Extralevator Abdominoperineal Resection (APR) for Recurrent Anal Cancer With an En Bloc Total Abdominal Hysterectomy and Bilateral Salpingo-Oophorectomy and Total Vaginectomy With Permanent Colostomy Formation and Pelvic Floor Reconstruction Using a Right Rectus Abdominis Flap
Zoe Garoufalia, MD; Steven D. Wexner, MD, FACS
Cleveland Clinic Florida
This video provides a step-by-step, detailed demonstration of this extensive surgical procedure performed on a 53-year-old female patient with recurrent anal cancer after initial chemoradiotherapy. The surgical technique is thoroughly illustrated, emphasizing the importance of proper anatomical planes, multidisciplinary coordination, and reconstructive considerations.
Diagnostic Laparoscopy and Small Bowel Resection for a Large Meckel’s Diverticulum in Adult with Persistent GI Bleed
Julie Thomann, MD; Nicole B. Cherng, MD, FACS, FASMBS
UMass Memorial Medical Center
Symptomatic Meckel’s diverticulum is a diagnosis most commonly associated with male children under two years old. It typically presents with painless hematochezia and is diagnosed with a Meckel’s scan, which uses Technetium-99 to detect ectopic gastric tissue. In an adult with gastrointestinal bleeding, the differential is far broader, including an extensive and at times, inconclusive, work-up. Here, we describe a diagnostic laparoscopy for suspicion of Meckel’s diverticulum in a young adult male whose work-up showed evidence of small bowel bleeding without a definitive source. A large 6.2-cm, broad-based Meckel’s diverticulum was identified about 90 cm proximal to the ileocecal valve and resected via small bowel resection.
Reversal of a Diversion Loop Ileostomy in a Patient with a Prior Gracilis Transposition Flap for Rectovaginal Fistula Due to Crohn’s Disease
Zoe Garoufalia, MD; Steven D. Wexner, MD, FACS
Cleveland Clinic Florida
This case takes an in-depth look at the reversal of a diverting loop ileostomy performed for a patient who had received a prior gracilis transposition flap for a rectovaginal fistula due to Crohn’s disease. This video provides a detailed step-by-step demonstration of the reversal of this diverting loop ileostomy. It serves as an excellent educational resource for surgeons learning how to close loop ileostomies.
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