Advances In Surgery Channel

Discuss and share your opinion. (We will publish our approach in 2 weeks)

Current data support that the laparoscopic approach is feasible and safe for the treatment of colorectal cancer. This is widely accepted as provides the same oncological quality of dissection with less aggression and prompter patient recovery.

Although all bariatric procedures improve non-alcoholic fatty liver disease in metabolically sick obese patients, it remains unclear whether different procedures achieve similar effects. Some studies show that the Sleeve Gastrectomy appears to improve the liver function test better than the Gastric bypass in well-matched obese patients with both elevated ALT and T2DM. This suggests that a Sleeve gastrectomy may have a better effect on non-alcoholic fatty liver disease than a Gastric bypass with similar effects on glycemic control.

AIS Channel is constantly working to broadcast the most interesting and exciting bariatric and colorectal operations for all the surgeons around the world. This is a summary of the first part of 2016.

Sigmoid volvulus is presented usually in elderly patients with some kind of neurological affection. It is produced when a redundant colon get twisted over its mesentery as the axis resulting in an acute or subacute obstruction. Its prompt diagnosis and treatment may prevent severe complications and allow surgical treatment by MIS when is required.

The surgical treatment of rectal cancer should be tailored depending on patient´s and tumor’s characteristics. Modern approaches pushes the limits and overcome old boundaries to deliver similar or better results and a minimum of aggression.

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.

Robotic surgery has only been around since the early 2000s, but in certain surgical fields it’s already overtaken traditional surgery. Now it’s poised to change the nature of surgery forever. In our hospital we have worked with the Da Vinci robot for 2 years, with good surgical results and positive feedback from the surgical team.

The transanal approach represents a revolution in the surgical treatment of rectal pathologies. Many colorectal surgeons are now aware of this.

The main steps of a gastric bypass can be modified depending on the hospital or the surgeon’s preferences. One possible alternative is to perform the procedure in the supramesocolic area, to avoid changing the position of the surgeon and the patient during the jejuno-jejunal anastomosis. This is the conventional procedure performed by our collegues at the Alcorcon Hospital in Madrid. You can watch the video and see the differences with respect to the procedures that we have shown before.

There is robust data regarding the surgical treatment of colon cancer. High-level scientific evidence shows that the laparoscopic approach reduces the morbidity and length of stay in cases of colon cancer resection. This lecture focuses on the randomized control trials aimed at studying the MIS for rectal cancer.

Unfortunately some morbid obese patients are not eligible for a Roux-n-Y gastric bypass. In these cases, a sleeve gastrectomy is a good surgical approach and maybe the only opportunity for surgical treatment. For this reason the sleeve gastrectomy should be performed in the best way so as to avoid complications and ensure long term results.

Endoluminal therapies in bariatrics constitute a relatively young field with vast potential applications. Modern surgeons should keep an eye on them as their ideal application is yet to be established.

Raquel Sánchez, Head of the General Surgery Department at the Pontevedra Hospital Complex (Galicia, Spain) presents the results and conclusions of the Spanish National Registry to evaluate the development of Sleeve Gastrectomy in Spain.

Crohn’s disease patients require a multidisciplinary evaluation to characterize the disease and its response to medical treatment. The MRI is a valuable tool that provides various data such as the intestinal affection and the stage of the disease (from an active form to a fibrotic stage). This information is crucial to tailor patient treatment.

A rationale for neoadjuvant therapy based on an expert opinion and literature review.