Advanced Laparoscopic Surgery: Techniques and Tips

Cover......Page 1
Advanced Laparoscopic Surgery......Page 2
Front Matter......Page 4
Copyright......Page 5
Dedication......Page 6
Preface......Page 8
Acknowledgements......Page 10
Contents......Page 12
The Team......Page 20
The Instruments......Page 21
Setup for Advanced Upper Abdominal Surgery......Page 22
Setup for Lower Abdominal Surgery......Page 24
The Working Environment......Page 26
Disposable Trocars......Page 28
Optical Viewing Trocars......Page 29
Triangulation of Trocars......Page 31
Laparoscopes......Page 32
Creation of the Pneumoperitoneum......Page 33
Control of Bleeding of Unnamed Vessels......Page 34
Control of Bleeding of a Main Named Vessel......Page 36
Irrigation and Suction Devices......Page 37
Selected Further Reading......Page 38
Basic Laparoscopic Cholecystectomy......Page 40
Acute Gangrenous Cholecystitis......Page 47
Impacted Stone (Hydrops, Empyema, Early Mirizzi)......Page 48
Avoiding Injury to the Common Bile Duct......Page 51
Adhesions Due to Previous Upper Midline Laparotomy......Page 54
Selected Further Reading......Page 56
The Transcystic Approach......Page 60
The Common Bile Duct Approach......Page 61
Hepaticojejunostomy with a Roux-en-Y......Page 63
Selected Further Reading......Page 66
The Need for Specialized Equipment......Page 68
Access to the Liver......Page 69
Maneuvers Common to All Laparoscopic Liver Surgery......Page 72
Resection of Liver Tumors......Page 74
Limited Resection of Minor Lesions......Page 76
Left Lateral Segmentectomy......Page 77
Right Hepatectomy......Page 80
Treatment and Prevention of Perioperative Complications......Page 81
Patient Selection......Page 82
Selected Further Reading......Page 83
Patient Positioning......Page 86
Technique......Page 87
Creation of a Window Under the Esophagus......Page 90
Division of the Short Gastric Vessels......Page 93
Crural Closure and Fundoplication......Page 98
Postoperative Course......Page 99
Perforation of the Esophagus......Page 100
Mechanical Problems......Page 101
Toupet Posterior Partial Fundoplication......Page 103
Paraesophageal Hernia......Page 105
Bilateral Truncal Vagotomy......Page 108
Highly Selective Vagotomy......Page 110
Lesser Curvature Seromyotomy and Posterior Truncal Vagotomy......Page 113
Selected Further Reading......Page 116
Pyloroplasty......Page 120
Port Placement......Page 122
Technique......Page 123
Division of the Right Gastroepiploic Artery and Retroduodenal Dissection......Page 125
Laparoscopic Gastrojejunostomy and Roux-en-Y Reconstruction......Page 126
Laparoscopically-Assisted Gastrojejunostomy......Page 128
Locating the Perforation......Page 129
Closure of the Perforation with an Omental Patch......Page 131
Postoperative Course......Page 132
Selected Further Reading......Page 134
OR Setup and Port Placement......Page 138
Stapling Technique......Page 141
Gangrenous or Perforated Appendicitis......Page 144
Laparoscopic Assisted Appendectomy......Page 148
Selected Further Reading......Page 149
Right Hemicolectomy......Page 152
Left Hemicolectomy......Page 154
Reversing the Hartmann Procedure......Page 158
Selected Further Reading......Page 160
9 Small Bowel Obstruction......Page 162
Selected Further Reading......Page 166
General Considerations and Surgical Anatomy......Page 168
Dissection of the Preperitoneal Space......Page 172
Placement of the Mesh and Fixation......Page 174
Closure of the Peritoneum......Page 179
Totally Preperitoneal Hernia Repair (TEP)......Page 181
Selected Further Reading......Page 185
Positioning......Page 188
Port Placement......Page 189
Adhesiolysis......Page 190
Placement of Mesh......Page 191
Pain Following Laparoscopic Ventral or Incisional Hernia Repair......Page 196
Laparoscopic Component Separation......Page 197
Selected Further Reading......Page 199
Preoperative Requirements and Workup......Page 200
Patient Positioning......Page 201
Port Placement......Page 205
Surgical Anatomy......Page 206
Division of the Short Gastric Vessels and Exposure of the Tail of the Pancreas......Page 207
Extraction of the Spleen in a Bag......Page 209
Management of Complications......Page 212
Maneuver of Last Resort During Bleeding of the Hilar Vessels......Page 214
Partial Splenectomy......Page 215
Hand Assisted Laparoscopic Splenectomy (HALS)......Page 217
Distal Splenopancreatectomy......Page 218
Selected Further Reading......Page 220
Left Adrenalectomy......Page 222
Right Adrenalectomy......Page 227
Selected Further Reading......Page 231
Laparoscopic Roux-en-Y Gastric Bypass......Page 234
Technique......Page 236
Leak......Page 254
Internal Hernia......Page 255
Technique......Page 258
Erosion......Page 263
Laparoscopic Sleeve Gastrectomy......Page 268
Selected Further Reading......Page 274
Basic Transumbilical Procedures......Page 276
Laparoscopic Inguinal Hernia Repair......Page 280
Alternative Technique Using Disposable Devices......Page 281
Selected Further Reading......Page 282
OR Table......Page 284
Trocar Placement and Triangulation......Page 285
Equipment......Page 286
Graspers......Page 287
Interrupted Stitch......Page 288
Running Stitch......Page 289
Extracorporeal Knot-Tying......Page 290
Roeder’s Knot......Page 291
Short Suture......Page 292
SelectedFurtherReading......Page 294
Subject Index......Page 296