Asian Journal of Endoscopic Surgery最新文献

{"title":"Nationwide Expert Survey on Appropriate Bile Duct Transection Line in Adult and Pediatric Congenital Biliary Dilatation Surgery in Japan: AOB Consensus Meeting","authors":"Toshiharu Matsuura,&nbsp;Yoshitaka Kiya,&nbsp;Masahiro Takeda,&nbsp;Hiroki Mori,&nbsp;Takahisa Tainaka,&nbsp;Tetsuya Idichi,&nbsp;So Nakamura,&nbsp;Toshiya Abe,&nbsp;Kohei Nakata,&nbsp;Kenoki Ohuchida,&nbsp;Takao Ohtsuka,&nbsp;Hiroki Ishibashi,&nbsp;Hiroyuki Koga,&nbsp;Hiroo Uchida,&nbsp;Yuichi Nagakawa,&nbsp;Tatsuro Tajiri,&nbsp;Masafumi Nakamura,&nbsp;Yuko Kitagawa","doi":"10.1111/ases.70194","DOIUrl":"https://doi.org/10.1111/ases.70194","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Resection of the extrahepatic bile duct including the gallbladder and the dilated segment, is a widely accepted surgical concept in congenital biliary dilatation (CBD) in both adult and pediatric surgeons. However, owing to the existence of various types of CBD and differences in the extent of dilatation, no consensus has been reached regarding the appropriate resection margins.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Consensus statements regarding the appropriate surgical margins for both the duodenal and hepatic hilum sides were developed as two clinical questions (CQs) during a multidisciplinary consensus meeting. A comprehensive literature review and expert survey were conducted. Consensus was achieved through a Delphi voting process, with statements approved when ≥ 75% agreement was reached.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In a nationwide expert survey, pediatric institutions resected the bile duct closer to the junction of the pancreatic duct on the duodenal side relative to adult institutions. In contrast, adult institutions aggressively transected higher levels of the hepatic duct on the hilum side. Taking literature reviews into account, the following consensus statement was developed: “The narrow segment is a good landmark to remove closely to the pancreatic junction on the duodenal side and the decision on the resection line on the hepatic hilum side should be dependent on the type of Todani's classification.” This statement achieved a unanimous agreement in the Delphi vote.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>It should be noted that there are differences in surgical concepts between adult and pediatric institutions. Further research is needed to determine the long-term outcomes related to the resection line.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626225","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}

{"title":"Preclinical Evaluation of a New Surgical Hybrid Energy Device Compared to the Conventional Energy Device","authors":"Satoru Matsuda,&nbsp;Kazuhisa Ehara,&nbsp;Hiroyasu Kagawa,&nbsp;Shunsuke Tsukamoto,&nbsp;Kohei Nakata,&nbsp;Mamoru Morimoto,&nbsp;Sayaka Yasui,&nbsp;Jumpei Torikai,&nbsp;Ichiro Uyama","doi":"10.1111/ases.70201","DOIUrl":"https://doi.org/10.1111/ases.70201","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Despite the development of surgical instruments combining ultrasonic scissors and an advanced bipolar device, thermal management has still been considered a persistent issue, similar to that in conventional ultrasonic scissors. To address this issue, the next-generation hybrid device (NGHD) with a new tip and handle design has been devised while maintaining the high cutting and sealing performance of combined surgical instruments (THUNDERBEAT Type S, TBS). We compared them in an ex vivo and nonclinical in vivo environment and investigated their perceived clinical usefulness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ex vivo testing included measurements of cutting speed, posterior thermal spread from the jaw, and lateral thermal spread. The nonclinical in vivo study involved evaluations such as cutting capability while maintaining the tissue layer, and handle ergonomics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The NGHD demonstrated a significantly faster cutting speed than did TBS (2.41 [2.31–2.50] vs. 3.04 [2.94–3.13] s, <i>p</i> &lt; 0.01) with 5–7 mm arteries, as well as significant improvements in the posterior thermal spread on arteries during activation (5.67 [0–12.84] vs. 84.22 [35.34–133.10] μm, <i>p</i> &lt; 0.01) and lateral thermal spread (2.22 [2.06–2.38] vs. 2.79 [2.55–3.03] mm, <i>p</i> &lt; 0.05). Surgeon assessments indicated more improvements with the NGHD than with TBS, especially regarding cutting while maintaining the tissue layer and handle ergonomics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The NGHD promoted improvements in thermal management generally associated with TBS and maintained the benefits of combining devices capable of ultrasonic and advanced bipolar output. The NGHD has the potential to support safe and efficient endoscopic procedures, pending further clinical evaluation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70201","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145626325","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}

