Expert Surgeon Explains Condyloma (Anal Warts)
Expert Surgeon Explains Condyloma (Anal Warts) Read More »
This video shows results of our study on EPSiT. A simple negative pressure dressing is added at the end of the procedure minimising the recurrence.
EPSiT: Endoscopic non invasive treatment for pilonidal sinus Read More »
AbstractFaecal incontinence (FI) is a common symptom. There are a variety of invasive treatments available, however, the benign nature of this problem and the varying degrees of severity, mean that conservative management is usually pursued first. The aims of this thesis were to investigate: the current practice of continence advisors who deliver conservative management in
Refining and improving the assessment and treatment of faecal incontinence Read More »
Abstract Background Endoscopic pilonidal sinus treatment (EPSiT) is a novel minimally invasive option for the treatment of pilonidal sinus disease (PSD). To optimise the postoperative wound management after EPSiT, an ultraportable negative pressure wound therapy (NPWT) device was used. The aim of this study was to assess the clinical outcomes of negative pressure-assisted (NPA) EPSiT.
Negative pressure‑assisted endoscopic pilonidal sinus treatment Read More »
Abstract Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this studyaimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort
Abstract Background In a surgical setting, COVID-19 patients may trigger in-hospital outbreaks and have worse postoperative outcomes. Despite these risks, there have been no consistent statements on surgical guidelines regarding the perioperative screening or management of COVID-19 patients, and we do not have objective global data that describe the current conditions surrounding this issue. This
This video demonstrates how to use the newer portable manometer THD® Anopress. In this specific case the Anopress was used in an healthy volunteer to better demonstrate normal values.
THD® Anopress: portable anorectal manometry Read More »
This video presentation was given by Mr Alex Leo at the ESCP 2020. The aim was to inform the audience on how early diagnosis and monitoring obstetric anal sphincter injuries (OASIS) may prevent and delay faecal incontinence.
Early diagnosis and monitoring of OASIS to prevent and delay FI. Read More »
A case report of a young woman having a severe gallstone pancreatitis 2 weeks after an emergency C section. In this video we show brief steps for a laparoscopic cholecystectomy with a fundus first approach and intra operative cholangiogram. Mr Kamran Kurashi & Mr Cosimo Alex Leo London North West NHS University Trust.
Early Post Partum Gallstone Pancreatitis and fundus first gallbladder dissection Read More »
Abstract Aim Sacral nerve stimulation (SNS) is a minimally invasive treatment for faecal incontinence (FI). We report our experience of patients who have undergone SNS for FI with a minimum of 5 years’ follow‐up. This is a single centre prospective observational study with the aim to assess the long‐term function of SNS. Method All patients
Long‐term outcome of sacral nerve stimulation for faecal incontinence Read More »
This short video presents an intraoperative cholangiography during a laparoscopic cholecystitis.
IOC: Intraoperative Cholangiography Read More »
Abstract Aim The SphinKeeper™ artificial bowel sphincter implant is relatively new surgical technique for the treatment of refractory faecal incontinence. This study presents the first experience in two UK tertiary centres. Method This is a retrospective audit of prospectively collected clinical data in relation to technique, safety, feasibility and short-term effectiveness from patients undergoing surgery
This educational video describes a standard technique for a laparoscopic cholecystectomy using a Veress needle technique, one 12 mm port and 3, 5 mm trocars. This particular case was performed in a 29 years old gentleman with cholelithiasis and a previous episode of acute cholecystitis that required hospitalisation and conservative treatment with IV antibiotics. Surgeons:
Laparoscopic Cholecystectomy with Veress needle technique Read More »
Abstract Background In March 2020, the World Health Organization confirmed COVID-19 infection as a pandemic. The absence of previous knowledge of the COVID-19 has made the decision-making difficult including in the surgical departments. The purpose of this report was to review the management recommendations regarding surgical activity and changes to surgical practice, identifying concordances and
Abstract Background Anal inserts and percutaneous tibial nerve stimulation may be offered to those with fecal incontinence in whom other conservative treatments have failed. Objective We aimed to compare anal inserts and percutaneous tibial nerve stimulation. Design This was an investigator-blinded randomized pilot study. Settings The study was conducted at a large tertiary care hospital.
