With the advent of endoscopic treatment modalities for surgical problems, we as surgeons need to be prepared to deal with and treat the resulting complications. This video shows the complication of a migrated esophageal stent placed for functional Gastro-jejunostomy obstruction in a 47 year female with history of Roux en Y gastric bypass. The video demonstrates our technique in handling this complication.
While minimally invasive partial gastorectomies for gastric submucosal tumors are widespread, it is challenging to identify resection margins from a laparoscopic perspective.We introduce a hybrid technique combining laparoscopic and endoscopic approaches called Laparoscopic and Endoscopic Cooperative Surgery (LECS).This approach allows us to perform a laparoscopic partial gastrectomy, while maintaining safe oncologic margins and optimizing post-operative functional outcomes.
This video is an illustration of functional lumen imaging probe measurements of esophagogastric junction distensibility in laparoscopic Heller myotomy and peroral endoscopic myotomy (POEM) for achalasia.
It specifically shows changes in distensibility with each operative step, emphasizing the effect of distal incremental gastric myotomy on EGJ function intraoperatively. It also provides a review of important operative steps of both Heller and POEM.
The video presented is shows a novel treatment for a case of severe peptic ulcer disease and gastric reflux that resulted in dysphagia due to an esophageal stricture 2cm proximal to the gastroesophageal junction. The esophageal stricture was resected endoscopically for treatment of dysphagia. A covered stent was placed in the esophagus to prevent stricture reformation during the healing phase. Within the same operation, a Nissen fundoplication was performed to limit further reflux and recurrence
Introduction
The incidence of marginal ulcers varies from 0.6% to 16% following a gastrectomy procedure and Billroth II reconstructions. The clinical presentation is unspecific in most cases. For patients who did not respond to medical therapy, surgical management is the indication.
Objective
To determine the feasibility and safety of laparoscopic revision for non-healing gastric ulcers.
Methods
We present a case of a 42 year old female, BMI of 16.13 kg/m2, with abdominal pain, vomiting and