Surgical management of gastric GIST can be approached through minimally invasive techniques. In this video, a gastric GIST is diagnosed due to acute bleeding and endoscopic and surgical management are discussed, with our experts’ tricks explained through the procedure.

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.

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.

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.

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.

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.

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.

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.

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.

Laparoscopic surgery has become an accepted method for the treatment of colorectal diseases, resulting in superior short-term functional outcome and equivalent long-term oncologic outcomes in cancer cases. Despite these benefits, laparoscopic rectal surgery remains a challenging procedure with conversion rates as high as 30%. Robotic technology is especially suitable for dissection in confined spaces such as the pelvis, in which three-dimensional vision and increased dexterity help in the performance of delicate operations such as a total mesorectal excision or prostatectomy. In this video we will show a pure laparoscopic robotic total proctocolectomy with transabdominal robotic anal mucosectomy.