Robotic Assisted Right Hemicolectomy with Intracorporeal Anastomosis

Contributors: Nell Maloney Patel

We present a case of a seventy-two year old female found on colonoscopy to have multiple polyps and an ascending colon mass that was biopsy proven adenocarcinoma who underwent a robotic assisted right hemicolectomy with intracorporeal anastomosis.

DOI# http://dx.doi.org/10.17797/54hba94993

Editor Recruited by: Vincent Obias

Gastric Sleeve Obstruction From Adjustable Gastric Band Capsule

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

Stapled Ileoanal Reservoir for Restorative Ileal Pouch Anal Anastomosis

Contributors: Roger Hurst and Neil Hyman

This video demonstrates the approach to stapled ileoanal reservoir (Ileal pouch anal anastomosis (IPAA)) construction initiated utilizing enterotomy at the future reservoir inlet.  This approach has the advantage of permitting reservoir eversion during construction to ensure hemostasis and limiting the apical enterotomy to a stab puncture for the sharp anvil trochar.  Dr. F. Michelassi and Dr. G.E. Block originally described this technique in 1993, and the authors have made minor adaptations (1)

DOI: http://dx.doi.org/10.17797/4gf38v9mw2

Editor Recruited By: Jeffrey B. Matthews, MD

Laparoscopic Transanal Total Mesorectal Excision: Rectal Cancer

Contributors: Justin A. Maykel MD

The following video demonstrates a laparoscopic transanal total mesorectal excision (taTME) for the treatment of a locally advanced mid-rectal tumor. Eight weeks following neoadjuvant chemotherapy and radiation she was brought to the operating room for radical resection.

DOI#: https://doi.org/10.17797/wvn5h86w7l

Referred by Jeffrey B. Matthews

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