Two-Year Follow-Up of the First Transanal Total Mesorectal Excision (TaTME) Case Performed in Community Hospital in Hawai'i: A Case Report and Literature Review.

Surgical management of rectal cancer has evolved with the advent of total mesorectal excision (TME) and neo-adjuvant treatment allowing for more sphincter-preserving proctectomies. The laparoscopic approach to TME has numerous advantages over the open approach, including faster recovery, fewer wound complications, and overall reduced morbidity. However, laparoscopic dissection around the distal portion of the rectum is particularly difficult, and thus makes achieving TME completeness and negative resection margins for low rectal tumors a challenge.

Short esophagus: how much length can we get?

Introduction: Laparoscopic antireflux surgery requires an adequate length of intra-abdominal esophagus. Short esophagus can cause wrap herniation and poor clinical outcomes. The aim of the study is to measure maximum length of esophageal elongation with transhiatal mediastinal dissection.

The patterns and costs of the Da Vinci robotic surgery system in a large academic institution.

The da Vinci ™Robotic System (dVRS) is the latest advancement in laparoscopic surgery allowing the surgeon more accurate and precise control of instrumentation with an added three-dimensional image. Technology comes with a price, $1.3 million.

Long-term outcome of cruroplasty reinforcement with human acellular dermal matrix in large paraesophageal hiatal hernia.

Background: Laparoscopic repair of a large hiatal hernia using simple sutures only for the cruroplasty is associated with a high recurrence rate. The solution was to place synthetic mesh over the cruroplasty thereby decreasing recurrence rates in exchange for complications, such as gastric and esophageal erosions. Our initial report investigated the use of human acellular dermal matrix (AlloDerm) as a more suitable alternative.

One hundred consecutive laparoscopic Nissen's without the use of a bougie.

Background: The creation of a floppy and symmetric fundoplication over a bougie has been the standard of care in laparoscopic surgery. The use of a bougie carries a risk of esophageal perforation but lowers the risk of postoperative dysphagia. Intraoperative esophagogastroduodenoscopy (IEGD) can be used to assess the orientation and position of a properly constructed Nissen.

Laparoscopic hiatal hernia repair with human acellular dermal matrix patch: our initial experience.

Background: The laparoscopic repair of large hiatal hernia followed by an antireflux procedure is currently the gold standard therapy for gastroesophgeal reflux disease. However, it is recognized that recurrent hiatal herniation and wrap migration are major sources of operative failures in these patients. Some have described a reduction of such events with the placement of nonbiodegradable prosthetic patches over the primary cruroplasty.

Patients with pancreatic adenocarcinoma benefit from staging laparoscopy.

Background: Unnecessary laparotomy in patients with advanced pancreatic cancer may both compromise the quality of life and delay the initiation of more appropriate therapy. Very often, peritoneal small liver metastases and true local status cannot be fully determined without surgery. Laparoscopy may spare laparotomy and decrease morbidity for patients with nonresectable advanced disease.

Role of endoluminal techniques in treatment of gastro-esophageal reflux disease.

This chapter addresses emergent endoluminal technologies available currently for treatment of gastroesophageal reflux disease (GERD). To date, the mainstay of GERD therapy has been achieved with either open or laparoscopic fundoplication, or life-long medical treatment. Endoluminal treatment modalities attempt to augment the gastroesophageal junction (GEJ) function by various techniques.