Although Bouveret syndrome has been a known condition since 1896, there have been very few case reports published till date. Surgical management of Bouveret syndrome is technically very challenging and needs excellent set of skills specially by laparoscopic approach. The surgical management varies based on the merit of the case; it is typically done in two stages. We encountered a difficult case, and managed the case by single stage surgery. This presentation will showcase a different approach t
Patients with unresectable hepatic metastases from colorectal cancer have a poor prognosis, with a median survival of only 15-20 months with systemic chemotherapy alone. For these patients, liver-directed therapy with hepatic arterial infusion of cytotoxic drugs offers an additional approach to improve control of metastatic disease. One of the main arguments against the use of hepatic arterial infusion therapy however, is that the pump carries long-term morbidity, and that the insertion procedur
The video presents the results of laparoscopic choledochoduodenostomy (CDD) was performed on 70-year-old female patient with impact stones in the distal part of common bile duct (CBD). This patient had cholelithiasis in the CBD which cannot be removed by Endoscopic Retrograde Cholangiopancreatography (ERCP). The single pigtail stent was placed to drain bile from obstruction. The laparoscopic port was placed by 4 trocars in standard cholecystectomy positions. Stone Forcep, saline flushing techniq
Background: Ampullectomy is mostly performed for periampullary malignancies, however, some benign disease may benefit from ampullectomy too. Transduodenal ampullectomy requires a precise dissection and complex reconstruction. Our group has been performing robotic ampullectomies for sphincter of Oddi dyskinesia (SOD) since 2005 with good results. The introduction of robotic techniques to our practice opened the possibility of performing this technically challenging operation with a minimally inva
Pancreatic pseudocysts are usually managed conservatively as many of these resolve without intervention. When these collections develop symptoms or complications, usually require treatment. Multiple modalities of drainage have been proposed including endoscopic, percutaneous or surgical internal drainage with variable success in selected patients. Surgical drainage still remains the gold-standard. These can be performed via a cystgastrostomy or cystenterostomy either with a laparoscopic or open