10 October 2017Recommendations for Surgical Management of Crohn’s Disease
Visual as well as manual assessments are sometimes necessary in order to evaluate a pathological bowel in Crohn’s disease. Operating during the acute obstruction process may help determine the transition point and therefore the diseased segment when other exams have failed. Here we review the surgical management of Crohn’s disease, focusing on the decision making as well as the different surgical options.
26 September 2017The most important points in the diagnostic approach to the thyroid nodule
A thyroid nodule is a discrete lesion within the thyroid gland that is radiologically distinct from the surrounding thyroid parenchyma. Generally, only nodules >1 cm should be evaluated, as they have a greater potential to be clinically significant cancers.
19 September 2017Laparoscopic Entry Techniques
In this lecture we will review the laparoscopic Entry Techniques. Laparoscopic surgery is the procedure of choice for most surgical pathologies, both scheduled and emergency. Complications associated with laparoscopy are often related to entry. Life-threatening complications include injury to the bowel, bladder, major abdominal vessels, and an anterior abdominal-wall vessel. Other less serious complications can also occur, such as postoperative infection, subcutaneous emphysema and extraperitoneal insufflation.
7 September 2017Combined robotic and transanal approach for rectal cancer with local extension
Surgical removal of rectal cancer has the strongest impact on oncologic outcomes. It is feasible to follow the principles of TME through a minimally invasive approach. Currently surgeons still struggle with issues such as male and obese patients with a narrow pelvis and section of the distal margin. Simultaneous dissection through a transabdominal and transanal approach represents a solution for these problems and many more (Cecil approach). The new transanal access platforms, 3D visualization system and robotic surgery turns this innovative approach into the least aggressive one for the treatment of rectal cancer. The following video shows a combined robotic and transanal approach to rectal cancer with local extension.
29 August 2017Intraabdominal insertion of proximal anvil: technical steps
The introduction of the EEA detachable anvil in the proximal colon when performing a colorectal anastomosis is usually performed transabdominally. However, intraabdominal insertion of the anvil should be regarded as an additional tool for colorectal anastomosis. The following video presents a case with intraabdominal introduction of the anvil during a total colectomy with an ileorectal anastomosis.
17 August 2017Indications of transanal approach for complicated inflammatory bowel disease
Minimally invasive surgery has proven its efficacy for the surgical treatment of inflammatory bowel disease. The recent evolution of laparoscopic surgery combined with transanal techniques could further facilitate the approach for these complicated patients. We present the case of a inflammatory bowel disease patient with rectal cancer located on the rectal remnant, where the stump was to be resected transanally, the ileoanal pouch mobilized and a new anastomosis performed.
15 August 2017Minimally Invasive Approach to tattooed colonic lesions
Intra-operative localization of small cancers and polyps during laparoscopic colorectal surgery is difficult due to reduced tactile feedback. Preoperative endoscopic tattooing is a safe and effective technique for intra-operative localization of colorectal lesions, improving the operative results of laparoscopic colorectal resections.
10 August 2017Median esternotomy for carinal goiter
Thyroidectomy is a common surgical procedure with a well standardized technique. However, modifications to the technique are necessary when facing more difficult cases. This video describes the technique for a total thyroidectomy with a partial sternotomy due to the presence of an endothoracic goiter.
27 July 2017Surgical Skills: Laparoscopic Suturing
When performing minimally invasive techniques, several skills must be fully mastered by every surgeon. One of the most important and difficult techniques is intracorporeal suturing, a skill that is essential in advanced laparoscopy. This Surgical Skills video presents the basics of laparoscopic intracorporeal suturing.
20 July 2017Show & Tell: AirSeal
The AirSeal is an insufflator and smoke-evacuating device that makes it possible to maintain a constant pressure. Proper use of this instrument is essential to its proper function. The essentials of AirSeal use are highlighted in this video.