By Bruce V. MacFadyen Jr., Maurice Arregui, Steve Eubanks, Douglas O. Olsen, Jeffrey H. Peters, Nathaniel J. Soper, Lee L. Swanstrom, Steven D. Wexner
An in-depth research of the technical elements of the main regularly played laparoscopic techniques, their symptoms, contraindications, and problems. seriously illustrated, Laparoscopic surgical procedure of the stomach breaks new flooring in visualising operative methods and difficulties. Seven sections, comprising the center curriculum of approved systems, current gallbladder ailment, universal bile duct exploration, hernia, colon illnesses, anti-reflux tactics, acute stomach and the function of diagnostic laparoscopy, and rising approaches at the spleen and adrenals. recognized leaders within the box take on each one part, emphasising what to do whilst and the way to unravel acute events.
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An in-depth research of the technical facets of the main often played laparoscopic strategies, their symptoms, contraindications, and problems. seriously illustrated, Laparoscopic surgical procedure of the stomach breaks new flooring in visualising operative approaches and difficulties. Seven sections, comprising the middle curriculum of permitted tactics, current gallbladder illness, universal bile duct exploration, hernia, colon ailments, anti-reflux techniques, acute stomach and the position of diagnostic laparoscopy, and rising systems at the spleen and adrenals.
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The esophagus should be enveloped by an untwisted fundus before suturing. 5 cm above and below the U-stitch to complete the fixation of the fundoplication. If the esophagus and fundus have been sufficiently wrapped, and if the wrap is not twisted, the stomach should remain in its original plane with the suture line of the fundoplication facing in the right anterior direction and the greater curvature, in the left posterior direction. 36 The port sites, the hiatal dissection, the fundic mobilization, and the crural closure are performed exactly as described in the technique of the Nissen fundoplication just outlined.
A new endoscopic technique for the resection of flat polypoid lesions. Gastrointest Endosc 1994;40:224–226. 21. Freischer DE, Dawsey S, Tio TL, et al. Tissue band ligation followed by snare resection (band and snare): a new technique for tissue acquisition in the esophagus. Gastrointest Endosc 1996;44:68–72. 22. Soehendra N, Binmoeller KF, Bohnacker S, et al. Endoscopic snare mucosectomy in the esophagus without any additional equipment: a simple technique for resection of flat early cancer. Endoscopy 1997;29:380–383.
The esophagus is mobilized via mediastinal dissection for 3–4 in. to provide maximal intraabdominal length. The importance of proper geometry in constructing the fundoplication is not often emphasized. Failure to adhere to the techniques outlined will result in a Nissen that is more of a twisted wrap than a true fundoplication. This distortion of the GE junction can result in failure of relaxation of the lower esophageal high-pressure zone and the development of dysphagia. The key to maintaining the proper geometry is to use the posterior fundus for the posterior fundoplication, with the anterior surface of the fundus brought around anteriorly.
Laparoscopic Surgery of the Abdomen by Bruce V. MacFadyen Jr., Maurice Arregui, Steve Eubanks, Douglas O. Olsen, Jeffrey H. Peters, Nathaniel J. Soper, Lee L. Swanstrom, Steven D. Wexner