Robotic Totally Extraperitoneal Hernia Repair: An Initial Experience with Cambridge Medical Robotics Versius.

Total extraperitoneal approach for laparoscopic inguinal hernia repair (L-TEP) allows for better dissection, lesser chance of bowel injury, and quicker operating time. However robotic groin hernia repair is currently performed only through transabdominal route as it allows for more mobility of the arms. This study is aimed at studying the feasibility and outcomes of robotic totally extraperitoneal (R-TEP).

Laparoscopic posterior rectopexy for complete rectal prolapse: Is it the ideal procedure for males?

Background: Rectal prolapse is more common in elderly women worldwide, but in India, it predominantly occurs in young- and middle-aged males. While ventral mesh rectopexy is proposed as the preferred procedure in females, the debate on the best procedure in men is still wide open.

Methods: A retrospective review of all adult male patients operated for external rectal prolapse (ERP) between January 2005 and December 2019 was performed.

Laparoscopic anterior resection: Analysis of technique over 1000 cases.

Purpose: Laparoscopic rectal surgery has moved from being experimental to getting established as a mainstream procedure. We aimed at analysing how rectal cancer surgery has evolved at our institute.

Methods: A retrospective review of 1000 consecutive patients who underwent laparoscopic anterior resection for rectal adenocarcinoma over a period of 15 years (January 2005 to December 2019) was performed.

Modified laparoscopic keyhole plus repair to manage a parastomal hernia: A single-center experience.

Introduction: Parastomal hernia (PH) is a common late complication of stoma formation for which laparoscopic repair is a well-accepted modality of treatment. Keyhole repair has been frequently reported with recurrence, but our modification in surgical technique have lesser and acceptable recurrence rates. The present study aimed to assess the results of modified laparoscopic keyhole plus repair in the treatment of symptomatic PH.

Single incision multiport versus conventional laparoscopic inguinal hernia repair: A matched comparison.

Background: The popularity of single-incision procedures is on the rise as wound cosmesis is increasingly being seen as an important body image-related outcome. In this study, we assess the potential benefits of single-incision multiport laparoscopic totally extra-peritoneal (S-TEP) without using specialised ports or instruments and compare the same with the conventional laparoscopic TEP (C-TEP) surgery in terms of operative time, post-operative pain, complications, cost and cosmesis.

Materials And Methods: This is a prospective case-matched study of the patients undergoing S-TEP versus C-TEP from June 2014 to December 2015.

Role of routine pre-operative screening venous duplex ultrasound in morbidly obese patients undergoing bariatric surgery.

Background/aims: It is well established that obesity is a strongly associated risk factor for post-operative deep vein thrombosis (DVT). Physical effects and pro-thrombotic, pro-inflammatory and hypofibrinolytic effects of severe obesity may predispose to idiopathic DVT (pre-operatively) because of which bariatric patients are routinely screened before surgery. The aim of this study was to audit the use of routine screening venous duplex ultrasound in morbidly obese patients before undergoing bariatric surgery.

Laparoscopic total pancreatectomy for multiple endocrine neoplasia type 1 syndrome-associated multifocal, non-functioning pancreatic neuroendocrine tumor: A case report.

Pancreatic neuroendocrine tumors are rare, accounting for less than 3% of all pancreatic tumors. Although laparoscopic pancreas-preserving surgery for managing sporadic pancreatic neuroendocrine tumors has been described in the literature, laparoscopic total pancreatectomy has rarely been reported. We present a 30-year-old man who was incidentally diagnosed with multiple endocrine neoplasia type 1 syndrome with parathyroid hyperplasia and a non-functioning pancreatic neuroendocrine tumor.

First Virtual Live Conference in Healthcare.

Background: Conferences and meetings bring together thousands of doctors from diverse locations. However, the traveling, accommodation, and arrangement of venues for conferences and meetings are expensive and a lot of time needs to be devoted to these logistics. The purpose of this article was to present our own virtual live conference experience using web conferencing and to briefly outline the basics and advantages of this technology in organization of healthcare conferences.

Comparison of weight loss outcomes 1 year after sleeve gastrectomy and Roux-en-Y gastric bypass in patients aged above 50 years.

Introduction: Safe, effective weight loss with resolution of comorbidities has been convincingly demonstrated with bariatric surgery in the aged obese. They, however, lose less weight than younger individuals. It is not known if degree of weight loss is influenced by the choice of bariatric procedure.

Management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity: A tertiary care experience and design of a management algorithm.

Background: Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed 'standalone' bariatric procedure in India. Staple line gastric leaks occur infrequently but cause significant and prolonged morbidity. The aim of this retrospective study was to analyse the management of patients with a gastric leak after LSG for morbid obesity at our institution.

Preliminary Evaluation of Acoustic Radiation Force Impulse Shear Wave Imaging to Detect Hepatic Fibrosis in Morbidly Obese Patients Before Bariatric Surgery.

Background And Aims: Acoustic Radiation Force Impulse (ARFI) shear wave imaging is a noninvasive method of assessment of the liver to detect fibrosis in patients with chronic hepatitis and nonalcoholic fatty liver disease (NAFLD). The aim of this retrospective study was to investigate whether noninvasive measurement of shear wave velocity (SWV) by ARFI shear wave imaging has a potential usefulness for detection of fibrosis secondary to NAFLD in patients with morbid obesity.

Methods: Twenty-eight morbidly obese patients were included in this study.

Laparoscopic Undo of Fundoplication with Roux-en-Y Gastric Bypass in a Morbidly Obese Patient with Prior Nissen's Fundoplication: A Video Report.

