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Tips and tricks

J Leroy (France), J Marescaux (France)

English - 20'22''
This video provides an excellent teaching demonstration of a laparoscopic transabdominal preperitoneal (TAPP) hernia repair.
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V Podelski (France), B Dallemagne (France), D Mutter (France), J Marescaux (France)

English - 05'00''
The objective of this clinical case is to illustrate the potential anatomical difficulties that may be encountered during the dissection of Calot’s triangle in the management of acute cholecystitis.
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V Podelski (France), M Vix (France), J Marescaux (France)

English - 05'45''
Gastric bypass for morbid obesity is a well standardized procedure but in case of previous surgery, perioperative challenging complications may occur. This is the case of a female patient who benefited from a gastric band removal 2 months ago because of band’s failure. The video shows the ...
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A Wattiez (France), S Maia (Portugal), A Vázquez Rodriguez (Spain), P Trompoukis (Greece)

English - 09'23''
In this interesting video, some small sequences of Professor Wattiez’s sacrocolpopexy technique that may have gone unnoticed but which may make your surgery easier are presented. Some questions will be answered, like when use a straight or a curved needle in bowel suspension to gain exposure, or ...
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AM Furtado Lima (Portugal), P Trompoukis (Greece), J Nassif (Lebanon), B Gabriel (France), A Wattiez (France)

English - 08'20''
This video demonstrates a partial cystectomy technique in a 26-year-old patient with a symptomatic bladder endometriotic nodule, localized proximal to the ureteral ostia. It is complemented with previous, intraoperative and six-week postoperative cystoscopies.
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A Wattiez (France), P Trompoukis (Greece), J Nassif (Lebanon), B Gabriel (France)

English - 07'18''
This is a case of a 30-year-old patient presenting with severe endometriosis and suffering from severe dysmenorrhea, dyspareunia, dyschezia and back pain. The MRI showed a severe reaction with rectovaginal nodule and fibrosis obliterating completely the cul-de-sac, left pararectal fossa, invading ...
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J Leroy (France), J Marescaux (France)

English - 09'53''
The objective of this video is to demonstrate the laparoscopic treatment of a recurrent voluminous suprapubic incisional hernia after the laparoscopic repair of a suprapubic incisional hernia.
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M Vix (France), J Marescaux (France)

English - 04'15''
The problem of revision of failed gastric banding (GB) procedure has become a common situation in bariatric surgery. This video presents a re-intervention in a female patient who had her gastric band removed and decides to have a laparoscopic sleeve gastrectomy.
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J Leroy (France), J Marescaux (France)

English - 10'33''
The objective of this film is to demonstrate a technique for cholecystectomy using a single port situated in the umbilicus. This home-made system is inexpensive. It has been used a lot in South Korea and Japan. It consists of a surgical glove connected to the Applied Medical Alexis® wound ...
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Gf Donatelli (France), P Dhumane (France), S Perretta (France), B Dallemagne (France), J Marescaux (France)

English - 08'08''
Duodenal diverticula are found in approximately 10-20% of patients undergoing Endoscopic Retrograde Cholangio-Pancreatography (ERCP).
Usually, these diverticula lie within 2cm of the major duodenal papilla and are called juxtapapillary diverticula. They are mostly acquired and their incidence ...
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A Wattiez (France), P Trompoukis (Greece), AM Furtado Lima (Portugal), J Nassif (Lebanon), B Gabriel (France)

English - 08'05''
Surgery is the treatment of choice for myomas. Myomectomy has undergone a dramatic evolution over the years. Laparoscopic myomectomy provides a preferable alternative to abdominal myomectomy for women with symptomatic fibroids who desire uterine preservation. It is also an excellent method for ...
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D Coumaros (France), N Lakhrib (Morocco), S Zirabe (France), J Leroy (France), J Marescaux (France)

