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We found 10 results for New York University Langone Medical Center in video

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Laparoscopic Pancreatico-Jejunostomy
video

Critical elements of the technique for Laparoscopic Pancreatic anastamosis for MIS Whipple procedure are demonstrated. This shows a 2 layered duct to mucosa anastamosis. DOI:http://dx.doi.org/10.17797/xe556mv1e9

Robotic Inferior Mesenteric Artery, Common Iliac Artery, and Retroperitoneal Lymph Node Dissection
video

David Schwartzberg MD, Tushar Samdani MD, FASCRS, Mario M. Leitao MD, FACOG, FACS, Garrett M. Nash MD, MPH, FACS, FASCRS Recent data has shown an improved survival with metastasectomy for metastatic rectal cancer. Metastasectomy on a minimally invasive plateform (robotic) can be used for an R0 resection in patients who have retroperitoneal metastasis from rectal cancer after control of the primary tumor. DOI # http://dx.doi.org/10.17797/wd7d09sjgc

Per Oral Endoscopic Myotomy (POEM) for Zenker's Diverticulum
video

In contrast to major thoracic operations, per oral endoscopic myotomy for Zenker's diverticulum offers the possiblity to resect a symptomatic Zenker's under monitored anesthesia care (MAC) for patients to ill to undergo general anesthesia. Patients have similar functional results when compared to small Zenker's treated with traditional operative approaches. DOI# http://dx.doi.org/10.17797/f3gyzc3k95

LINX Procedure for GERD
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This video depicts the procedure for the implantation of a LINX implant for augmentation of the LES for refractory GERD. DOI:http://dx.doi.org/10.17797/69av5w723r Editor Recruited by: Dr. H. Leon Pachter

Laparoscopic Portal Vein Resection
video

Key aspects of vascular isolation and control for en bloc PV resection during laparoscopic whipple. Xenograft vein patch is used for reconstruction DOI: http://dx.doi.org/10.17797/ee9p182opy Editor Recruited by: H. Leon Pachter

Laparoscopic Adrenalectomy
video

Laparoscopic adrenalectomy (LA) was first described by Gagner et al. in the early 1990s, and has since become the gold standard for removal of small and medium sized adrenal tumors. Most commonly, LA is performed for unilateral benign adrenal lesions, however the minimally invasive technique is also routinely used for bilateral disease, as well as myelolipomas, adrenal cysts, adrenal hemorrhage and androgen-secreting tumors.  Compared with the open approach, LA offers shorter hospital stay, improved patient satisfaction, decrease post-operative pain and markedly improved cosmesis.  Even more, the difficulty in obtaining adequate open surgical exposure, combined with the diminutive size of the adrenal gland make laparoscopy an especially attractive option. Given this, we decided to proceed with LA approach for our patient who presented with NSCLC metastasis to his right adrenal. DOI# http://dx.doi.org/10.17797/4ek02iupxd Mellon MJ, Sethi A, Sundaram CP. Laparoscopic adrenalectomy: Surgical techniques. Indian Journal of Urology : IJU : Journal of the Urological Society of India. 2008;24(4):583-589. doi:10.4103/0970-1591.44277. Gagner M, Lacroix A, Bolte E. Laparoscopic adrenalectomy in Cushing's syndrome and pheochromocytoma. N Engl J Med. 1992;327:1033.

Gastric Sleeve Obstruction From Adjustable Gastric Band Capsule
video

The field of metabolic and bariatric surgery has recently switched from laparoscopic gastric banding (LGB) to laparoscopic sleeve gastrectomy (LSG) as the procedure of choice for weight loss surgery. As LGB has been replaced with LSG many patients who had complications with LGB or failed to loose a satisfactory amount of weight with LGB have had a conversation from their band to a sleeve gastrectomy. Meticulous dissection takes place when removing a band, as the fibrotic scar capsule that surrounds the band must be resected in its entirety to avoid staple firings across fibrotic tissue rather than healthy gastric tissue. In addition to ensuring a healthy staple line by resecting the fibrotic capsule, we present a case where the band capsule was thought to be removed however was incompletely dissected and caused a postoperative strictured proximal stomach with complete PO intolerance. For this reason, we routinely perform intra-operative endoscopy to ensure the lumen of the stomach is patent prior to staple firing to complete the sleeve gastrectomy in band to sleeve patients. DOI#: http://dx.doi.org/10.17797/19tn2xjdda

Laparoscopic Ligation of a Type II Endoleak from the Inferior Mesenteric Artery
video

