Introduction: Solid pseudopapillary neoplasms of the pancreas (SPN), first described by pathologist Virginia Kneeland Franzt in 1951, are a relatively rare pathological condition that accounts for approximately 2% - 3% of pancreatic neoplasms. Over time, as awareness and knowledge regarding SPN gradually increased among the various medical specialties and subspecialties, while imaging techniques gradually evolved, the number of patients diagnosed with SPN gradually increased. Materials and methods: This review presents the recent literature data in relation to the diagnosis concerning SPN. It is a narrative literature review, with a focus on published scientific data from the last 15 years. Conclusion: Solid pseudopapillary neoplasms of the pancreas are relatively rare, occurring tumors of this organ, typically affecting young women, without characteristic symptoms. Their behaviour in the vast majority is mild and could be classified as benign, with patients surviving for a long time after radical excision of the tumour. All in all, excellent long-term outcomes in patients with SPN have been seen due to early diagnosis and appropriate surgical intervention. In the future, we expect to see an improvement in patient care and prognosis with the constant development of diagnostic algorithms and a deeper understanding of the disease’s molecular biology.

Background: Postoperative complications following gastrointestinal (GI) surgery represent a major clinical concern, contributing to increased morbidity, prolonged hospital stays, and elevated healthcare costs globally. To anticipate these adverse outcomes, clinicians often rely on traditional risk stratification tools such as the American Society of Anesthesiologists (ASA) classification and the Surgical Apgar Score. However, these tools exhibit limited predictive accuracy, especially for rare or complex complications, prompting exploration into more sophisticated alternatives such as artificial intelligence (AI). Objective: This review aimed to critically evaluate and synthesize current evidence comparing the predictive performance of AI-based models with traditional clinical risk scores in forecasting postoperative complications in GI surgery. Methods: A systematic search was conducted in PubMed/MEDLINE, EMBASE, and Web of Science databases through December 2024. Studies included had to directly compare AI models with clinical scores in adult patients undergoing GI surgery. The primary outcome was the area under the receiver operating characteristic curve (AUC), with sensitivity and specificity as secondary metrics. Risk of bias was assessed using the Newcastle-Ottawa Scale. Results: Out of 1,588 screened records, five studies met the inclusion criteria. Across these, AI models consistently outperformed traditional clinical scores. For instance, Merath et al. reported an AUC of 0.74 for a machine learning model versus 0.58 for ASA. Leonard et al. found a Random Forest model achieved an AUC of 0.757 compared to 0.730 with logistic regression. Neural networks showed particular promise in detecting rare complications such as anastomotic leaks. Conclusion: Despite promising results, limitations include risk of bias, limited external validation, and interpretability challenges, necessitating further prospective research.

Background: Anastomotic leak (AL) is a serious complication following intestinal anastomosis. In South Africa high trauma volumes and resource constraints intersect with a heavy burden of chronic and infectious diseases. Local data regarding AL risk factors are, however, scarce. This study aims to determine risk factors for AL in trauma patients in this setting. Methods: A retrospective analytical observational study was performed on patients who underwent exploratory laparotomy with intestinal injuries at a tertiary and regional hospital in Durban, South Africa. Patients aged ≥18 years and with a postoperative survival of >48 hours were included. Patients managed with an ostomy, those who died within 48 hours, or with incomplete records were excluded. Demographic, biochemical, intraoperative data were assessed for an association with AL. Results: A total of 234 patients were included, of which 19 (8.1%) developed AL. Most patients were young and male (94.4%). On univariate analysis, significant associations with AL were noted for age 36-45 years (p = 0.007), gunshot wound (GSW) trauma (p = 0.008), and time to presentation 6-12 hours (p = 0.038). Preoperative dyschloremia (both hypo- and hyperchloremia) was also associated with AL (p = 0.01). Intraoperative factors included surgical time >120 minutes (p 0.001), use of inotropes (p = 0.009), peritoneal contamination (p = 0.03), and damage control surgery (DCS) (p = 0.001). In logistic regression analysis, independent preoperative predictors were age, GSW injury and dyschloremia, while surgical time and DCS remained significant intraoperative predictors. Conclusion: In this cohort, GSW injuries, increasing age, preoperative dyschloremia, prolonged surgical time, and the need for DCS were independent predictors of AL. These findings underscore the importance of early optimization of physiological parameters and careful intraoperative decision-making in resource-constrained settings. Future studies are warranted to validate these predictors and refine management strategies.

