Recent Advances in Minimal Access Surgery Subhash Khanna
INDEX
Page numbers followed by ‘f ’ and ‘t’ indicate figures and tables respectively.
A
Abdomen
incision 198
middle upper 47
Abdominal
closure 236, 246
compartment syndrome 179
laparoscopic techniques 166
wall 41, 46
injury to 41
transillumination of 47
Abdominoperineal resection 199
Access-related pain 49
Accidental eventuality 210
Adhesion formation, risk of 193
Adipocyte cytokines 123
Adipokines 127
Adipose tissue 127
Alkaline phosphatase 152
American Edwards Laboratories California 3
American Society for Metabolic and Bariatric Surgery 14
American Society of Colon and Rectal Surgeons 190
American Society of Gastrointestinal Endoscopy 1
Amino acid protein 127
Anaglyph filter glasses 58
mechanism of 59f
Anastomosis gastric bypass 146, 148
Anastomotic leakage 193
Anesthesia, extension of 218
Antidiabetic medications 122
Anti-incretin effect 127
Antireflux procedure 37, 105, 112
Antisecretory pharmacologic therapy 92
Anvil into esophagus, insertion of 116
Apollo OverStitch Device 9f, 10f
Appendectomies 54
Arantius ligament 170
ASMBS guidelines on hernia in obese 72
Aspire Assist aspiration device 8f
Assessment, main role of 35
Auditory information 33
Australasian Laparoscopic Colon Cancer Study 189
Autosomal dominant polycystic kidney disease 95
Avascular lateral attachments 191
retrorectal plane 193
B
Band leakage 137
Bariatric procedures, modalities of 126
Bariatric surgery 1, 37, 70, 123, 148f
effect of 124
in diabetes 122
modalities of 125, 130, 131
prior to hernia repair 71
advantages 70t
disadvantages of 70t
procedures, commonly performed 128
revisions 138
types of 137
Barrett's
esophagus 88
metaplasia 111
Belsey's fundoplication 88
Beta cell function 122
Bile duct stone 152
following lap cholecystectomy 157
Biliary
fogarty balloon 155, 157
pancreatitis 152
reconstruction 174
sludge and stone 157
sphincterotomy 154
tract malignancy 178, 182
Biliopancreatic diversion 125, 129f, 130, 130, 131
limb 138
Billroth II gastrectomy 158
Binocular cues 58, 58f
Bioenteric intragastric balloon 4
Biopsy
percutaneous 182
under guidance 183
Bipolar devices 21
Blood pressure, elevated 124
Blunt
hemostat under vision 44f
inline retraction 107
trocar 44f
Body mass index 10, 42, 123, 124, 137
basis of 67
Bolam's test 211
Boston Scientific Corporation 9
Botulinum toxin 110
Bowel
adherent 41
in a normal location, injury to 41
injuries 40
resection 236
resection and ileal pouch creation 246
Bypass liners 2, 10
C
Caloric
malabsorption 130
restriction 126
Calot's triangle 168
Capnothorax 107
Carcinoma breast, mastectomy in 213
Cavitron ultrasonic surgical aspirator 165
Cefoperazone 232
Center for Devices and Radiological Health 48
Cesarean section 213
Chemoradiotherapy 202
Cholangitis 11
incidence of 11
Cholecystectomy 22f, 29
on porcine liver 30
Choledochoscope 21, 156
Chronic kidney disease 81
Chronic obstructive pulmonary disease 81
Clinical Practice Guidelines Committee 190
Clinical risk score system 182
Closed technique See Veress needle technique
Closed-entry technique 48
Cognitive
ability 25
function, combination of 17
skills 29
technical and nontechnical skills 38
training constitutes 17
Colic vessels, right 191f
Collagen production 81
College of American Pathologists 249
Collis gastroplasty 110
Colon cancer
ascending 198
laparoscopic 89
Colon mobilization start-up, right 241f
Colonic neoplasia 228
Colorectal cancer 182, 196
conventional vs laparoscopic-assisted surgery 189
Colorectal
malignancy 178
mobilization 229
resection 193
specimen 229
surgery 37
Common bile duct
exploration 37
stones 219
transcystic exploration of 156
Competency assessment tool 29, 36
Competency-based surgical education 23
Complete mesocolic excision 187, 197, 228
Computer-based simulators 21
Concomitant abdominoplasty 70
Concomitant bariatric surgery 69
Concomitant hernia repair
advantages 70t
disadvantages of 70t
Confidence interval 202
Congress of the German Surgical Society 17
Consumer Protection Act 211
Continuing medical education 18
Controlled radial expansion 155
Conventional 2D laparoscopy 61
Convergence
mechanism of 57f
parallel edges 55
Coronary ligament 169
Corridor 215
Couinaud's segments 167
Cremaster and hernial sac 80
Criminal medical negligence, complaints of 211
Criminal negligence amounts 210
