אסותא | חדשנות בתחום הכירורגיה

Minimally invasive surgical approach for abdominal wall reconstruction: A new era in treatment of complex abdominal wall hernias Youri Mnouskin, MD Samson Assuta Ashdod Hospital Ben-Gurion University of the Negev, Beer- Sheva, Israel

Procedures for the treatment of hernias are the most common of all types of operations in general surgery. At the same time, hernias differ from each other in localization and degree of complexity. That requires an individual approach from a surgeon and a

wide range of procedures in his arsenal. Inthe lastdecadewehaveseenabreakthrough in abdominal wall surgery associated with both thedevelopment of newtechnologiesand a deeper understanding of the anatomy and physiology of the abdominal wall. This review

presents a brief history of the development of minimally invasive surgery of the abdominal wall, current achievements, and prospects for the future. Keywords: hernias, abdominal wall, mini invasive surgery

A progressive laparoscopy course Youri Mnouskin, MD Samson Assuta Ashdod Hospital Ben-Gurion University of the Negev, Beer- Sheva, Israel

In modern surgical practice, laparoscopic totally extra-peritoneal (TEP) inguinal hernia repair is considered one of the recommended treatment choices. TEP repair is a complex laparoscopic procedurewith a steep learning curve, which prevents residents from mastering it and achieving autonomy during residency. We developed a new teaching method aimed at enabling rapid progression

of residents’ proficiency in performing TEP while enhancing patient safety and tested the implementation of this method among six residents. The course included two consecutive stages: a preparatory stage and a main stage. Each of the stages included theoretical and practical studies. Training took place in a general surgical department and in a simulation center. The programalso

included self-study assignments. Analysis of the results demonstrated unconditional efficacy of the proposedmethod. Proficiency based learning through a designated methodological course is highly effective in allowing residents to master difficult procedures in a short period of time. Keywords: laparoscopic surgery, inguinal hernia repair, residents, training program

International Federation for Surgery of Obesity and Metabolic Disorders (ISFO) consensus conference statement on one-anastomosis gastric bypass (OAGB-MGB) Nasser Sakran, MD Bariatric Centers, Assuta Medical Centers, Tel Aviv, Israel

One-anastomosis gastric bypass – mini gastric bypass (OAGB-MGB) is an attractive and standard bariatric procedure. There are two components to the procedure via restriction of the stomach andmalabsorptive mechanisms. It is effective inweight loss and comorbidity resolution. Globally, it is the third most common procedure in the bariatric surgery field. The International Federation for SurgeryofObesityandMetabolicDisorders (IFSO) has initiated a consensus study among

representatives of bariatric specialists from around theworldwith the aimof formulating uniformstandards for OAGB-MGB. The results of the study demonstrated an average agreement of 70% among physicians. The majorityof surgeons (98%) agreed thatOAGB MGB isanappropriateandeffectiveprocedure for morbidly obese patients. The issues examined in the study included: surgical inclusion criteria, complications, surgical efficacy, preoperative and postoperative

treatments as well as technical standards. In Israel, vast experience has been gained with this procedure; since 2015, about 15,000 OAGB-MGB procedures have been performed, and it was the most common bariatric procedure in 2019. Keywords: Bariatricsurgery, one-anastomosis gastricbypass ,mini gastricbypass, consensus, morbid obesity

55 AMR ASSUTAMEDICAL REPORT VOL 8 ISSUE 1