View the following archived webcast series from the Department of Surgery at Massachusetts General Hospital - now available online. All you'll need is a current browser and the latest copy of Windows Media Player. If you're unsure of the version you have,
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Laparoscopic Pancreatic Resection 
Surgeons: Drs. Rattner, Fernandez-del-Castillo
Description: Traditionally pancreatic surgery is very complex and requires large incisions to complete. MGH surgeons, however, are offering minimally invasive pancreatic surgery to selected patients with small tumors in the tail of the pancreas. In this video, Drs. Rattner and Fernandez-del-Castillo demonstrate the removal of the tail of the pancreas and spleen laparoscopically. Laparoscopic pancreatic resection is particularly suitable for patients with either neuroendocrine tumor or cystic neoplasm of the pancreas. Compared to traditional open surgery, blood loss is less and patients recover faster from the surgery.
Laparoscopic Heller Myotomy
Surgeon: Dr. Rattner
Description: Patients with achalasia often have difficulty swallowing food or have retention of undigested food in their esophagus. This is because the LES, a “valve” at the bottom of their esophagus fails to open. Left untreated, the esophagus could dilate and elongate eventually making swallowing nearly impossible. In this video, Dr. Rattner demonstrates the technique of laparoscopic Heller myotomy. He dissects out the esophagus and splits the thick muscle bundle at the LES. He then checks with an endoscope to make sure that the myotomy is adequate. He then finishes by constructing a partial wrap of the stomach around the esophagus to prevent future reflux. For achalasia patients, surgical treatment is considered definitive, and minimally invasive surgery has become the procedure of choice.
Laparoscopic (preperitoneal) inguinal hernia repair
Surgeons: Dr. Rattner
Description: Inguinal hernia repairs are the most commonly performed surgical procedure by general surgeons. MGH surgeons are offering a minimally invasive alternative to traditional open repair of groin hernias. First, a space is created by inflating a dissecting balloon through three small, half-inch incisions in the lower abdomen. The hernias are then identified and reduced. A piece of mesh is then inserted and secured to the anterior abdominal wall to prevent recurrence. Laparoscopic inguinal hernia repair is particularly suitable for patients with groin hernias on both sides or a recurrent groin hernia after a previous open repair. Hernias on both sides can be repaired through the same small incisions. Patients enjoy faster recover and less postoperative pain compared to traditional open groin hernia repair.
Laparoscopic hiatus hernia repair
Surgeons: Dr. Rattner
Description: When hiatus hernias become very large, they can become trapped in the chest cavity stomach. This may lead to symptoms such as chest pain, upper abdominal pain, difficulty swallowing food, or anemia secondary to chronic stomach bleeding. In this video, Dr. Rattner demonstrates the repair of such a large hiatus hernia through the laparoscope. After pulling the stomach back into the abdomen, the stomach is anchored by partially wrapping it around the esophagus as well as suturing it to the crural ( Diaphragm) muscles. Since large, symptomatic hiatus hernias often affect elderly patients, the minimally invasive method of hiatus hernia repair is our procedure of choice.
Laparoscopic colon surgery
Surgeons: Dr. Rattner
Description: Surgery of the colon is commonly performed for either diverticular or neoplastic diseases. Compared to traditional open surgery, laparoscopic colon resection affords patients smaller incisions, less postoperative pain, and faster recovery. In this video, Dr. Rattner demonstrates the technique of removing the sigmoid colon laparoscopically for diverticulitis. After mobilizing the colon from the spleen and the pelvic sidewall, he divides the blood vessels with a stapler. He then separates the colon from the upper rectum and exteriorizes the colon. After cutting out the diseased portion, the colon is dropped back into the abdomen and a new connection between the colon and the rectum is created with a special circular stapler.
Laparoscopic Nissen Fundoplication (Redo)
Surgeon: Dr. Rattner
Description: Approximately 10% of the U.S. population is affected by acid reflux symptoms. Although most are controlled by medications such as Prilosec, still some are not. A surgically created “wrap” of the stomach around the lower end of the esophagus helps to tighten the incompetent valve and relieves reflux symptoms in 80-90% of appropriately selected patients. In this video, Dr. Rattner demonstrates the technique of such a procedure called laparoscopic Nissen fundoplication. It is worth-noting that the particular procedure shown is a redo operation after an initial failed attempt performed at an outside institution. Redo operations are in general more challenging and have higher incidences of complications. Therefore, they should only be performed by experienced laparoscopic surgeons.
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