Advances In Surgery Channel

The Esophagectomy is a surgical treatment associated with morbidity.  Restoration of gastrointestinal continuity after resection can be technically challenging. Long term survivors may experience complications that deteriorates their quality of life (dysphagia, choke, odynophagia, reflux) or threatens their life (complicated hiatal hernia).

Surgeons, urologists and gynecologist have used the da Vinci system with the intention to have a shorter hospital stay, less blood loss, fewer complications and faster recovery. Several improvements were implemented  since the surgical robot was released. The da Vinci Xi incorporates smaller and lighter arms making feasible four quadrant surgery and simpler single quadrant surgery among others procedures.

Gastric outlet obstruction has an etiology that varies depending on the age of the patient. In pediatric population the most common cause is idiopathic hypertrophic pyloric stenosis and the tumors in the adult age. Definitely an heterotopic pancreas is a rare cause at any age representing a challenge for its diagnoses.

The management of patients with Inflammatory Bowel Disease (IBD) is diverse, many cases require surgery due to failure of medical treatment, bowel obstruction, fistulas or abscess. Laparoscopic approach performed by experienced surgeons may give patients several advantages.

Secca and Stretta offer a low aggressive therapy for selected cases of fecal incontinence and Gastroesophageal Reflux Disease (GERD). These are novel procedures that appear as a response to current health care problems.

The current outbreak of Ebola Virus Disease (EVD) started in Africa, it is a severe disease that can reach high rates of morbi-mortality. The virus is transmitted through corporal fluids of infected hosts representing a challenge for prevention strategies. Well defined protocols are needed and a global effort to find a specific treatment is an actual goal.

Biliary stricture is a common cause of complication of liver transplantation, most frequent after a living donor. The diagnostic and accurate treatment is important to preserve the graft function. Endoscopic dilatation or biliary stents may be used with good results, but in some cases this approach is not feasible and surgery is mandatory.

There are several indications for mobilization of the splenic flexure; it can be a difficult maneuver with a long learning curve for laparoscopic surgeons and there is no doubt that clear anatomic references are needed to avoid unexpected injuries of surrounding organs.

Sigmoid volvulus usually presents itself in older and institutionalized patients due to an underlying neurologic or psychiatric disease. The treatment by colonoscopy offers a therapy with low aggression, but sometimes it is not effective or long lasting. This case reflects a patient with a recidivant sigmoid volvulus fully treated by minimally invasive surgery that presented a complication discovered by X-Ray.

Sometimes an iliac crest graft may be used to repair traumatologic defects, this leads to potential complications such as herniation of the abdominal content due to the loss of continuity of the abdominal wall. This video demonstrates a rare clinical situation treated by minimally invasive surgery.

The development of minimally invasive techniques has significantly decreased the morbidity associated with surgery for rectal cancer. However, challenges remain in achieving total mesorectal excision preserving patients safety and oncological results.

This October Annals of Surgery published a retrospective analysis of a prospective database focused in minimally invasive treatment for pancreatic adenocarcinoma. The interesting point is that the article comes from a center with high volume, pioneer around the world in Laparoscopic Pancreatectomy.

Is there a direct association between the anatomical / hormonal changes produced in morbid obese patients after bariatric surgery and the resolution of T2DM?

Transanal endoscopic microsurgery (TAMIS) is a well established approach for selected cases of rectal cancer, there is no doubt that it can be the final treatment for T1N0 lesions. It also represents a diagnostic tool in cases of non conclusive staging or patients with multiple comorbidities.

International meetings represent a good opportunity to gain knowledge, one of its main handicaps is the necessity to travel around the world. As a result,  several scientific societies provide grants to selected professionals.

Due to a vast active scientific community in Barcelona a variety of courses are being held  in Barcelona. This October is the month for colorectal education. The Hospital Clínic gives two taTME courses and surgeons from other hospitals (Bellvitge and Vall d’Hebron) also organize the second edition of the  course for Update and Training in Colorectal Surgery.