Advances In Surgery Channel

The evolution of rectal cancer treatment led to the development of different techniques and technologies to perform the colorrectal anastomosis. The mechanical staplers constituted, some decades ago, a breakpoint in rectal treatment; however, the introduction of transanal-transabdominal TME has led us to modify some of the conventional steps and instruments used previously to adapt to the new technique. In this next video, we will show different types of mechanical and hand sewn anastomosis which it would be useful to know how to perform in the different situations during the TaTME procedure.

The Transanal Total Mesorectal Excision is an innovative approach for rectal cancer. It provides several advantages compared to the fully laparoscopic technique.  With this procedure, issues like transection of the distal margin and difficult cases may have found a solution.

Several studies have shown improved survival outcomes in selected patients with peritoneal carcinomatosis of colorectal origin treated with cytoreductive surgery and HIPEC, as opposed to a treatment based on systemic chemotherapy alone. However, the most recent studies concerning oxaliplatin-based HIPEC have shown no improvement in survival compared to surgery alone. Does this mean that HIPEC should be abandoned? No. This means that HIPEC with a high dose of oxaliplatin and for 30 minutes should be questioned. In this video we will discuss these studies and the current role of oxaliplatin for 30 min.

P-NETs are relatively uncommon tumors of the pancreas andconstitute a heterogeneous disease. Hormone production can help in diagnosis. They have a better prognosis than adenocarcinomas and the only curativetreatment is surgery. There is not a widely accepted staging system. Radical resection or enucleation can be performed. Pancreatic postoperative fistula can be seen, especially after enucleation of tumors in the head of the pancreas and close to the pancreatic duct. Tumor size and location, as well as histopathologic behavior, determine both the surgical treatment and prognosis.

Mechanical Bowel Preparation (MBP) has been thought to reduce postoperative infectious complications and the risk of anastomotic leak. Recent evidence challenges this statement and might change clinical practice in the future.

After 15 weeks we reached the last lecture of our Ileal Pouch Series. Dr. Gabriela Moslein MD discusses the role of the continent ileostomy and explains, step by step, how to construct it. Although created decades ago, this Kock pouch may still be an option for some of the patients submitted to total proctocolectomy.

In this fifth chapter of the Paraesophageal hernia repair series, the impact of the different techniques on quality of life is reviewed.

This open class aims to answer questions about the surgical anatomy of the peritoneum – what you always wanted to know but were afraid to ask. Three questions will be answered and their related theoretical aspects will be discussed.

Pouch leak can affect up to 20% of patients in the first year after surgery. Treatment options will take in consideration the timing to diagnosis and the presentation. In this lecture, Dr. Willem Bemelman MD PhD shows the role of vacuum therapy in the treatment of pouch leaks and some results of his institution’s study on the matter. Vacuum therapy with early closure was instituted with good results, not only regarding function of the pouch but also chronic sinuses and redo surgery.

We conducted a literature review of the literature published so far on the use of anticoagulation treatment in the patients that need a surgical intervention.

This video is intended to be a reminder of the best practices and clarify the reasons why recommendations are not followed.

Surgical site infections are one of the most important causes of healthcare-associated infections and are associated with considerable morbidity. Gastrointestinal procedures are among the highest risk procedures for SSI due to the presence of intraluminal bacteria. Surgical antibiotic prophylaxis is an effective management strategy for reducing postoperative infections.