Background: Roux-en-Y gastric bypass (RYGB) may be a better option for morbidly obese patients with gastroesophageal reflux (GERD) for long-term reflux control. It is recommended after fundoplication if a patient is morbidly obese with GERD with failed fundoplication or if bariatric surgery is planned with a prior successful fundoplication (Kim et al., Am Surg 80(7):696-703, 2014; Kambiz Zainabadi, Surg Endosc.

Initial retrocolic endoscopic tunnel approach (IRETA) for complete mesocolic excision (CME) with central vascular ligation (CVL) for right colonic cancers: technique and pathological radicality.

Introduction: The concept of complete mesocolic excision (CME) with central vascular ligation (CVL) for treatment of right colon cancer evolved over last one decade. It decreases local recurrences and improves the survival rates. We describe our novel technique which involves first posterior sharp dissection between planes of parietal and visceral fascia of mesocolon followed by ligation of ileocolic, right colic and middle colic pedicles at their origin.

Management of Type 1 Late Sleeve Leak with Gastrobronchial Fistula by Laparoscopic Suturing and Conversion to Roux-en-Y Gastric Bypass: Video Report.

Background: Gastrobronchial fistula (GBF) is a rare but serious complication after laparoscopic sleeve gastrectomy (LSG). It commonly appears sometime after the primary LSG. (Alharbi Ann Thorac Med.

A single-centre experience of relaparoscopy in complications of laparoscopic inguinal hernia repair-feasibility and outcomes.

Background: Management of complications of laparoscopic inguinal hernia repair remains challenging as well as debatable. Relaparoscopy in management of these complications is relatively newer concept. We tried to analyse the feasibility of relaparoscopy (transabdominal preperitoneal approach) in management of complications of laparoscopic inguinal hernia repair.

Concomitant Bariatric Surgery with Laparoscopic Intra-peritoneal Onlay Mesh Repair for Recurrent Ventral Hernias in Morbidly Obese Patients: an Evolving Standard of Care.

Background And Aims: Repair of recurrent ventral hernias (RVHs) has a high failure rate more so in the presence of obesity. The chronic increase in intra-abdominal pressure (IAP) associated with obesity might, in part, be an important implicating factor that needs to be addressed in these patients. Laparoscopic ventral hernia repair (LVHR) done with concomitant bariatric surgery in morbidly obese patients with RVHs may avoid multiple failures.

Management of Type 2 Late Sleeve Leak by Laparoscopic Suturing and Conversion to Roux-en-Y Gastric Bypass: Video Report.

Background: Laparoscopic sleeve forming gastrectomy (SFG) is a commonly performed bariatric procedure for the surgical management of morbid obesity. Staple line gastric leaks occur infrequently but are the most feared complication causing prolonged morbidity (Burgos et al., Obes Surg 19(12):1672-7, 2009; Márquez et al.

Diagnostic Yield and Clinical Implications of Preoperative Upper Gastrointestinal Endoscopy in Morbidly Obese Patients Undergoing Bariatric Surgery.

Background And Aims: Upper gastrointestinal (UGI) endoscopy in patients undergoing bariatric surgery is controversial. It is recommended routinely by some authors to detect benign or malignant pathology that mostly remains asymptomatic. Others recommend selective use, suggesting not much impact on surgical management of detected pathology, especially in asymptomatic patients.

Comparison of Pathological Radicality between Open and Laparoscopic Pancreaticoduodenectomy in a Tertiary Centre.

Laparoscopic pancreaticoduodenectomy (LPD) remained a formidable challenge owing to retroperitoneal location, difficult dissection near great vessels and critical intracorporeal anastomoses. Recent reviews of literature have established the feasibility and comparable short term outcomes of laparoscopic pancreaticoduodenectomy (LPD) with that of open pancreaticoduodenectomy (OPD). This study was undertaken to compare the pathological radicality of LPD with OPD.

Prevalence and Predictors of Non-Alcoholic Fatty Liver Disease in Morbidly Obese South Indian Patients Undergoing Bariatric Surgery.

Background: Numerous studies worldwide have identified a high prevalence of non-alcoholic fatty liver disease (NAFLD) among morbidly obese subjects. Several predictors have been found to be associated with NAFLD and its histological high-risk components. Similar data from India is lacking.

Long-term results of laparoscopic pancreaticoduodenectomy for pancreatic and periampullary cancer-experience of 130 cases from a tertiary-care center in South India.

Background: Laparoscopic pancreaticoduodenectomy (LPD), although an advanced surgical procedure, is being increasingly used for pancreatic head and periampullary tumors. We present our experience of 15 years with the largest series in total LPD for periampullary and pancreatic head tumors with data on oncological outcome and long-term survival.

Materials And Methods: Prospective and retrospective data of patients undergoing LPD from March 1998 to April 2013 were reviewed.

Concomitant laparoscopic intraperitoneal onlay mesh repair with other clean contaminated procedures-study of feasibility and safety.

Background: Laparoscopic ventral hernia mesh repair has gained wide popularity with the benefits of shorter hospital stay, improved patient outcome, and fewer complications compared with traditional open procedures. It also offers the advantage of combining procedures at different quadrants of the abdomen. In this article we have retrospectively studied the safety of combining laparoscopic intraperitoneal onlay mesh (IPOM) repair with clean contaminated surgeries like cholecystectomy and hysterectomy.

Laparoendoscopic approach for refractory Roux-en-Y hepaticojejunostomy stricture in an acute setting: a unique case and technique.

Roux-en-Y hepaticojejunostomy stricture is a substantial problem that develops in 10%-30% of patients and requires frequent intervention. Although endoscopic/percutaneous approaches are preferred, especially for refractory stricture, open surgical reconstruction remains the gold standard. However, such an operation may be highly challenging.