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Live Sleeve Gastrectomy Surgery Video Transcription

Dr. Cirangle: Okay. Good morning everybody. We're here at John Muir Hospital, and we're broadcasting live on the web and we're also broadcasting to Las Vegas, to the WSFA conference. I'd like to give a special thanks to Bo McCoy from Obesity Help for being there to help us out. We're going to do a laparoscopic sleeve gastrectomy this morning.

Kind of special, we're going to do it in a needlescopic fashion with very small, three millimeter instruments, trying to hide the incisions to make it very cosmetically appealing. If anybody's interested in asking questions, you can send questions over Twitter, and we'll go ahead and get started.

What I've done here is I've insufflated the abdominal cavity with some carbon dioxide, and we're going to go ahead and put our first port in.

This is a special trochar that lets us turn our overhead lights off, that lets us enter the abdominal cavity under direct vision. You can see the trochar just slowly separating the muscles.

Just go ahead and put your finger over that.

There we go. All right, let's put her in reverse please. Let's switch over to our 30 degree scope.

I put the first port in her belly button, so she will not see this incision. By the way, for those of you who don't know who I am, I'm Dr. Cirangle. We have a crack team here at John Muir, all set to entertain you this morning.

All right. The first thing we see when we put our laproscope in is our stomach, our liver. We have a falciform ligament which is basically just a little fatty appendage. We look around, we see a spleen up there. Over here is the gall bladder and the other side of the liver.

What we're going to do is we're going to put a retractor in to get the liver out of the way. Let me have the local, please. We use local anesthesia in each of these incisions. That dramatically reduces the discomfort and the pain after the operation.

Let's bring this down just a little bit.

If we can get a close-up of this incision I'm going to make, you'll see how very small and tiny this is going to be. It's literally just a little poke, and we put a little trochar, what a trochar is, is basically our port into the abdominal cavity. Through this I'm going to put an instrument.

Let me have my Thompson retractor. I'm sorry, don't want to grab your finger. Okay, go ahead, lift up the sheet. This is a retractor that allows us to have the instrument held so that we don't have to hold it.

I'm good, thank you. All right. Sort of delicate here. Let's take this and I'll get this, hold that like that. For right now, I'm just going to grab this. Can you steady that for me?

Hold that like that, and then we're going to go ahead and use this to retract. We'll adjust this a little bit more later, once we get the other ports in. Okay, good, excellent.

All right. That's our first port. That lets us see the top part of the stomach. The next port, we're going to put in over at the upper left portion of the abdominal cavity. Right about here. Another three, right there.

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