Background: In patients with early-stage breast cancer, neoadjuvant chemotherapy (NAC) is currently utilized to help de-escalate surgery. NAC has been shown to downstage breast and nodal disease, preventing mastectomy and axillary dissection. This research aimed to assess the likelihood aborting of axillary and breast surgery following NAC. Material and Methods: From October 2022 to October 2024, 66 breast cancer patients with NAC had full clinical and radiological responses. Following the pre-NAC mass clipping, the patient had conservative breast surgery, and a sentinel lymph node biopsy was performed using an intraoperative frozen section to ensure negative margins and axilla. The post-operative paraffin histopathological result was then awaited in order to determine pathological staging, which was then compared with clinical and radiological staging. Results: Pre NAC 66 patients 58 patients were stage IIb (88%) and 8 patients stage IIIa (12%). After receiving NACT there is complete clinical and radiological response in mass as turned to cT0 clinical impalpable and radiological disappeared. Pathologically only 26 (39%) patients were complete pathological response pT0N0 and rest of 40 patients (61%) were partial response with residual malignancy in breast as 24 patients or residual lymph node metastasis in 16 patients. Conclusions: Surgery for breast and axilla after NACT is recommended due to residual tumor even with complete clinical and radiological response and aborting surgery is highly not recommended.

Background: Obesity has become a growing problem worldwide which is associated with significant morbidity and mortality linked to increased cardiovascular risk, osteoarthritis, diabetes, cancer, and gastroesophageal reflux disease (GERD). since, several bariatric surgeries have been developed for weight loss. one of those surgeries is laparoscopic sleeve gastrectomy which has been a single step surgery for morbid obesity patients. A considerable number of those who undergo this surgery complains of postoperative gastro-esophageal reflux symptoms in form of heart burn, chest pain, dysphagia and even sleep problems so our study aimed to evaluate outcomes and long-term quality-of-life in patients who had gastropexy with sleeve gastrectomy and those who did not in terms of presence of reflux symptoms. Aim and objectives: To evaluate the effect of gastropexy in reducing postoperative gastro oesophageal reflux symptoms in laproscopic sleeve gastrectomy patients. Subjects and methods: This study was conducted in the general surgery department, faculty of Medicine, Cairo University at Cairo university hospitals (Kasr Alainy) on seventy patients undergoing laparoscopic sleeve gastrectomy. Results: A statistically significant difference was found regarding GERD-Q scores and likelihood at 3- and 6-month follow-up in favour of group A (Independent sample t test, P = .000). Conclusion: In summary, the application of gastropexy in laparoscopic sleeve gastrectomy was superior to laparoscopic sleeve gastrectomy alone in reducing postoperative gastro esophageal reflux symptoms with lower complications and shorter length of hospital stay.

Background / Aim of the Study: Very elderly patients undergoing emergent gastrointestinal (GI) surgery are at high perioperative risk due to frailty, multimorbidity and limited cardiopulmonary reserve. In this population, general anesthesia (GA) is associated with increased hemodynamic instability and respiratory complications. Combined spinal-epidural (CSE) anesthesia may reduce physiological stress while providing adequate surgical conditions; however, evidence supporting its use as the sole anesthetic technique in very advanced age, high-risk patients is limited. This study aimed to evaluate the feasibility and safety of CSE anesthesia in this population. Materials (Patients) and Methods: This observational case series included 40 consecutive patients aged ≥85 years, classified as ASA IV E, who underwent emergent GI surgery over a three-month period. All patients had severe cardiac and/or pulmonary comorbidities conferring prohibitive risk for GA. CSE anesthesia was performed using lumbar epidural catheter placement combined with spinal chloroprocaine, followed by incremental epidural dosing with lidocaine and ropivacaine. Sensory block level, hemodynamic parameters, vasopressor use and conversion to GA were recorded. Results: Adequate sensory blockade (T4-T6) was achieved in all patients. Hemodynamic stability was maintained, with ≤3 hypotensive episodes in 39 patients and one transient episode of bradycardia. Vasoactive support was required in six patients. No patient required conversion to GA or postoperative intubation. Conclusion: CSE anesthesia was safe and effective for emergent GI surgery in very elderly, high-risk patients and represents a viable alternative to GA in carefully selected fragile populations.

