Atlas of Minimally Invasive Techniques in Upper Gastrointestinal Surgery

Preface
Contents
Contributors
1 Surgical Anatomy of the Esophagus
	1.1	Introduction
	1.2	Composition
	1.3	Fixation
	1.4	Topography
	1.5	Arteries and Veins
	1.6	Lymphatics
	1.7	Innervation
	References
2 A Concentric-Structured Model for the Understanding of the Surgical Anatomy in the Upper Mediastinum Required for Esophagectomy with Radical Mediastinal Lymph Node Dissection
	2.1	Introduction
	2.2	Surgical Anatomical Model
	2.3	Validation of the Surgical Procedure
	References
3 A Surgical Concept for the Subcarinal Anatomy of the Esophagus and Mediastinum
	3.1	Introduction
	3.2	Surgical Anatomical Observation
	References
4 270 Degrees Fundoplication for Gastroesophageal Reflux Esophagitis
	4.1	Description of the Surgical Technique
		4.1.1	Patient and Trocar Position
		4.1.2	Position a Liver Retractor
		4.1.3	Opening the Pars Flaccida of the Gastrohepatic Ligament
		4.1.4	Incision of the Oesophago-Phrenic Ligament
		4.1.5	Blunt Mobilization of the Oesophagus Below the Dorsal Vagal Nerve
		4.1.6	Division of the Short Gastric Vessels and Gastrosplenic Ligament
		4.1.7	Cut Oesophago-Phrenic Ligament on the Left Side
		4.1.8	Dissection of the Left Crus from the patient’s Right Side
		4.1.9	Keep Track of the Vagal Nerves
		4.1.10	Start of the Suturing of the Crus
		4.1.11	Fundus Pull Through
		4.1.12	Suturing of the Fundus and Creation of the Fundoplication
		4.1.13	Checking and Ending
	References
5 Laparoscopic Nissen Fundoplication
	5.1	Introduction
	5.2	Description of the Surgical Technique
		5.2.1	Patient and Trocars’ Position
		5.2.2	Exposure of Operative Field
		5.2.3	Start the Intervention
		5.2.4	Circumferential Exposure of the Distal Esophagus
		5.2.5	Taping of the Esophagus for Retraction
		5.2.6	Mediastinal Dissection and Esophagus Mobilization
		5.2.7	Construction of Floppy Wrap
		5.2.8	Crural Opposition
		5.2.9	Construction of Fundoplication
		5.2.10	Completed Procedure
	References
6 Minimally Invasive Surgery of Paraesophageal Hernias
	6.1	Introduction
	6.2	Description of the Surgical Technique (Video 6.1)
		6.2.1	Instruments and Equipment Required
		6.2.2	Patient and Trocars’ Position
		6.2.3	Reduction of the Sac and Its Contents to the Abdominal Cavity
		6.2.4	Division of the First Short Vessels
		6.2.5	Dissection of the Sac, from the Left Crus Anti-Clockwise from Left to Right
		6.2.6	Dissection Continues to the Dome of the Hiatus and the Right Crus
		6.2.7	The Sac (and Lipomas) is Completely Dissected from Mediastinum into the Abdominal Cavity
		6.2.8	Mobilization of the Esophagus by Pulling Down the Sac
		6.2.9	Creation of a Retroesophageal Window
		6.2.10	Approximation of the Pillars Using a Bougie (Foucher) for Calibration
		6.2.11	Mesh Placement
		6.2.12	Creation of 360 Degrees Fundoplication
	References
7 Minimally Invasive Treatment of Esophageal Leiomyoma
	7.1	Introduction
	7.2	Description of the Surgical Technique (See Videos 7.1 and 7.2)
	References
8 Peroral Endoscopic Myotomy (POEM) for Achalasia
	8.1	Introduction
	8.2	Description of the Peroral Endoscopic Myotomy (POEM) Technique (Video 8.1)
	8.3	Description of the Endoscopic Procedure
		8.3.1	Post-Procedural Management
	References
9 Laparoscopic Heller Myotomy and Dor Fundoplication for Treatment of Esophageal Achalasia: Surgical Technique
	9.1	Background
	9.2	Surgical Technique. Step by Step
	References
10 Endoscopic Treatment of Early Esophageal Cancer
	10.1	Introduction
	10.2	Description of the Surgical Technique (Video 10.1)
		10.2.1	Lift-Suck-Cut Technique
		10.2.2	Ligate-And-Cut Technique
		10.2.3	Endoscopic Submucosal Dissection
	References
11 Transmediastinal Approach for Esophageal Cancer: Upper and Middle Mediastinal Dissection with Single-Port Technique
	11.1	Introduction
	11.2	Description of the Surgical Technique of Single-Port MATHE (Videos 11.1–11.4)
		11.2.1	Surgical Team Members
		11.2.2	Left Cervical Procedure
		11.2.3	Right Cervical Procedure (Fig. )
