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Bariatrics
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Sleeve gastrectomy for morbid obesity
The author: A.Forgione
Sleeve gastrectomy for morbid obesity. Professor A.Forgione is performing an operation (2017).
In this video the technique of bariatric operation-standard sleeve gastrectomy-is demonstrated. The first stage presents the positioning of troacars. For dissection of gastroesophageal isthmus a 10 mm Liga Sure MEDTRONIC COVIDIEN instrument is used. Sleeve gastrectomy is performed by means of stitching and transection of stomach by a 60 mm Endo GIA MEDTRONIC COVIDIEN apparatus with blue casettes. Preparation is placed into a special plastic container MEDTRONIC COVIDIEN, that is removed at the end of operation through the expanded access.
SADI operation after previously performed sleeve gastrectomy
The author: Evdoshenko V.V. and Fedenko V.V.
SADI operation after previously performed sleeve gastrectomy. D-r Evdoshenko V.V. and D-r Fedenko V.V. are performing an operation (2017).
In this video the technique of bariatric SADI operation is demonstrated. Pay attention to the minimally used duodenal dissection with preserving blood supply of duodenum. One more peculiarity of this operation is the use of EndoStitch apparatus that in fact improves the ergonomics of the operation.
Proximal transfer of duodenoileal anastomosis after SADI operation
The author: Evdoshenko V.V. and Fedenko V.V.
Proximal transfer of duodenoileal anastomosis after SADI operation. D-r Evdoshenko V.V. and D-r Fedenko V.V. are performing an operation (2017).
One of the problems after bariatric SADI operation is deficiency of protein. In case of absence of the effect after the conservative treatment there is an indication to transfer anastomosis into more proximal position. Elongation of large colon loop will give a possibility to improve the absorbtion of protein.
Hemorrhage into the lumen of interintestinal anastomosis after gastric shunting according to Roux
The author: Evdoshenko V.V. and Fedenko V.V.
Hemorrhage into the lumen of interintestinal anastomosis after gastric shunting according to Roux. D-r Evdoshenko V.V. and D-r Fedenko V.V. are performing an operation (2017).
Hemorrhage from the interintestinal anastomosis as complication after bariatric operation for gastric shunting according to Roux is rarely met. In case of continuing hemorrhage a repeated laparoscopy is performed, then revision of anastomosis is done and the source of hemorrhage is liquidated. It should be done in this way, as the use of flexible endoscopy for hemostasis is difficult to use, while using a standard equipment. In this case they have removed suture from anastomosis. Blood clot is visualized that is fixed to the source of hemorrhage. Hemostasis is fulfilled, using EndoStitch apparatus.
Gastroplication operation is converted into sleeve gastrectomy.
The author: Evdoshenko V.V. and Fedenko V.V.
Gastroplication operation is converted into sleeve gastrectomy. D-r Evdoshenko V.V. and D-r Fedenko V.V. are performing an operation. (2017)
The aim of bariatric gastroplication operation is to reduce the volume of stomach by means of “screwing in” the greater curvature of stomach into the big sulcus inside the stomach and to fix that sulcus, starting from Giz angle until the pyloric part of stomach. This operation is not a standard bariatric one and has a big percentage of unfavourable outcomes - rupture of stitching or the sulcus is straightened of its own. Naturally, this situation promotes weight gaining. The same thing has happened to this patient whose repeated operation we are demonstrating now. We separated all the adhesions that had been formed after the previous operation. Then we have performed a standard sleeve gastrectomy.
A simple way of closing of troacar wounds that does not require special instruments
The author: Evdoshenko V.V. and Fedenko V.V.
A simple way of closing of troacar wounds that does not require special instruments. D-r Evdoshenko V.V. and D-r Fedenko V.V. are performing an operation (2017).
The question about closure of troacar wounds in case of laparoscopic operations is very important, especially if the port has been expanded for getting out removed organs. In this video it is demonstrated the way troacar wound is stitched inside the abdominal cavity, using a usual surgical needle and a standard laparoscopic needle-holder that each operation theatre has got.
Sleeve gastrectomy, hiatal hernia, reconstruction of esophageal-diaphragmatic membrane
The author: Evdoshenko V.V. and Fedenko V.V.
Sleeve gastrectomy, hiatal hernia, reconstruction of esophageal-diaphragmatic membrane. D-r Evdoshenko V.V. and D-r Fedenko V.V. are performing an operation.
While performing an operation for sleeve gasterectomy, it has been found out that a patient has hiatal hernia. It is known that sleeve gasterectomy can promote development of hiatal hernia in 30-50 % of cases. So, an operation for hiatal hernia is compulsory when you are performing an operation for sleeve gasterectomy. Thus, cruroraphy has been performed, as well as reconstruction of esophageal-diaphragmatic membrane as a kind of circular esophagophrenopexy.