Abstract Background The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods This international, multicentre, cohort study at 235 hospitals in
Abstract Purpose Complex abdominal wall repair (CAWR) in a contaminated operative field is a challenge. Available literature regarding long-term outcomes of CAWR comprises studies that often have small numbers and heterogeneous patient populations. This study aims to assess long-term outcomes of modified-ventral hernia working group (VHWG) grade 3 repairs. Because the relevance of hernia recurrence
Long‑term outcomes after contaminated complex abdominal wall reconstruction Read More »
Abstract Background Short-term outcomes for patients undergoing contaminated complex abdominal wall reconstruction (CCAWR), including risk stratification, have not been studied in sufficiently high numbers. This study aims to develop and validate riskstratification models for Clavien–Dindo (CD) grade ≥ 3 complications in patients undergoing CCAWR. Methods A consecutive cohort of patients who underwent CCAWR in two
Abstract Aim Anorectal physiology tests provide a functional assessment of the anal canal. The aim of this study was to compare the results generated by standard high-resolution water-perfused manometry (WPM) with the newer THD Anopress manometry system. Method This was a prospective observational study. Conventional manometry was carried out using a water-perfused catheter with high-resolution
Abstract Background Right hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn’s disease (CD) and malignant ones like colon cancer (CC). Aim To investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD. Methods This is a sub-group analysis of the European Society
Abstract Introduction The Renew® Anal Insert is a recent treatment for patients who suffer from passive faecal incontinence (FI). The aim was to assess the effectiveness of the insert and patient satisfaction. Method A retrospective audit of patients who were treated with the Renew® Anal Insert was undertaken. The St Mark’s Incontinence Score was used
Abstract Background THD® Anopress has been promoted as a new portable anal manometer providing measurements of whole anal canal pressures. This study aims to report the anorectal function of patients suffering from Faecal Incontinence (FI) using this new device and the associated patient comfort. Methods We reviewed data from patients suffering from FI who had
Evaluation of the Portable THD® Anopress Device in Patients with Faecal Incontinence Read More »
Abstract Introduction Transanal total mesorectal excision (TaTME) has rapidly emerged as a novel approach for rectal cancer surgery. Safety profiles are still emerging and more comparative data is urgently needed. This study aimed to compare indications and short-term outcomes of TaTME, open, laparoscopic, and robotic TME internationally. Methods A pre-planned analysis of the European Society
Abstract Introduction Some evidence suggests that primary anastomosis following left sided colorectal resection in the emergency setting may be safe in selected patients, and confer favourable outcomes to permanent enterostomy. The aim of this study was to compare the major postoperative complication rate in patients undergoing end stoma vs primary anastomosis following emergency left sided
Abstract Background Laparoscopy has now been implemented as a standard of care for elective colonic resection around the world. During the adoption period, studies showed that conversion may be detrimental to patients, with poorer outcomes than both laparoscopic completed or planned open surgery. The primary aim of this study was to determine whether laparoscopic conversion
Abstract Introduction The optimal bowel preparation strategy to minimise the risk of anastomotic leak is yet to be determined. This study aimed to determine whether oral antibiotics combined with mechanical bowel preparation (MBP+Abx) was associated with a reduced risk of anastomotic leak when compared to mechanical bowel preparation alone (MBP) or no bowel preparation (NBP).
Abstract Background/Aims The Anopress device is a new portable manometry system. The aim of this study is to formulate normative data using this new device by recording the anorectal function of asymptomatic subjects. Patient comfort was also assessed. Methods Anorectal function was assessed in asymptomatic volunteers using the Anopress. All volunteers were examined in a
Abstract Introduction The mainstay of management for locally advanced rectal cancer is chemoradiotherapy followed by surgical resection. Following chemoradiotherapy, a complete response may be detected clinically and radiologically (cCR) prior to surgery or pathologically after surgery (pCR). We aim to report the overall complete pathological response (pCR) rate and the reliability of detecting a cCR
Abstract Aim There is little evidence to support choice of technique and configuration for stapled anastomoses after right hemicolectomy and ileocaecal resection. This study aimed to determine the relationship between stapling technique and anastomotic failure. Method Any unit performing gastrointestinal surgery was invited to contribute data on consecutive adult patients undergoing right hemicolectomy or ileocolic
Abstract Introduction Restorative proctocolectomy has gained acceptance in the surgical management of medically refractive ulcerative colitis and cancer prevention in familial adenomatous polyposis. Incontinence following restorative proctocolectomy occurs in up to 25% of patients overnight. The Renew® insert is an inert single-use device which acts as an anal plug. The aim of this study was
Abstract Purpose This study aims to compare the outcomes of posterior component separation and transversus abdominis release (PCSTAR) with the open anterior component separation (OACS) technique. OACS, first described by Ramirez et al. (Plast Reconstr Surg 86(3):519-526, 1990), has become an established technique for local myofascial advancement in abdominal hernia surgery. PCSTAR, described by Novitsky
Abstract We evaluated the benefit of tailoring treatments for a colorectal adenocarcinoma cancer cohort according to tumor molecular profiles, by analyzing data collected on patient responses to treatments that were guided by a tumor profiling technology from Caris Life Sciences. DNA sequencing and immunohistochemistry were the main tests that predictions were based upon, but also
Abstract Background Patient and disease-related factors, as well as operation technique all have the potential to impact on postoperative outcome in Crohn’s disease. The available evidence is based on small series and often displays conflicting results. Aim To investigate the effect of pre- and intra-operative risk factors on 30-day postoperative outcome in patients undergoing surgery
Abstract Objectives The best treatment of early stage anal squamous cell carcinoma (SCC) is under debated. Wide local excision (WLE) may be considered adequate for stage 1 anal margin cancer. This study demonstrates our experience in treatment of patients with SCC over 5 years. Patients and methods We conducted a retrospective study of patients who
Five year experience of the treatment of squamous cell carcinoma of the anus Read More »
Abstract Aim To investigate the current practice of continence advisors in the United Kingdom. Method Continence advisors were contacted by email or letter to participate in a survey. The survey contained 27 questions which addressed the practice of each continence advisor, their knowledge of continence management and the adequacy of their training. Results Two hundred
Abstract Aim Potential screening modalities for early diagnosis of squamous cell anal cancer (SCC) in HIV patients include digital anorectal examination (DARE), anal Papanicolaou testing (Pap test), human papilloma virus (HPV) cotesting, and high-resolution anoscopy. The aim of this study was to demonstrate the results of a five-year screening program for SCC in HIV patients.
