The Perfect Gastric Sleeve

30min sped up version of a one hour uncut videoclip showing the best in difficult bariatric revisional surgery

free all adhesions and use the band as a guide to dissect the tunnel and the surrounding adhesions

remove the gastric band associated scar tissues and adhesions causing gastric deformity
dissect the hiatus, free the mediastinal adhesions and reduce the hiatus hernia, repair by posterior crural proximation with oeso-phrenic fixation
staple a uniform gastric tube from the pylorus to the angle of His
thorough fixation of the gastric tube to the omentum to avoid twisting, kinking or hiatal herniation
the conversion is best performed in one operation

Exemplary Surgery

Band to Sleeve Conversion

FlexDex

Exemplary Surgery -TEP

Total extraperitoneal bilateral inguinal hernia mesh repair – uncut video

The patient had three previous laparotmies – a vertical midline laparotomy for endometriosis, a Pfannenstiel incision for hysterectomy and a midline subumbilical laparotomy for bowel obstruction.

Despite all odds the surgery is performed like there was no previous surgery:

-The extraperitoneal space is dissected with an optical trocar and insufflation.

-The anatomy is very clearly presented.

-The mesh fixation is performed with biological glue avoiding stapling which causes pain and nerve injury.

-The patient is pain free next morning.

Exemplary Surgery - Emergency laparoscopic right hemicolectomy for severe acute GI bleeding from ulcerated adenocarcinoma

- 3 port MIS with intra-corporeal anastomosis

- 79 year old with multiple major comorbidities

- transfused 11 units packed cells and recurrent bleeding

- CCF/AF/Pacemaker/anticoagulation/diabetes

- severe renal failure

- non-Hodgkin lymphoma, end stage liver cirrhosis, obesity

- patient mobile in 24 hours, eating in 3 days, no further bleeding or transfusions, no other minor or major complications