Advances In Surgery Channel

Dr. Pär Myrelid discusses the role of ileorectal anastomosis in ulcerative colitis and reviews the literature on bowel function, continence, quality of life, sexual function and fecundability.

When to perform an anastomotic urethroplasty rather than other surgical techniques. Description of the main aspects. Optimal cases selection for best surgical outcomes.

Parastomal hernia is one of the most common complications following stoma creation, with a reported incidence of up to 50%in clinical examination and even 78% using computed tomography. The surgical approaches for parastomal hernia include local repair by suture, stoma relocation and mesh-based techniques, although none of the techniques has been able to provide satisfactory results. We report a case of recurrent parastomal hernia treated laparoscopically using the Sandwich technique which combines the keyhole and the Sugarbaker techniques.

Anastomotic leakage is one of the most feared complications in colorectal surgery. As surgery evolves we try riskier anastomosis facing new complications. In this online congress we talked about how to deal with anastomotic leakage.

The most important prognostic factor for patients with peritoneal carcinomatosis is the completeness of the surgical cytoreduction. The probability of a complete cytoreduction is directly proportional to the extent of the peritoneal carcinomatosis, which is currently based on imaging and surgical modalities. In this video we will focus on the role which these techniques play in staging patients with peritoneal carcinomatosis.

This video focuses on the main steps to perform a Laparoscopic Total Extraperitoneal inguinal hernia repair (TEP).

Intraoperative sentinel lymph node assessment for macrometastases can be achieved by one-step nucleic acid amplification (OSNA). In this video Dr. González and Dr. Balibrea present a case of papillary thryoid carcinoma treated by surgery with the use of this technique.

Low anterior resection is one of the most widespread approaches to treat rectal cancer. Sphincter-sparing procedures are currently feasible in up to 80 percent of patients requiring surgery for rectal cancer. Between 25 and 80 % of patients who undergo this kind of procedure develop one or more symptoms of low anterior resection syndrome (LARS).

Systemic Inflammatory Response Syndrome (SIRS) requires more than one of the following findings: temperature >38°C or <35°C; heart rate >90 beats per minute; respiratory rate >20 breaths per minute or PaCO2 12,000/cu mm, <4,000/cu mm, or >10% immature (band) forms. When using the term “sepsis”, this means that the SIRS is due to an infectious origin. Sepsis, when not treated correctly, evolves producing multiorgan dysfunction. In this video, we will revise the different definitions that sepsis has presented over the years and the screening scores that we use daily.

A colostomy is an anastomosis of the colon to the skin. It has been used in situations where it is not possible to perform an intestinal anastomosis or when a derivation is necessary. About 10 to 60% of colostomies will develop a complication, some of which are more common than others.

In this lecture, professor Ali Aminian explains the positive effect of bariatric surgery on the death rate of patients after a heart attack and a stroke.

Appendectomy is the standard of care for acute appendicitis. In recent years non-operative management (NOM) with antibiotics has been shown to be a feasible therapy for uncomplicated appendicitis. This video reviews the pros and cons of NOM for uncomplicated appendicitis in adults.

Endourological techniques currently involve a long, sequential learning curve and take up significant learning time, so urologists-in-training sometimes have little opportunity to develop and refine their skills in daily clinical practice. For this reason, training based on simulation outside the operating room is currently accepted as a supplementary scenario in clinical training.

The Clavien-Dindo classification has been shown to be understandable, simple, objective and reproducible, and has enjoyed a wide implementation into clinical practice. A more novel aspect has been the development of the Comprehensive Complication Index (CCI). The CCI, based on complications graded in the Clavien-Dindo classification, is a reflection of the entire postoperative experience and seems to be superior to traditional morbidity endpoints.

Abdominal wall hernia complicates 11% to 50% of all laparotomies. Traditional methods of repair have unacceptable rates of recurrence in long-term follow-up. Component separation techniques have emerged to overcome this problem, allowing for a more effective repair with fewer complications.

Urology is becoming increasingly reliant on interdisciplinary collaboration among various fields of knowledge, technology and innovation. Thus, the current training and skills certification system needs constant revision to adapt to new challenges.