Critical resource, management of 29
Customer relationship management 200
Cytoreductive surgery 180
D
Deliberate practice 33
Denonvillier's fascia 243
Dense adhesions 148f
Depth perception, principles of 56
Diabetes
induced mortality 123
remission: bariatric surgery 124
Didactic endoscopic retrograde cholangiopancreatography 20
Didactic module 20
Dietary assessment 138, 147
Difficult bile duct stones, management of 158
Dilated
gastric pouch 14
gastrojejunal stoma 12
Dilemmas 208
Dingfelder technique, direct trocar insertion 41
Dipeptidyl peptidase 4 122
Direct trocar insertion technique 45
Direct vision entry trocar 51
Discharge/death summary 221
Discount application 225
Disease-free survival 197, 200201
results of local recurrence 198
Distal gastrectomies conventional 119
Distal gastrectomies vagal preservation in 119
Distal gut 131
Distal transverse mesocolon mobilization 239f
Doctors and hospitals 220
Doctrine of consent 215
Dormia basket 157
Dreyfus model of skill acquisition 25
Dumbbell-shaped device 7
Dumping syndrome 14, 150
Duodenal
bulb 11
exclusion 131
mucosal resurfacing 12
switch 129f, 130
ulcer 37
Duodenojejunal
bypass liner 11
nutrients 11
E
Early gastric cancer, detection of 119
Echogenic serosal layer 106
Educational and training program 33
Elective preoperative ERCP, role for 154
Electrical stimulation 2
Electrosurgery, fundamentals of 21
Elipse balloon 7
Emergency surgery 231
Endobarrier gastrointestinal liner 10
Endocatch bag 116
Endogastric solutions 94f
Endohernia Society 75
classification 82t
recommendations of 83
Endoloop placement 19
Endoluminal
bariatric surgery 1
emerging trends and techniques 1
indications 1
procedures 3f
surgery 1
suturing 92
Endoscopic bariatric
devices 2, 21
evaluation 138
gastrostomy, percutaneous 19
jejunostomy, percutaneous 20
retrograde cholangiopancreatography 152
RFe delivery 89
sleeve gastroplasty 8, 9
stone extraction 154
surgery, fundamentals of 20
suturing 14
techniques, number of 138
therapies 21
therapy 14
ultrasound 177
Endoscopist maneuvers 93
Endo-trainers 214
Energy-based devices in pediatric surgery 21
Enhanced recovery after surgery 119, 231
Enoxaparin 232
Entails creating 229
Enteral access 20
Enteroendocrine hormones 122, 130
Enzyme dipeptidyl peptidase IV 126
Epidemic proportions 67
Epigastric vessels 41
Ergonomic restrictions 28
Esogastric junction creating a neostomach 9
Esophageal
cancer 182
dilatation 138
division, level of 116
injuries 107
malignancy 178
perforation 96
wall 105
Esophagectomy 111
Esophagitis 88
Esophagogastrectomy 111
Esophagogastric
fundoplication 93
junction malignancy 178
Esophagogastroduodenoscopy 20
Esophagojejunal anastomosis 117, 118
Esophyx device 93, 94f
EsophyX2 device 93
European Association for Endoscopic Surgery guidelines 83
Excess weight loss 1, 136, 144, 149
Extracorporeal suturing 19
Extracorporeal tourniquet 161, 162f
Extraparenchymal division 169
F
Falciform ligament 169, 170
Familial adenomatous polyposis 229, 230, 231f
colonoscopic view of 231
Family counseling sheet 214
Fascial
attachments 229
degeneration 81
Fasting plasma glucose 124
elevated 124
Fatty tissue surrounding 169
Feedback
appropriate 34
extrinsic 33
formative 34
frequency of 34
performance 33
summative 34
Female gender 81
Fibroblast proliferation 81
Fine needle aspiration for cytology 177
FLS trainer system 18f
Fluid-filled balloon 4
Fluorodeoxyglucose-positron emission tomography 178
Fluoroscopically guided 157
Foregut hypothesis proposes 127
Foreign body removal 21
Frequency of incisional hernia 161
Function preserving gastrectomies, concept of 119
Fundal wrap, assessment of 105
Fundic wall 9
G
Gallstones with concomitant bile duct stones 152154
Garren-Edwards gastric bubble 3
Gas embolism 41
Gastric
artery, left 116f
balloon implantation 71
bypass 139
component 127
Roux-en-Y 128f
cancer 181
risk of developing 113
cardia 113
contents, aspiration of 8
emptying 127
fundal injury 108
lumen 105
malignancies 177, 178
mucosal involvement 177
outlet obstruction 138
stenosis 140
Gastrocolic attachments 191
Gastroduodenojejunal bypass liner sleeve 11
Gastroepiploic vessels 115
Gastroesophageal junction 89, 117f
level of 9
Gastroesophageal reflux disease 104
causes of mortality 108
complications and failures 104
endoscopic versus surgical procedures for 88
endotherapy for failed fundoplication 109
