We present a case of a recurrent inguinal bladder hernia that was previously unsuccessfully operated on three times and was repaired using totally extraperitoneal repair (TEP). A 79-year-old man presented with a right inguinal swelling that had been treated three times on the same side with anterior approaches. Computed tomography confirmed a recurrent inguinal bladder hernia. TEP was performed after identifying the bladder hernia preoperatively, with previous surgeries that used a plug-and-patch technique through an anterior approach. The extraperitoneal approach allowed the bladder to be reduced without injury and the hernia to be safely repaired using a 3D Max® Light Mesh. The postoperative recovery was uneventful, with no recurrence after 1 year. TEP facilitates the diagnosis and repair of bladder hernias, emphasizing the importance of preoperative diagnosis and the efficacy of endoscopic procedures in bladder hernia repair, even in recurrent cases.
我们介绍了一例复发性腹股沟膀胱疝患者，该患者之前曾接受过三次手术，但均未成功，后采用完全腹膜外修补术（TEP）进行了修补。一名 79 岁的男性因右侧腹股沟肿物就诊，曾在同一侧接受过三次前方入路治疗。计算机断层扫描证实他患有复发性腹股沟膀胱疝。在术前确定膀胱疝后，进行了TEP手术，之前的手术采用的是经前方入路的插补技术。腹膜外入路可以在不损伤膀胱的情况下缩小膀胱，并使用 3D Max® Light 网片安全地修复疝。术后恢复顺利，一年后未再复发。TEP 有助于膀胱疝的诊断和修补，强调了术前诊断的重要性以及内窥镜手术在膀胱疝修补中的有效性，即使是复发病例也不例外。
{"title":"Laparoscopic totally extraperitoneal repair for recurrent inguinal bladder hernia: A case report","authors":"Yuto Kitano, Koji Okamoto, Tatsuya Aoki, Kazuhide Watanabe, Akira Takehara, Kazushige Shibahara","doi":"10.1111/ases.13352","DOIUrl":"10.1111/ases.13352","url":null,"abstract":"<p>We present a case of a recurrent inguinal bladder hernia that was previously unsuccessfully operated on three times and was repaired using totally extraperitoneal repair (TEP). A 79-year-old man presented with a right inguinal swelling that had been treated three times on the same side with anterior approaches. Computed tomography confirmed a recurrent inguinal bladder hernia. TEP was performed after identifying the bladder hernia preoperatively, with previous surgeries that used a plug-and-patch technique through an anterior approach. The extraperitoneal approach allowed the bladder to be reduced without injury and the hernia to be safely repaired using a 3D Max® Light Mesh. The postoperative recovery was uneventful, with no recurrence after 1 year. TEP facilitates the diagnosis and repair of bladder hernias, emphasizing the importance of preoperative diagnosis and the efficacy of endoscopic procedures in bladder hernia repair, even in recurrent cases.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"17 3","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493834","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 aims to prove the feasibility and safety of robotic gastrectomy using the hinotori™ Surgical Robot System (Medicaroid Corporation, Kobe, Japan).
Methods
We retrospectively enrolled the 16 patients who underwent gastrectomy by the hinotori™ Surgical Robot System for gastric cancer at our hospital between June 2023 and January 2024. Console surgeons performed almost all lymphadenectomies, including the clipping of vessels. Assistant surgeons supported the lymphadenectomy using vessel sealing devices and during reconstruction.
Results
Thirteen patients were cStage I, one patient was cStage II, and two patients were cStage III. Distal gastrectomy, proximal gastrectomy, and total gastrectomy were performed in 11, 1, and 4 patients, respectively. D1+ and D2 lymphadenectomies were performed in 11 and 5 patients, respectively. Billroth-I, Billroth-II, Roux-en-Y, and esophagogastrostomy were performed in three, six, six, and one patients, respectively. The median operation time was 282 (245–338) min, and the median console time was 226 (185–266) min. The median blood loss was 28 (12–50) mL, and the median amylase levels in drainage fluid were 280 (148–377) U/L on postoperative day 1 and 74 (42–148) U/L on postoperative day 3. There was anastomotic leakage (Clavien–Dindo [CD] IIIa) in one patient who underwent proximal gastrectomy. The median postoperative hospital stay was 12.5 (12–14) days.
