- •Preface
- •Acknowledgements
- •Contents
- •The Team
- •The Instruments
- •Patient Positioning
- •Setup for Upper Abdominal Surgery
- •Setup for Lower Abdominal Surgery
- •The Working Environment
- •Appraisal of Surgical Instruments
- •Trocars
- •Other Instrumental Requirements
- •Troubleshooting Loss of Pneumoperitoneum
- •Principles of Hemostasis
- •Control of Bleeding of Unnamed Vessels
- •Control of Bleeding of a Main Named Vessel
- •Selected Further Reading
- •2 Cholecystectomy
- •Impacted Stone (Hydrops, Empyema, Early Mirizzi)
- •Adhesions Due to Previous Upper Midline Laparotomy
- •Selected Further Reading
- •Selected Further Reading
- •The Need for Specialized Equipment
- •Access to the Liver
- •Maneuvers Common to All Laparoscopic Liver Surgery
- •Resection of Liver Tumors
- •Limited Resection of Minor Lesions
- •Left Lateral Segmentectomy
- •Right Hepatectomy
- •Patient Selection
- •Principles of Surgical Therapy in the Management of Gastroesophageal Reflux Disease
- •Patient Positioning
- •Technique
- •Postoperative Course
- •Management of Complications
- •Paraesophageal Hernia
- •Esophageal Myotomy for Achalasia
- •Vagotomies
- •Bilateral Truncal Vagotomy
- •Highly Selective Vagotomy
- •Lesser Curvature Seromyotomy and Posterior Truncal Vagotomy
- •Selected Further Reading
- •Pyloroplasty
- •Vagotomy with Antrectomy or any Distal Gastrectomy
- •Port Placement
- •Technique
- •Locating the Perforation
- •Abdominal Washout
- •Closure of the Perforation with an Omental Patch
- •Postoperative Course
- •Selected Further Reading
- •7 Appendectomy
- •OR Setup and Port Placement
- •Technique
- •Gangrenous or Perforated Appendicitis
- •Laparoscopic Assisted Appendectomy
- •Left Hemicolectomy
- •Reversing the Hartmann Procedure
- •Selected Further Reading
- •Selected Further Reading
- •Transabdominal Preperitoneal Repair (TAPP)
- •Patient and Port Positioning
- •Dissection of the Preperitoneal Space
- •Dissection of the Cord Structures and the Vas Deferens
- •Placement of the Mesh and Fixation
- •Closure of the Peritoneum
- •Indications
- •Technique
- •Positioning
- •Pneumoperitoneum
- •Port Placement
- •Adhesiolysis
- •Measurement of the Hernia Defect
- •Placement of Mesh
- •Difficult Ventral or Incisional Hernias
- •Pain Following Laparoscopic Ventral or Incisional Hernia Repair
- •Preoperative Requirements and Workup
- •Patient Positioning
- •Port Placement
- •Surgical Anatomy
- •Surgical Principles
- •Technique
- •Division of the Short Gastric Vessels and Exposure of the Tail of the Pancreas
- •Division of the Hilar Vessels and Phrenic Attachments
- •Extraction of the Spleen in a Bag
- •Final Steps of the Procedure
- •Control of an Unnamed Vessel
- •Control of a Major Vessel
- •Splenic Injury
- •Maneuver of Last Resort During Bleeding of the Hilar Vessels
- •Distal Splenopancreatectomy
- •Selected Further Reading
- •13 Adrenalectomy
- •Principles
- •Patient Positioning
- •Technique
- •Immediate Postoperative Complications
- •Late Postoperative Complications
- •Laparoscopic Adjustable Band
- •Technique
- •Complications
- •Laparoscopic Sleeve Gastrectomy
- •Selected Further Reading
- •Laparoscopic Cholecystectomy
- •Laparoscopic Appendectomy
- •Laparoscopic Inguinal Hernia Repair
- •Selected Further Reading
- •Monitors
- •OR Table
- •Trocar Placement and Triangulation
- •Equipment
- •Needle Holders
- •Graspers
- •Suture Material
- •Intracorporeal Knot-Tying
- •Interrupted Stitch
- •Running Stitch
- •Pirouette
- •Extracorporeal Knot-Tying
- •Roeder’s Knot
- •Endoloop
- •Troubleshooting
- •Lost Needle
- •Short Suture
- •Subject Index
Advanced Laparoscopic Surgery: Techniques and Tips
Namir Katkhouda
Namir Katkhouda
Advanced
Laparoscopic
Surgery
Techniques and Tips
2nd Edition
123
NAMIR KATKHOUDA, MD
Professor of Surgery
Vice Chairman for Clinical Affairs Chief, Division of General and Laparoscopic Surgery
Director, Bariatric Surgery Program University of Southern California Keck School of Medicine Department of Surgery