English - 07'56''
Large pedunculated gastrointestinal tract polyps are often difficult to remove by endoscopic polypectomy. In this video, whe show our approach to perform endoscopic resection under laparoscopic control in order to intervene should there be a massive bleeding or a perforation that could not be ...
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F Costantino (France), J Marescaux (France)

English - 03'17''
This video shows a Roux-en-Y alimentary jejunostomy in a 48-year-old patient who had had symptoms of maniac and depressive psychosis and who had tried to commit suicide by drinking a cleaning product. This caused an ischemia without necrosis all along the esophagus, without reaching the stomach.
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J Leroy (France), J Marescaux (France)

English - 07'36''
Total coloproctectomy with ileal pouch-anal anastomosis is the operation of choice for both ulcerative colitis and familial adenomatous polyposis. The objective of this film is to demonstrate the benefits of mesenteric lengthening using vascular divisions in order to perform an ileoanal anastomosis ...
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J Leroy (France), F Costantino (France), J Marescaux (France)

English - 12'45''
Internal small bowel herniation through a mesenteric defect is a rare but severe complication. The purpose of the video is to demonstrate the closure of a mesenteric defect following a full left colectomy. This closure is controversial, and when performed, the closure must be perfect. This is the ...
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AJZ Khan (United Kingdom)

English - 07'34''
The key to an oncologically resection of mid or low rectal cancer is the 'en bloc' resection of the rectum and its enveloping mesentery to the level of the pelvic floor with a negative distal and radial resection margin, the total mesorectal excision (TME). This video illustrates a laparoscopic low ...
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C Mathoulin (France), P Liverneaux (France)

English - 20'00''
Wrist arthroscopy allows a thorough exploration of the radiocarpal and midcarpal joints simply by carrying out small portals. This video shows how to achieve them and what can be seen in the wrist.
The purpose of this video is to understand the principle of wrist arthroscopy and how to perform the ...
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A Wattiez (France), J Nassif (Lebanon), B Gabriel (France), S Barata (Portugal), J Marescaux (France)

English - 05'00''
In this video, we show a technique to excise a non-infiltrating endometriotic nodule of the bladder wall. After MRI study and cystoscopy, the decision to do a mucosal skinning is undertaken. Filling of the bladder, use of adequate energy and traction are the main features to perform mucosal ...
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J Leroy (France), J Marescaux (France)

English - 01'56''
The objective of this film is to demonstrate the operative strategy in case of bleeding in contact to large vessels, and here the superior mesenteric vein following division of the ileocolic vessels.
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J Leroy (France), J Marescaux (France)

English - 01'23''
The purpose of this video is to demonstrate a technique for the identification of intracolonic polyps during laparoscopy. Numerous techniques have been described, in particular ultrasonic-assisted identification for lesions of the distal colon and upper rectum. We use this identification technique ...
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E Kovoor (France), I Miranda-Mendoza (Chile), J Nassif (Lebanon), A Wattiez (France), J Marescaux (France)

English - 03'23''
In this video, we show the indications, technique and contraindications of direct port entry in laparoscopic surgery. Although this way of entry is not popular, recent data show that there are no differences in terms of safety for a way of entry (i.e., Veress needle, open laparoscopy, Hasson's ...
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N Tanigawa (Japan)

English - 06'20''
Adequate exposure enables an operation to be performed safely and with precision. In most of the upper abdominal operations, good retraction of the hepatic lobe is necessary. A simple, effective and inexpensive method of liver retraction is clearly described in this video. We apply a hand-made ...
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F Costantino (France), B Dallemagne (France), J Marescaux (France)

English - 05'14''
Schwannomas, also known as neurinomas, are generally benign, slow-growing neoplasms representing 0.2% of all gastric tumors. This is the case of a 48-year-old patient presenting with epigastralgias. A 4cm lesion is found as evidenced by the CT-scan. Gastroscopy and endoscopic ultrasonography did ...
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D Mutter (France), F Costantino (France), J Marescaux (France)

