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22° CAD anno 2011 M. GAGNER (Doha QATAR)
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0:18
We are in between the legs.
0:23
David.
0:24
it this is a setup in between the legs first and second assistant on each side we have the
0:38
umbilical open umbilical trocar we have paramedian right the head is this way because anesthesia is
0:48
here and we have some costal right for liver retraction or after view we have
0:59
upper midline then we have our medium left to do the dissection in the upper
1:08
part of the stomach and some costal left for stomach retraction we're going to
1:15
to get in. And this is a sphygostectomy. So we're going to insert the liver retractor.
1:36
Okay. Very good. We're going to retract the left lobe of the liver.
1:47
with an orogastric tube, removed with the liver retractor.
1:58
We might go in the opposite view.
2:02
Slight rotation of the patient towards the right side.
2:06
What?
2:07
Yes.
2:08
Get two, one that you do mobilization first,
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and one that you do mobilization.
2:21
And I start at a point where somewhere between
2:33
the lower stomach and the left side of the stomach,
2:35
enter the left side.
2:43
Harmonic, maybe you can lower the sound
2:45
of the harmonic a little bit.
2:47
Lower the sound.
2:48
Open the valve.
2:49
Let the valve open.
2:52
It takes vaporization.
3:02
You can see the gastroploid here, so we stay on the inside.
3:23
Can you hear me? Hello? Are they still mute?
3:32
They are muting on their side.
3:37
We're going to just go...
4:04
This might turn out to be a large amount.
4:07
This may turn out to be a large stomach.
4:09
I'm going to continue.
4:13
It's a bit of a bankers now.
4:19
We'll take a look at the camera.
4:20
Yeah.
4:21
Okay.
4:23
Yeah.
4:29
Good.
4:33
Yeah.
4:45
Yeah.
4:46
Thank you, Shane.
4:47
We're looking at the gastrocnemius fold here.
4:58
Okay.
5:10
Very good.
5:11
Now we're utilizing the power of the pivot screen to locate your camera on time.
5:45
I'm going to expose you here.
5:52
Okay.
5:57
Just go ahead and move.
6:02
It's happening to the inferior.
6:18
Okay, then I have some clips on the table.
6:22
Clips on the table.
7:00
You gotta think you're crying.
8:15
We're on the cruise, we need to walk it around, good so we can put it back on the membrane.
9:02
It's proud.
9:05
It's proud.
9:15
Now we're going to go in front.
9:29
Here we have to clean up the interior.
9:49
I'd like to clear the center of the bathroom, please.
9:56
Hello?
10:18
I think that cleans the upper part. You can see the motivation. Now we're going to go
10:26
towards the interim. Don't push this tube in the wrong way. Okay? Okay. Transition of
10:47
at the end trim, you have to watch for the fenders, sometimes the peritoneum is so thin
10:57
that you're exposed to the engine and vision, I'll put it on.
12:08
The back, the middle pole going to the left, good, stay on the side there, that's what you're doing.
12:51
Scissors.
12:54
Okay.
12:55
Sometimes scissors get dirty.
12:59
Thank you.
13:01
Last complaint.
13:12
Okay.
13:59
More props and close their plans at all.
14:11
The interior leaflet.
14:14
And close.
14:22
So close.
14:24
Okay.
14:42
Okay, now we're going to un-start the stapling, let's give us a green cartridge, 60mm distance,
14:52
and the polaris is 4 cm, which corresponds to this way.
14:56
You see the polaris here, 4 cm,
15:05
and it comes down like this.
15:16
Okay, I'm going to start the statement inserting this in the parametric order.
15:26
I like to put a portion of time here.
15:43
The patient has a relatively slim jaw.
15:59
And the first and second, and there's got to be one state for the side of the music.
16:12
Can you start inserting the bougie please?
16:18
And we're going to wait for some tissue compression, the thicker the more we have to wait.
16:27
I'm using Bio-Otobo C-Guard with the external flex that has a green cartridge, maximum height of stable, this area.
16:40
And in fact, we're going to be using the green one.
16:48
Firing the first.
16:57
Second.
17:00
You have to watch the tip of your finger when you're doing this.
17:25
We are not seeing them, why we are not seeing them?
17:28
They just made their spring out of it there.
17:33
The bougie gun, yes.
17:46
Watching the bougie gun here from behind.
18:04
Put your time there.
18:19
Like an axis.
18:21
Shoot.
18:25
Power to grease.
18:32
Okay, could you bring it up?
18:34
Yeah, stop.
18:42
Advance a bit more.
18:44
Advance, that's good.
18:58
A bit more?
19:00
Okay, keep it that way.
19:08
Now make sure it doesn't slip out, so someone will have to hold the stapler again.
20:14
Ok, so we are waiting for compression again.
20:53
NG is out.
21:19
We need a Maryland to get the crotch.
21:33
See this thing?
21:36
This is the problem.
21:54
Now, a little higher.
22:09
First, second firing.
22:16
I'm putting staples.
22:57
This one, this one.
23:01
Get the mover.
23:23
Make sure you have a pot, a nice tube, pick it up.
23:35
Compression.
23:40
Compression.
23:44
First firing.
23:49
Second firing.
23:56
They're retiring.
24:01
Working on this.
24:16
Clutch.
24:18
Clutch.
25:03
Are you sure it's okay that we don't see it?
25:05
Yeah.
25:06
It's okay.
25:08
What's okay with me?
25:09
Oh.
25:54
Got the thought away, more time, compression, buttress would come in all the way.
26:09
Second, firing.
26:16
Third.
26:33
It's possible that I may need the last one without any butchers.
26:42
Yeah.
26:47
Yeah.
26:51
Yeah.
26:55
Yeah.
26:57
You need another one?
26:59
And here's another one.
27:01
Like that.
27:05
The company makes it so that there's always the need for a blast.
27:09
Yeah.
27:10
Yeah.
27:19
Okay, give me a short one, without.
27:23
Yeah.
27:26
And then a fortress, a fortress.
27:34
Hmm? I need a last one without...
27:39
Wait, wait, wait.
27:42
We like green.
27:47
This is an ecological operation.
27:56
And during the Canadian election, the host said.
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