Conclusion
In this initial case series, the hinotori™ Surgical Robot System was found to be safe and feasible for patients with gastric cancer and is suggested to be appropriate for gastrectomy, including distal gastrectomy and total gastrectomy.
{"title":"Robotic gastrectomy using hinotori™ Surgical Robot System: Initial case series","authors":"Junya Kitadani, Toshiyasu Ojima, Keiji Hayata, Taro Goda, Akihiro Takeuchi, Shinta Tominaga, Naoki Fukuda, Tomoki Nakai, Shotaro Nagano, Manabu Kawai","doi":"10.1111/ases.13349","DOIUrl":"10.1111/ases.13349","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aims to prove the feasibility and safety of robotic gastrectomy using the hinotori™ Surgical Robot System (Medicaroid Corporation, Kobe, Japan).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively enrolled the 16 patients who underwent gastrectomy by the hinotori™ Surgical Robot System for gastric cancer at our hospital between June 2023 and January 2024. Console surgeons performed almost all lymphadenectomies, including the clipping of vessels. Assistant surgeons supported the lymphadenectomy using vessel sealing devices and during reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirteen patients were cStage I, one patient was cStage II, and two patients were cStage III. Distal gastrectomy, proximal gastrectomy, and total gastrectomy were performed in 11, 1, and 4 patients, respectively. D1+ and D2 lymphadenectomies were performed in 11 and 5 patients, respectively. Billroth-I, Billroth-II, Roux-en-Y, and esophagogastrostomy were performed in three, six, six, and one patients, respectively. The median operation time was 282 (245–338) min, and the median console time was 226 (185–266) min. The median blood loss was 28 (12–50) mL, and the median amylase levels in drainage fluid were 280 (148–377) U/L on postoperative day 1 and 74 (42–148) U/L on postoperative day 3. There was anastomotic leakage (Clavien–Dindo [CD] IIIa) in one patient who underwent proximal gastrectomy. The median postoperative hospital stay was 12.5 (12–14) days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this initial case series, the hinotori™ Surgical Robot System was found to be safe and feasible for patients with gastric cancer and is suggested to be appropriate for gastrectomy, including distal gastrectomy and total gastrectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"17 3","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477703","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 left kidney is often preferred for living donor kidney transplantation because of its anatomical advantages. However, the right kidney may be procured due to donor conditions. Few studies have assessed the safety and graft outcome of right retroperitoneal laparoscopic donor nephrectomy (RDN). This study aimed to compare the outcomes between right and left RDN with respect to donor outcome and the graft function of recipients.
Methods
This retrospective study included 230 consecutive living donor kidney transplants performed at our institution between May 2019 and March 2023. We reviewed the outcomes of kidney transplant in the right and left kidneys after RDN.
Results
A total of 230 living donor kidney transplants were performed, with 32 donors receiving right RDN (right RDN group) and 198 donors receiving left RDN (left RDN group). The renal veins and ureters were significantly shorter in the right RDN group than in the left RDN group (both p < .001). Donor operation and warm ischemia time were significantly longer in the right RDN group than in the left RDN group (p = .012 and p < .001, respectively). None of the groups exhibited any cases of delayed graft function owing to donor-related reasons. Perioperative changes in the estimated glomerular filtration rate of recipients and death-censored graft survival were not significantly different between the two groups.
Conclusions
In RDN, the outcomes of right donor nephrectomy were comparable to those of left donor nephrectomy in terms of donor safety and recipient renal function.