evaluation 105
dynamic contrast imaging 106
endoscopic ultrasound 105
endoscopy 105
impedance 106
magnetic resonance imaging 106
failure
of surgery for 104
description of 108
gastroparesis 109
intraoperative complications 107
esophageal injuries 107
other injuries 108
management options for complications 104
postoperative complications 108
severe 137
surgery for failed fundoplication 110
Gastrogastric fistulae 138
fundoplication 93
Gastrograffin swallow 147
Gastrointestinal barium studies 137
Gastrointestinal endoscopy
lower 20
upper 20
Gastrojejunostomy 146
Gastropancreatic masses 46
Gentle retraction 117
Gerota fascia 192
Ghrelin concentration 127
Global assessment forms, using of 30
Global Assessment of Gastrointestinal Endoscopic Skills 36
Global assessment of skills 36
Global Operative Assessment of Laparoscopic Skills 35
Global rating skills 35
Glucagon-like peptide 1 122
Glucose-dependent insulinotropic polypeptide 126
Glycemic control 11
postbariatric surgery 125
postbariatric surgery, mechanism of 126
Glycemic status 12
Granulation tissue production 81
Greater curvature, mobilization of 115
Greater omental attachment 193
Groin hernia, diagnosis of 68
Gynecological malignancy 178, 182
H
Hand-assisted approach 171
Handling
google patients 220
instruments 17
Haptic feedback 33
Hasson technique 179
advantages 44
complications 44
limitations 44
overview of 43
Healthcare, safety of 38
Health-related quality of life 91
Hemi-hepatectomy 160
Hemostasis 20
Hepatic
branch of vagus 108
flexure retrocolic mobilization 241f
lobectomy, left 172
metastasis, detecting of 181
pedicle 168, 170
Hepatobiliary surgery 37, 160
Hepatocellular carcinoma 164
Hepatorenal ligament 169
Hereditary
connective tissue disorders 81
nonpolyposis cancer 230
Hernia
after ileostomy reversal 198
in obesity
epidemiology of 68
pathogenesis of 67
recent guidelines 67
what to treat first 70
repair in obese complications of 69
repair options 69
bariatric surgery with 69
laparoscopic approach 69
open repair 69
size of 79
surgery in obese, algorithm for 71
Herniasurge group, levels of risk factors 81
HHL (Berlin), mechanism of display 61f
Hiatal dissection 116
Hiatal hernia 96
repair of 88
High density lipoprotein 124
High intraperitoneal pressure entry 50
High vascular capture 230
High-resolution manometry 105
Hilar plate 170
Hindgut hypothesis assumes 127
Homemade single-port device 172f
Hospital violence 221
Human vision 55
Hybrid Nissen 110
Hydrophilic guidewire 155
Hypercapnia 179
Hyperglycemia 123
Hyperglycemic status 124
Hyperinsulinemia 123
Hyperthermic intraperitoneal chemotherapy 179, 180f
Hypogastric plexus, superior 244
Hypoproteinemia 81
Hysterectomies 55
Hysterectomy 213
I
Ileal
anal pouch anastomosis, completed 248f
anal stapled anastomosis 248f
J-pouch creation 247f
pouch creation 236
Ileocolic
pedicle 190, 191
vasculature, high-transection of 241f
vessels 191f
Ileostomy 246
Iliac port
left 235
right 235
Incisional hernia 193, 200
after colorectal cancer surgery 203t
in laparoscopy vs open colorectal cancer surgery 197
primary, recurrent 67
repair 37, 68
Incisionless operating platform 9
Incretin
hormone function 127
secreting cells 127
Infection 79
Inflammatory bowel disease 229
Infradiaphragmatic wrap 109
Inguinal
eventration 82
hernia repair 37
Inpatient department 212
Intact specimen, safe extraction of 230
Intensified depth perception 55
Intensive care unit 178, 215
Intercostal space CO2 insufflation, ninth or tenth 47
Internal herniation 130
International Diabetes Federation 123, 124t
International Federation for the Surgery of Obesity 138
International Index of Erectile Function 199
International Prostate Symptom Score 199
Intestinal mucosa, cellular level 128
Intestines, division of 192
Intra-abdominal
abscess 150, 193
aspect 41
pressure 67
Intracorporeal
anastomosis 246
suturing 19
Intragastric balloon, option of 4f
Intraperitoneal
hemorrhage 41
laparoscopic access techniques 40
Investigational devices and modalities 11
J
Jaundice 81
obstructive 152
Jejunal limb 118
Jejunojejunostomy 146
Jejunum limb 130
Judgment, error of 210
K
Kugel meshes 84
L
Laparoendoscopic
rendezvous procedure 158
single site 171
Laparoscopic
access
alternative access sites 46
choice of technique 48
injuries types of 41t
primary 41
radially expanding access system 45
sites of entry 45