English - 08'36''
The laparoscopic approach to adrenalectomy is based on the identification of vascular landmarks. We present a typical case of right adrenalectomy using 4 ports: one epigastric port to retract the liver, three subcostal ports to explore and dissect the adrenal fossa. This is a very interesting video ...
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J Leroy (France), F Costantino (France), J Marescaux (France)

English - 07'50''
Bleeding-related complications during the mobilization of the splenic flexure via a laparoscopic approach during left colon and rectum surgery are rare. This video shows how to manage a bleeding due to a decapsulation of the inferior pole of the spleen.
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J Leroy (France), J Marescaux (France)

English - 08'50''
Vascular injury is the most urgent type of trauma at laparoscopy. The objective of this film is to demonstrate the control and mechanism of an injury to the inferior mesenteric artery during its dissection at its origin. This dissection has been performed using monopolar scissors.
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J Leroy (France), J Marescaux (France)

English - 05'36''
The aim of this video is to show a tip involving the transmesenteric route of the transverse colon to perform a tension-free colorectal anastomosis following an extensive excision of the left colon.
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J Leroy (France), J Marescaux (France)

English - 05'53''
Transanal Endoscopic Microsurgery (TEM) is a minimally invasive technique for the resection of adenomas and early rectal carcinomas unsuitable for local or colonoscopic excision, which would otherwise necessitate major surgery. The objective of this film is to demonstrate the transanal resection of ...
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D Mutter (France), J Marescaux (France)

English - 01'05''
After any major procedure, bleeding into the abdominal cavity or from the abdominal wound is possible. This complication is unusual because of the precautions that are taken, but when important bleeding happens, it may be necessary to return to the operating room. Drainage tubes are often used for ...
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J Leroy (France), J Marescaux (France)

English - 09'50''
The combination of laparoscopy and specimen extraction through a natural orifice has the potential to decrease wound complications and to improve postoperative recovery.
The objective of this film is to demonstrate the possibilities of specimen extraction of a sigmoid diverticulitis transanally ...
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A Wattiez (France), I Miranda-Mendoza (Chile), J Nassif (Lebanon), E Kovoor (France)

English - 08'42''
The laparoscopic vascular injury is an uncommon but serious complication in laparoscopy. In this video, we show a left external iliac vein injury during the dissection of the physiological attachments of the sigmoid colon in a 30-year-old woman with severe endometriosis.
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J Leroy (France), J Marescaux (France)

English - 06'20''
In hand-assisted surgery, the surgeon can insert a hand through the small incision in the abdomen and inserts his/her hand into the patient’s body, using it for sensory perception and to guide surgical instruments. Hand-assisted laparoscopic surgery is the use of the non-dominant hand ...
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M Vix (France), J Marescaux (France)

English - 09'20''
In current surgical practice, the majority of the anastomoses is performed using a stapling device. Despite correct usage, staple line failure might still occur.
Concerning surgical stapling devices, the United States Food and Drug Administration (FDA) received reports of 22,804 malfunctions, ...
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O Asoglu (Turkey)

English - 12'05''
The aim of rectal cancer surgery is to ensure good oncological outcome and maintain a good quality of life. What has laparoscopy provided us in this aspect? Using laparoscopy and considering the anatomical relationship of the superior hypogastric plexus (SHP) and inferior mesenteric artery (IMA), ...
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R Austin (United Kingdom)

English - 04'25''
Use of the total mesorectal excision technique (TME) for the abdominal part of an abdominoperineal resection procedure for a very low rectal cancer requires dissection of the mesorectum off the levator ani muscles. This results in the resected specimen having a narrow waist where the mesorectum ...
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J Leroy (France), J Marescaux (France)

English - 04'05''
Total mesorectal excision (TME) has been established as a standardized radical surgical procedure in malignant tumors of the middle and lower rectal third. The objectives of TME are low rates of locoregional recurrences and good functional results. Total mesorectal excision in the radical surgical ...
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J Leroy (France), J Marescaux (France)