{"title":"Safety and graft outcome of right retroperitoneal laparoscopic donor nephrectomy for living donor kidney transplantation: A comparison with left retroperitoneal laparoscopic donor nephrectomy","authors":"Fumika Goto, Yu Sato, Hiroshi Noguchi, Shinsuke Kubo, Keizo Kaku, Yasuhiro Okabe, Masafumi Nakamura","doi":"10.1111/ases.13355","DOIUrl":"10.1111/ases.13355","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The left kidney is often preferred for living donor kidney transplantation because of its anatomical advantages. However, the right kidney may be procured due to donor conditions. Few studies have assessed the safety and graft outcome of right retroperitoneal laparoscopic donor nephrectomy (RDN). This study aimed to compare the outcomes between right and left RDN with respect to donor outcome and the graft function of recipients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 230 consecutive living donor kidney transplants performed at our institution between May 2019 and March 2023. We reviewed the outcomes of kidney transplant in the right and left kidneys after RDN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 230 living donor kidney transplants were performed, with 32 donors receiving right RDN (right RDN group) and 198 donors receiving left RDN (left RDN group). The renal veins and ureters were significantly shorter in the right RDN group than in the left RDN group (both <i>p</i> < .001). Donor operation and warm ischemia time were significantly longer in the right RDN group than in the left RDN group (<i>p</i> = .012 and <i>p</i> < .001, respectively). None of the groups exhibited any cases of delayed graft function owing to donor-related reasons. Perioperative changes in the estimated glomerular filtration rate of recipients and death-censored graft survival were not significantly different between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In RDN, the outcomes of right donor nephrectomy were comparable to those of left donor nephrectomy in terms of donor safety and recipient renal function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"17 3","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141493835","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}
Hybrid total laparoscopic hysterectomy combines conventional laparoscopic surgery and robot-assisted devices: the camera and assistant forceps are operated by a robotic device, whereas the surgeon performs laparoscopic procedures, enabling surgery with a completely fixed field of view and significantly reducing errors in forceps grasping and needle misalignment. Here, we examined whether using two arms of the Hugo™ robot-assisted surgery system, one for the camera and one for the assistant, would improve surgical accuracy compared with conventional total laparoscopic hysterectomy.
Materials and Surgical Technique
The surgical system reduced surgeon errors in grasping the forceps during training and stabilized forceps operation. Compared with conventional laparoscopic surgery, the use of the surgical system did not result in different operative durations. The stable surgical procedure was considered a major advantage.
Discussion
This new technique involving new equipment can improve surgeon training and performance. In the future, we will develop new techniques to improve surgical performance.
{"title":"New surgery technique combining robotics and laparoscopy using the Hugo™ RAS system","authors":"Hiroaki Komatsu, Mayumi Sawada, Yuki Iida, Ikumi Wada, Yukihiro Azuma, Akiko Kudoh, Shinya Sato, Tasuku Harada, Fuminori Taniguchi","doi":"10.1111/ases.13344","DOIUrl":"10.1111/ases.13344","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hybrid total laparoscopic hysterectomy combines conventional laparoscopic surgery and robot-assisted devices: the camera and assistant forceps are operated by a robotic device, whereas the surgeon performs laparoscopic procedures, enabling surgery with a completely fixed field of view and significantly reducing errors in forceps grasping and needle misalignment. Here, we examined whether using two arms of the Hugo™ robot-assisted surgery system, one for the camera and one for the assistant, would improve surgical accuracy compared with conventional total laparoscopic hysterectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Surgical Technique</h3>\u0000 \u0000 <p>The surgical system reduced surgeon errors in grasping the forceps during training and stabilized forceps operation. Compared with conventional laparoscopic surgery, the use of the surgical system did not result in different operative durations. The stable surgical procedure was considered a major advantage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This new technique involving new equipment can improve surgeon training and performance. In the future, we will develop new techniques to improve surgical performance.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"17 3","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477702","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}
Radical cystectomy after low anterior resection is rare, and no cases of robotic surgery have been reported. Cystectomy in patients who have undergone a previous pelvic surgery, whether open or endoscopic, requires caution to avoid damaging other organs due to anatomical changes caused by adhesions in a limited space. Additionally, the curative nature of the treatment must be maintained. We describe a 69-year-old man with a history of open low anterior resection for rectal cancer who underwent robot-assisted radical cystectomy with extracorporeal ileal conduit construction. Although this procedure is challenging, it was performed safely with the collaboration of colorectal surgeons. The patient was discharged without perioperative complications and remained recurrence-free for 5 years.