techniques for 41
adjustable gastric banding 135, 146
appendectomy 64, 213
approach 219
biopsy 182
bowel grasper and purse-string suture 118f
cart 233
cholecystectomy 54, 64, 155156, 213
colon resection 185
colorectal
cancer surgery 228
resection long-term, results of 196
surgery short-term, advantages of 196
common bile duct exploration 156
ductal exploration 157
entry
current perspectives of 40
in high-risk patients 49
sites of 46
technique 51
fundoplication 104
gastrectomies 113
gynecologic surgeon 213
hysterectomy 64
in oncological sciences
contraindications 179
diagnostic accuracy of the procedure 181
indications 178
recent advances role of 177
technique 178
incisional 70
inguinal hernia repair 83
inappropriate fixation 79
incomplete dissection 79
recurrence after 79
left colectomy, technique of 192
left hepatectomy 171f
left lateral hepatectomy 162f
liver resection 173
liver surgery 160
major hepatectomy 174
Nissen fundoplication 64
ovarian cystectomy 64
ports and liver retractor placement 115f
primary access procedures 40
procedures 18, 19, 40, 50
proctocolectomy 229
aim 230
anesthesia 233
contraindications 231
triple-track technique for
indications 230
operative theater setup 232
patient position 233
patient preparation 231
port strategy 235
position of the surgical team 234
rationale for 228
stages of the operation 236
technical summary 229
repair of recurrent inguinal hernia 83
resection in rectal cancer 199
resection of colorectal cancer 196
right hepatectomy 168f, 170f, 190
Roux-en-Y gastric bypass 139
segment 1 hepatectomy, port positioning 167f
simulators 20
skills gradation of 23
sleeve gastrectomy 64, 135
splenectomy 64
surgery for
colon cancer 202t
colorectal cancer 196, 200
data analysis 197
methodology 196
review 196
fundamentals of 1820
safe performance of 51
3-D visualization technology for 54
surgical techniques, development of 185
total proctocolectomy 250
totally extraperitoneal 64
toupet fundoplication 107
training, basic 33
transabdominal preperitoneal 64
triple-track technique 250
ultrasonography 177, 179
uro-surgeon 213
vagal sparing total gastrectomy 113
operative technique 113114
patient selection 113
postoperative course 119
ventral hernioplasty 64
vs open colorectal surgery, trials on 188t
vs open surgery, comparison of 197
vs robot-assisted 199
Large hiatal hernia 88
Latif's point 47
Law collagen 81
Lax capsules, tightening of 89
Leaving against medical advice cases 222
Lee-Huang point 47, 49, 50
Legal and ethical issues 208
Legal defense
good 212
poor 212
Life, cost and quality of 186
Ligasure and clip application 192
LINX device 96, 97f, 98f
LINX reflux, management system 96
augments 99
current evidence 97
procedure 96
recommendation 98
Lipoma 80, 85
Liver
disease 113
malignancy 178
metastases, superficial 182
parenchyma, bridge of 162
Lower anterior resection syndrome 199, 202
Low-molecular-weight heparin 232
Lymph node
intermediate 230
metastases 181
Lymphoma 178, 182
M
Magnetic resonance imaging 21
Magnetic sphincter augmentation using linx device 89
Major blood vessels, injury to 41
Malabsorptive procedure 137
primary 138
Malabsorptive segment, correction of 138
Mallory-Weiss tear 3
Malnutrition 81
Mass practice for skills acquisition 34
Matrix metalloproteinase 81
McGill inanimate system 18, 35
Medial recurrent hernia 80
Medical Council of India 213
Medical litigations 211
Medical negligence 209
Medical practice 213
continuity of care in 211
Medical records 211
good 212
poor 212
Medicolegal
cases 211
problems 208
Medigus Ultrasonic Surgical Endostapler 93
Mesenchymal metabolic defects 81
Mesenteric artery
inferior 192, 229, 238f
superior 229
Mesenteric vein, inferior 193, 229
Mesh 80
Mesh fixation in laparoscopic approach 85, 86f
Mesh infection, risk of 69
Metabolic
disorders 138
syndrome 124
disease 177
low risk of developing 119
Methylene blue dye 149
Metronidazole 232
Microwave energy systems 21
Midclavicular lines 114
Minilaparotomy 236
and specimen extraction 246
Minimal access
advantages of 186
colorectal surgery, complications of 193
hepatectomy, technique of 160
proctocolectomy 228
surgery 28
basic and advanced to specialty procedures 28
benefits to patients 55
benefits to surgeons 55
monocular aspects 55
program grades 2932, 36, 37
prospective randomized controlled study 54
subjects and methods 54
