Advances In Surgery Channel

Not all medical societies have reached consensus regarding colorectal cancer follow-up. In this video we will review general recommendations to optimize patient outcomes as well as examine the best surveillance practices in special cases, as hereditary syndromes and stage IV colorectal cancer patients.

Laparoscopic bariatric surgery has become the gold standard treatment for morbid obesity. SADI-S is a new bariatric technique that has appeared recently and can be used as a first-option treatment or in revisional cases.

Internal hernia after laparoscopic colorectal surgery has been described, but its incidence is not well known. We review the causes, diagnosis and treatment of this pathology.

This second chapter on the management of paraesophageal hernias will focus on the indications, history and development of the different techniques and the main steps in hiatal hernia repair.

Prostate cancer is the second most common cancer in men worldwide and the fourth most common cancer overall. In patients with intermediate and high-risk disease, the cause of death may be related to occult metastatic disease. Adding pelvic lymph node dissection to radical prostatectomy in these patients may improve the outcome.

Acute pancreatitis is one of the most common and lethal gastrointestinal conditions. It can be edematous or necrotizing, and can present as a mild, moderately severe, or severe disease. Patients with necrotizing pancreatitis have higher morbidity and mortality rates, specially when necrosis becomes infected. The Step-Up Approach has been the ideal treatment for these patients.

Surgical site infection is a frequent and costly postoperative complication. The microbiome plays a key role in its pathogenesis and its recognition may allow for the development of new and more effective preventive measures for wound infection.

The development of laparoscopic techniques has revolutionized hernia repair, which is the most common procedure in general surgery worldwide. Among endoscopic hernioplasties, the totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) approaches are widely accepted alternatives to open surgery, both causing less postoperative pain, length of hospital stay, and early return to work. In the following video we show the totally extraperitoneal (TEP) approach as a technique of choice for a giant inguinoscrotal hernia that contains the urinary bladder inside.

Paraesophageal hernias are a protrusion of the stomach into the mediastinum. Although its real prevalence is unknown, it is a common disorder. In this video the basic concepts about paraesophageal hernias are reviewed.

To standardize the outcomes of BS in different studies, the American Society for Metabolic and Bariatric Surgery has proposed a uniform method of defining the results on comorbidity remission after BS. In this video we focus on the definitions of T2DM, HT and HCLT remission after BS.

Staphylococcus aureus is one the most common microorganisms responsible for healthcare-associated infections. Of these, respiratory infections have the highest morbidity and mortality rates. Our focus has been MRSA infections, but this study shows that MSSA infections are exceeding MRSA in incidence rate.

In this video, David Nocca et al. show a new procedure to handle morbid obesity. The sleeve gastrectomy (SG) is currently one of the most frequently performed bariatric procedures worldwide but there is a growing concern about its connection to gastroesophageal reflux. In general, it is estimated that 10% to 20% of patients suffer from symptomatic reflux after an SG, regardless of whether or not they used to have it before surgery (1) . In this study, 25 patients undergo a Nissen Sleeve gastrectomy. This surgical technique consists on creating a short and narrow Nissen valve around the sleeved stomach. Good results have been shown after a year of follow up. According to this group, the Nissen sleeve could be a great choice among bariatric techniques. even to prevent the new onset of GERD in sleeve patients.

This video will focus on cytoreductive surgery and HIPEC in peritoneal carcinomatosis from colorectal cancer, a review of the evidence-based research. Cytoreductive surgery and HIPEC seem to prolong survival in selected patients with peritoneal carcinomatosis of colorectal origin, especially those with limited peritoneal disease, compared to systemic chemotherapy. There is a substantial number of patients with peritoneal metastases from colorectal cancer who can achieve cure after cytoreductive surgery and HIPEC. The most significant factors associated with survival are the PCI and the completeness of the cytoreduction.

Pancreatic cancer has a poor prognosis, with best survival rates if the pancreatic cancer can be treated operatively. At the time of diagnosis, 20% of the patients have a locally resectable tumor. This video aims to provide an overview of the resectability criteria for pancreatic cancer.

Obesity is an epidemic condition affecting about 39% of the adult population worldwide. Bariatric surgery procedures provide the most effective treatment. Of those, laparoscopic Roux-en-Y gastric bypass is the best established. This procedure mandates the construction of a gastrojejunal anastomosis between the gastric pouch and the alimentary limb, which can be hand-sewn, stapled circular or stapled linear.