Screening for Squamous Cell Anal Cancer in HIV Positive Patients: A Five-Year Experience Read More »
Abstract Purpose Single port laparoscopic surgery (SPLS) is a technique which is increasing in popularity. The benefit of SPLS in complex Crohn’s disease (CD), which includes a significant cohort of young patients sometimes needing multiple operations, has not been comprehensively assessed. This study analyses our early experience with this technique. Methods Patients who underwent SPLS
Abstract Purpose To evaluate long-term functional outcomes of Internal Delorme’s Procedure (IDP) in patients refractory to conservative treatment for Obstructed Defecation Syndrome (ODS), and to compare those who received postoperative rehabilitation with those who did not. Materials and methods All patients withODS refractory to nonoperative therapy were identified across three regional pelvic floor referral hospitals,
Abstract Aim The anastomosis technique used following rightsided colonic resection is widely variable and may affect patient outcome. This study aimed to assess the association between leak and anastomosis technique (stapled vs handsewn). Method This was a prospective, multicentre, international audit including patients undergoing elective or emergency right hemicolectomy or ileo-caecal resection operations over a
Abstract Background and Aims Restorative proctocolectomy in elderly inflammatory bowel disease [ IBD] patients is controversial and limited data are available on the outcomes of surgery. The aim of this study was to evaluate the safety, efficacy, and long-term results of ileal-pouch-anal anastomosis in elderly patients, in a multicentre survey from European referral centres. Methods
Abstract Aim Minimal evidence exists to guide surgeons on the risk of complications when performing abdominal wall reconstruction (AWR) in the presence of active infection, contamination or enterocutaneous fistula. This study aims toestablish the outcomes of contaminated complex AWR. Method Analysis was conducted according to PRISMA guidelines. Systematic search of the MEDLINE, EMBASE and Pubmed
Abstract Background Obturator hernia is a rare condition associated with a high morbidity and mortality. It is an uncommon cause of bowel obstruction most commonly described in elderly females with comorbidity. Surgical intervention is often delayed as a result of subtle presenting signs. Coexisting ipsilateral femoral hernia is an even rarer condition represented by non-exhaustive
Coexisting incarcerated femoral and obturator hernia: a case report Read More »
Abstarct Sorafenib has improved the median overall survival of unresectable or otherwise untreatable hepatocellular carcinoma (HCC) of *3 months, compared to supportive cares. Complete response, although rare, has been reported. The authors reported herein a case of complete biochemical and radiological remission of advanced unresectable HCC with lymph node metastasis and tumoral portal vein thrombosis
Abstract Aim Laparoscopic surgery is well established for colon cancer, with defined benefits. Use of laparoscopy for the performance of restorative proctocolectomy (RPC) with ileoanal anastomosis is more controversial. Technical aspects include difficult dissection of the distal rectum and a potentially increased risk of anastomotic leakage through multiple firings of the stapler. In an attempt
Abstract Aim Idiopatic thrombocytopenic purpura (ITP) is the most common indication for splenectomy. The failure rate of surgery is about 8% and the failure rate after splenectomy is approximately 28% for all patients. When the presence of an accessory spleen is diagnosed, splenectomy is recommended. Laparoscopic approach is considered the first choice. Patients and methods
Abstract Background Macrocystic serous cystadenomas (MaSCA) are rare benign tumor of the pancreas which represent an atypical macroscopic morphologic variant of serous cystadenomas (SCA). They are characterized by a limited number of cysts with a diameter of >2 cm and share imaging features overlapping those of mucinous cystic neoplasm (MCN) and branch-duct intraductal papillary mucinous
Macrocystic serous cystadenoma of the pancreas: Report of 4 cases Read More »
Abstract Aim To investigate differences in the physiopathological findings (manometry and pH monitoring) and symptomsbetween cases of non-erosive reflux disease (NERD) and erosive reflux disease (ERD) found positive at 24 hpH monitoring. Methods For a total of 670 patients who underwent 24 h pH monitoring, esophageal manometry and upper endoscopy were retrospectively evaluated, assessing the