English - 02'00''
The technique used for extraction of operative specimens is critical. It has the objective of avoiding too large incisions at the level of the abdominal wall since such an incision may induce incisional hernias. It also has the objective of ensuring a perfect protection of the extraction site to ...
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J Leroy (France), F Costantino (France), J Marescaux (France)

English - 03'30''
This video shows how to perform laparoscopic dissection of the presacral space following the principle of 3-directional retraction as described in open surgery by Bill Heald. Monopolar cautery scissors are used. This video is very suitable for surgeons interested in rectal surgery.
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J Leroy (France), J Marescaux (France)

English - 03'36''
This video presents a stepwise approach to perform the pelvis’ reperitonization following removal of the rectum after an abdominoperineal resection in a female patient. The surgeon uses absorbable monofilament suture material that is much easier to manipulate. Two half running sutures with an ...
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A Wattiez (France), J Nassif (Lebanon), I Miranda-Mendoza (Chile)

English - 04'00''
The identification of the ureters in some laparoscopic procedures is mandatory and is done by dissection. However, the dissection must not be regarded as a means to avoid ureteral lesions. One must always remember that after dissecting the ureters, they are no longer at their anatomical position. ...
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J Leroy (France), J Marescaux (France)

English - 03'30''
The surgical technique of intersphincteric resection (ISR) with colo-anal anastomosis has been proposed to offer sphincter preservation and to avoid permanent colostomy in patients with very low rectal carcinoma. Several studies have reported that functional results and local recurrence rates after ...
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J Leroy (France), J Marescaux (France)

English - 08'49''
The purpose of the movie is to show our technique of laparoscopic repair of a rectal prolapse using indirect pexy with a mesh.
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J Leroy (France), J Marescaux (France)

English - 03'20''
The omentum has the potential to obliterate the pelvic defects created during urological, gynecologic or digestive surgeries. The omentoplasty has been proposed as a means for reducing the perineal complication rate frequently associated. In this case, we present the technique of a laparoscopic ...
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J Leroy (France), J Marescaux (France)

English - 01'40''
Peristomial hernia is a very common complication in gastrointestinal surgery. Some degree of peristomial herniation has been claimed to be an almost inevitable complication of any ostomy formation. A stepwise approach to perform a subperitoneal tunnel iliac colostomy is presented in an attempt to ...
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E McDougall (United States)

English - 06'17''
Introduction & objective: laparoscopic partial nephrectomy is rapidly emerging as a potential surgical option for select renal tumors. The most challenging aspect of the procedure is the effective hemostatic closure of the collecting system and the renal parenchyma. We present our modification of ...
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D Fausto (Mexico)

English - 05'52''
In 1997, we initiated what we considered our philosophy of the "surgery without trace", when replacing the ports of attendance by percutaneous needles of 1mm or less (hook-needle, passing suture needle, reins of traction). Of immediate way our technique showed its kindness to us and since then we ...
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D Varela (France), J Marescaux (France)

English - 08'25''
One of the disadvantages of open nephrectomy is the appearance of symptomatic incisional hernias. In this video, we present the case of a patient with a subcostal incisional hernia occuring after an open nephrectomy repared laparoscopically.
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J Leroy (France), J Marescaux (France)

English - 03'00''
A stepwise approach to perform a laparoscopic ileocolic anastomosis is shown. The anastomosis is performed totally intra-abdominally, thus avoiding the need to perform a mini-laparotomy.
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TOC link: 
General and digestive > Colon > Diverticulitis

J Leroy (France), J Marescaux (France)

October 2008
English - 05'46''

This video shows a unique procedure during which a sigmoidectomy was performed with a single trocar and entirely through the umbilicus. The principles applied to benign colonic resections are respected. An original colo-colonic anastomosis is presented with the use of external magnets to aid in with the totally intracorporeal anastomosis. The postoperative cosmetic results are shown.