surgeons medicolegal dilemmas for 208
3D vision vs 2D vision in 54
training and assessment path in 28
surgical skills 17
optimal training technique 17
surgical training 25
Minimally invasive
colorectal surgery 185
early short-term 186
conventional open surgery oncological 186
hernia repair to prevent recurrence, important points for 85
liver surgery benefits 161
surgery 187
surgical trainer 22
vs conventional open surgery, advantages of 185
Missed hernias 80
Mobile omentum 228
Monitor display systems 54
Monocular
cues 58
vision 56f
Monofilament suture, absorbable 119
Monopolar devices 21
Motion parallex, size constancy 59f
Motivation 33
Mucosal inspection 21
Mucosal lacerations 92
Multifocal intramucosal cancer 113
Multimodality venous thromboembolism 232
Multiple small tumor nodules, confluence of 179
Multirecurrent hernias 82
Multisegmental colorectal resections 228
Myocardial infarction 70
Myopectineal orifice 76
anterior view 78f
posterior view 78f
N
Nathanson liver retractor 114
National Accreditation Board for Hospitals and Healthcare 212
National Commission 219
National Consumer Disputes Redressal Commission 210
Natural Orifice Transluminal Endoscopic Surgery 1
Neomycin, consisting of 232
Nephrectomy 213
Neuronal signaling 122
Newer minimally invasive techniques 187
Nichols-Condon bowel preparation 232
Nissen fundoplication 55, 93, 88, 105
Nodal resection 115
Noncommunicable disease, chronic 135
Nonsite specific studies, results of 201t
Nonsteroidal anti-inflammatory drugs 130
Nontechnical skills training 37
Nontraumatic forceps 157
Nonverbal communication supplemented 214
Nutritional deficiency, severe 137
Nyhus classification 82, 82t
Nylon tape encircling 117
O
Obalon gastric balloon 6
Obesity 1, 67, 135
conducted to manage 122
dependent diabetes 122
related comorbidities 123
surgery endoluminal, primary 8
Observational Clinical Human Reliability Analysis 36
Oncological resection 229
Online consultations 219
Online e-learning portal, using 29
Open technique See Hasson technique
Operating room 240f
Operation
related factors 79
stages of 236
diagnostic laparoscopy 236
left-track stage 236
pelvic-track stage 240
right-trac stage 237
Operative room 244f
Orbera intragastric balloon 5f
OTSC clips for revision bariatric surgery 13f
Outpatient department records 212
Ovarian cystectomies 55
P
Palmer's point 46, 4950
Pancreatic and periampullary carcinoma 181
malignancy 178
Paracolic lymph nodes 230
Parastomal hernia 37
probability of 68
Parenchymal transection 170
Parietal hematoma 41
Partial resection of posterosuperior segments 160
Patient communication 214
chart 215, 223
Patient controlled analgesia 119
Pelvic dissection
anterior 245
posterior 244
Pelvic fascia 243
Penrose drain wrap 107
Peptide YY 127
Peristomal granulation 8
Peritoneal
cancer index 179, 180f
carcinomatosis management of 180
cavity 44f
metastasis 182
Pfannenstiel laparotomy incision 163
Pigtail plastic stent 155
Plausible solutions 111
Pneumoperitoneum 40, 161, 179
creation of 114
facilitates 169
Polarization of light, mechanism of 62f
Polarizing filters 58
Polymer pill 7
Polyposis syndromes 229
Porcine liver 29
Port placement for left hemicolectomy 190f, 192f
Port positioning 164f
segmentectomy 166f
Port strategy 235f
Pose device 10f
procedure 9
Positron emission tomography 113, 177
Postfundoplication gastroparesis 109
Postlaparoscopic adjustable gastric banding 139, 144
Postsleeve gastrectomy 140
Postvertical gastric banding 140
Potential life-threatening complications 152
Pouch dilatation 137
Practice
distribution 34
variability 35
Practicing physicians 25
Preperitoneal space, dissection of 86
Pringle maneuver 161, 162
Procedure-based assessment 24
Proctectomy prograde 229
Professional
indemnity insurance 211
jurisdiction 213
Proficiency-based curricula 35
Prolene hernia system 84
Prostate ablation benign prostate hyperplasia 89
Proton pump inhibitor 88
advent of 104
Prototype from philips, mechanism of 62f
Proximal enteric vasculature 229
Psychological evaluation 138
Psychomotor skills 17
automating 17
programmed 17
assessment 29
Pulmonary complication 108
Pure laparoscopic
anterior liver segments resection 163
approach 161
left lateral sectionectomy 161
major hepatectomy 167
posterior-superior liver segments resection 165
segmentectomy I 166
Pyloric antrum 9
Q
