The biliopancreatic limb (BPL) obstruction occurrence after one-anastomosis gastric bypass (OAGB) has not been well described in the literature. A 65-year-old female with a history of OAGB surgery presented with acute weight loss and abdominal pain. Imaging studies revealed a bezoar in the duodenal diverticulum obstructing the small bowel. An urgent laparoscopic intervention was performed to remove the bezoar and alleviate the obstruction. The patient experienced postoperative complications, including gastrostomy drainage and subsequent biliobezoar migration. additional surgeries were required to address these complications. This is a rare condition, and it is usually seen in patients with predisposing factors like DM, previous surgery, and duodenal diverticulum. CT scan study is the useful diagnostic modality, and laparoscopic intervention is the choice treatment; this case highlights the importance of recognizing and managing bezoars as a potential complication following bariatric surgery.
{"title":"Biliopancreatic limb obstruction after one-anastomosis gastric bypass; a very rare and fatal event: A case report and literature review","authors":"Rahmatullah Athar, Alireza Khalaj, Parvin Shapori","doi":"10.1111/ases.13402","DOIUrl":"10.1111/ases.13402","url":null,"abstract":"<p>The biliopancreatic limb (BPL) obstruction occurrence after one-anastomosis gastric bypass (OAGB) has not been well described in the literature. A 65-year-old female with a history of OAGB surgery presented with acute weight loss and abdominal pain. Imaging studies revealed a bezoar in the duodenal diverticulum obstructing the small bowel. An urgent laparoscopic intervention was performed to remove the bezoar and alleviate the obstruction. The patient experienced postoperative complications, including gastrostomy drainage and subsequent biliobezoar migration. additional surgeries were required to address these complications. This is a rare condition, and it is usually seen in patients with predisposing factors like DM, previous surgery, and duodenal diverticulum. CT scan study is the useful diagnostic modality, and laparoscopic intervention is the choice treatment; this case highlights the importance of recognizing and managing bezoars as a potential complication following bariatric surgery.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In many cases of female radical cystectomy for bladder cancer, the procedure involves simultaneous removal of the uterus, fallopian tubes, ovaries, anterior vaginal wall, and urethra. After this procedure, rare complications like vaginal dehiscence and evisceration may occur. We herein describe this article surgical technique involving preservation of the distal anterior vaginal wall to maintain pelvic floor strength and retrograde resection of the proximal anterior vaginal wall.
Materials and Surgical Technique
The presented case was a 61-year-old woman who had a bladder tumor. After undergoing a transurethral resection, the pathology revealed muscle-invasive squamous cell bladder cancer. Consequently, she received a robot-assisted radical cystectomy (RARC) without neoadjuvant chemotherapy. Before opening the vaginal wall, the urethra, including the external urethral meatus, was dissected along its entire length. Next, a transverse incision was made in the anterior vaginal wall at the level of bladder neck, and the wall was resected retrogradely toward the anterior vaginal fornix while preserving the distal anterior vaginal wall. The opened vaginal wall was closed in a tubular shape.
Discussion
Preservation of the distal anterior vaginal wall and retrograde anterior vaginal wall resection can be safely performed in female RARC and may reduce the risk of vaginal dehiscence by minimizing the vaginal wall defect.
