The gallbladder concentrates and stores bile as a pear-shaped sac which it can release to help digestion after a fatty meal.
Laparoscopic tools have opened up opportunities for doctors to take a look inside without a largely invasive procedure. Using these methods, chances of infection are reduces, healing can occur more quickly and the body undergoes less stress. The surgical instruments are introduced into the body through small incisions, along with the camera which is connected to a monitor. The camera allows for a whole different view of the surgical field without opening a large surface on the body.
The magnified view of the surgical field makes finding small bleeders and anomalies easier. It also opens up the possibility of recording video from the camera or capturing still photos which are also helpful to medical students who are getting introduced into the world of surgery. Many interesting shots have been collected from interesting encounters with a variety of cases.
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The center of the image demonstrates the needle and suture during the robotic anastomosis. The nerve graft is demonstrated on the right side of the screen while the ganglia is on the left. Two to three sutures were used at each anastomosis.
The first robotic sympathectomy reversal was performed using intercostal nerves as grafts to bridge the distance where the sympathetic trunk was burned during the original operation. The image shows the two robotic microinstruments and 8-0 Prolene suture. The operation maintained all principles of…
Robotic sympathectomy reversal uses robotic technology to provide microsurgical techniques of nerve reconstruction in a minimally invasive fashion. Severe compensatory hyperhidrosis may sometimes limit lifestyle more than a patient's initial complaints. Sympathectomy reversal in select cases…
The shape of the stomach is also changed during gastric bypass. The stomach is changed into a small tube that extends from the esophageal junction downwards. This photo demonstrates that the bottom of the new stomach pouch has already been created and now the stapling is proceeding back up the…
The stomach and the alimentary limb of the intestines are sewn together by hand. This connection is called a gastrojejunal anastomosis because it combines the stomach (gastric) with part of the small intestine (the jejunum). Dr. Belsley prefers to handsew this connection in multiple layers in order…
During a laparoscopic gastric bypass, the intestines are changed from their regular configuration into the shape of a Y. This is why the operation is called a Roux-en-Y gastric bypass or RYGB. This photo demonstrates the intestines being prepared for the base of the Y connection
During a gastric bypass, the stomach size is reduced from approximately the size of a football to the size of an egg. This photo demonstrates the first firing of the stapler after a window has been created behind the stomach allowing placement of the stapler.
A small gastric pouch is important for the success of a gastric bypass. This photo demonstrates the dissection of the stomach with the creation of a window behind the stomach. Eventually a stapler will be passed into the hole allowing the stomach size to be reduced.
During laparoscopic gastric bypass, the intestines are changed from their normal orientation into a Y. The procedure is called a Roux-en-Y for this reason. This photo demonstrates the division of intestines as one of the first steps in constructing the Roux-en-Y.
This photo demonstrates a patient the first post-operative day after a type IV Hiatal Hernia performed with combination laparoscopy and robotics. The swallow demonstrates reduction of the hernia as well as free flow of contrast past the Nissen wrap into native stomach.