Quadrant, left upper 46
R
Radiofrequency
ablation 12
energy with endoscopy 89
for soft tissue ablation 21
Radiological assessment 138
Recirculating hot water balloons 12
Rectal cancer 199
compression of result 200f
Rectum proximally 229
Recurrence after hernia repair, etiology of 79
Recurrence in laparoscopic inguinal hernia repair, causes of 80t
Recurrence of large hernias, incidence of 79
Recurrence-free survival 197
Recurrent
hernia 68
classified 82
incidence of 81
management of 83
inguinal hernia
anterior surgical approach 76f
for laparoscopic repair 84
minimal access surgery in 75
myopectineal orifice 77f
posterior surgical approach 77f
problems with laparoscopic repair 84
recurrence statistics 75
surgical anatomy 76
Redo surgery 110
principles of 110
role of resectional procedures 111
role of surgery for failed 111
Referral summary 222
Reflux symptoms 88
Reinhold criteria for predicting 136
Renal
cell carcinoma 182
malignancy 178
Reoperative bariatric surgery 144
complications 150
indications 144
morbidity rate of 145
preoperative evaluation 147
dietary assessment 147
documentation 147
imaging studies 147
technical intraoperative factors 147
types of 145, 146t
Resected specimen, examination of 248
Resection, lower anterior 197, 202
Reshape duo: fluid-filled dual balloon 5
Restrictive
procedures 8
vs malabsorptive procedures 147
Retinal disparity 58
Retrocolic mesenteric defect 119
Retroflexion technique 105
Retroperitoneal
hemorrhage 41
space, injury to 41
structure 229
tumors 179
Revision bariatric surgery 141
Revisional surgery, principles of 138
Revita device for mucosal resurfacing 12f
Robot-assisted laparoscopic
liver resection 174
major hepatectomy 173f
Robotic
approaches 250
liver resection 173
surgery 37
Roticulator stapler 169
Roux limb 128, 130
Roux-en-Y gastric bypass 69, 110, 125, 128, 135, 146
primary versus revision 139
jejunal loop, construction of 117
Roux-en-Y procedure 111
Roux-en-Y rescue procedure 135, 139
indications for reoperation 135
patient evaluation 137
S
Sacral promontory 244
Safe access techniques 40
Safeguarding quality 38
Safety tests 42
SAGES university master's program 25
Scissural vein 163
Sclerotherapy for Roux-en-Y stoma 13f
Screen-detected diabetes 122
Sectionectomy 160
Sedation and analgesia 20
Seereal technologies 61
Segmentectomy 160
Serosafuse fasteners 93
Serum glutamic
oxaloacetic transaminase 152
pyruvic transaminase 152
Sexual and urinary complications 204
Sham procedure 91
Shielded trocars 50
Shutter glasses 60
advantage 60
disadvantage 61
Sigmoid
cancer 199
colectomy 229
mesocolon 192, 237f
resection 192
Signet-ring cell gastric carcinoma 177
Sine-wave energy 89
Single session procedures 154
Single-port laparoscopic surgery 187
Skills
acquisition, leading to enhanced 35
laboratory 33
Sleep apnea, obstructive 140
Sleeve gastrectomy 9, 55, 125, 129f, 130, 144, 146
mechanism of action of 130
with duodenojejunal bypass 146
Sleeve stenosis, case of 148f
Sliding hernia, presence of 81
Slippage 138
Slipped stomach 109
Small bowel diverting therapies 10
Small gastric pouch restricts 130
Smoking and chronic cough 81
Society for American Gastrointestinal and Endoscopic Surgeons 92, 250-251
Solid visceval space-occupying lesion 183
Space-occupying devices 2
Spatz adjustable balloon 6
Spatz balloon 6f
Specimen extraction 236
Spectrum of issues 208
Sphincter function, results of 202t
Splenectomy 37, 55
Splenic flexure, mobilization of 193
Standalone procedure 14
Standard operating procedures 210
Staple line disruption 137
State commission dismissed 219
Stereopsis 55, 56
Stereoscopic in 3D 55
Stereoscopic view in 3D vision, mechanism of 57f
Stimulate angiogenesis 81
Stomach
and division of duodenum 115
specimen retrieval of 118f
Stomal
marginal ulceration 130
ulcer 138
Stretta 89
device 89
procedure 90, 91f
to laparoscopic fundoplication 91
Stylet-fastener assembly 93
Subcostal
port, left 235
colectomy 228
Subxiphisternal port, right 235
Subxiphoid 172
Sugarbaker technique 180
Supracolic compartment 117
Supradiaphragmatic herniation 109
Supradiaphragmatic slip of stomach 109
Suprapubic port 235
Supreme Court of India 210
Surgical
energy program, fundamental use of 21
energy, fundamental use of 21
knots 17
rehearsal 22
site infection 81
site infections, increased risk for 67
skills, acquisition of 17
skills, nontechnical 29