{"title":"Distal preservation and retrograde resection of the anterior vaginal wall in female robot-assisted radical cystectomy","authors":"Ryo Iguchi, Koji Inoue","doi":"10.1111/ases.13399","DOIUrl":"10.1111/ases.13399","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In many cases of female radical cystectomy for bladder cancer, the procedure involves simultaneous removal of the uterus, fallopian tubes, ovaries, anterior vaginal wall, and urethra. After this procedure, rare complications like vaginal dehiscence and evisceration may occur. We herein describe this article surgical technique involving preservation of the distal anterior vaginal wall to maintain pelvic floor strength and retrograde resection of the proximal anterior vaginal wall.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Surgical Technique</h3>\u0000 \u0000 <p>The presented case was a 61-year-old woman who had a bladder tumor. After undergoing a transurethral resection, the pathology revealed muscle-invasive squamous cell bladder cancer. Consequently, she received a robot-assisted radical cystectomy (RARC) without neoadjuvant chemotherapy. Before opening the vaginal wall, the urethra, including the external urethral meatus, was dissected along its entire length. Next, a transverse incision was made in the anterior vaginal wall at the level of bladder neck, and the wall was resected retrogradely toward the anterior vaginal fornix while preserving the distal anterior vaginal wall. The opened vaginal wall was closed in a tubular shape.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Preservation of the distal anterior vaginal wall and retrograde anterior vaginal wall resection can be safely performed in female RARC and may reduce the risk of vaginal dehiscence by minimizing the vaginal wall defect.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Esophageal hiatal hernias, most of which are transhiatal migrations of the gastric cardia into the mediastinum, include a minor category called paraesophageal hernias. Herniation of organs other than the stomach belongs to this category. A 75-year-old man who developed esophageal hiatal hernia of an isolated transverse colon underwent elective laparoscopic surgery. Intraoperative findings revealed a preserved phrenoesophageal attachment on the patient's left dorsal side. Sac excision, sutured cruroplasty, and Toupet fundoplication were performed. The postoperative course was uneventful, and the patient's stooping-induced dyspnea was relieved after surgery. Our literature review indicated that hiatal hernia of the isolated colon has the unique characteristic of causing secondary gastroduodenal outlet obstruction and shares a mutual nature with Type II hiatal hernia. Although rare, this uncommon type of hiatal hernia may be recognized as a distinct subtype of paraesophageal hernia.
食管裂孔疝大多是胃贲门经食管移位到纵隔，其中还有一个小类别叫做食管旁疝。胃以外的其他器官疝也属于这一类。一名 75 岁的男性因孤立横结肠食管裂孔疝接受了择期腹腔镜手术。术中发现，患者左侧背侧有一个保留的膈食管附件。手术进行了囊肿切除、缝合嵴成形术和图佩特胃底折叠术。术后病程顺利，患者因弯腰引起的呼吸困难在术后得到缓解。我们的文献综述表明，孤立性结肠食管裂孔疝具有引起继发性胃十二指肠出口梗阻的独特特征，并且与 II 型食管裂孔疝具有相同的性质。这种不常见的食管裂孔疝虽然罕见，但可被视为食管旁疝的一个独特亚型。
{"title":"Isolated esophageal hiatal hernia of the colon: A case report and review of literature","authors":"Shinsuke Maeda, Shunichi Ito, Kei Hosoda","doi":"10.1111/ases.13400","DOIUrl":"10.1111/ases.13400","url":null,"abstract":"<p>Esophageal hiatal hernias, most of which are transhiatal migrations of the gastric cardia into the mediastinum, include a minor category called paraesophageal hernias. Herniation of organs other than the stomach belongs to this category. A 75-year-old man who developed esophageal hiatal hernia of an isolated transverse colon underwent elective laparoscopic surgery. Intraoperative findings revealed a preserved phrenoesophageal attachment on the patient's left dorsal side. Sac excision, sutured cruroplasty, and Toupet fundoplication were performed. The postoperative course was uneventful, and the patient's stooping-induced dyspnea was relieved after surgery. Our literature review indicated that hiatal hernia of the isolated colon has the unique characteristic of causing secondary gastroduodenal outlet obstruction and shares a mutual nature with Type II hiatal hernia. Although rare, this uncommon type of hiatal hernia may be recognized as a distinct subtype of paraesophageal hernia.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to investigate the correlation between forceps grasp count and procedure time in single-incision laparoscopic percutaneous extraperitoneal closure surgeries and the evolution of these metrics with accumulated experience.
