22 June 2017Denonvillier’s fascia: to take it or not to take it
The inclusion of Denonvilliers’ fascia is still a matter of debate among the surgical community, as it has functional consequences when taken during the total mesorectal excision. Some experts would agree on including it only for anterior tumors. Do you agree with these experts recommendations? Join our debate and enrich our surgical community!
20 June 2017Abdominal pain after laparoscopic gastric bypass: a surgical emergency
The Laparoscopic Roux-en-Y gastric bypass (LRYGB) is considered the gold standard for bariatric surgery. Small bowel obstructions are a known perioperative complication of laparoscopic Roux-en-Y gastric bypass and common etiologies include internal hernia, port site hernia, jejunojejunostomy stricture, ileus and adhesions. Patients presenting with abdominal pain after LRYGB warrant careful attention to avoid missing or delaying the diagnosis of severe bowel obstructions.
8 June 2017Left colic artery: to take or not to take it? That is the question
Preservation of left colic artery has clinical, functional and oncologic implications and is an ongoing debate. Several studies have compared results with and without preserving the left colic artery. Performing a low ligation of the inferior mesenteric artery (IMA) with preservation of the left colic artery provides excellent vascular supply, while potentially limiting mesenteric length and the number of lymph nodes harvested. On the other hand, standard high ligation without preservation of the left colic artery is technically easier to perform and provides excellent mesenteric length but relies solely on marginal vessel blood supply from the middle colic artery. Furthermore, several studies have compared results with and without preserving the left colic artery. So when should we preserve the left colic artery and when not?
11 May 20173D Laparoscopic cameras
The development of laparoscopy started in the 20th century along with the advancement of technology, extending to different disciplines. Many technological improvements have been implemented in laparoscopic equipment, particularly in optics. One of the latest revolutions is the evolution of cameras from 2D to 3D, creating a new working environment for the surgeon. On the next presentation, a summary of the most current 3D optics is shown.
11 April 2017Right colectomy by robotic approach: step by step
Robot-assisted right colectomy with intracorporeal anastomosis is a relatively new means to overcome some of the technical challenges of the laparoscopic approach, and early studies have reported its feasibility and safety, improved early postoperative outcomes, and similar rates of anastomotic leakage.
30 March 2017Laparoscopic surgical staplers: Theoretical approach, uses, technical and professional comparison
When performing surgical procedures, sections and anastomosis must be made. Different tissues are therefore connected, with different thickness and biomechanical properties. Staplers to build anastomoses are designed to overcome these differences and achieve excellent results. Surgical trainees or young surgeons may lack a clear understanding of which stapler should be used in each case or which staple size would be indicated, due to the wide range of staplers commercially available. The AIS Lab section at AIS Channel has provided a summary of stapler characteristics, as well as a comparison based on marketing studies and expert opinions. An explanatory video demonstrates their use during a surgical procedure.
16 March 201713th AIS Live Congress: Reaching again every corner of the world
The 13th AIS Channel live congress held on March 9th, 2017 focused on sleeve gastrectomy. Viewers were able to watch presentations by world-leading experts followed by 3 simultaneous live surgeries from Barcelona, Bruges and Montreal. Over 16,000 people from 102 countries were connected live during the entire event. Again another example of how AIS Channel is connecting the world surgical community and bringing the best education to every corner of the globe by the hand of the best professionals. And for free!
9 March 2017Pathologic Outcomes of Laparoscopic vs Open Mesorectal Excision for Rectal Cancer
The results of the comparison of the laparoscopic versus the open approach for rectal cancer are still under debate. A recent systematic review and meta-analysis of randomized controlled trials (RCT) compared the pathologic outcomes of laparoscopic vs open mesorectal excision for rectal cancer, leaning towards the open approach. Dr. Martínez and Dr. Lacy will discuss the controversial results of this paper and launch a proposal for the main randomized trials to make a conjoined effort in search of a final answer.
16 February 2017Complete mesocolic excision with central vascular ligation (D3)
The role of lymph node dissection in the management of right-sided colon cancer remains controversial. The D3 lymphadenectomy is defined as central lymph node dissection. The right retrocolic space is the main surgical plane and the superior mesenteric vein is the most important anatomical landmark for vascular dissection.
14 February 2017Pure laparoscopic sigmoidectomy with inferior mesenteric artery preservation
Patients undergoing a left hemicolectomy, especially an anterior rectal resection, have been noted to experience postoperative defecatory disorder or anterior rectal resection syndrome. This disorder is characterized primarily by fecal incontinence, soiling, urgency, alternate bowel function and stool fragmentation. Denervation of the distal colonic segment is the main cause of postoperative defecatory disorder after sigmoid resection. The innervations of the descending colon and rectum are provided by either ascending fibers from the pelvic plexus or descending fibers from the inferior mesenteric plexus that run around the inferior mesenteric artery (IMA). Sectioning of the IMA at its origin during the left hemicolectomy leads to a transection of the ascending and descending nerve fibers, which results in a denervation of the remaining distal colon. Preservation of the IMA by sectioning of the sigmoid arteries reduces the risk of colonic denervation and may improve postoperative intestinal functions, preventing defecatory disorders.