Patients with biliary obstruction after a Roux-en-Y gastric bypass present a challenge for endoscopic management due to the anatomic re-arrangements. The incidence of primary bile duct stones has been documented to be 10% in overall. Laparoscopic-assisted trans-gastric ERCP is a technique well documented in the literature to treat this entity. In this video, we present our method to treat primary bile duct stones status post Roux-en-Y gastric bypass. The technique remains a safe and effective ap
Here we show the case of a 60 years old female patient who presented to emergency room with a 24-hrs history of nausea, vomiting and severe abdominal pain. She referred symptoms of intolerance during the last six months.
An abdominal ultrasound reported gallstones without evidence of acute gallbladder disease, and a CT scan was performed showing an increase in the density of the head and the uncinate process of pancreas, pararrenal fluid collection and peripancreatic fat necrosis compatible wi
Purpose: This video presents a case of a 55 year old female with a history of diverticulitis and a previous open sigmoid resection. She presented one year after surgery with a perforation at the colorectal anastomosis. This patient was treated with a combination of laparoscopy, TAMIS (Transanal Minimally Invasive Surgery), and colonoscopy to diagnose and treat the anastomotic disruption.
Methods: This patient underwent laparoscopic exploration when she presented with free air under the diaphrag
Background: Gallbladder volvulus is a rare entity with an incidence of approximately 1 in 365,000 cases of gallbladder disease. A recent review of the literature resulted in approximately 500 cases of gallbladder volvulus being reported since it first appeared in the medical literature in 1898. It predominantly affects elderly women with a 4:1 female to male ratio, with the highest incidence in the 6th to 8th decades of life.
Case Summary: We present the case of an 88-year-old female who exper
Background: We present the case of a 46-year-old female that was referred to us for primary hyperparathyroidism. Pre-operative imaging with SPECT CT and chest CT scan confirmed the presence of a 12 mm left, inferior retrosternal nodule. The patient was evaluated for robotic transaxillary versus transthoracic left parathyroidectomy. We opted for the transaxillary approach.
Results: Intraoperatively, the patient was positioned supine with the left arm partially abducted to expose the axilla. A