Keywords: single port sigmoidectomy: tips and tricks for exposure and anastomosis


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00'02'' Clinical case presentation
00'21'' Trocars
01'56'' Introduction of the anvil
02'52'' Colonic resection
03'44'' Anvil exposure and extraction
04'22'' Lateral mobilisation
05'35'' Endoscopic view of the anastomosis
05'44'' Specimen extraction

J Leroy (France), J Marescaux (France)

English - 14'00''
This video shows a series of technical tips and tricks for the identification, dissection and ligation of the main vascular elements during a laparoscopic left colonic resection using the LigaSure Advance™.
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J Leroy (France), J Marescaux (France)

English - 03'00''
This video presents a stepwise approach to a TME dissection in a female patient. It shows the advantages of using the new Ligasure advance for landmark identification and preservation in restrained areas; here, the pelvic area.
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M Vix (France), J Marescaux (France)

English - 06'46''
This video demonstrates a series of technical tricks designed to overcome the specific challenges of laparoscopic cholecystectomy in morbidly obese patients.
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M Vix (France), J Marescaux (France)

English - 04'05''
This video shows the advantages of performing a laparoscopic gastrojejunostomy in a gastric bypass with the new DST Series EEA stapler. Every operative step is clearly shown and described.
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J Leroy (France), J Marescaux (France)

English - 04'02''
This video presents a laparoscopic right colectomy performed with the aid of the new Ligasure Advance. The combination of advanced tissue fusion and division functionalities thanks to a dissecting electrode, allows for a more effective and a less time-consuming procedure.
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J Leroy (France), J Marescaux (France)

English - 05'20''
This video describes an elective laparoscopic sigmoidectomy for benign disease with the aid of the new Ligasure Advance. This 5mm laparoscopic electrosurgical instrument incorporates both a monopolar and tissue fusion (bipolar) function.
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J Leroy (France)

English - 09'15''
This is a detailed demonstration of an anterior resection, specifically highlighting the key steps to prevent nerve injury at various stages.
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D Mutter (France), J Marescaux (France)

English - 07'22''
This video demonstrates the laparoscopic approach to cholecystectomy for acute cholecystitis. Key points such as gallbladder decompression, adhesiolysis and exposure of the operative field and dissection of Calot’s triangle during acute inflammation are described in detail.
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M Simone (France), J Leroy (France), J Marescaux (France)

English - 14'00''
This didactic video describes the principles of sigmoid colon resection. Different operative strategies are presented; contrasting the key steps in resection for neoplastic and non-neoplastic conditions. The vascular approach is emphasized, and super-selective vascular dissection of the inferior ...
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F Rubino (United States), M Vix (France), M Simone (France), S Sereno (Mexico), J Marescaux (France)

English - 03'57''
Internal hernia is a known complication after gastric bypass, especially when performed laparoscopically.
Potential internal locations include a transverse mesocolon defect; Petersen’s space, the area between the mesentery of the Roux limb and the transverse mesocolon; and a jejunojejunostomy ...
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M Vix (France), M Simone (France), F Rubino (United States), J Marescaux (France)

English - 08'00''
This video demonstrates the use of a EEA circular stapler in performing the gastro-jejunal anastomosis during the gastric bypass surgery. The surgeon demonstrates the preparation of the anvil, the transoral intubation, and introduction of the shaft. This video is intended to provide basic ...
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M Vix (France), M Simone (France), F Rubino (United States), J Marescaux (France)

English - 08'00''
This video demonstrates a technique of jejunojejunostomy in an antecolic Roux-en-Y gastric bypass procedure. The surgeon shows how to measure the alimentary and biliary limb and to complete the anastomosis without twisting of the bowel. He also demonstrates the closure of mesenteric defects, which ...
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J Leroy (France), M Simone (France), J Marescaux (France)

English - 07'00''
Obesity may pose certain technical difficulties for the laparoscopic surgeon in terms of positioning, exposure, and dissection. We believe that the surgical outcome might be equalized between obese and non-obese patients if the appropriate key operative steps are respected. Here we show certain ...
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