
Jorge DaesClinica PORTOAZUL,Barranquilla, Colombia · Minimally Invasive Surgery
Jorge Daes
MD
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56
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Publications (56)
This article discusses the use of intraoperative autonomic neural blockade as a technique to manage postoperative visceral pain and symptoms of postoperative nausea and vomiting in minimally invasive surgery.
Background
The eTEP Rives-Stoppa (RS) procedure, increasingly used for ventral hernia repair, has raised concerns about postoperative upper abdominal bulging. This study aims to objectively evaluate changes in the abdominal contour after eTEP RS and explore potential causes using a novel analytical tool, the Ellipse 9.
Methods
Thirty patients unde...
BACKGROUND
The intraoperative autonomic neural blockade (ANB) was found safe and effective in controlling pain and associated symptoms and reducing analgesic consumption after laparoscopic sleeve gastrectomy (LSG). This study evaluated whether ANB performed at the outset of LSG reduces anesthetic consumption and promotes hemodynamic stability.
MET...
Background
Pain is increasingly recognised as a syndrome not merely a symptom, emphasizing the importance of pain management. Visceral pain impacts up to 75% of bariatric patients during recovery. Concurrently, postoperative nausea and vomiting (PONV) persist as challenges after laparoscopic sleeve gastrectomy (LSG). An earlier RCT demonstrated the...
Introduction
Sleeve gastrectomy has become a primary bariatric procedure for obesity treatment, but it is associated with the development of hiatal hernias and gastric migration. This migration can lead to complications such as gastro-oesophageal reflux disease. The study aims to classify and analyse gastric migration patterns after sleeve gastrect...
Safety and efficacy should be paramount in the mind of every surgeon when choosing a surgical approach. Minimally invasive surgical (MIS) inguinal hernia repair is no exception to this rule. The first laparoscopic inguinal hernia repairs were performed over 30 years ago, but acceptance of the technique was limited and accounted for only 10–15% of r...
Purpose
Effects of component separation (CS) on abdominal wall morphology have only been investigated in smaller case series or cadavers. This study aimed to compare abdominal wall alterations following endoscopic anterior CS (EACS) or open transverse abdominis release (TAR).
Methods
Computed tomography scans were evaluated in patients who had und...
Background
Visceral pain (VP) following laparoscopic sleeve gastrectomy remains a substantial problem. VP is associated with autonomic symptoms, especially nausea and vomiting, and is unresponsive to traditional pain management algorithms aimed at alleviating somatic (incisional) pain. The present study was performed to evaluate the safety and effe...
Background
More than 20 million inguinal hernia repair (IHR) procedures are performed worldwide every year. The critical view of the myopectineal orifice (CV of the MPO) is a stepwise guide to the achievement and standardization of minimally invasive IHR (MI IHR). We propose a scoring system as an objective method for fulfillment of the CV of the M...
Purpose: The aim of this study was to develop and validate a reproducible low-cost model useful for the development and acquisition of skills and competencies required for endoscopic hernia repairs.
Methods: Ten general surgery residents (PGY3) were instructed to construct the model and perform the maneuvers necessary for the simulation of laparosc...
Key message
Knowledge of the changes that occur in the abdominal wall after component separation (CS) is essential for understanding the mechanisms of action of the various CS techniques, the changes observed on computed tomography images, and, perhaps most importantly, the anatomic and physiologic changes observed in patients who have undergone CS...
Aim
Effects of component separation (CS) on abdominal wall musculature have only been investigated in smaller case series. The study aimed to compare abdominal wall alterations following endoscopic anterior component separation (EACS) or transverse abdominis release (TAR).
Material and Methods
Computed tomography scans were evaluated in patients w...
The somatic pain induced by surgical trauma to the abdominal wall after laparoscopic sleeve gastrectomy (LSG) is effectively managed using conventional analgesia and transversus abdominis plane (TAP) blocks. In contrast, the visceral, colicky, pain that patients experience after LSG does not respond well to traditional pain management. Patients typ...
