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.

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.

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.

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!

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.

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.

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.

The first laparoscopic biliopancreatic diversion with a duodenal switch (BPD-DS) was performed by Dr. Gagner in 1999. Once considered the most challenging bariatric procedure, improvements in patient selection, surgical instruments, and the standardization of the surgical technique have made it a common procedure in bariatric surgeons’ arsenal.

The use of temporary loop ileostomies in colorectal surgery is usually performed to protect high risk anastomosis, such as low colorectal anastomosis, or ileal pouch ileoanal anastomosis. Ileostomy is usually closed between eight weeks and three months following the initial procedure, once the anastomosis has healed properly. With the advent of the new surgical techniques, procedures with higher risk anastomosis are more often performed, such as transanal total mesorectal excision. Thus, as the rate of derivative ileostomies increases, a revision of the surgical ileostomy closure technique is necessary, especially focusing on our young trainees.

Rectal prolapse is defined as the protrusion of the rectal wall through the anal canal; with a prevalence of less than 0.5%. The most frequent symptoms include pain, a feeling of incomplete defecation with blood and mucus, fecal incontinence and/or constipation. The surgical approach can be perineal or abdominal with a tendency towards minimal invasion. The effectiveness of open sacrocolpopexy has been proven in surgical treatment of pelvic organ prolapse with a significant reversion in a large number of patients. Laparoscopic sacrocolpopexy reproduces this surgical technique with reduced morbidity and may benefit from the recent development of robotic techniques. Many technical variants have been developed around the original procedure.