Background: Laparoscopic sleeve gastrectomy (LSG) is widely performed for obesity treatment; however, some patients experience insufficient weight loss or weight regain. Aim: This study aimed to evaluate the role of CT gastric volumetry to assess pouch size (gastric remnant volume) in patients with insufficient weight loss or recurrent weight gain after sleeve gastrectomy. Patients and methods: This cross-sectional study included 35 patients (29 females and 6 males) attended the outpatient clinic of the bariatric surgery unit complaining of weight regain or failure of weight loss after sleeve gastrectomy at Cairo University hospital during the period from 1/7/2021 to 15/1/2023. Results: The mean total gastric volume was 378.3 ± 141.8 cc, residual gastric wall volume 65.1 ± 13.9 cc, and luminal volume 313.3 ± 135.1 cc. After 1.5 years, patients achieved a mean %EWL of 70.1%; however, 20% failed to lose sufficient weight. Larger gastric volumes were significantly associated with higher current weight, BMI and waist circumference, and inversely correlated with %EWL. No significant volumetric differences were found between patients with recurrent weight gain and those with failed weight loss. A significant positive correlation was observed between total gastric volume and interval time after LSG. Conclusion: CT gastric volumetry effectively quantifies residual gastric pouch size after LSG. Larger pouch volumes are associated with poorer weight loss outcomes, supporting its role in evaluating patients with weight regain or insufficient weight loss.

Introduction: Anal fissure is a prevalent issue affecting men and women of all ages. Surgical treatment is effective but carries the fear of incontinence. Various medical therapies have been used for curing anal fissures without fear of incontinence. Our research aims to compare the improvement of resting and squeeze anal pressures and pain in chronic anal fissure (CAF) cases treated with topical diltiazem (DTZ), topical Glyceryl-trinitrate (GTN), and combined therapy. Methods: This randomized clinical trial was conducted between October 2022 and July 2023 on 90 cases with symptomatic CAF. They were classified randomly into the GTN group, treated with 0.2% GTN ointment; the DTZ group, treated with 2% DTZ ointment; and the combined group, treated with a combination of GTN & DTZ twice daily for 6 weeks. The cases were followed up after 4 and 6 weeks for improvement of pain and changes in anal pressures. Results: The improvement percentage of resting pressure in GTN, DTZ, and combined groups had a mean of 63.45 ± 2.21, 66.29 ± 1.46, and 71.72 ± 2.35, respectively. The improvement percentage of squeeze pressure in GTN, DTZ, and combined groups had a mean of 59.55 ± 1.89, 62.71 ± 1.7, and 67.51 ± 2.08, respectively. The improvement percentage of pain scores in GTN, DTZ, and combined groups had a mean of 54.2 ± 3.68, 58.19 ± 4.39, and 60.28 ± 3.69, respectively. Differences in pressure and pain improvements show statistically substantial variations (p ≤ .001) between the groups. Conclusion: The combination of GTN and DTZ 2% ointments gave better improvement on resting and squeeze anal pressures than either ointment alone, with better patient outcomes.

Introduction: Traditionally, bowel obstruction (BO) management primarily relied on surgery. However, certain surgeons have advocated for a nonoperative approach for selected patients with complete BO. Nevertheless, there exists no standardized scoring system to determine non-operative versus operative management in adults, particularly for patients with partial BO. This study aims to address this gap. Methods: This prospective observational study took place in a tertiary care teaching hospital in Mumbai, Maharashtra, India. It focused on adult patients clinically diagnosed with BO, earmarked for conservative management by their treating surgeon. A scoring system was developed, assigning one point each for the following criteria: (1) Age 65 years, (2) Continuous abdominal pain lasting >4 days, (3) Vomiting, (4) History of previous abdominal surgery, (5) Previous history of bowel obstruction, (6) Fever, (7) Tachycardia (pulse rate >100/minute), (8) Total leukocyte count >11,000/mm3, (9) Complete small bowel obstruction on X-ray (absence of air in colon), (10) Free fluid in abdomen on ultrasound, and (11) CT findings indicating “small bowel feces sign”. Patients scoring above 5 points were classified as requiring surgery. Results: Out of 35 patients, 5 (14.29%) were deemed needing surgery according to the scoring system. All 5 of these patients and 2 out of 30 (6.67%) from the conservative management group underwent surgery. Hence, our scale demonstrated a sensitivity of 71.43% and specificity of 84.84% for predicting surgery. Conclusion: While our scale showed promising sensitivity and specificity, larger studies are needed to validate its utility before clinical adoption.

