Minimally Invasive Ivor Lewis Esophagectomy
Christopher Morse, MD
Massachusetts General Hospital
Esophageal cancer is a growing problem in the United States. Surgical resection, often in combination with chemoradiotherapy, provides the only approach to offer a cure for these patients. Traditional open approaches are burdened by high levels of morbidity and mortality. Minimally invasive esophagectomy (MIE) has been proposed as an alternative approach. Although MIE is complex and perhaps more time-consuming, perioperative results are encouraging and generally trend toward fewer pulmonary complications, lower blood loss, shorter ICU stays, and shorter overall hospitalization durations.
Colon Interposition to Replace an Absent Esophagus is the Procedure of Choice in Low-Income Countries
Yoko Young Sang, MD1; Caroll Alvarado Lemus, MD2; Domingo Alvear, MD3
1Louisiana State University Shreveport
2Mario Catarino Rivas Hospital, Honduras
3World Surgical Foundation
This surgical video article offers a comprehensive demonstration of the colon interposition procedure, highlighting the critical operative steps and technical nuances involved in performing a successful esophageal replacement, particularly in resource-limited settings, where advanced treatment options such as gastric pull-up or jejunal interposition may be limited. Colon interposition remains a viable solution for restoring swallowing function in patients with EA or other esophageal disorders requiring esophageal replacement.
By providing a detailed visual representation of the surgical process, this video serves as a valuable educational resource for surgeons and healthcare professionals involved in the care of patients with EA or related conditions. It underscores the importance of meticulous surgical technique, vascular preservation, and careful planning to ensure successful outcomes. Moreover, the video emphasizes the crucial role of multidisciplinary care in managing these complex cases. The involvement of specialists in pediatric surgery, anesthesiology, and intensive care is essential for optimizing patient outcomes and addressing potential complications.
Per-Oral Endoscopic Myotomy (POEM)
Massachusetts General Hospital
David Rattner, MD
Chief of General and Gastrointestinal Surgery
Ozanan R Meireles, MD
General and Gastrointestinal Surgery
Dr. Rattner and Dr. Meireles endoscopically generate a submucosal tunnel to reach and release the circular muscles of the lower esophageal sphincter to help alleviate a patient’s achalasia.
Laparoscopic Paraesophageal Hernia Repair
David Rattner MD
Chief of Gastrointestinal and General Surgery
Massachusetts General Hospital
Dr. Rattner tackles a problematic paraesophageal hernia, systematically retracting the stomach into the abdominal cavity. He finishes the procedure by performing both a toupet fundoplication and gastropexy.
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