Activation of Hepatic AMP-Protein Kinase (AMPK) Is Mediated By LKB1 After Roux-en-Y Gastric Bypass in Obese Rats

In this video presentation we are presenting a patient with a submucosal mass at the gastroesophageal junction (GEJ).At time of laparoscopic surgery, the mass was adherent to the GEJ and extended into the distal left esophagus.Resection of the mass included a portion of the lower esophageal sphincter and distal left esophagus.This area was then reconstructed primarily over a 42 Fr tapered Bougie with running 3.0 and 2.0 Vicryl® suture in two layer fashion.The patient did well post-operatively and was discharged home on day six. 448Laparoscopic Paraesophageal Hernia Repair with Mesh and Collis Gastroplasty with Nissen Fundoplication Preeti Malladi, Nathaniel J. Soper Symptomatic paraesophageal hernias should be repaired.Occasionally, esophageal foreshortening is encountered.We review the case of a 73 year old female with a large paraesophageal hernia and the surgical technique of the repair.The patient had an 18 month history of shortness of breath and epigastric/chest discomfort and imaging of a large paraesophageal hernia.She underwent a laparoscopic repair.In order to obtain more intra-abdominal esophageal length, a neoesophagus was created by resection of a portion of the fundus.Trans-abdominal Collis gastroplasty is a preferred technique to obtain more esophageal length if needed during a laparoscopic paraesophageal hernia repair.