy with unilateral adnexectomy and the excision of a vesical endometriotic nodule.
This patient is a 46-year-old lady with a previous surgical history of one laparotomy for a hemoperitoneum (endometriotic ovarian cyst rupture) and 6 laparoscopies because of endometriosis, the last one 3 years ago with a segmental sigmoid resection. After this last surgery, the patient starts to complain of dysmenorrhea, chronic pelvic pain and dysuria. She has never had any urinary infection.
Because of urinary stress incontinence, she had botulinic toxin injection and underwent a cystoscopy, which revealed a bladder nodule.