We present a video displaying our experience with emergent laparoscopic intervention in an elderly female presenting with several days of obstructive symptoms, and found to have an incarcerated left sided obturator hernia on CT scan. Intraoperatively we found bilateral obturator hernias, as well as bilateral inguinal hernias, and we performed a hybrid TAPP/TEP repair with polypropylene mesh.
BACKGROUND: Like Laparoscopic Heller Myotomies (LHM), Per Oral Endoscopic Myotomy (POEM) has proven to be a viable therapeutic modality for the treatment of idiopathic achalasia. Similarly, POEM failure is related to distal extent of the myotomy onto the stomach resulting in an incomplete myotomy.
Evaluation of the extent of the POEM myotomy has been performed in a variety of methods. First, the extent of the dissection is visualized within the mucosal tunnel. The distal extent of the myotomy
Introduction: achalasia of the esophagus is a primary esophageal motility disorder of uncertain etiology. Aperistalsis of the esophagus and lack of relaxation of the lower esophageal sphincter in response to swallow are characteristic of this disease. Esophageal manometry is the diagnostic test and the gold standard treatment is the esophageal myotomy. An extended myotomy is mandatory to achieve relief of the dysphagia.
Description of contents: 15-year-old man who presented to another instituti
Recurrent achalasia after a prior myotomy can be a challenge, particularly when surgical intervention is necessary. We present a case of a redo-myotomy following a previously performed open left thoracic myotomy. The patient is a 56 year old male with a history of achalasia managed with an open left thoracic myotomy and reported fundoplication 30 years ago. He had symptoms of dysphagia with workup confirming recurrence of his achalasia. Despite his prior open myotomy, we demonstrate the successf
Introduction:
Gastrointestinal stromal tumor (GIST) are mesenchymal tumors that account for approximately 0.1-3% of GI neoplasm. GISTs are most commonly found in the stomach, small intestine, colon and rectum. Two-thirds of patients may have overt or occult GI bleeding, 40 percent have an abdominal mass, and 20 percent abdominal pain. We present the case of a massive GIST treated with partial gastrectomy.
Materials/Methods:
An 86 year old male with multiple comorbidities and a history of epig