Esophageal disease states Achalasia Definition Achalasia is a primary esophageal motor disorder of unknown cause, which is characterized by insufficient lower esophageal sphincter (LES) relaxation and aperistalsis. Etiology The cause…
Esophageal testing Endoscopy Indications Endoscopy is the technique of choice to detect structural abnormalities of the esophagus and to evaluate the mucosa. The most common indications include dysphagia, symptoms of…
Esophageal symptom assessment Typical symptoms Heartburn (pyrosis) and acid regurgitation Definition Heartburn is a substernal burning sensation, usually occurring from 30 minutes to 2 hours post-prandial, that can radiate up…
Normal esophageal anatomy and physiology Gross anatomy The esophagus is a muscular tube connecting the pharynx to the stomach, the proximal margin of which is the upper esophageal sphincter (UES)….
Additional Operative Procedures LAPAROSCOPIC LATERAL-TO-MEDIAL MOBILIZATION OF THE SIGMOID COLON Please review the accompanying video for this chapter. In this video, we demonstrate an alternate approach to sigmoid mobilization. A…
Complications and Difficulties KEY STEPS 1. Transilluminating the abdominal wall and inserting ports lateral to the visualized epigastric vessels will reduce hemorrhagic port site problems. 2. To avoid inadvertent cautery…
Laparoscopic Reversal of Hartmann’s Procedure KEY STEPS 1. Peristomal incision for stoma mobilization; 0 polypropylene purse-string suture and insertion of a circular stapler anvil into the distal end of the…
Laparoscopic Hartmann’s Procedure KEY STEPS 1. Insertion of ports: 10-mm umbilical Hasson technique; 12-mm right iliac fossa; 5-mm right upper quadrant; 5-mm left iliac fossa (optional). 2. Patient rotated to…
Laparoscopic Loop Ileostomy and Loop Colostomy Formation KEY STEPS 1. Insertion of ports: a. Loop ileostomy: 10-mm umbilical Hasson technique; 5-mm left iliac fossa; optional 5-mm left upper quadrant. b….
Laparoscopic Resection Rectopexy KEY STEPS 1. Insertion of ports: 10-mm umbilical open technique; 12-mm right iliac fossa; 5-mm right upper quadrant; 5-mm left iliac fossa. 2. Patient rotated to the…