Hernia is a condition characterized by an outpouching of tissue through a fissure, which can become harmful over time. Genetic inheritance is considered the primary causative factor since modern technology provides a more comprehensive understanding of how genetic factors contribute to hernias. Improved knowledge of genetics could lead to better management of hernias. Various genomic regions have been suggested to be associated with different types of hernias, but no single gene or group of genes has been definitively implicated. Some genetic components are frequently highlighted as likely contributors, interacting with environmental factors to cause hernias. The genetic background of hernias is complex, with many genes and environmental factors likely playing a role in its development. Providing suggestions for key genetic markers for diagnosing different types of hernias and discussing modern treatment options, including AI-based strategies, could offer valuable insights for managing hernias successfully. The review aims to summarize existing data on the genetics of hernias, including inheritance patterns, candidate genes, gene variants, epigenetics, gene-environment interactions, key genetic markers for diagnosis, and modern treatment approaches. This information could inform future research efforts to better understand hernia pathology and improve the management of hernias.

Background/Aim: Complicated acute cholecystitis often requires hospitalisation and surgery. Although conservative management is initially attempted, failure can lead to increased morbidity and delayed definitive care. Early identification of patients at risk of failure is essential to support timely surgical intervention. This study aimed to determine the clinical, laboratory, and radiological predictors of failed conservative management in complicated acute cholecystitis. Materials and methods: A retrospective study was conducted involving 163 patients diagnosed with complicated acute cholecystitis at Hospital Pakar Universiti Sains Malaysia from January 2022 to June 2024. Data on demographic, clinical, biochemical, and imaging characteristics were collected. Patients were classified based on success or failure of conservative treatment. Logistic regression analyses were used to identify independent predictors of failure. Results: Of the 163 patients, 82 (50.3%) failed conservative management and required emergency laparoscopic cholecystectomy. Gallbladder empyema was identified as the strongest independent predictor (adjusted odds ratio [OR]: 23.93; 95% confidence interval [CI]: 2.77-206.64; p = 0.004). The presence of a right upper quadrant tender mass (adjusted OR: 2.59; p = 0.031) and prolonged hospital stay (adjusted OR: 1.28 per day; p 0.001) were also significantly associated with failure. Age over 60, dyslipidemia, leukocytosis, and hepatic abscess were significant on univariable analysis but not retained in multivariable modelling. Conclusion: Gallbladder empyema, right upper quadrant mass, and longer hospitalisation were found to independently predict failure of conservative treatment. Early identification of these factors may assist in clinical decision-making and promote timely surgical intervention to reduce complications.

Background: Small and medium size breasts with early breast cancer present a major problem to BCS, as usually leave a distorted or disfigured breast. This leaves reconstruction with volume replacement to achieve good aesthetic outcomes. Aim: to avoid mastectomy and to deliver satisfactory cosmetic appearance without compromising the adequacy of tumor resection by using latissimus dorsi flap and thoraco-dorsal artery perforator flap. Patients and methods: This study was a prospective clinical randomized trial on 30 patients with early breast cancer (stage I & II) especially those with small and medium sized breasts. Patients were divided into two groups each group include fifteen patients. Results: The mean age of the patients was (39.85) years with a range between (32-51) years. In all patients, the tumor was in upper outer quadrant of the breast. Breast size was cup “A” in twelve cases (40%), cup “B” in 15 cases (50%) and cup “C” in 3 cases (10%). The mean tumor size was 2.47 ± 0.6 cm with a range of 1.4-3.5 cm. The margins were free by intraoperative frozen section assessment in all cases. The mean operative time was 172.75 mins (with range between 140-250 mins). Flap harvesting time for LD group was 90 (with range between 40-130) while TDAP group was 105 (with range between 45-170 mins). Conclusion: Immediate volume replacement with LD flap can extend the role of BCS to those patients. This can be achieved without compromising resection, no effect on oncological outcome, with minimal morbidity, very satisfactory cosmetic results.

