Extralevator excision of the rectum has been shown to improve margin negativity in abdominoperineal resection. This can be technically challenging, and the resultant pelvic floor defect can make adequate closure difficult. Here we present a hybrid laparoscopic and robotic extralevator abdominoperineal excision of the rectum with pelvic floor reconstruction using biologic mesh. This approach facilitates pelvic dissection and perineal closure while maintaing acceptable hernia, wound and pelvic com
Case Presentation: A 15-year-old female with morbid obesity who underwent workup for recurrent right upper quadrant abdominal pain. Ultrasonography detected extra-hepatic cystic lesion. Subsequent Magnetic Resonance cholangiopancreatography demonstrated 3.7 x 3.0 cm type I choledochal cyst. She underwent robotic-assisted excision of choledochal cyst with hepaticoduodenostomy.
Technique details:
Extensive adhesions between omentum and the gallbladder were noticed and divided with the hook elec
Our patient is a 72 year old female who underwent an open roux-y-gastric bypass nine years ago at an outside hospital in a retrocolic, antegastric fashion. She underwent a diagnostic laparoscopy for nausa/vomitting 1 year ago and had an internal hernia repaired with a questionable twist in her intestines. She presented to our institution with worsening abdominal pain, intractable nausea/vomitting with CT scan findings concerning for an internal hernia. Pt was taken to the operating room. It
We performed laparoscopic complete mesocolic excision (CME) via combining medial and cranial approaches with mesofascial separation for right colon cancer. The procedure allowed us radical lymph node dissection via 3-dimentional recognition of gastrocolic trunk.
We present a case of a 57 year old patient with a history of ulcerative colitis and alcohol abuse presenting initially with gallstone pancreatitis who developed walled off pancreatic necrosis (WON) three weeks s/p laparoscopic converted to open cholecystectomy. His WON was initially treated with placement of two fully covered, double flanged, lumen opposing, metal stents for internal drainage. A total of 6 sessions of endoscopic debridement were performed, each providing temporary relief; howeve