Methods
We retrospectively reviewed 741 procedures performed by surgeons between 2015 and 2023. Surgical videos were analyzed to calculate the procedure time, defined as the time required for suturing around the hernial orifice, and the forceps grasp count. Correlations were evaluated using Spearman's rank correlation coefficients. Changes in experience were assessed using linear regression.
Results
Surgeons demonstrated a significantly longer procedure time (585 s vs. 437 s, p < .001) and higher grasp counts (22 times vs. 17 times, p < .001) for surgeries performed on male patients than on female patients. Grasp count was strongly correlated with procedure time (male patients: r = .800; female patients: r = .758, p < .001). With accumulated experience, both procedure time and grasp count decreased, although novice surgeons showed delayed improvement in forceps manipulation compared with improvement in procedure time.
Conclusion
Grasp count was strongly correlated with procedure time in single-incision laparoscopic percutaneous extraperitoneal closure. Accumulated experience improved both metrics, with novice surgeons possibly requiring more time to acquire efficient forceps manipulation skills. Efficient forceps manipulation is a valuable metric for evaluating surgical skills.
{"title":"Correlation between forceps grasp count and skill proficiency in single-incision laparoscopic percutaneous extraperitoneal closure: A retrospective single-center study","authors":"Yohei Sanmoto, Akio Kawami, Yudai Goto, Takahiro Jimbo, Chikashi Gotoh, Kouji Masumoto","doi":"10.1111/ases.13403","DOIUrl":"10.1111/ases.13403","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study aimed to investigate the correlation between forceps grasp count and procedure time in single-incision laparoscopic percutaneous extraperitoneal closure surgeries and the evolution of these metrics with accumulated experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed 741 procedures performed by surgeons between 2015 and 2023. Surgical videos were analyzed to calculate the procedure time, defined as the time required for suturing around the hernial orifice, and the forceps grasp count. Correlations were evaluated using Spearman's rank correlation coefficients. Changes in experience were assessed using linear regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Surgeons demonstrated a significantly longer procedure time (585 s vs. 437 s, <i>p</i> < .001) and higher grasp counts (22 times vs. 17 times, <i>p</i> < .001) for surgeries performed on male patients than on female patients. Grasp count was strongly correlated with procedure time (male patients: <i>r</i> = .800; female patients: <i>r</i> = .758, <i>p</i> < .001). With accumulated experience, both procedure time and grasp count decreased, although novice surgeons showed delayed improvement in forceps manipulation compared with improvement in procedure time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Grasp count was strongly correlated with procedure time in single-incision laparoscopic percutaneous extraperitoneal closure. Accumulated experience improved both metrics, with novice surgeons possibly requiring more time to acquire efficient forceps manipulation skills. Efficient forceps manipulation is a valuable metric for evaluating surgical skills.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The da Vinci SP (SP) has only 1 robotic arm, containing 4 channels. It provides a wide space for assistant surgeons using laparoscopic forceps. We performed a new type of minimally invasive surgery using laparoscopy and a robot (MILAR) utilizing the SP in distal gastrectomy for gastric cancer.
Materials and Surgical Technique
An incision at the umbilicus was made for the SP, and 2 ports were inserted from the right abdomen for laparoscopic surgery. In the above view, where surgeons look down at the surgical field, the scope was inserted from the channel at 12 o'clock, and the round tooth retractor was inserted from 6 o'clock. In the below view, where surgeons look up at the surgical field, the scope and retractor were inserted from opposite directions. The robotic operator uses 3 forceps and a scope. The laparoscopic operator uses 2 forceps. On the greater curvature side, the left or right epiploic artery pedicles was retracted by the robot operator under the below view. The suprapancreatic area was dissected with the pedicle of the left gastric artery retracted by the laparoscopic operator under the above view.
Discussion
By setting the scope and the retractor in a diagonal direction of 12–6 o'clock, robotic surgeons have a wide space bilaterally for using forceps for nodal dissection under the co-axial setting. Laparoscopic surgeons can use this space easily. Gastrectomy by MILAR using SP could provide quality surgery within a short operative time.
