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Online university

The largest online video library in minimally invasive surgery.

Educational support

WebSurg is a virtual university created by surgeons for surgeons. It is an extensive source of knowledge in minimally invasive surgery. It is free and accessible to all. WebSurg promotes technological advances in the field of minimally invasive surgery, in all surgical fields, i.e. general and digestive surgery, urology, gynecology, pediatric surgery, endoscopic surgery, skull base surgery, arthroscopy and upper limb surgery. Define your educational objectives and watch the videos which correspond to your specialty.

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WeBsurg allows you to improve your surgical skills but also to share your knowledge with the largest community of surgeons worldwide. Submit the video of your surgical procedure on our website and become part of our international Faculty.

Surgical intervention
12:41
Laparoscopic subtotal gastrectomy with ICG-oriented extended D2 (D2+) lymphadenectomy
The concept of fluorescence-guided navigation surgery based on indocyanine green (ICG) testifies to a developing interest in many fields of surgical oncology. The technique seems to be promising, also during nodal dissection in gastric and colorectal surgery in the so-called “ICG-guided nodal navigation”.
In this video, we present the clinical case of 36-year-old man with a seeming early stage antral gastric adenocarcinoma, as preoperatively defined, submitted to a laparoscopic subtotal gastrectomy and D2+ lymphadenectomy.
Before surgery, the patient was submitted to endoscopy with the objective to inject indocyanine green near the tumor (2mL injected into the mucosa 2cm proximally and 2cm distally to the tumor) in order to visualize the lymphatic basin of that tumor during the operation.
Thanks to the ICG’s fluorescence with the light emitted from the photodynamic eye of our laparoscopic system (Stryker 1588® camera), it is possible to clearly visualize both the individual lymph nodes and the lymphatic collectors which drain ICG (and lymph) of the specific mucosal area previously marked with indocyanine green.
This technique could allow for a more precise and radical nodal dissection and a safer work respecting vascular and nerve structures.
Laparoscopic subtotal gastrectomy with ICG-oriented extended D2 (D2+) lymphadenectomy
G Baiocchi, S Molfino, B Molteni, L Arru, F Gheza, M Diana
1073 views
1 month ago
Surgical intervention
09:34
Laparoscopic revision of Nissen fundoplication to Roux-en-Y gastric bypass
Introduction: Obesity is a known etiological factor for gastroesophageal reflux disease (GERD) and is also a growing public health concern. Although Nissen fundoplication is a highly effective technique to treat GERD, it may fail in obese patients. Roux-en-Y gastric bypass provides excellent long-term control of GERD symptoms with the additional benefit of weight loss.
Clinical case: A 57-year-old woman underwent a laparoscopic Nissen fundoplication for GERD (BMI 30.0 Kg/m2) with excellent outcomes during the first postoperative year in 2011. Two years later, GERD symptoms recurred, and her weight increased progressively (BMI of 36.0 Kg/m2). The patient was proposed to a laparoscopic conversion of Nissen fundoplication to a Roux-en-Y gastric bypass. The procedure was uneventful, and the patient was discharged on postoperative day 4. One year later, she remained asymptomatic, off antacids medication, and with her weight decreased to 63.5Kg which corresponded to a BMI of 25.4 Kg/m2.
Discussion/conclusion: Roux-en-Y gastric bypass successfully reduces GERD symptoms by diverting bile away from the esophagus, decreasing acid production in the gastric pouch, therefore limiting the amount of acid reflux and by promoting weight loss decreases abdominal pressure over the lower esophageal sphincter and esophageal hiatus. In obese patients (BMI>35) with GERD, Roux-en-Y gastric bypass seems to be the most effective and advantageous treatment since it provides control of GERD symptoms with the additional benefit of weight loss. In patients who have previously undergone anti-reflux surgery, bariatric surgery can be technically demanding. However, if performed by high-volume surgeons in high-volume centers, it is perfectly feasible with low morbidity and excellent results.
Laparoscopic revision of Nissen fundoplication to Roux-en-Y gastric bypass
J Magalhães, AM Pereira, T Fonseca, R Ferreira de Almeida, M Nora
553 views
1 month ago
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