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Transthoracic transdiaphragmatic approach in laparoscopic liver resection for hepatocellular carcinoma in a patient with severe obesity and history of deceased donor liver transplantation.
Asian J Endosc Surg
April 2024
Department of Surgery, Iwate Medical University School of Medicine, Yahaba, Japan.
Article Synopsis
- - The transthoracic transdiaphragmatic approach (TTA) in laparoscopic liver resection (LLR) is not commonly used, but a case is presented where it was successfully employed for a patient with hepatocellular carcinoma and severe obesity.
- - The procedure involved careful planning, including transthoracic ultrasonography to guide diaphragm transection and ensure proper removal of the tumor while mitigating risks from the patient's prior liver transplant and severe adhesions.
- - Despite the successful outcome without needing hepatic inflow control, the authors stress that more research is needed to establish guidelines for using TTA in LLRs in similar cases.
Pulmonary Seeding Beyond the Gastrointestinal Tract.
J Community Hosp Intern Med Perspect
January 2024
MedStar Franklin Square Medical Center, Baltimore, MD, USA.
Article Synopsis
- * Imaging indicated a loculated left-sided pleural effusion, and diagnostic thoracentesis confirmed the presence of Clostridia, leading to a diagnosis of empyema and subsequent surgical intervention.
- * The patient also had acute cholecystitis, suggesting that the Clostridia infection may have originated from the abdomen, and he was successfully treated with laparoscopic cholecystectomy and antibiotics, highlighting the importance of prompt diagnosis and treatment.
Subsegmental approaches to S7: anatomic laparoscopic transdiaphragmatic and nonanatomic robotic transthoracic.
Surg Endosc
October 2023
Department of Surgery, St. Elizabeth's Medical Center, Boston University School of Medicine, Boston, MA, USA.
Background: Minimally invasive liver surgery of postero-superior segments (S4a, S7, S8) remains a challenge. The caudal view, an increased distance between trocars and the operative field, and the liver fulcrum limiting the view, contribute to the difficulty [1, 2]. We and other groups have previously reported the use of intercostal trocars to access subdiaphragmatic tumors (transdiaphragmatic approach) [3-5], only few reports on a laparoscopic total transthoracic approach, none (to our knowledge) dynamic manuscripts of a total transthoracic robotic approach, and none (to our knowledge) that use preoperative port site and anatomic modelling exist.
View Article and Find Full Text PDFGastrocardiac Fistula as a Complication of Prior Bariatric Surgery.
Am Surg
June 2023
Department of Surgery, TriHealth Good Samaritan Hospital, Cincinnati, OH, USA.
Gastrocardiac fistula is a rare, typically fatal, diagnosis which has been reported infrequently in post-esophagectomy patients and, to a much lesser extent, patients with history of Roux-en-Y gastric bypass. This case describes a patient with a history of an eroded adjustable gastric band and subsequent removal with conversion to Roux-en-Y gastric bypass that initially presented with an upper gastrointestinal bleed. She was found to have a transdiaphragmatic fistula between the gastric lumen and left ventricle.
View Article and Find Full Text PDFIntrapericardial liver herniation after coronary artery bypass grafting: a case report of minimally invasive repair with 20-year follow-up.
Acta Chir Belg
April 2024
Hopitaux Robert Schuman (HRS), Luxembourg City, Luxembourg.
Background: Transdiaphragmatic intrapericardial herniation (DIPH) of intra-abdominal organs is a rare but potentially life-threatening phenomenon often requiring urgent repair. There are currently no guidelines on the preferred repair technique in this situation.
Methods: Retrospective case report with long-term follow-up.
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