{"title":"A new hybrid robotic surgery by minimally invasive laparoscopic and robotic (MILAR) system using da Vinci single-port (SP) in distal gastrectomy for gastric cancer","authors":"Takaki Yoshikawa, Tsutomu Hayashi, Masashi Nishino, Rei Ogawa, Yurina Fujisaki, Shunya Honda, Takeyuki Wada, Yukinori Yamagata, Yasuyuki Seto","doi":"10.1111/ases.13401","DOIUrl":"10.1111/ases.13401","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The da Vinci SP (SP) has only 1 robotic arm, containing 4 channels. It provides a wide space for assistant surgeons using laparoscopic forceps. We performed a new type of minimally invasive surgery using laparoscopy and a robot (MILAR) utilizing the SP in distal gastrectomy for gastric cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Surgical Technique</h3>\u0000 \u0000 <p>An incision at the umbilicus was made for the SP, and 2 ports were inserted from the right abdomen for laparoscopic surgery. In the above view, where surgeons look down at the surgical field, the scope was inserted from the channel at 12 o'clock, and the round tooth retractor was inserted from 6 o'clock. In the below view, where surgeons look up at the surgical field, the scope and retractor were inserted from opposite directions. The robotic operator uses 3 forceps and a scope. The laparoscopic operator uses 2 forceps. On the greater curvature side, the left or right epiploic artery pedicles was retracted by the robot operator under the below view. The suprapancreatic area was dissected with the pedicle of the left gastric artery retracted by the laparoscopic operator under the above view.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>By setting the scope and the retractor in a diagonal direction of 12–6 o'clock, robotic surgeons have a wide space bilaterally for using forceps for nodal dissection under the co-axial setting. Laparoscopic surgeons can use this space easily. Gastrectomy by MILAR using SP could provide quality surgery within a short operative time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although laparoscopic pancreaticoduodenectomy (LPD) and robot-assisted pancreaticoduodenectomy (RPD) are gradually gaining popularity, their advantages over open pancreaticoduodenectomy (OPD) remain controversial. This study aimed to compare the short-term outcomes of OPD, LPD, and RPD to elucidate the advantages and disadvantages of each procedure.
Methods
We retrospectively analyzed 16 LPD, 43 RPD, and 36 OPD procedures performed at a single center between April 2020 and May 2024. Clinical data, including operative time, estimated blood loss, postoperative complications, length of hospital stay, and hospitalization costs, were retrospectively collected and analyzed.
Results
RPD demonstrated a significantly longer operative time (553 min) than OPD (446 min) and LPD (453 min) but a significantly lower estimated blood loss than OPD (150 mL vs. 400 mL, p < .001). Postoperative complication rates (Clavien–Dindo grade ≥3) were lower for RPD (24.4%) than those for OPD (50.0%) and LPD (68.8%). RPD also showed a significantly lower rate of clinically relevant postoperative pancreatic fistula (14.6% vs. 38.9% for OPD and 43.8% for LPD) and a shorter duration of hospitalization (11 vs. 28 days for OPD and 21 days for LPD, p < .001). Hospitalization costs were higher for RPD (20 109 USD) than for OPD (18 487 USD, p < .001), with LPD (20 496 USD) and RPD costs being similar.
Conclusions
RPD appears to offer advantages in terms of reduced blood loss and postoperative complications and shortened hospital stay despite longer operative times and higher hospitalization costs. Therefore, RPD may be a more beneficial approach than OPD or LPD in pancreatic surgery.
