robotic-vagus-sparing-total-gastrectomy-for-cdh1-gene-mutation

Robotic Vagus-Sparing Total Gastrectomy for CDH1 Gene Mutation Treatment

Hereditary diffuse gastric cancer (HDGC) caused by the CDH1 gene mutation is an inherited cancer syndrome that increases the risk of diffuse gastric ...

The University of New South Wales

Acute cholecystitis is a common condition. Recent studies have shown an association between creation of an acute surgical unit (ASU) and improved outcomes. This study aimed to evaluate the outcomes of a subspecialty based approach to the management of acute cholecystitis as an alternative to the traditional 'generalist' general surgery approach or the ASU model.

Subspecialty approach for the management of acute cholecystitis: an alternative to acute surgical unit model of care.

Laparoscopic ventral repair is safe, with lower wound infection rates compared with open repair. 'Venetian blinds' technique of plication in combination with mesh reinforcement, is totally intra-corporeal, with hernia defect and sac plication to reduce seroma formation. While laparoscopic suturing of the abdominal wall can represent a technical challenge, pre-operative botulinum toxin A (BTA) injections as an adjunct can assist. This study aims to demonstrate feasibility and efficacy of this technique in abdominal wall hernia repair, with BTA adjunct in midline hernias.

Minimally invasive Venetian blinds ventral hernia repair with botulinum toxin chemical component separation.

Obesity is becoming increasingly prevalent in Asia. Bariatric surgery in the region is growing in popularity to reflect increasing demand. Hiatal hernia (HH) is common among the obese population. There is a lack of evidence comparing preoperative endoscopy against intraoperative findings as a standard of reference for HH diagnosis.

Accuracy of hiatal hernia diagnosis in bariatric patients: Preoperative endoscopy  intraoperative reference.

There is a complex association between obesity, hiatal hernia (HH), and reflux. There is a deficiency of literature on the accuracy of preoperative high-resolution manometry (HRM) in detecting HH before both primary and revision bariatric surgery.

Accuracy of High-Resolution Manometry in Hiatal Hernia Diagnosis in Primary and Revision Bariatric Surgery.

Gastroesophageal reflux is a known complication following laparoscopic sleeve gastrectomy (LSG) as anatomical changes predispose to reduced lower esophageal sphincter pressure and development of hiatus hernia. The mainstay of surgical management has been Roux-en-Y gastric bypass (RYGB) which is not without risk. Hiatus hernia repair (HHR) with surgical reattachment of the oesophagus to the crura, recreating the phreno-esophageal ligament is a simple procedure specifically targeting a number of anatomical changes responsible for reflux in this population.

Article	Year
Subspecialty approach for the management of acute cholecystitis: an alternative to acute surgical unit model of care. ANZ journal of surgery\| PubMed ID: 28512772	2017
Minimally invasive Venetian blinds ventral hernia repair with botulinum toxin chemical component separation. ANZ journal of surgery\| PubMed ID: 31566297	2020
Accuracy of hiatal hernia diagnosis in bariatric patients: Preoperative endoscopy intraoperative reference. JGH open : an open access journal of gastroenterology and hepatology\| PubMed ID: 33319039	2020
Accuracy of High-Resolution Manometry in Hiatal Hernia Diagnosis in Primary and Revision Bariatric Surgery. Obesity surgery\| PubMed ID: 33852151	2021
Hiatal reconstruction is safe and effective for control of reflux after laparoscopic sleeve gastrectomy. BMC surgery\| PubMed ID: 36131312	2022

Michael L. Talbot

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