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Showing posts from September, 2011

Hand Assisted Laparoscopic Surgery

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Case of Cancer of the lower end of the bile duct

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This is a case of cholangio carcinoma i.e cancer of the lower end of the bile duct. The image shows an MRCP(MR cholangiopancreatography) with blockage of the lower end of the bile duct. The pancreatic duct is also dilated. The patient was operated and a whipple’s operation was done where we removed the tumour along with part of the stomach, head of pancreas, lower end bile duct and re anastomosed the remaining structures. The patient is doing well.







HALS ( Hand Assisted Laparoscopic Surgery) used for colorectal cancer surgery

Lot of surgeons doing open colorectal oncology surgery but only < 10 % doing laparoscopic colorectal surgeryMost of these laparoscopic colorectal procedures require an incision 5-6cmExtracorporeal resection, anastomosis, purse string for anvil and Retrieval of specimenMost of the surgeons are doing basic laparoscopic procedures and would like to venture into laparoscopic colorectal surgery but have basic inhibitions: equipment, learning curve BleedingSuturingApprehension of conversion HALS( Hand assisted laparoscopic surgery) is a hybrid operation which allows the surgeon to introduce the non-dominant hand into the abdominal cavity through a special hand port while maintaining the pneumoperitoneumMain advantages of HALS areAdequate maneuverability Tissue retraction blunt dissection control of vascular pedicleImproved tactile feed back, Specimen removal easierResults of patient recovery are similar to total la…