{"title":"Short-term surgical outcomes of open, laparoscopic, and robot-assisted pancreatoduodenectomy: A comparative, single-center, retrospective study","authors":"Naohisa Kuriyama, Takehiro Fujii, Benson Kaluba, Tatsuya Sakamoto, Haruna Komatsubara, Daisuke Noguchi, Takahiro Ito, Aoi Hayasaki, Yusuke Iizawa, Yasuhiro Murata, Akihiro Tanemura, Masashi Kishiwada, Shugo Mizuno","doi":"10.1111/ases.13397","DOIUrl":"https://doi.org/10.1111/ases.13397","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Although laparoscopic pancreaticoduodenectomy (LPD) and robot-assisted pancreaticoduodenectomy (RPD) are gradually gaining popularity, their advantages over open pancreaticoduodenectomy (OPD) remain controversial. This study aimed to compare the short-term outcomes of OPD, LPD, and RPD to elucidate the advantages and disadvantages of each procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 16 LPD, 43 RPD, and 36 OPD procedures performed at a single center between April 2020 and May 2024. Clinical data, including operative time, estimated blood loss, postoperative complications, length of hospital stay, and hospitalization costs, were retrospectively collected and analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>RPD demonstrated a significantly longer operative time (553 min) than OPD (446 min) and LPD (453 min) but a significantly lower estimated blood loss than OPD (150 mL vs. 400 mL, <i>p</i> < .001). Postoperative complication rates (Clavien–Dindo grade ≥3) were lower for RPD (24.4%) than those for OPD (50.0%) and LPD (68.8%). RPD also showed a significantly lower rate of clinically relevant postoperative pancreatic fistula (14.6% vs. 38.9% for OPD and 43.8% for LPD) and a shorter duration of hospitalization (11 vs. 28 days for OPD and 21 days for LPD, <i>p</i> < .001). Hospitalization costs were higher for RPD (20 109 USD) than for OPD (18 487 USD, <i>p</i> < .001), with LPD (20 496 USD) and RPD costs being similar.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RPD appears to offer advantages in terms of reduced blood loss and postoperative complications and shortened hospital stay despite longer operative times and higher hospitalization costs. Therefore, RPD may be a more beneficial approach than OPD or LPD in pancreatic surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142451764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Shabani, Fatemeh Behnam, Hossein Akbari, Mohammad Eidy
Background and Objective
Hydatid cyst is a benign parasitic disease that is usually asymptomatic and is discovered incidentally. The gold standard for the treatment of this disease is surgery. Recently, a laparoscopic approach has been used to remove hydatid cysts. We decided to compare this new technique with an open conventional method.
Materials and Methods
Patients—This retrospective analytical study was conducted on patients with hepatic hydatid cysts who underwent surgery in Kashan during 2013–2020. A total of 58 patients were included in this study, 18 of whom underwent laparoscopic surgery and 40 underwent open surgery. The comparison of the two groups was performed using chi-square and Fisher's exact tests.
Results
The average duration of surgery in the laparoscopic and open surgery groups was 135 and 151.6 min, respectively, which was not statistically significant (p-value = .179). There was no significant difference in terms of the need for blood transfusion, conversion of laparoscopic surgery to open surgery, anaphylactic shock, infection, and death between the two groups (p > .05). However, the laparoscopic surgery group had a significantly shorter hospital stay compared with the open surgery group (p-value < .001), and more favorite patients.
Conclusion
Considering the lack of significant difference between the two surgical methods and the reduction in the duration of surgery by a laparoscopic approach, the reduction in hospital stay of patients, and consequently the reduction in the cost of patients, it is expected that this method is a more suitable method compared with open surgery.