Objective: Throughout human history, natural disasters have significantly influenced civilizations, shaping cultures, landscapes, and testing humanity’s resilience against nature’s forces. This literature review provides a comprehensive overview of the landscape of disasters, exploring definitions, classifications, subtypes, and their impacts, as well as national emergency plans in Greece versus the European context. Methods: A comprehensive review of the literature was conducted through systematic searches of PubMed, Cochrane Library, and Google Scholar, focusing on English-language, peer-reviewed studies related to natural and man-made disasters. Non-peer-reviewed sources and articles not directly related to disaster management were excluded. Results: The analysis revealed the multifaceted impacts of disasters and highlights the pivotal role of prevention, preparedness, response, and recovery pillars in enhancing social resilience. Additionally, the interplay between national emergency plans in Greece and European initiatives was examined, emphasizing collective efforts to strengthen disaster management capacities. Conclusions: Integration of national and European disaster management programs is advocated to bridge gaps, enhance resilience, and foster an integrated approach to crisis management. Overall, this review underlines the importance of understanding and addressing the complex dynamics of disasters for effective disaster preparedness and response.

Intersphincteric resection has been increasingly accepted as the ultimate sphincter-preserving procedure in low rectal cancer. Intersphincteric resection preserves the natural anus and avoids permanent colostomy. Intersphincteric resection is a surgical technique intended to avoid abdominoperineal resection in patients diagnosed with low-lying rectal cancer. The most critical complication of this technique is anastomotic leak, with incidence rate from 5.1% to 20%. Majority of these patients require a reoperation with complete take-down of anastomosis and fecal diversion. We report a case with total colo-anal anastomitic leak after convencional intersphincteric resection, which was successfully treated by Turnbull-Cutait two-stage procedure, saving bowel continuity, avoiding diverting ostomy, and stoma-related complications.

Biliary ascariasis occurs when Ascaris lumbricoides worms invade the biliary system. It may cause biliary obstruction, cholangitis, and acute pancreatitis. We reported the case of a seventy-one year old Malay lady who presented with recurrent biliary ascariasis and who was successfully managed with Endoscopic Retrograde Cholangiopancreaticography (ERCP) and albendazole therapy for deworming.

Internal herniation into the lesser sac is a rare but potentially life-threatening cause of small bowel obstruction (SBO), often diagnosed late due to nonspecific symptoms and inconclusive imaging. This report presents a case of a 61-year-old woman who developed small bowel gangrene caused by internal herniation into the lesser sac, initially misdiagnosed as perforated viscus. Despite challenging preoperative diagnosis, emergency laparotomy confirmed strangulated bowel loops, which were resected. Early surgical intervention improved the patient’s outcome, emphasizing the importance of high clinical suspicion and timely diagnosis in managing this rare condition.

Hypercalcaemia in primary hyperparathyroidism (PHPT) can present in a diverse spectrum of pancreatitis, ranging from acute to chronic pancreatitis with its complications. We report two distinct clinical cases of young gentlemen presenting with acute pancreatitis in first case and chronic pancreatic pseudocyst in second case. Both were diagnosed with PHPT secondary to single parathyroid adenoma and underwent parathyroidectomy. Case 1 albeit presented with severe necrotising pancreatitis, recovered well without recurrence of pancreatitis whilst Case 2 had persistent symptoms post-surgery. Early diagnosis and treatment of PHPT may reduce the risk of developing chronic pancreatitis and its complication in PHPT patients with hypercalcaemia. We also would like to highlight the role of 4D-CT in diagnosis of parathyroid adenoma.

Background: The Stapled Mesh Stoma Reinforcement Technique (SMART) has emerged as an effective prophylactic method for preventing parastomal hernias during stoma creation. While the technique has demonstrated efficacy in reducing hernia rates, specific complications related to SMART remain underreported in the literature. Case Presentation: We report a novel complication in a 50-year-old male who underwent total pelvic exenteration with SMART technique for colostomy creation due to locally recurrent rectal carcinoma. On postoperative day 6, the patient developed erythema and swelling around the stoma site. Initial exploration revealed a hematoma, but subsequent vacuum-assisted closure therapy led to drainage of intestinal content. Re-exploration demonstrated small bowel entrapment between the circular stapler line and abdominal wall, resulting in partial bowel wall compression, ischemic injury, and fistula formation to the subcutaneous space. The entrapped bowel segment was resected with end-to-end anastomosis, and the SMART mesh was removed. The patient recovered uneventfully with no complications at 6-month follow-up. Conclusion: Small bowel entrapment under the circular stapler line represents a previously unreported but serious complication of the SMART technique that may not be immediately apparent on standard imaging studies due to preserved bowel lumen patency. This case emphasizes the importance of meticulous surgical technique during SMART procedures and maintaining high clinical suspicion when managing postoperative complications. Surgeons should be aware of this potential complication and implement appropriate preventive measures during the procedure.