		11.2.4	Transhiatal procedure (Figs.  and )
		11.2.5	Esophageal Reconstruction
		11.2.6	Postoperative Management
	11.3	Conclusions
	References
12 Laparoscopic Transhiatal Resection for Distal Esophageal and Gastro-Esophageal Junction Cancer
	12.1	Introduction
	12.2	Description of the Operative Technique
	References
13 Robot-Assisted Minimally Invasive Transhiatal Esophagectomy
	13.1	Introduction
	13.2	Description of the Surgical Technique
		13.2.1	Position of the Robot Xi DaVinci Platform (Intuitive Surgical, Sunnyvale CA)
		13.2.2	Patient and Trocar Position
		13.2.3	Mobilization of the Stomach and Esophagus
		13.2.4	Steps Through Hand Port Supraumbilical—7 cm (Fig. )
		13.2.5	Mobilization of the Cervical Esophagus and Resection
		13.2.6	Gastric Conduit Creation and Passage Through the Posterior Mediastinum to the Neck
		13.2.7	Narrowing the Hiatus
		13.2.8	Cervical Esophagogastric Anastomosis According to Orringer
	References
14 Minimally Invasive Esophagectomy: Ivor Lewis
	14.1	Introduction
	14.2	Description of the Surgical Technique (see Video 14.1)
		14.2.1	Laparoscopic Phase
		14.2.2	Thoracoscopic Phase in Prone Position (Single-Lumen Tube)
15 Thoracoscopic Radical Oesophagectomy for Cancer
	15.1	Introduction
	15.2	Thoracoscopic Mediastinal Dissection
		15.2.1	Surgical Anatomy of Mediastinum with Reference to the Oesophagus
			15.2.1.1 Layer Structures and Principle of Dissection in the Mediastinum
	15.3	Description of the Surgical Technique (see Video 15.1)
		15.3.1	Dissection of the Right Recurrent Nodes
		15.3.2	Mobilization of the Dorsal Aspect of the Oesophagus
		15.3.3	Mobilization of the Ventral Aspect of the Oesophagus
		15.3.4	Dissection of the Left Recurrent Nodes
		15.3.5	Dissection of the Tracheobronchial Nodes
	References
16 Three-Stage McKeown Minimally Invasive Esophagectomy Procedure in Prone Position
	16.1	Introduction
	16.2	Step-By-Step Description of the Surgical Procedure (see Videos 16.1 and 16.2)
	References
17 Robot-Assisted Minimally Invasive Esophagectomy (RAMIE)
	17.1	Introduction
	17.2	Description of the Surgical Technique (Robot-Assisted Minimally Invasive Thoraco-Laparoscopic Esophagectomy (RAMIE) at UMC Utrecht)
		17.2.1	Thoracoscopic Preparation and Positioning
		17.2.2	Thoracoscopic Phase: Operative Procedure
		17.2.3	Laparoscopic Phase: Positioning
		17.2.4	Laparoscopic Phase: Operative Procedure
		17.2.5	Cervical Phase
	17.3	Future Directions
	17.4	Hand-Sewn Intrathoracic Anastomosis and Upper Esophageal Cancer
	17.5	The Steps to Perform an Intrathoracic Gastroesophageal Anastomosis (see Videos 17.1–17.3)
	17.6	cT4b Esophageal Cancer
	17.7	Conclusion
	References
18 Cervical Esophagogastric Anastomosis
	18.1	Introduction
	18.2	Description of the Operative Technique (see Video 18.1)
	18.3	Stapled Anastomosis
	18.4	Hand-Sewn Anastomosis
	References
19 Intrathoracic Esophago-Gastrostomy After MIE Ivor Lewis Esophageal Resection: End-To-Side Anastomosis by Means of Circular  Stapler. The Flap and Wrap Technique
	19.1	Introduction
	19.2	Description of the Surgical Procedure (see Video 19.1)
	19.3	Thoracoscopic Phase in Prone Position
20 Intrathoracic Oesophago-Gastrostomy After MIE Ivor Lewis Resection: Side-To-Side Oesophago-Gastrostomy by Means of a Linear Stapler
	20.1	Description of the Operative Procedure (see Video 20.1)
21 Intrathoracic Esophago-Gastrostomy After MIE Ivor Lewis Resection: End-To-Side Anastomosis by Means of a Circular Stapler and Endoloop
	21.1	Description of the Operative Procedure (see Video 21.1)
	References
22 Intrathoracic Esophago-Gastrostomy After MIE Ivor Lewis Resection: End-to-Side Anastomosis Using a Double Endoloop System
	22.1	Description of the Surgical Procedure (See Video 22.1)
	Reference
23 Intrathoracic Esophago-Gastrostomy After MIE Ivor Lewis Resection: End-To-Side Hand-Sewn Anastomosis
	23.1	Description of the Surgical Technique (see Video 23.1)
	Reference
24 Intrathoracic Robot-Assisted Minimally Invasive Esophagectomy (RAMIE) Ivor Lewis End-To-Side Anastomosis