{"title":"Comparison of the frequency of complications resulting from open and laparoscopic surgery for hydatid cyst","authors":"Mohammad Shabani, Fatemeh Behnam, Hossein Akbari, Mohammad Eidy","doi":"10.1111/ases.13391","DOIUrl":"https://doi.org/10.1111/ases.13391","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objective</h3>\u0000 \u0000 <p>Hydatid cyst is a benign parasitic disease that is usually asymptomatic and is discovered incidentally. The gold standard for the treatment of this disease is surgery. Recently, a laparoscopic approach has been used to remove hydatid cysts. We decided to compare this new technique with an open conventional method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Patients—This retrospective analytical study was conducted on patients with hepatic hydatid cysts who underwent surgery in Kashan during 2013–2020. A total of 58 patients were included in this study, 18 of whom underwent laparoscopic surgery and 40 underwent open surgery. The comparison of the two groups was performed using chi-square and Fisher's exact tests.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average duration of surgery in the laparoscopic and open surgery groups was 135 and 151.6 min, respectively, which was not statistically significant (<i>p</i>-value = .179). There was no significant difference in terms of the need for blood transfusion, conversion of laparoscopic surgery to open surgery, anaphylactic shock, infection, and death between the two groups (<i>p</i> > .05). However, the laparoscopic surgery group had a significantly shorter hospital stay compared with the open surgery group (<i>p</i>-value < .001), and more favorite patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Considering the lack of significant difference between the two surgical methods and the reduction in the duration of surgery by a laparoscopic approach, the reduction in hospital stay of patients, and consequently the reduction in the cost of patients, it is expected that this method is a more suitable method compared with open surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142443380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Robotic surgery without contact-force feedback could be less safe, as forces exerted by the robot system may exceed tissue tolerance. This study aimed to evaluate the benefit of contact-force feedback.
Methods
Nine junior and 11 senior surgeons performed two tasks using Saroa, a robotic surgical system with a force feedback function. In Task A, the participants estimated the order of stiffness of substances when feedback was on and off. In Task B, the effect of feedback on compression with a designated force (3 N) was assessed.
Results
In Task A, the proportion of participants who correctly estimated the order of stiffness of the substances was similar when feedback was on and off. However, the median maximum force applied to the substances was significantly smaller when feedback was on than when it was off (5.0 vs. 6.9 N, p = .011), which was more obvious among the junior surgeons (5.0 vs. 7.7 N, p = .015) than among the senior surgeons (4.7 vs. 5.9 N, p = .288). In Task B, deviations from the designated force (3 N) for three substances were smaller when feedback was on (0, −0.1, and 0.7, respectively) than when it was off (−0.3, −0.5, and 1.3, respectively). Regarding the dispersion of the force to the substances, the interquartile range tended to be smaller with feedback; this trend was more obvious in the junior surgeons.
Conclusion
With contact-force feedback, tissue stiffness could be estimated with a small force, particularly by the junior surgeons; specified force could be accurately applied to the tissue.
导言：没有接触力反馈的机器人手术安全性可能较低，因为机器人系统施加的力可能会超过组织的耐受力。本研究旨在评估接触力反馈的益处。 方法 9 名初级外科医生和 11 名高级外科医生使用具有力反馈功能的机器人手术系统 Saroa 完成了两项任务。在任务 A 中，参与者估算了反馈开启和关闭时物质硬度的顺序。在任务 B 中，评估了反馈对指定力（3 N）压缩的影响。 结果 在任务 A 中，当反馈开启和关闭时，正确估计物质硬度顺序的参与者比例相似。但是，当反馈开启时，施加在物质上的最大力的中位数明显小于反馈关闭时（5.0 N vs. 6.9 N，p = .011），这在初级外科医生中（5.0 N vs. 7.7 N，p = .015）比在高级外科医生中（4.7 N vs. 5.9 N，p = .288）更为明显。在任务 B 中，三种物质在开启反馈时（分别为 0、-0.1 和 0.7）与关闭反馈时（分别为 -0.3、-0.5 和 1.3）的指定力（3 N）偏差较小。关于力对物质的分散性，反馈时的四分位数间范围往往较小；这一趋势在初级外科医生中更为明显。 结论 通过接触力反馈，可以用很小的力来估计组织的硬度，尤其是初级外科医生；指定的力可以准确地施加到组织上。