Contributors: Gregory Westin and Paresh Shah Endovascular stent grafting (EVAR) is now the preferred approach to repair of abdominal aortic aneurysms for many patients. One of the most common complications associated with EVAR is the development of an endoleak, or continued flow of blood into the aneurysm sac outside the graft. Type II endoleaks, those due to retrograde flow through a branch vessel such as the inferior mesenteric artery (IMA) or a lumbar artery, are the most common. Options for treatment include transarterial embolization, translumbar embolization, and laparoscopic ligation. Embolization techniques require reintervention in approximately 20%, with less than half free from aneurysm sac growth at five years, though current evidence is insufficient to determine a clear threshold for intervention or optimal technique.[1,2] DOI#: http://dx.doi.org/10.17797/wu4visdfw2

Laparoscopic Right Hemicolectomy with Isoperistaltic Intracorporeal Anastomosis
video

Authors: David Schwartzberg, Noah Cohen, Jordan Schwartzberg, Paresh C. Shah Oncologic outcomes of laparoscopic and open colectomy have been demonstrated to be equivalent, with similar three-year disease-free survival and overall survival rates for any stage. Compared to patients who undergo open colectomy, patients who undergo laparoscopic colectomy benefit from a shorter median length of hospital stay and decreased post-operative use of pain medication. Intraoperative and post-operative complications are similar between open and laparoscopic colectomy. A Comparison of Laparoscopically Assisted and Open Colectomy for Colon Cancer. The Clinical Outcomes of Surgical Therapy Study Group. N Engl J Med 2004;350:2050-9 DOI: https://doi.org/10.17797/fdschc17au

Endoscopic resection of a vallecular cyst in a pediatric patient
video

Base of tongue masses are rare in the pediatric population, when present they can be remain asymptomatic for years or can cause acute respiratory distress. The differential diagnosis includes dermoid, vallecular cyst, thyroglossal duct cyst, lingual thyroid, lymphangioma, hemangioma, and teratoma (1). Vallecular cysts consist of mucus filled cysts or pseudocysts arising either from the mucosa on the lingual surface of the epiglottis or on the base of tongue (2). These benign mucous retention cysts most commonly present as stridor, difficulty feeding, respiratory distress but they can also remain asymptomatic and can be found incidentally (3,4). Vallecular cysts may occur in isolation, but they can be associated with laryngomalacia and GERD in a significant number of patients(5). Initial screening of the airway is done using flexible fiberoptic laryngoscopy which provides a quick assessment of the larynx and visualization of the cyst(6). Imaging (ultrasonography, CT, MRI) can also be useful for evaluation of the mass and more detailed visualization of the mass and surrounding structures(6). Conservative medical treatment is not adequate for the management of vallecular cysts. Several surgical options have been described, these include aspiration, transoral endoscopic excision, marsupialization and deroofing with CO2 laser or microdebrider (6). There is a high recurrence rate when simple aspiration is performed (7), and there is reported risk of recurrence with marsupialization techniques. Excision using transoral endoscopic technique ensures complete resection with adequate visualization and preservation of surrounding structures and mucosa with low risk of recurrence (4). Here, we describe transoral endoscopic approach for excision of base of tongue cyst in a 3 year-old female. The patient presented with the diagnosis of PFAPA and she was seen to discuss tonsillectomy and adenoidectomy. On physical exam, a 1.5 cm midline base of tongue cyst was seen when she protruded her tongue. The cyst had been increasing in size. Plan was to proceed with tonsillectomy & adenoidectomy and excision of base of tongue cyst. After informed consent was obtained, the patient was brought to the operating room and placed supine on the operating table. Correct patient and procedure were identified and general anesthesia by mask was induced. A laryngeal mask airway was placed first. A red rubber catheter was placed through the left nostril after the Davis mouth gag was inserted with a small tongue blade. The soft palate and uvula were palpated to be normal. The adenoid was mildly enlarged and was cauterized completely with suction cautery. Following that, Afrin was placed in the nasal cavity. The child was intubated with a nasotracheal tube through her left nostril that allowed for exposure. A red rubber catheter was left in her right nostril. The side-biting mouth gag was used. Two separate 2-0 silk sutures were placed in the midline to retract her tongue. A 30-degree telescope was used for visualization of the base of tongue cyst. With the Hurd elevator and other means of retraction, an extended Colorado needle tip with a 45 degree bend at the distal portion, was used to completely remove the base of tongue cyst which was quite deep. At the distal part, there was mucus seen, but the cyst was completely excised. The wound was irrigated thoroughly. There was no bleeding. The side-biting mouth gag was removed and the Davis mouth gag reinserted. A complete tonsillectomy was then performed. She was then extubated without difficulty in the OR and transferred to PACU. Patient was discharged on oxycodone and amoxicillin. On her follow up visits, the oral cavity and tongue were healing well with no evidence of recurrence. Pathology result: consistent with extravasation mucocele. Mucin filled cystic space rimmed by a lympho-histiocytic reaction and granulation tissue. Minor salivary glands w/ dilated ducts focally surrounded by chronic inflammation are present in the surrounding fibromuscular tissue.

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