Management of Staple Line Leaks after Laparoscopic Sleeve Gastrectomy.

Background And Objectives: Laparoscopic sleeve gastrectomy has become one of the most popular bariatric surgeries in the United States with a low rate of morbidity and effective weight loss. However, staple line leak remains a feared complication requiring a lengthy and difficult treatment course until resolution. This study outlines the various treatment methods used within a high-volume bariatric practice for successful leak resolution without necessitating a conversion procedure.

Laparoscopic resection of gastrointestinal stromal tumors: Does laparoscopic surgery provide an adequate oncologic resection?

Gastrointestinal stromal tumors (GISTs) are rare tumors of the GI tract. Surgical resection remains the mainstay of non-metastatic disease. However, the ability to provide an adequate oncologic resection using laparoscopic surgery is still an area of debate.

Laparoscopic-Assisted Transversus Abdominis Plane Block for Postoperative Pain Control in Laparoscopic Ventral Hernia Repair: A Randomized Controlled Trial.

Background: Laparoscopic ventral hernia repair (LVHR) is associated with considerable postoperative pain. Transversus abdominis plane (TAP) blocks have proven effective in controlling postoperative pain in a variety of laparoscopic abdominal operations. To date, no studies have focused on TAP blocks in LVHR.

Laparoscopic surgery in the management of Crohn's disease.

Crohn's disease is a chronic inflammatory bowel disease with surgery still frequently necessary in its treatment. Since the 1990's, laparoscopic surgery has become increasingly common for primary resections in patients with Crohn's disease and has now become the standard of care. Studies have shown no difference in recurrence rates when compared to open surgery and benefits include shorter hospital stay, lower rates of wound infection and decreased time to bowel function.

Laparoscopic resection of gastric and small bowel gastrointestinal stromal tumors: 10-year experience at a single center.

Background: Complete curative resection remains the treatment of choice for nonmetastatic gastrointestinal stromal tumors (GISTs). The safety and feasibility of laparoscopy in the treatment of this disease has been shown, however, the long-term oncologic outcomes of this technique remain unclear.

Study Design: An ongoing prospectively maintained database including all laparoscopically resected gastric and small bowel GISTs (n = 116) at Mount Sinai Medical Center from July 1999 to December 2011 was retrospectively analyzed.

Safety of outpatient laparoscopic cholecystectomy in the elderly: analysis of 15,248 patients using the NSQIP database.

Background: Studies have shown that laparoscopic cholecystectomy (LC) in an ambulatory setting is a safe alternative to the traditional overnight hospital stay. However, there are limited data on the morbidity and mortality of outpatient LC in elderly patients. We evaluated the safety of ambulatory LC in the elderly and identified risk factors that predict inpatient admission.

Laparoscopic management of presacral myelolipoma.

Myelolipomas are rare, benign nonfunctioning tumors, most commonly found in the adrenal glands. At least 43 cases of extra adrenal myelolipomas have been reported, with at least 50% of these reported cases occurring in the presacral region. Herein we report a case of presacral myelolipoma managed laparoscopically.

Polyester composite versus PTFE in laparoscopic ventral hernia repair.

Introduction: Both polyester composite (POC) and polytetrafluoroethylene (PTFE) mesh are commonly used for laparoscopic ventral hernia repair. However, sparse information exists comparing perioperative and long-term outcome by mesh repair.

Methods: A prospective database was utilized to identify 116 consecutive patients who underwent laparoscopic ventral hernia repair at The Mount Sinai Hospital from 2004-2009.

Risk factors for anastomotic leak following colorectal surgery: a case-control study.

Objective: To assess anastomotic leak (AL) risk factors in a large patient series.

Design: Case-control study.

Setting: The Mount Sinai Hospital.

Comparison of comorbidity resolution and improvement between laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding.