{"title":"Robot-assisted radical cystectomy for bladder cancer after low anterior resection: A case report","authors":"Shoutarou Watanabe, Hiroaki Kobayashi, Nao Hiroe, Tomohiro Iwasawa, Michio Kosugi, Masayuki Shimizu, Masaru Ishida","doi":"10.1111/ases.13345","DOIUrl":"10.1111/ases.13345","url":null,"abstract":"<p>Radical cystectomy after low anterior resection is rare, and no cases of robotic surgery have been reported. Cystectomy in patients who have undergone a previous pelvic surgery, whether open or endoscopic, requires caution to avoid damaging other organs due to anatomical changes caused by adhesions in a limited space. Additionally, the curative nature of the treatment must be maintained. We describe a 69-year-old man with a history of open low anterior resection for rectal cancer who underwent robot-assisted radical cystectomy with extracorporeal ileal conduit construction. Although this procedure is challenging, it was performed safely with the collaboration of colorectal surgeons. The patient was discharged without perioperative complications and remained recurrence-free for 5 years.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"17 3","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471555","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}
Situs inversus complicates diagnosis and treatment due to the mirrored organ placement in relation to normal anatomy. This report describes a 78-year-old female patient with situs inversus totalis who underwent laparoscopic cholecystectomy and laparoscopic common bile duct exploration for cholecystolithiasis and choledocholithiasis. Utilizing the “French mirror technique” for port placement, the surgeon adeptly mirrored standard maneuvers with a 2-mm needle forceps in the left hand and a 5-mm forceps in the right in a reversed anatomical setting. This technique maintained familiar hand movements, despite the patient's unique anatomy. The surgeon applied transcystic ductal bile duct exploration, using choledochoscopy for duct exploration and a basket catheter for stone removal. Laparoscopic cholecystectomy and common bile duct exploration through the transcystic ductal route are viable and effective for patients with situs inversus.
{"title":"Laparoscopic cholecystectomy and laparoscopic common bile duct exploration for cholecystolithiasis and choledocholithiasis in a patient with situs inversus totalis: A case report","authors":"Hirokazu Matsuura, Hidenori Haruta, Takamichi Suzuki, Daisuke Kusama, Shoichi Shinohara, Shuji Hishikawa, Masayuki Kojima","doi":"10.1111/ases.13346","DOIUrl":"10.1111/ases.13346","url":null,"abstract":"<p>Situs inversus complicates diagnosis and treatment due to the mirrored organ placement in relation to normal anatomy. This report describes a 78-year-old female patient with situs inversus totalis who underwent laparoscopic cholecystectomy and laparoscopic common bile duct exploration for cholecystolithiasis and choledocholithiasis. Utilizing the “French mirror technique” for port placement, the surgeon adeptly mirrored standard maneuvers with a 2-mm needle forceps in the left hand and a 5-mm forceps in the right in a reversed anatomical setting. This technique maintained familiar hand movements, despite the patient's unique anatomy. The surgeon applied transcystic ductal bile duct exploration, using choledochoscopy for duct exploration and a basket catheter for stone removal. Laparoscopic cholecystectomy and common bile duct exploration through the transcystic ductal route are viable and effective for patients with situs inversus.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"17 3","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471553","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}
Lesser omental hernias are rare; however, they should be considered in symptomatic bowel obstruction subsequent to a subtotal or total colectomy. This report describes two cases of recurrent bowel obstruction secondary to lesser omental hernias after laparoscopic total colectomies for ulcerative colitis. Initially, these patients had been treated conservatively; however, due to symptom recurrence, surgical intervention was decided on. In both cases, laparoscopic surgery revealed lesser omental hernias. The small bowel, which had entered from the dorsal aspect of the stomach, was returned to the original position, and the lesser omentum was closed. The patients were discharged uneventfully, with no recurrent bowel obstruction during the follow-up period. These cases highlight the importance of including internal hernias in the differential diagnosis relative to recurrent bowel obstruction, in patient subpopulations with a prior history of a subtotal or total colectomy. Confirmation by computed tomography is preferable.