1510 San Pablo St.
Los Angeles, CA 90033, USA
katkhoud@surgery.usc.edu or nkatkhouda@surgery.usc.edu
Illustrator:
Timothy C. Hengst 1631 Calle de Oro Thousand Oaks CA 91360-7012, USA tim@thengst.com
ISBN 978-3-540-74842-7 |
eISBN 978-3-540-74843-4 |
Springer Heidelberg Dordrecht London New York
Library of Congress Control Number: 2010935945
1998 W.B. Saunders Company Ltd., 2010 Springer-Verlag Berlin Heidelberg
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Springer is part of Springer Science+Business Media (www.springer.com)
To God, who guides my life.
To my wife, Dominique, for her eternal love and support. Without her, many important things would not have happened. To my beloved children, Nadine and Philippe.
They deserve the absolute best for their understanding of their “busy” father. To my mother whom I love dearly.
To my brothers.
In memory of my father.
Preface
When I wrote and published the first edition of Advanced Laparoscopic Surgery “Techniques and Tips” in 1998, I wanted to share with all general surgeons, residents, attendings and senior faculty alike the experience that I accumulated in laparoscopic surgery over a period of 10 years. I knew at the time that the biggest hurdles for a wide adoption of advanced techniques were the specialized surgical skills involved, including laparoscopic suturing. The chapters included the procedures that were performed routinely and for which there was evidence to support the practice of the techniques. The continued success of the book after it was translated into Spanish and its widespread sale even in Asia confirmed that I was correct in my assumptions. My greatest satisfaction was that the “red book”, as it became known, was on the shelf of most surgical residency program libraries. In 2008, 10 years later and 20 years following my first laparoscopic cholecystectomy, I embarked on another big project, namely to write the second edition. For this book, I deleted procedures that were abandoned, such as laparoscopic spine fusion, but added all the newest procedures, including laparoscopic ventral hernia repair, laparoscopic hepatectomy, and a large chapter on laparoscopic bariatric surgery including gastric bypass, gastric band and sleeve gastrectomy. I also ensured that the newest, most innovative techniques were presented, such as laparoscopic single access surgery, and of course advanced laparoscopic suturing , the Holy Grail of advanced laparoscopic surgery, a skill without which advanced laparoscopic training remains incomplete.
I did not forget the rest of the GI procedures, many of which were redone, and color figures were added. Another new feature is the inclusion of 2 DVDs of some of my techniques so readers can get a more “live” idea of my concepts.
I hope that I have reached the ambitious goals that I set forth in this “blue book”: complex laparoscopic techniques made simpler and upheld by surgical excellence.
Los Angeles, February 14, 2010 |
NAMIR KATKHOUDA, MD, FACS |
Acknowledgements
ASHKAN MOAZZEZ, MD
Assistant Professor of Clinical Surgery
Division of General and Laparoscopic Surgery
Department of Surgery
University of Southern California
His assistance was invaluable
TIM HENGST
Medical illustrator
His artistic talent is unsurpassed
VAUGHN A. STARNES, MD, FACS
Distinguished Professor and Chairman
Department of Surgery
Founder and Director, USC Cardiothoracic Institute
University of Southern California
“In the USC Department of Surgery”, he once said,“surgical excellence is minimum standard”. I could not agree more. For his confidence and friendship.