The enhanced-view totally extraperitoneal (eTEP) approach fulfills all modern principles for the repair of ventral hernias. In the hands of well-trained hernia surgeons, the approach is safe and effective and improves the patient’s quality of life, as demonstrated in more than 30 publications in the last 2 years. However, the eTEP approach is a com...
Purpose:
Although changes in lateral abdominal wall musculature after posterior component separation with transversus abdominis release have been investigated, the effects of endoscopic subcutaneous anterior component separation (ES-ACS) on postoperative muscle anatomy have not been evaluated. The purpose of this study was to evaluate changes in t...
Introduction:
Diastasis recti is a common condition with functional and cosmetic effects that can occur in both female and male patients. However, it is more prevalent in females after pregnancies and can be associated with midline hernias. The preaponeurotic endoscopic repair (REPA) has become an emerging procedure for the surgical treatment of t...
Hiatal hernia repair as part of laparoscopic sleeve gastrectomy continues to be a controversial topic, with most surgeons currently choosing to repair hiatal hernias during the procedure. An aggressive search for and repair of hiatal hernias seems advisable for those groups that have good results in gastroesophageal reflux symptoms and hiatal herni...
Many experts in abdominal wall reconstruction believe that the combination of simultaneous ipsilateral anterior component separation (ACS) and posterior component separation (PCS) is contraindicated. We performed ipsilateral endoscopic ACS and either endoscopic or open PCS-transversus abdominis release (TAR) in 5 fresh cadaver models. The full leng...
Se sabe desde hace tiempo que una cirugía ejecutada de forma hábil, rápida y efectiva conlleva buenos resultados, incluyendo menos dolor posoperatorio. Las acciones que conducen a este resultado son más difíciles de dilucidar [1]. Esto es especialmente cierto en el campo del reparo de las hernias inguinales, en el que confluyen la variedad de técni...
ABSTRACT The eTEP access concept is defined as a set of operative maneuvers and strategies undertaken to enhance a useable extra-peritoneal space for the minimally invasive repair of inguinal, ventral and lumbar hernias and the performance of other procedures such as the triple neurectomy. These maneuvers include the remote access, creation of a la...
Resumen
La técnica eTEP consiste en la serie de maniobras y estrategias operatorias destinadas a potenciar un espacio extraperitoneal de trabajo, para el reparo mínimamente invasivo de la hernias inguinales, ventrales y lumbares y la realización de otros procedimientos. Estas maniobras incluyen el acceso remoto, la creación de un gran espacio extra...
Standardization of ventral hernia repair remains elusive. Surgeons use a plethora of techniques, tools, and technology to repair similar defects. Nevertheless, evidence-based principles exist that should be applied to all repairs irrespective of technique allowing standardization and improved outcomes. Six principles are proposed as the basis for c...
The extended-view totally extraperitoneal (eTEP) technique has evolved as a way to compensate for the disadvantages of working within a limited space. The eTEP technique is based on a better understanding of the abdominal wall anatomy and the notion that the extraperitoneal space is limitless once the confluence of the arcuate arch and semilunar li...
Complex ventral hernia repairs remain a frequent and intricate problem with satisfactory results requiring a combination of techniques, technologies and materials. Primary closure of defects as part of the abdominal wall reconstruction (AWR) has been an essential part of open repairs and recently also of minimal invasive approaches because it attem...
Background:
The enhanced-view totally extraperitoneal (eTEP) technique has been previously described for Laparoscopic Inguinal Hernia Repair. We present a novel application of the eTEP access technique for the repair of ventral and incisional hernias.
Methods:
Retrospective review of consecutive laparoscopic retromuscular hernia repair cases uti...
Background
Proper defect closure during abdominal wall reconstruction (AWR) is a key to improving cosmetic and functional results, and reducing morbidity. We have completed the initial prospective evaluation of a technique we previously described and published: endoscopic subcutaneous anterior component separation (ACS) as an adjunct to mainly lapa...