{"title":"Laparoscopically treated bowel obstruction secondary to a lesser omental hernia resulting from a previous laparoscopic total colectomy for ulcerative colitis: A report of two cases","authors":"Yusuke Makutani, Masayoshi Iwamoto, Koji Daito, Tadao Tokoro, Junichiro Kawamura, Kazuki Ueda","doi":"10.1111/ases.13347","DOIUrl":"10.1111/ases.13347","url":null,"abstract":"<p>Lesser omental hernias are rare; however, they should be considered in symptomatic bowel obstruction subsequent to a subtotal or total colectomy. This report describes two cases of recurrent bowel obstruction secondary to lesser omental hernias after laparoscopic total colectomies for ulcerative colitis. Initially, these patients had been treated conservatively; however, due to symptom recurrence, surgical intervention was decided on. In both cases, laparoscopic surgery revealed lesser omental hernias. The small bowel, which had entered from the dorsal aspect of the stomach, was returned to the original position, and the lesser omentum was closed. The patients were discharged uneventfully, with no recurrent bowel obstruction during the follow-up period. These cases highlight the importance of including internal hernias in the differential diagnosis relative to recurrent bowel obstruction, in patient subpopulations with a prior history of a subtotal or total colectomy. Confirmation by computed tomography is preferable.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"17 3","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471554","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}
<p>The first edition of the Practice Guidelines on Endoscopic Surgery was published on September 1, 2008 and the second edition 6 years later in September 2014. The Guideline Committee for the revision work of the third edition started its activities in December 2015 under the guidance of former Professor Toshiaki Watanabe of the University of Tokyo. However, Dr. Watanabe passed away suddenly amid the revision, whereupon I, who was appointed vice-chairman of the committee, assumed his duties. I am pleased to report that the revision process has been successfully completed, and I offer my prayers for the repose of Dr. Watanabe's soul.</p><p>This guideline covers almost all departments where endoscopic and robotic surgery are used. It was not easy to create a guideline in a uniform format as was mentioned in the first and second editions. In addition, it became clear that it would be a challenging task to keep up with the ever-increasing speed of technological progress in endoscopic surgery by publishing the guidelines in paper format since robotic surgery will be covered by insurance in many areas when the contents of the guidelines are nearly finalized. As a result, we have decided to publish these guidelines only in electronic media and not in a paper format from this guideline onward.</p><p>Although there were some difficulties in implementing Minds2017, we were able to successfully complete the guidelines with the help of special advisors Dr. Takeo Nakayama (Department of Health Informatics, Kyoto University Graduate School of Medicine and School of Public Health) and Dr. Masahiro Yoshida (Department of HBP & Gastrointestinal Surgery, International University of Health and Welfare). We would like to once again express our gratitude and appreciation. After its publication, we will immediately start work on the remaining issues such as robotic surgery, and those revision results will be published on the web sequentially.</p><p>Finally, I would like to express my gratitude to all those who worked so hard on this revision and sincerely hope that this guideline will contribute to the safe spread of endoscopic surgery.</p><p>Masafumi Nakamura.</p><p>Chairman of the Guidelines Committee of JSES.</p><p>September 2019.</p><p>These guidelines are intended for the qualified surgeons accredited by the Endoscopic Surgical Skill Qualification System of the JSES or its equivalent.</p><p>The revised guidelines are expected to promote the safe and widespread use of endoscopic surgery, improve treatment outcomes, and further enhance patient benefits.</p><p>The JSES shall be responsible for the content of these guidelines. However, responsibility for treatment results should be attributed to the direct treating physician, and the JSES will not be held accountable.</p><p>❶Progress of preparation: The description method, certainty of the evidence, and strength of recommendation were standardized in consultation with the related academic societies, including Th
3) 以患者为中心的结果有些方面没有涉及患者的主观评估项目，如术后疼痛、痛苦持续时间和 QOL。4) AGREE II 评估作为参考，我使用 AGREE II（https://www.agreetrust.org/agree-ii/，日文版；日本医疗质量委员会 EBM 医疗信息部 2016.7 版）对指南进行了评估，该工具是指南质量方法评估的通用工具。然而，鉴于本指南的特殊性，其对象是日本内镜外科技能资格认证系统或同等系统中的合格外科医生，因此使用 AGREE II 进行质量评估存在局限性。此外，对符合性项目的数量进行评分（总分）并将其与其他实践指南进行比较并不一定合适。所有作者均同意手稿内容。为了尽量减少偏见，他没有参与所有与接受本文发表相关的编辑决策。
