آموزش مجازی ویژه جراحان جنرال

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, with the majority found in the stomach. Surgical resection of the primary gastric GISTs with complete resection margin has been the forefront of curative treatment. The indications for surgical resection are usually related to symptomatic gastric GISTs at presentation. Primary gastric GISTs resection performed conventionally through an open surgery can now be frequently achieved by minimal invasive surgery with similar oncological outcome. Surgeon’s selection of the type of surgical techniques such as open, laparoscopic and endoscopic resections depends on the site, size and local invasion of gastric GISTs to the adjacent organ. Similarly those factors dictate the extent of gastric resections in the form of wedge, partial or total gastrectomy. All these inherent tumor factors (size and mitotic index), patient factors (older age, male) and surgical factors (incomplete resection margin, tumor rupture or spillage) play an important role in stratifying the malignant potential risk of primary gastric GISTs and their chances of recurrence.

Step 1: Dissection of the hepatocystic triangle. ...Step 2: Establishing the critical view of safety. ...Step 3: Cystic artery is clipped and divided. ...Step 4: Operative cholangiography and division of the cystic duct. ...Step 5: Gallbladder separation from the liver bed.

Modern laparoscopy was introduced into the world of abdominal surgery in the late 1980’s. Since then, laparoscopic colorectal surgery has quickly evolved, and it has become the preferred surgical approach for most patients with colorectal disease. A laparoscopic approach to right colon resection can be performed for a variety of benign and malignant conditions. Many studies have demonstrated the benefits of laparoscopic colorectal surgery which include faster patient recovery. In this video, we demonstrate dissection, vascular identification and hemostasis and anastomosis.