Laparoscopic Sacrocolpopexy, operated by Dr Fouad Khoury, in which he’sperforming a laparoscopic pelvic organ prolapse repair. This video features anterior plane dissection for Grade 4 bladder prolapse using polyester mesh placement and fixation to sacral promontory.
NB: Posterior plane repair should always be done in those cases, however, in this particular case, the patient had a previous rectocele repair 2 years ago by vaginal approach with no signs of current rectocele.
For more inspiring information regarding this matter, please visit the following link to watch Bladder Prolapse.
Dr Fouad Khoury, a referral urologist in Lebanon and the Middle East, performing pyeloplasty for UPJ stenosis. This video features step by step approach along with captions for successful and smooth completion of pyeloplasty operation, with antegrade intra operative JJ insertion.
The procedure was performed using 2x5mm and 2x10mm trocars. Smooth dissection of colon and identification of ureter and enlarged kidney pelvis. Once the proximal ureter is dissected without jeopardizing its blood supply, division and excision of UPJ stenosis. As you see, very minimal cauterization used in order to prevent scarring and possible re stenosis at anastomosis site. Therefore working in an oozing field should be tolerated in those cases.
Meticulous anastomosis was done using vicryl 4.0 starting with the posterior plane, followed by antegrade JJ 6Fr * 26cm inserted over guidewire. Once the JJ is placed, the anterior plane is completed using vicryl 4.0.
Laparoscopic NephroU done for management of upper tract TCC that was causing extensive bleeding and anemia for the patient. Due to advanced patient’s age (94 years old) and comorbidities, only a proximal ureterectomy was done after making sure that distal ureter is free of tumor in order to decrease operative time and surgical morbidity.
In the clip below, Dr Fouad Khoury demonstrates a laparoscopic left radical nephrectomy along with proximal ureterectomy.
Laparoscopic right adrenalectomy of a large 8cm tumor compressing the Vena Cava. After dissection and isolation of adrenal gland from vital surrounding structures mainly the Vena Cava, hand assisted technique was used at the end in order to detach the adrenal from the posterior bed.
Adrenal tumor removal by laparoscopic approach has been shown to be as effective as traditional open surgeries with the major advantage of early recovery, shorter hospital stay, less post-operative pain and more favorable cosmetic results.
In this particular case, Aorto Cava space dissection was carefully performed, making sure the posterior Vena Cava is completely tumor free, thus avoiding major bleeding from Vena Cava or perforating lumbar veins.
In this clip, Dr Fouad Khoury demonstrates a laparoscopic right adrenalectomy for a large adrenal tumor compressing the Vena Cava.
LAPAROSCOPIC SURGERY FOR ADRENAL GLAND (left side)
Laparoscopic surgery for adrenal gland became the standard procedure for removal of adrenal tumors. When done in expert hands, even large tumors can be safely performed through this minimally invasive approach. It provides patients with less discomfort and equivalent oncologic results when compared to larger incisions required with traditional open surgeries.
In comparison to open adrenalectomy, the laparoscopic approach has been shown to result in less pain, significantly less blood loss, better cosmetic results, shorter hospital stay and early recovery.
In this procedure, Dr Fouad Khoury demostrates a laparoscopic left adrenalectomy of a large 7.5 cm tumor. As it is a non secreting tumor, the adrenal vein was dissected at the end of procedure after careful isolation and identification of surrounding structures.
Dr Fouad Khoury discussing minimally invasive approach to repair pelvic organ prolapses such as cystocele and rectocele. The repair can be done either through a laparoscopic or robotic approach with a success rate higher than 90 percent when done in expert hands.