{"title":"Practice guidelines on endoscopic surgery for qualified surgeons by the endoscopic surgical skill qualification system: Introduction","authors":"Masafumi Nakamura, Masahiko Watanabe","doi":"10.1111/ases.13339","DOIUrl":"10.1111/ases.13339","url":null,"abstract":"<p>The first edition of the Practice Guidelines on Endoscopic Surgery was published on September 1, 2008 and the second edition 6 years later in September 2014. The Guideline Committee for the revision work of the third edition started its activities in December 2015 under the guidance of former Professor Toshiaki Watanabe of the University of Tokyo. However, Dr. Watanabe passed away suddenly amid the revision, whereupon I, who was appointed vice-chairman of the committee, assumed his duties. I am pleased to report that the revision process has been successfully completed, and I offer my prayers for the repose of Dr. Watanabe's soul.</p><p>This guideline covers almost all departments where endoscopic and robotic surgery are used. It was not easy to create a guideline in a uniform format as was mentioned in the first and second editions. In addition, it became clear that it would be a challenging task to keep up with the ever-increasing speed of technological progress in endoscopic surgery by publishing the guidelines in paper format since robotic surgery will be covered by insurance in many areas when the contents of the guidelines are nearly finalized. As a result, we have decided to publish these guidelines only in electronic media and not in a paper format from this guideline onward.</p><p>Although there were some difficulties in implementing Minds2017, we were able to successfully complete the guidelines with the help of special advisors Dr. Takeo Nakayama (Department of Health Informatics, Kyoto University Graduate School of Medicine and School of Public Health) and Dr. Masahiro Yoshida (Department of HBP & Gastrointestinal Surgery, International University of Health and Welfare). We would like to once again express our gratitude and appreciation. After its publication, we will immediately start work on the remaining issues such as robotic surgery, and those revision results will be published on the web sequentially.</p><p>Finally, I would like to express my gratitude to all those who worked so hard on this revision and sincerely hope that this guideline will contribute to the safe spread of endoscopic surgery.</p><p>Masafumi Nakamura.</p><p>Chairman of the Guidelines Committee of JSES.</p><p>September 2019.</p><p>These guidelines are intended for the qualified surgeons accredited by the Endoscopic Surgical Skill Qualification System of the JSES or its equivalent.</p><p>The revised guidelines are expected to promote the safe and widespread use of endoscopic surgery, improve treatment outcomes, and further enhance patient benefits.</p><p>The JSES shall be responsible for the content of these guidelines. However, responsibility for treatment results should be attributed to the direct treating physician, and the JSES will not be held accountable.</p><p>❶Progress of preparation: The description method, certainty of the evidence, and strength of recommendation were standardized in consultation with the related academic societies, including Th","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"17 3","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.13339","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study evaluates surgical outcomes of minimally invasive Ivor Lewis esophagectomy (ILE) for esophageal and esophagogastric cancer, with the comparison of the robotic approach (RA) and the conventional minimally invasive approach (CA).
Methods
Selected patients who underwent minimally invasive ILE for esophageal cancer were included between January 2017 and December 2023. We retrospectively investigated the patients' background characteristics and the short-term surgical outcomes.
Results
In this period, among a total of 840 esophagectomies, 81 patients (9.6%) underwent minimally invasive ILE, consisting of 24 cases with RA and 57 with CA. The major indications for ILE were adenocarcinoma of the distal esophagus or esophagogastric junction and patients with prior head and neck cancer treatment. Among these thoracic approaches, there were no significant differences in the patients' indications and characteristics, including age, histology, tumor location, clinical TNM stage, and preoperative therapy. Compared with the CA group, no anastomotic leakage was observed in the RA group (17.5% vs. 0, p = .035). Rates of total postoperative complications and length of hospital stay also tended to be reduced in the RA group but did not reach significance.
Conclusion
In the Ivor Lewis esophagectomy with a side-to-side linear-stapled anastomosis, the fully robotic approach has the potential to powerfully reduce anastomotic leakage compared to the conventional minimally invasive approach.