	24.1	Description of the Surgical Technique (See Video 24.1)
	References   (References 2 and 3 could be deleted)
25 Surgical Anatomy of the Stomach and the Omental Bursa
	25.1	Introduction
	25.2	Anatomical Features
	25.3	Structure
	25.4	Topographical Relationships
	25.5	Vascular Supply
	25.6	Lymphatic Drainage
	25.7	Innervation
	25.8	Omental Bursa
	References
26 Minimally Invasive Treatment of Gastric GIST
	26.1	Introduction
	26.2	Description of the Surgical Technique
		26.2.1	Transgastric Resection
		26.2.2	Transgastric Resection
	References
27 Minimally Invasive Surgery for Treatment of Complications of Gastroduodenal Ulcer
	27.1	Introduction
	27.2	Description of the Surgical Technique (Videos 27.1 and 27.2)
		27.2.1	Ulcer Perforation
		27.2.2	Bleeding
		27.2.3	Stenosis
	References
28 Laparoscopic Adjustable Gastric Band
	28.1	Introduction
	28.2	Description of the Surgical Technique (Video 28.1)
	References
29 Laparoscopic Roux-En-Y Gastric Bypass
	29.1	Introduction
	29.2	Description of the Surgical Technique (Video 29.1)
	References
30 Laparoscopic Sleeve Gastrectomy
	30.1	Introduction
	30.2	Description of the Surgical Technique (Video 30.1)
	References
31 Laparoscopic Duodenal Switch
	31.1	Introduction
		31.1.1	Description of the Surgical Technique (Video 31.1) [1]
	References
32 Single Anastomosis Duodenoileal Bypass with Sleeve Gastrectomy
	32.1	Introduction
	32.2	Description of the Surgical Technique (Video 32.1)
	References
33 Endoscopic and Minimally Invasive Surgical Treatment of Early Gastric Cancer
	33.1	Introduction
		33.1.1	Laparoscopic Distal Gastrectomy
		33.1.2	Description of the Operative Technique (Videos 33.1 and 33.2)
		33.1.3	Postoperative Management
		33.1.4	Tips, Tricks, and Pitfalls
	33.2	Laparoscopy and Endoscopy Cooperative Surgery for Early Gastric Cancer with Sentinel Lymph Node Biopsy
		33.2.1	Description of the Operative Technique (See Video 33.1)
	References
34 Laparoscopic Partial Gastrectomy for Gastric Cancer
	34.1	Introduction
	34.2	Clinical Staging and Surgical Plan
	34.3	Description of the Surgical Technique (See Video 34.1)
	34.4	Description of the Surgical Technique of  Roux Y gastrojejunostomy anastomosis
	References
35 Modified Billroth-I Delta-Shaped Anastomosis After Distal Gastrectomy
	35.1	Introduction
	35.2	Description of the Surgical Technique (See Video 35.1)
	References
36 Robotic Distal Gastrectomy for Gastric Cancer
	36.1	Introduction
	36.2	Indication
	36.3	Description of the Surgical Steps (See Video 36.1)
	References
37 Laparoscopic Total Gastrectomy for Gastric Cancer
	37.1	Introduction
	37.2	Clinical Staging and Surgical Plan
	37.3	Description of the Surgical Technique (See Video 37.1)
	37.4	Reconstruction After Total Gastrectomy
	References
38 Spleen-Preserving Splenic Hilar Dissection for Proximal Gastric Cancer
	38.1	Introduction
	References
39 End-To-Side Esophagojejunal Anastomosis Using the Circular Orvil Device
	39.1	End-To-Side Esophagojejunal Anastomosis Using the Orvil Device
	39.2	Description of the Surgical Technique (See Videos 39.1 and 39.2)
	39.3	Linear Side-To-Side Esophagojejunal Anastomosis
	39.4	Description of the Surgical Technique (See Video 39.2)
	References
40 Hand-Sewn Anastomosis After 95% Gastrectomy, Total Gastrectomy, and Total Gastrectomy Extended to the Distal Esophagus for Gastric Cancer
	40.1	Introduction
	40.2	Description of the Operative Technique (See Videos 40.1–40.4)
	References
41 Robot-Assisted Total Gastrectomy for Gastric Cancer
	41.1	Description of the Surgical Procedure (See Video 41.1)
	References
42 Laparoscopic Immunofluorescence-Guided Lymphadenectomy in Gastric Cancer Surgery
	42.1	Near-Infrared Fluorescent Imaging for Gastric Cancer Surgery
	42.2	Description of the Surgical Procedure (See Video 42.1)
	42.3	Laparoscopic Total Gastrectomy with D2 Lymph Node Dissection
	42.4	Robotic Gastrectomy
	References
43 Final Considerations
	43.1	Proficiencies
	43.2	Permanent Learning
	43.3	Progress
Index