Large high output enterocutaneous fistulas pose great difficulties, especially in the setting of recent surgery and compromised skin integrity. This video demonstrates a technique of endoscopic control of enterocutaneous fistula by using two covered overlapping stents. This was performed as a temporizing and nutrition optimizing measure prior to a definitive surgical procedure.
Introduction
Herniation through the hiatus after a trashiatal esophagectomy is a common clinical situation. Most of the time is asymptomatic and may be incidentally found in abdominal CT. Surgical repair is the treatment of choice for this situation when the patient is symptomatic and the Robotic approach may minimize the morbidity of this operation. We present a video of robot-assisted repair of a colonic hiatal herniation after total esophaghetomy for malignancy.
Methods
A 60 year old
We are presenting the case of a 39 year old obese female patient that was transferred from an outside hospital with a diagnosis of incarcerated paraesophageal hernia by CT scan.
This video shows the laparoscopic approach for repair of an incarcerated and strangulated diaphragmatic hernia initially thought to be a paraesophageal hernia.
The abdominal cavity is entered and a diagnostic laparoscopy is performed. A large diaphragmatic hernia is found. The procedure starts by gently reducing the st
This is a case of a 79yo gentleman who presented with an acutely incarcarated paraesophageal hernia with gastric volvulus and perforation. The patient underwent an emergent laparoscopic paraesophageal hernia repair and was found to have necrotic stomach and perforation requiring total gastrectomy, leaving the patient in discontinuity in the acute setting with the plan for reconstruction 2-3 months later. This video demonstrates that even in complicated emergent cases of incarcarated and perfora
We started a minimally invasive esophagectomy program at Johns Hopkins University in 2012.
This video summarizes our technique and early results.The procedure is conjointly performed by a minimally invasive and thoracic surgery teams.
After technical adjustments during the early phase of the learning curve, our results show low mortality and morbidity while preserving optimal oncologic radicality.