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Photos Actual Laparoscopic Procedures

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A study published in the New England Journal of Medicine has shown that laparoscopic hernia repair was superior to the open repair in terms of less postoperative pain, and quicker return to home and normal activity.  Recurrence rate was lower. 
Dr. Katkhouda performs the pre-peritoneal hernia repair routinely at  the USC Division of Minimally Invasive Surgery.

Photo - Laparoscopic Totally Pre-Peritoneal Hernia Repair showing placement of mesh to cover and repair all hernia spaces (direct, indirect and femoral).

Laparoscopic Nissen Fundoplication in Acid reflux disease (GERD) and Hiatal Hernia.Heartburn is the most common gastric complaint in the western world. More than sixty million Americans suffer from this condition. Photo showing Hiatal Hernia and Hiatal Hernia Repaired
  
Twenty-Five percent of those have chronic symptoms refractory to modern anti-acid medication (e.g., Prilosec). Moreover, some patients develop severe complications such as srticture and Barrett's esophagus, a known pre-malignant condition. Those patients can see gastro-esophageal reflux disease (GERD) eradicated with laparoscopic Nissen fundoplication. This constitutes a definitive mechanical solution to a mechanical problem (defective lower esophageal sphincter - LES), thus alleviating the need for anti-acid medication for the reat of the patient's life. This operation is currently performed in 90 minutes with a two day hospital stay. Return to work is allowed after one week.

Extraction of Gallbladder through the umbilical port

Laparoscopic Cholecystectomy with intraoperative cholangiogram.  More than 2500 cholecystectomies were performed by Dr. Katkhouda in ten years without a single bile duct injury following very strict surgical principles.  This procedure is now performed on an outpatient basis. 

Laparoscopic Common Bile Duct Exploration including laparoscopic T-tube placement.   This advanced technique alleviates the need to perform a preoperative ERCP.   When performed successfully, the hospital stay has been reduced to three days.



Photo - shows compression of the stomach by a large liver cyst to be removed laparoscopically.



Photo - shows large cyst of the left lobe of the liver to be resected laparoscopically.


Splenic and Adrenal Disorders

Laparoscopic Splenectomy in ITP, hereditary spherocytosis, hemolytic anemia, and other ITP-like syndromes.  (Photo shows accessory spleen as identified through the laparoscope.)  We have performed more than 170 laparoscopic splenectomies, the largest series in the world.  Results were published in the Annals of Surgery, October 1998 issue.  The conclusion of this paper was that laparoscopic splenectomy for benign hematologic disorders is the gold standard when surgery is indicated.

Laparoscopic Adrenalectomy in Conn's Syndrome, pheochromocytoma and adrenal adenomas.   Photo shows cut specimen demonstrating characteristic golden yellow color of adrenal gland.  This operation is performed in about an hour and patients can be discharged the following day.  We have performed hundreds of cases since 1993, both nationally and internationally with minimal morbidity and no mortality.

 

 

 

 

 

 

 

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