technical skills 29
technique for
left hepatectomy 169
right hepatectomy 168
Suture material 79
Symptomatic cholelithiasis 152
Synchronous cancers 230
T
Task complexity, increasing level of 35
Task difficulty 35
Teaching methods, variety of 25
Technical skills
acquisition of 34
feedback 33
Tension 79
Terminal ileum 247f
Thigh-length antiembolic stockings 232
Thoracic surgery 37
Thoracoscopic surgery 54
Three-dimensional
camera final view of object 63
endoscope
mechanism of 63f
view with two cameras 63f
work 61
high definition system 64
laparoscopic surgery 187
Time taken: various procedures 64t
Tissue removal 20
Total laparoscopic hysterectomy 213
Total mesorectal excision 202
concept of 187
Total proctocolectomy
specimen 249t
triple track-technique for 250f
Totally extraperitoneal vs transabdominal preperitoneal 84
Training proficiency-based 34
Training sessions 34
Trans cul-de-sac CO2 insufflation 47
Transabdominal
individualized levator transection 199
preperitoneal 54
Transanal minimally invasive surgery 187
Transcystic exploration 154
Transductal exploration 154
Transgastric
endoscopy 21
procedures 1
Transient lower esophageal sphincter 88
Transillumination of anterior abdominal wall 48f
Transoral incisionless fundoplication 89, 92
esophyx device 93
procedure 95f
Transpyloric shuttle 7, 7f
Transumbilical 45
incision 198
Transuterine insufflation 47
Transverse colon cancer 197
Trendelenburg position 114, 114f, 234
Triglycerides, elevated 124
Tubular fluoropolymer sleeve device 11
Tumor
dimension 231
invading surrounding structures 231
rupture of 230
Turnbull “no-touch” technique 230
Twin session therapy 154
U
Ulcerative colitis 229
Ultrasonic energy devices 21
Umbilical
hernia surgery 70
tube 44f
wound 119
Umbilicus 45
Union for International Cancer Control 196
United States Food and Drug Administration 89
Unresectable disease 181
Urinary
and sexual complications 199
bladder 41, 232
tract infection 108
Urological malignancy 182
US Preventive Services Task Force 49
V
Vagal nerve injury 109
Vagal preservation
advantages of 120
important role in 120
Vagal trunk 120
preservation
anterior 116
posterior 115
Vascular injury 41
VBLAST system 24f
Vena cava, inferior 162
Ventral hernia 67, 68
Ventral hernioplasties 55
Veress intraperitoneal pressure 42
Veress needle technique 4142, 48, 179
angle of insertion 42
complications 43
high-pressure entry 42
modifications 43
number of veress needle insertions attempts 43
overview of 42
safety tests 42
Vergence 56
Vertical
banded gastroplasty 137
gastric banding 135
Very-low-calorie diets 71
Vessels of the abdominal wall, injury to 41
Video recording
communication of 218
factum of 218
procedures of 218
Virtual simulators 21
Visceral
fat 68
injury 41
Vitamin deficiencies 81
W
Weight loss 139
inadequate 136, 144
options prior to hernia surgery 70
procedures 135, 136t
Weight regain 136, 139, 145
revisional therapies 12
Wide stoma 137
Will of God 215
Will-power of the patient 215
Wolff-Parkinson-White syndrome 89
Wound
cellularity 81
infection 108, 193
Z
Z-line based 90
×
Chapter Notes

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Recent Advances in MINIMAL ACCESS SURGERY
Recent Advances in MINIMAL ACCESS SURGERY
Editor-in-Chief Subhash Khanna MS FICS FIAGES FALS Head, Department of Minimal Access, Bariatric and GI Surgery Swagat Super Speciality Surgical Institute Dean Swagat Academy of Medical Sciences Guwahati, Assam, India President Indian Association of Gastrointestinal Endo-Surgeons Mumbai, India Associate Editors Ramesh Agarwalla M Kanagavel Suviraj John Editorial Board Members Abhay Dalvi Ajay Kripalani Sayandev Dasgupta Foreword Daniel B Jones
Jaypee Brothers Medical Publishers (P) Ltd
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© 2019, Jaypee Brothers Medical Publishers
The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily represent those of editor(s) of the book.
All rights reserved. No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers.
All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book.
Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.
This book is sold on the understanding that the publisher is not engaged in providing professional medical services. If such advice or services are required, the services of a competent medical professional should be sought.
Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material. If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity. The CD/DVD-ROM (if any) provided in the sealed envelope with this book is complimentary and free of cost. Not meant for sale.
Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com
Recent Advances in Minimal Access Surgery
First Edition: 2019
9789352709830
Printed at
To my parents for teaching me
the dignity of labor and for blessing me
with their wisdom that shaped my life.
To my wife Dr Swagata for her
unconditional love, understanding and encouragement.
To my children Dr Angshuman, Dr Chaitra and Dr Ayushman
for enriching my life and making it worth living.
I Love You.
Contributors Foreword
The Minimal Invasive Surgery (MIS) revolution began with the laparoscopic cholecystectomy three decades ago. More and more complex operations are being performed with fewer and smaller incisions. Patients benefit with less pain and shorter hospital stays. Enhanced recovery protocols further recuperation. With the introduction of new technologies, come the challenges for training. Robotic surgery shortens the learning curve for minimal access surgery for many surgeons.
Dr Subhash Khanna, President of Indian Association of Gastrointestinal Endo-Surgeons (IAGES), highlights advances in MIS in Recent Advances in Minimal Access Surgery. Topic range from training to the emergence of new techniques and description on novel technologies. This international compilation from experts in the field is a terrific read. Surgery continues to evolve and “Recent Advances in MAS” is a great read for both novice and master surgeons alike.
Daniel B Jones MD MS FACS
Professor
Department of Surgery
Harvard Medical School
Boston, Massachusetts, USA
Preface
Over the past two decades the field of “Minimal Access Surgery” has made continual progress across the globe in an ever increasing fashion, both in the appearance of newer approaches to well established surgical techniques and the emergence of new technologies to further reduce injury to human physiology and anatomy during an endosurgical procedure. The practical amalgamation of the above is an arduous and if not impossible task for the practicing surgeon who must critically appraise the flood of a seemingly endless deluse of published scientific evidence while carrying on his/her busy clinical routine. Yet, the clear imperative is for active clinicians to be able to access the latest emerging clinical evidence in a meaningful manner. With many thousands of surgeons currently actively performing minimal access surgery in extremely different settings, the need for updated clinical information that is relevant and responsible could not be greater.
Recognizing this, the Swagat Academy of Medical Sciences in association with Indian Association of Gastrointestinal Endo-Surgeons (IAGES) has taken up the initiative of providing a rapidly updated clinical resource—The Recent Advances in Minimal Access Surgery.
The first edition aims to provide a topical and practical surgical manual on various emerging and new clinical scenarios and arenas. This being the first edition, emphasis is also laid on new approach to basic sciences. Although in the first article I have given an overview of the progress in the field of endoscopic bariatric surgery, the articles by Rahul Gupta, Daniel Jones and by Jack Jakimowicz covers all the important aspects of the current and future emerging trends in training surgeons. Whereas Sanoop Koshy Zachariah and Venkatesh articles revisit the basics and throw light on current perspective of endoscopic vision and safe access, the other authors cover the most recent trends in colorectal, bariatric and solid organ surgery. Finally the book concludes with a very thought provoking and a must read article by Promod Kohli on medicolegal issues related to these emerging techniques.
I hope the readers will find this book a very valuable resource material for their clinical practice.
Subhash Khanna
ACKNOWLEDGMENTs
The fact of my becoming the President of Indian Association of Gastrointestinal Endo-Surgeons in the year 2018 has been the most significant and memorable event of my life.
As a teacher in Gauhati Medical College, Guwahati, India, I had already dreamt of adding value to the precious life that God Almighty has given me and this was one such occasion not only to fulfill my long cherished dream of writing a medical book but it became an obligation too for me to pay back my association in my best of ability and capacity of what I could do. I took help of my trust, the “Swagat Health and Educational Trust” to fund the book and conceptualized this book, the first edition of a series of books that are going to come forth for the benefit of MAS surgeons and students of surgery.
I thank my wife Professor Swagata for her constant support and encouragement and also my children for bearing with me and tolerating me working at odd hours all throughout.
I must offer my sincere thanks from the core of my heart to all the authors who had been very supportive and I acknowledge the fact that it is because of their efforts that I could come up with this edition as per the target date planned by me.
I would like to place on record my gratitude and indebtedness to the associate editors Ramesh Agarwalla, M Kanagavel and Suviraj John for being on their toes for helping me complete this work on time.
Apart from my team members Dhiman, Nessa and Jadav, I want to offer special thanks to Mr Sabyasachhi Hazra and Ms Nikita Chauhan of Jaypee Brothers Medical Publishers, New Delhi, for constantly guiding, supporting and following up promptly, so that this dream of mine could see the light of the day.
I assure all the readers that it would be an enriching experience for all of you going through the contents on the latest developments in minimal access surgery. I do hope this book will be an asset for all of you in the days to come.