J Vasc Surg. 2009 Jul;50(1):134-9. Celiac artery compression syndrome managed by laparoscopy. Baccari P, Civilini E, Dordoni L, Melissano G, Nicoletti R, Chiesa R. Department of General Surgery, Scientific Institute San Raffaele University Hospital, Milan, Italy. paolo.baccari@hsr.it Abstr...

act OBJECTIVE: Celiac artery compression syndrome (CACS) is an unusual condition caused by abnormally low insertion of the median fibrous arcuate ligament and muscular diaphragmatic fiber resulting in luminal narrowing of the celiac trunk. Surgical treatment is the release of the extrinsic compression by division of the median arcuate ligament overlying the celiac axis and skeletonization of the aorta and celiac trunk. The laparoscopic approach has been recently reported for single cases. Percutaneous transluminal angioplasty (PTA) and stenting of the CA alone, before or after the surgical relief of external compression to the celiac axis, has also been used. We report our 7-year experience with the laparoscopic management of CACS caused by the median arcuate ligament. METHODS: Between July 2001 and May 2008, 16 patients (5 men; mean age, 52 years) were treated. Diagnosis was made by duplex ultrasound scan and angiogram (computed tomography [CT] or magnetic resonance). The mean body mass index of the patients was 21.2 kg/m(2). One patient underwent laparoscopic surgery after failure of PTA and stenting of the CA, and two patients after a stenting attempt failed. RESULTS: All procedural steps were laparoscopically completed, and the celiac trunk was skeletonized. The laparoscopic procedures lasted a mean of 90 minutes. Two cases were converted to open surgery for bleeding at the end of the operation when high energies were used. The postoperative course was uneventful. Mean postoperative hospital stay was 3 days. On follow-up, 14 patients remained asymptomatic, with postoperative CT angiogram showing no residual stenosis of the celiac trunk. One patient had restenosis and underwent aortoceliac artery bypass grafting after 3 months. Another patient had PTA and stenting 2 months after laparoscopic operation. All patients reported complete resolution of symptoms at a mean follow-up of 28.3 months. CONCLUSIONS: The laparoscopic approach to CACS appears to be feasible, safe, and successful, if performed by experienced laparoscopic surgeons. PTA and stenting resulted in a valid complementary procedure only when performed after the release of the extrinsic compression on the CA. Additional patients with longer follow-up are needed.

A video showing Laparoscopic Resection of Splenic Artery Aneurysm

lapr. nissen's fundoplication

3 Port Cholecystectomy

Laparoscopic Assisted Right Hemicolectomy

laparoscopic anterior resection

Video of Cholecystectomy with common bile duct Exploration

Laparoscopic varicocellectomy for Varicocele

Laparoscopic Surgery varicocellectomy

Laparoscopic varicocellectomy Surgery

Difficult Laparoscopic Cholecystectomy for Gall bladder Stones

Bleeding during the ligation of an artery during right hemicolectomy

Laparoscopic resection of the right hepatic lobe for a 5 cm hepatoma

Laparoscopic removal of the spleen

The Digging and Peeling off method is of absolute value to the laparoscopic myomectomy since that can provide time necessary to remove the large and multiple leiomyoma and suture the uterus. Please do not hesitate to contact us if you require any further information or help, it will be a pleasure for mr to assist you. e-mail : eunds1212@yahoo.co.kr homepage : www.eunhospital.co.kr

DMC Plastic Surgeon Doctor Bruce Chau uses minimally invasive surgery called Liposelection to ultrasonically "melt" fat and remove it, resulting in smoother, younger-looking skin and body. Watch as one patient feels transformed through a procedure to revitalize her breasts and her outlook. ~ Detroit Medical Center

Losing Weight- Gaining Health with LapBand Surgery video

Doctors at the Detroit Medical Center pioneer laparoscopy procedures and other minimally invasive techniques that result in less pain, fewer risks, and quicker recovery time for surgical patients. ~ Detroit Medical Center

Harper University Hospital has been accredited as a Bariatric Center of Excellence by the American Society of Bariatric Surgeons. By employing laparoscopy, this bariatric procedure is minimally invasive and results in quicker recovery time, as well as less scarring. ~ Detroit Medical Center

Urological surgeons have become proficient at performing complex pelvic urological procedures, such as radical prostatectomy, using the laparoscopic approach. Declan Murphy and Daniel Moon share their experience of four less common procedures they have performed recently using laparoscopic techniques. These include: excision of a urachal cyst; partial cystectomy for endometriosis (combined endoscopic-laparoscopic approach); repair of an intra-peritoneal bladder rupture; and repair of a ureteric injury (combined endoscopic-laparoscopic approach).