Background: This study aimed to compare the rates for resolution and improvement of common comorbidities between laparoscopic sleeve gastrectomy (LSG) and laparoscopic adjustable gastric banding. The comorbid conditions included were type 2 diabetes mellitus (DM), hypertension (HTN), hyperlipidemias (LPD), degenerative joint disease (DJD), gastroesophageal reflux disease (GERD), obstructive sleep apnea (OSA), and asthma.

Methods: A retrospective chart review of the patients who underwent LSG or laparoscopic adjustable gastric banding at our institution from July 2004 to July 2007 was performed.

A novel laparoscopic ventral herniorrhaphy training system.

Surgical simulation offers a safe opportunity to develop the skills required for the operating room. Box trainers are an excellent low-cost training option but there are limited options for teaching laparoscopic ventral hernia repair. We developed a realistic and cost-effective box system for laparoscopic ventral herniorrhaphy that will enhance training experience before entering the operating theater.

Factors that predict outcome of abdominal operations in patients with advanced cirrhosis.

Background & Aims: Patients with cirrhosis have an increased risk of complications during surgery that is relative to the severity of liver disease; it is a challenge to determine which patients are the best candidates for surgery. We performed a hospital-based study to identify factors that might facilitate selection of operative candidates and guide their management.

Methods: A retrospective review was performed of 100 cirrhotic patients (50 classified as Child-Turcotte-Pugh [CTP] A, 33 as CTP B, and 17 as CTP C) who underwent abdominal surgery at an institution specializing in liver medicine and transplant from 2002-2008.

Management and treatment of iliopsoas abscess.

Hypothesis: Even with improved diagnostic modalities, the optimum management strategy for iliopsoas abscess (IPA) is not uniform, and a better understanding of treatment options is needed.

Design: Retrospective case series.

Setting: Academic center.

Selective management of patients with acute biliary pancreatitis.

Background: Detection of common bile duct (CBD) stones in patients with acute biliary pancreatitis (ABP) proves challenging. We hypothesized that grouping clinically significant predictors would increase reliability of detection.

Methods: A retrospective review was performed of 144 consecutive patients who presented to a single tertiary care institution from 2002 to 2007 with ABP.

Diagnosis of gastrointestinal anastomotic dehiscence after hospital discharge: Impact on patient management and outcome.

Background: Anastomotic leaks are inevitable complications of gastrointestinal surgery. Early hospital discharge protocols have increased concern regarding outpatient presentation with anastomotic leaks.

Methods: One hundred anastomotic leaks in 5,387 intestinal operations performed at a single institution from 2002 to 2007 were identified from a prospectively maintained database.

Laparoscopic resection of giant adrenal cavernous hemangioma.

Background: Large adrenal tumors were initially believed to be a relative contraindication to laparoscopic adrenalectomy.

Methods: Here we discuss the case of a 42-year-old female with a 12-cm adrenal mass.

Results: The patient underwent successful laparoscopic resection, and pathology revealed a cavernous hemangioma, a rare benign tumor of the adrenal gland.

Laparoscopy: a safe approach to appendicitis during pregnancy.

Background: The aim of this study was to evaluate laparoscopic versus open surgery for suspected appendicitis during pregnancy.

Methods: A hospital-based retrospective review of 65 consecutive pregnant patients who underwent surgery for suspected appendicitis from 1999 to 2008 was performed. Significance was determined by Pearson's chi(2) test, Fisher's exact test, Mann-Whitney test, and Kruskal-Wallis test.

Current recommendations on diagnosis and management of right-sided diverticulitis.

We present the case of a 52-year-old female with recurrent symptomatic ascending colon diverticulitis who ultimately underwent elective laparoscopic right hemicolectomy. The following is a case report and literature review pertaining to right colonic diverticular disease.

Laparoscopic resection for Crohn's disease: an experience with 335 cases.

Background: Laparoscopic resection for Crohn's disease has had a slow adoption rate in gastrointestinal surgery. This is not unexpected considering the inflammatory nature of the disease, the need for reoperative surgery, and the presence of fistulas. The authors review their experience with 335 laparoscopic resections for Crohn's disease over the past 15 years.