1;Advanced Laparoscopic Surgery;3 1.1;Preface;7 1.2;Acknowledgements;9 1.3;Contents;11 1.4;1 General Concepts;19 1.4.1;The Checklist Approach;19 1.4.1.1;The Team;19 1.4.1.2;The Instruments;20 1.4.2;Patient Positioning;21 1.4.2.1;Setup for Upper Abdominal Surgery;21 1.4.2.1.1;Basic Laparoscopic Cholecystectomy;21 1.4.2.1.2;Setup for Advanced Upper Abdominal Surgery;21 1.4.2.2;Setup for Lower Abdominal Surgery;23 1.4.3;The Working Environment;25 1.4.4;Appraisal of Surgical Instruments;27 1.4.4.1;Trocars;27 1.4.4.1.1;Choosing an Appropriate Trocar;27 1.4.4.1.2;Disposable Trocars;27 1.4.4.1.3;Nondisposable Trocars;28 1.4.4.1.4;Optical Viewing Trocars;28 1.4.4.1.5;Prevention of Accidents with Trocars;30 1.4.4.1.6;Triangulation of Trocars;30 1.4.4.2;Other Instrumental Requirements;31 1.4.4.2.1;Laparoscopes;31 1.4.4.2.2;Cameras;32 1.4.5;Creation of the Pneumoperitoneum;32 1.4.5.1;Troubleshooting Loss of Pneumoperitoneum;33 1.4.6;Principles of Hemostasis;33 1.4.6.1;Control of Bleeding of Unnamed Vessels;33 1.4.6.2;Control of Bleeding of a Main Named Vessel;35 1.4.7;Irrigation and Suction Devices;36 1.4.8;Selected Further Reading;37 1.5;2 Cholecystectomy;39 1.5.1;Basic Laparoscopic Cholecystectomy;39 1.5.2;Acute Gangrenous Cholecystitis;46 1.5.3; "Dangerous" Cholecystectomy;47 1.5.4;Impacted Stone (Hydrops, Empyema, Early Mirizzi);47 1.5.5;Avoiding Injury to the Common Bile Duct;50 1.5.6;Controlling Bleeding in the Liver Bed;53 1.5.7;Adhesions Due to Previous Upper Midline Laparotomy;53 1.5.8;Selected Further Reading;55 1.6;3 Common Bile Duct Explorations and Bilioenteric Anastomosis;58 1.6.1;The Transcystic Approach;58 1.6.2;The Common Bile Duct Approach;59 1.6.3;Choledochoduodenostomy;61 1.6.4;Hepaticojejunostomy with a Roux-en-Y;61 1.6.5;Selected Further Reading;64 1.7;4 Laparoscopic Liver Surgery;66 1.7.1;The Need for Specialized Equipment;66 1.7.2;Positioning the Patient and Operating Team;67 1.7.3;Access to the Liver;67 1.7.4;Maneuvers Common to All Laparoscopic Liver Surgery;70 1.7.5;Diagnostic Laparoscopy;72 1.7.6;Fenestration of Liver Cysts (Fig. 4.6);72 1.7.7;Resection of Liver Tumors;72 1.7.8;Limited Resection of Minor Lesions;74 1.7.9;Left Lateral Segmentectomy;75 1.7.10;Right Hepatectomy;78 1.7.11;Treatment and Prevention of Perioperative Complications;79 1.7.12;Patient Selection;80 1.7.13;Selected Further Reading;81 1.8;5 Esophageal Surgery;83 1.8.1;Nissen Fundoplication;83 1.8.1.1;Principles of Surgical Therapy in the Management of Gastroesophageal Reflux Disease;83 1.8.1.2;Patient Positioning;83 1.8.2;Technique;84 1.8.2.1;Access to the Hiatus;87 1.8.2.2;Identification of the Left Crus at the Right Side of the Esophagus;87 1.8.2.3;Creation of a Window Under the Esophagus;87 1.8.2.4;Division of the Phrenoesophageal Membrane;90 1.8.2.5;Division of the Short Gastric Vessels;90 1.8.2.6;Crural Closure and Fundoplication;95 1.8.3;Postoperative Course;96 1.8.4;Management of Complications;97 1.8.4.1;Bleeding During the Procedure;97 1.8.4.2;Perforation of the Esophagus;97 1.8.4.3;Mechanical Problems;98 1.8.5;Toupet Posterior Partial Fundoplication;100 1.8.6;Paraesophageal Hernia;102 1.8.7;Esophageal Myotomy for Achalasia;105 1.8.8;Vagotomies;105 1.8.8.1;Bilateral Truncal Vagotomy;105 1.8.8.2;Highly Selective Vagotomy;107 1.8.8.3;Lesser Curvature Seromyotomy and Posterior Truncal Vagotomy;110 1.8.9;Selected Further Reading;113 1.9;6 Gastric Surgery;117 1.9.1;Pyloroplasty;117 1.9.2;Vagotomy with Antrectomy or any Distal Gastrectomy;119 1.9.2.1;Port Placement;119 1.9.2.2;Technique;120 1.9.2.2.1;Division of the Right Gastroepiploic Artery and Retroduodenal Dissection;122 1.9.2.2.2;Intra-abdominal Gastrojejunostomy and Billroth II Reconstruction;123 1.9.2.2.3;Laparoscopic Gastrojejunostomy and Roux-en-Y Reconstruction;123 1.9.2.2.4;Laparoscopically-Assisted Gastrojejunostomy;125 1.9.3;Perforated Duodenal Ulcer;126 1.9.3.1;Locating the Perforation;126 1.9.3.2;Abdominal Washout;128 1.9.3.3;Closure of the Perforation with an Omental Patc