The unique presentation of complex hernias requires a wide range of repair options. Posterior component separation via a transversus abdominis muscle release has increased in popularity owing to the natural anatomic extension from a retromuscular approach. However, endoscopic anterior component separation remains an important and effective techniqu...
The classical TEP technique is the laparoscopic technique considered closest to ideal for inguinal hernia repair, but the technique has several drawbacks such as limited space for dissection and mesh placement, restricted port placement, a low tolerance of accidental pneumoperitoneum, and difficulty in teaching and learning the technique. These dis...
This chapter describes strategies for optimizing the laparoscopic totally extraperitoneal (TEP) and transabdominal preperitoneal (TAPP) techniques for repair of inguinal hernias to prevent postoperative pain, based on review of the literature, our own experience, and the experience of leading surgeons in the field.
The general and technical aspects...
To the editor,I read with interest the letter by Serra et al.I concur with the authors that suture reinforcement of the staple line in gastric sleeve surgery can help prevent leaks related to ischemia and staple line failure and can assist in hemostasis. Oversewing of the staple line has other advantages not mentioned in the letter, such as correct...
Introducción. La separación clásica de componentes crea un colgajo compuesto, el cual se moviliza para reparar primariamente hernias ventrales sin tensión. La extensa disección requerida produce muchas complicaciones e incapacidad. El abordaje mínimamente invasivo ofrece una alternativa menos mórbida. Se describe en detalle nuestra modificación téc...
Gastroesophageal reflux disease (GERD) is present in half of morbidly obese patients. Published data reporting the results of laparoscopic sleeve gastrectomy (LSG) in patients with GERD are contradictory. We have shown in a previous study that symptoms of GERD can be reduced for up to 12 months after LSG with careful attention to surgical technique...
Traditional component separation (CS) creates a compound flap that can be advanced for tension-free closure of ventral hernias. Wound complications are common because of the extensive dissection that is necessary with the traditional approach. Endoscopic CS offers an alternative with lower morbidity. We describe our initial experience with endoscop...
Background:
The best approaches to repairing large inguinoscrotal hernias and handling of the distal sac are still debated. Complete dissection of a distal sac which extends deep into the scrotum carries a risk of orchitis and damage to the cord structures. However, failure to deal with the distal sac often results in the formation of a large and...
Background
Bariatric surgery is the most effective treatment for gastro-esophageal reflux disease (GERD) in obese patients, with the Roux-en-Y gastric bypass being the technique preferred by many surgeons. Published data reporting the results of laparoscopic sleeve gastrectomy (LSG) in patients with GERD are contradictory. In a previous observation...
The totally extraperitoneal (TEP) approach for repair of inguinal hernia is the preferred technique since it does not penetrate the peritoneal cavity, thus avoiding potential intraperitoneal complications. The TEP technique allows for regional or even local plus sedative anesthesia, and it gives us an incomparable view of the inguinal region and he...
Este artículo describe una modificación a la técnica totalmente extraperitoneal, la cual mejora notablemente el espacio quirúrgico y facilita la ejecución del reparo endoscópico extraperitoneal de la hernia.This article describes de progressive global acceptance of laparoscopic inguinal hernia repair and describes a totally extraperitoneal techniqu...
La técnica totalmente extraperitonenal (TEP) para la reparación de la hernia inguinal es la técnica laparoscópica preferida ya que no penetra a la cavidad abdominal, con lo cual disminuye el riesgo de lesiones viscerales y abdominales, el potencial de obstrucción intestinal por adherencias a la malla y las hernias de los puertos. Esta técnica permi...
The aim of this study was to identify factors associated with Multiple Organ Failure (MOF), and assess possible interactions between the risk factors identified as such. We studied 40 MOF cases and 120 controls, out of all the surgery and trauma patients who needed intensive care at our institution in a 24-month period. The univariate analyses show...
The aim of this study was to identify factors associated with Multiple Organ Failure (MOF), and assess possible interactions between the risk factors identified as such. We studied 40 MOF cases and 120 controls, out of all the surgery and trauma patients who needed intensive care at our institution in a 24-month period. The univariate analyses show...