Acute intestinal obstruction is a frequent surgical emergency, typically classified as functional or mechanical. While functional ileus often occurs in acute appendicitis due to peritoneal inflammation, mechanical obstruction caused by appendicitis is rare. Among the rare variants, an appendicular tourniquet, where the appendix forms a ring around bowel loops can lead to internal herniation and obstruction. We present a case of a 78-year-old man with no prior abdominal surgery who presented with signs of bowel obstruction. CT abdomen revealed dilated small bowel loops with a transition zone in the right lower quadrant and a whirlpool sign. Emergency laparotomy identified an inflamed appendix adhered to the jejunum, forming a ring through which proximal bowel herniated. Appendicectomy was performed, and the patient recovered uneventfully. This case highlights the importance of early imaging and surgical exploration in elderly patients with obstruction, especially when no prior surgery suggests an adhesive cause.

Introduction: Intussusception refers to the invagination of a segment of the gastrointestinal tract into the lumen of an adjacent segment. It is significantly more prevalent in children than in adults. In contrast to the pediatric population, adult intussusception is frequently associated with a pathological lead point. However, certain benign conditions, such as lipomas, may mimic malignant lesions radiologically and clinically. Case presentation: A 44-year-old male patient was admitted to our department with complaints of tachycardia, nausea, abdominal pain, vomiting, and diarrhea accompanied by hematochezia. Physical examination revealed generalized abdominal tenderness with mild abdominal distension. Abdominal ultrasonography indicated signs of intestinal obstruction. Contrast-enhanced computed tomography demonstrated a jejunojejunal intussusception involving approximately a 10 cm segment of the small intestine, located in the upper midline and left abdominal quadrant. Within the intussuscepted segment, a well-circumscribed, hypodense intraluminal lesion measuring approximately 2 cm in diameter –radiologically consistent with a lipoma–was identified. The patient underwent diagnostic laparotomy, during which approximately 10 cm of invaginated mid-jejunal segment was resected. Primary end-to-end anastomosis was performed. The postoperative course was uneventful, and the patient was discharged without complications. Conclusion: Although intestinal lipomas are rare in adults, they should be considered in the differential diagnosis of small bowel obstruction due to intussusception. Prompt radiological evaluation and timely surgical intervention are essential for optimal management and favorable outcomes.

Large splenic cysts are uncommon, and their occurrence during pregnancy is particularly rare, posing complex management challenges. The primary concern lies in ensuring both maternal and fetal safety while addressing potential complications. Splenic cysts are classified as either primary (true) or secondary (pseudocysts), with the latter often associated with prior trauma or infection. Although typically asymptomatic, cysts larger than 10 cm may lead to serious issues such as rupture, hemorrhage, infection, or hypersplenism. The physiological and anatomical changes of pregnancy can accelerate cyst progression, aggravate compressive symptoms, and contribute to hematological abnormalities. Diagnosis is primarily based on imaging such as ultrasound and computed tomography scan combined with laboratory investigations to assess blood parameters. Management depends on the cyst’s size, growth rate, and symptomatology, ranging from conservative observation to percutaneous drainage or surgery. Surgical interventions, including splenectomy, are usually postponed until after delivery unless there is an urgent indication. A multidisciplinary, patient-centered approach that takes into account gestational age, clinical presentation, and potential risks is crucial for achieving favorable maternal and fetal outcomes.

Oesophagectomy is the standard treatment for resectable oesophageal cancer and may be performed using several different approaches. Gastric mobilisation is a critical step common to all approaches, enabling a distal resection margin, lymphadenectomy, and formation of a gastric conduit. Laparoscopic gastric mobilisation has significant benefits over open mobilisation with reduced postoperative morbidity, fewer pulmonary complications, and shorter hospital length of stay. In this video, we demonstrate the key steps of laparoscopic gastric mobilisation as performed for an Ivor Lewis oesophagectomy. The operative technique is presented in a stepwise manner, including patient positioning, port placement, preservation of the right gastroepiploic artery, division of the short gastric vessels and lesser omentum, hiatal dissection, ligation of the left gastric vessels, and creation of the gastric conduit. This video aims to provide a clear guide to laparoscopic gastric mobilisation, applicable across different approaches to oesophagectomy.