{"title":"Evaluating the benefit of contact-force feedback in robotic surgery using the Saroa surgical system: A preclinical study","authors":"Yoshihiro Sakai, Masanori Tokunaga, Yoshimi Yamasaki, Hiroki Kayasuga, Teruyuki Nishihara, Kotaro Tadano, Kenji Kawashima, Shigeo Haruki, Yusuke Kinugasa","doi":"10.1111/ases.13395","DOIUrl":"https://doi.org/10.1111/ases.13395","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Robotic surgery without contact-force feedback could be less safe, as forces exerted by the robot system may exceed tissue tolerance. This study aimed to evaluate the benefit of contact-force feedback.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nine junior and 11 senior surgeons performed two tasks using Saroa, a robotic surgical system with a force feedback function. In Task A, the participants estimated the order of stiffness of substances when feedback was on and off. In Task B, the effect of feedback on compression with a designated force (3 N) was assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In Task A, the proportion of participants who correctly estimated the order of stiffness of the substances was similar when feedback was on and off. However, the median maximum force applied to the substances was significantly smaller when feedback was on than when it was off (5.0 vs. 6.9 N, <i>p</i> = .011), which was more obvious among the junior surgeons (5.0 vs. 7.7 N, <i>p</i> = .015) than among the senior surgeons (4.7 vs. 5.9 N, <i>p</i> = .288). In Task B, deviations from the designated force (3 N) for three substances were smaller when feedback was on (0, −0.1, and 0.7, respectively) than when it was off (−0.3, −0.5, and 1.3, respectively). Regarding the dispersion of the force to the substances, the interquartile range tended to be smaller with feedback; this trend was more obvious in the junior surgeons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>With contact-force feedback, tissue stiffness could be estimated with a small force, particularly by the junior surgeons; specified force could be accurately applied to the tissue.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142435696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Although anomalies of the celiac and/or superior mesenteric arteries are occasionally encountered during abdominal surgery, anomalous venous confluence is seldom reported during pancreatic surgery. Herein, we present a rare case of laparoscopic spleen-preserving distal pancreatectomy (LSPDP) for the treatment of a solid pseudopapillary neoplasm in an asymptomatic 37-year-old male with an anomalous splenic vein (SpV) confluence. Computed tomography angiography (CTA) revealed an anomaly of the SpV, which coursed transversely through the superior border of the pancreas, over the celiac artery and into the portal vein, along the superior line of the common hepatic artery. We successfully performed an LSPDP without peripancreatic vessel injury by exposing the SpV and splenic artery through an approach from the superior position of the pancreas. Preoperative imaging, especially CTA, is crucial to ensuring a safe, successful laparoscopic pancreatectomy.
{"title":"A case of laparoscopic spleen-preserving distal pancreatectomy for small solid pseudopapillary neoplasm in an adult male with anomalous splenic vein confluence","authors":"Sunao Uemura, Rikiya Daike, Kenji Yorita, Hiromichi Yamai, Mitsuteru Yoshida, Norihiro Hokimoto, Hisashi Matsuoka, Jun Iwabu, Fuyumi Izaki, Michiyo Okazaki, Nobuyuki Tanida","doi":"10.1111/ases.13396","DOIUrl":"10.1111/ases.13396","url":null,"abstract":"<p>Although anomalies of the celiac and/or superior mesenteric arteries are occasionally encountered during abdominal surgery, anomalous venous confluence is seldom reported during pancreatic surgery. Herein, we present a rare case of laparoscopic spleen-preserving distal pancreatectomy (LSPDP) for the treatment of a solid pseudopapillary neoplasm in an asymptomatic 37-year-old male with an anomalous splenic vein (SpV) confluence. Computed tomography angiography (CTA) revealed an anomaly of the SpV, which coursed transversely through the superior border of the pancreas, over the celiac artery and into the portal vein, along the superior line of the common hepatic artery. We successfully performed an LSPDP without peripancreatic vessel injury by exposing the SpV and splenic artery through an approach from the superior position of the pancreas. Preoperative imaging, especially CTA, is crucial to ensuring a safe, successful laparoscopic pancreatectomy.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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