简介本研究评估了微创 Ivor Lewis 食管切除术（ILE）治疗食管癌和食管胃癌的手术效果，并对机器人方法（RA）和传统微创方法（CA）进行了比较：纳入2017年1月至2023年12月期间接受食管癌微创ILE的部分患者。我们对患者的背景特征和短期手术结果进行了回顾性调查：在此期间，在总共840例食管切除术中，有81例患者（9.6%）接受了微创ILE，其中24例为RA，57例为CA。ILE 的主要适应症是食管远端或食管胃交界处的腺癌，以及曾接受头颈部癌症治疗的患者。在这些胸腔镜方法中，患者的适应症和特征（包括年龄、组织学、肿瘤位置、临床 TNM 分期和术前治疗）没有明显差异。与CA组相比，RA组未观察到吻合口漏（17.5% 对 0，P = 0.035）。RA 组的术后总并发症发生率和住院时间也趋于减少，但未达到显著性水平：结论：与传统微创方法相比，在采用侧对侧线性缝合吻合术的 Ivor Lewis 食管切除术中，全机器人方法有可能有效减少吻合口漏。
{"title":"Fully robotic side-to-side stapled anastomosis provides less anastomotic leakage than conventional minimally invasive approach in Ivor Lewis esophagectomy","authors":"Jun Kanamori, Masayuki Watanabe, Suguru Maruyama, Yasukazu Kanie, Kengo Kuriyama, Masayoshi Terayama, Naoki Takahashi, Masahiro Tamura, Akihiko Okamura, Yu Imamura","doi":"10.1111/ases.13340","DOIUrl":"10.1111/ases.13340","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study evaluates surgical outcomes of minimally invasive Ivor Lewis esophagectomy (ILE) for esophageal and esophagogastric cancer, with the comparison of the robotic approach (RA) and the conventional minimally invasive approach (CA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Selected patients who underwent minimally invasive ILE for esophageal cancer were included between January 2017 and December 2023. We retrospectively investigated the patients' background characteristics and the short-term surgical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In this period, among a total of 840 esophagectomies, 81 patients (9.6%) underwent minimally invasive ILE, consisting of 24 cases with RA and 57 with CA. The major indications for ILE were adenocarcinoma of the distal esophagus or esophagogastric junction and patients with prior head and neck cancer treatment. Among these thoracic approaches, there were no significant differences in the patients' indications and characteristics, including age, histology, tumor location, clinical TNM stage, and preoperative therapy. Compared with the CA group, no anastomotic leakage was observed in the RA group (17.5% vs. 0, <i>p</i> = .035). Rates of total postoperative complications and length of hospital stay also tended to be reduced in the RA group but did not reach significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In the Ivor Lewis esophagectomy with a side-to-side linear-stapled anastomosis, the fully robotic approach has the potential to powerfully reduce anastomotic leakage compared to the conventional minimally invasive approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"17 3","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459834","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}
Vipul Thakur, Sonakshi Jamwal, R. N. Naga Irrinki Santosh, Siddhant Khare
Introduction
Endoscopic-assisted surgery for breast tumors has the advantage of inconspicuous scars, less breast volume loss, and nipple areolar distortion. A novel endoscopic-assisted technique through inframammary fold for excision of fibroadenomas is presented.
Materials and Surgical Technique
Endoscopic-assisted excision of fibroadenoma(s) through inframammary fold was performed in four patients after informed written consent via three ports (12, 5, and 5 mm). Breast Cancer Treatment Outcome Score-12 (BCTOS-12) was used to evaluate patient satisfaction after surgery.
Discussion
No intraoperative and wound complication was noted. On median follow-up of 26.5 months, patients reported satisfactory responses to aesthetic and functional outcomes. No scar related complications were noted. Endoscopic-assisted excision of fibroadenoma through inframammary fold can be a safe and feasible option with good aesthetic outcomes.
{"title":"Endoscopic excision of breast fibroadenoma through inframammary fold: Feasibility, safety and medium-term outcomes","authors":"Vipul Thakur, Sonakshi Jamwal, R. N. Naga Irrinki Santosh, Siddhant Khare","doi":"10.1111/ases.13338","DOIUrl":"10.1111/ases.13338","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Endoscopic-assisted surgery for breast tumors has the advantage of inconspicuous scars, less breast volume loss, and nipple areolar distortion. A novel endoscopic-assisted technique through inframammary fold for excision of fibroadenomas is presented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Surgical Technique</h3>\u0000 \u0000 <p>Endoscopic-assisted excision of fibroadenoma(s) through inframammary fold was performed in four patients after informed written consent via three ports (12, 5, and 5 mm). Breast Cancer Treatment Outcome Score-12 (BCTOS-12) was used to evaluate patient satisfaction after surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>No intraoperative and wound complication was noted. On median follow-up of 26.5 months, patients reported satisfactory responses to aesthetic and functional outcomes. No scar related complications were noted. Endoscopic-assisted excision of fibroadenoma through inframammary fold can be a safe and feasible option with good aesthetic outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"17 3","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141459833","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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