{"title":"Clinical Outcomes of Fusion Robot-Assisted Thoracic Surgery: A Retrospective Analysis With Propensity Score Matching","authors":"Yasuaki Kubouchi,&nbsp;Toho Wada,&nbsp;Ryota Yasuda,&nbsp;Yuji Nozaka,&nbsp;Wakako Fujiwara,&nbsp;Shinji Matsui,&nbsp;Yugo Tanaka","doi":"10.1111/ases.70193","DOIUrl":"10.1111/ases.70193","url":null,"abstract":"<div>\u0000 \u0000 <p>Fusion robot-assisted thoracic surgery (fusion RATS) has gained much attention as an alternative to console-only approaches (pure RATS), as during fusion RATS, the bedside assistant performs stapling and actively supports the procedure. This study retrospectively analyzed data from 553 patients who underwent robotic anatomical pulmonary resection with either fusion or pure RATS to compare perioperative outcomes. After 1:2 propensity score matching, 294 patients were included in the analysis. Fusion RATS exhibited substantially shorter operative and console times without an increase in complication rates. Moreover, it allowed for flexible stapler insertion angles, enabling the use of reinforced staplers. Assistant participation in key steps may provide educational benefits and improve adaptability, specifically when integrated robotic staplers are unavailable. Fusion RATS proved to be a practical and safe alternative with additional technical and educational advantages, supporting its broader adoption in thoracic surgery.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606778","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}

{"title":"Consensus Meeting on the “Anatomy on the Border”: Systematic Thoracic Lymph Node Dissection Procedures for Lung and Esophageal Cancer","authors":"Junji Ichinose,&nbsp;Susumu Shibasaki,&nbsp;Koji Shindo,&nbsp;Yujin Kudo,&nbsp;Toshiya Abe,&nbsp;Kenoki Ohuchida,&nbsp;Hisashi Shinohara,&nbsp;Kazutaka Obama,&nbsp;Masato Watanabe,&nbsp;Kimihiro Shimizu,&nbsp;Hisashi Iwata,&nbsp;Hirokazu Noshiro,&nbsp;Norihiko Ikeda,&nbsp;Masafumi Nakamura,&nbsp;Yuko Kitagawa,&nbsp;Mingyon Mun,&nbsp;Ichiro Uyama,&nbsp;Koichi Suda","doi":"10.1111/ases.70186","DOIUrl":"10.1111/ases.70186","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to explore the commonalities and differences in systematic lymph node dissection between lung and esophageal cancer surgeries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A survey comprising 11 questions related to systematic lymph node dissection techniques for both lung and esophageal cancer was conducted across 265 facilities specializing in thoracic and esophageal surgeries. Additionally, a comprehensive search was performed using the MEDLINE database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Responses were received from 63 facilities specializing in thoracic surgery and 79 facilities specializing in esophageal surgery. Many facilities chose minimally invasive surgery for lung and esophageal cancer. Most thoracic and esophageal surgeons paid attention to the concepts of visceral and vascular sheaths. The results of the survey and literature review revealed the key anatomical structures that define the area of mediastinal lymph node dissection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This survey and the literature review have clarified the current consensus among thoracic and esophageal surgeons regarding systematic mediastinal lymph node dissection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606776","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}

{"title":"Consensus Meeting of Anatomy on the Border, Appropriate Use and Precautions for ICG in Liver, Lung, and Renal Surgery","authors":"Junji Ichinose,&nbsp;Shinji Itoh,&nbsp;Shintaro Narita,&nbsp;Daisuke Asano,&nbsp;Yujin Kudo,&nbsp;Toshiya Abe,&nbsp;Kenoki Ohuchida,&nbsp;Keiichi Akahoshi,&nbsp;Go Wakabayashi,&nbsp;Kimihiro Shimizu,&nbsp;Hisashi Iwata,&nbsp;Atsushi Takeneka,&nbsp;Minoru Tanabe,&nbsp;Norihiko Ikeda,&nbsp;Masatoshi Eto,&nbsp;Masafumi Nakamura,&nbsp;Yuko Kitagawa,&nbsp;Tomoharu Yoshizumi,&nbsp;Tomonori Habuchi,&nbsp;Mingyon Mun","doi":"10.1111/ases.70175","DOIUrl":"10.1111/ases.70175","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The liver, lungs, and kidneys are all parenchymal organs and are useful targets for indocyanine green (ICG) fluorescence. We created a consensus statement on the appropriate use and precautions for ICG in liver, lung, and kidney surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a comprehensive literature search and questionnaire survey for expert surgeons in each area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We extracted 11 articles related to the liver, 23 to the lung, and 8 to the kidney. A total of 86 facilities, 50 facilities, and 32 surgeons responded to the questionnaire survey for the liver, lung, kidney, respectively. ICG fluorescence is widely employed for segment delineation of the liver, lung, and kidney and has been reported to exhibit high efficacy. The dosage and timing greatly vary depending on the target organ and administration route. Tumor localization via ICG fluorescence is widely performed in the liver area, with numerous reports highlighting its high efficacy. Contrarily, in the lung and kidney, despite the existence of clinical studies, ICG fluorescence has not been generally performed in clinical practice. There have been no reported complications or adverse experiences related to the use of ICG agents, indicating their safety for clinical use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This survey, along with a literature review, has elucidated the current consensus of liver, lung, and kidney surgeons regarding ICG fluorescence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606822","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}

{"title":"Clinical Practice and Survey of Three-Dimensional Images, Virtual Reality, Augmented Reality and Mixed Reality for Robotic-Assisted Surgery in Urology—“Anatomy on the Border” Expert Consensus Meeting","authors":"Satoshi Kobayashi,&nbsp;Daisuke Asano,&nbsp;Yujin Kudo,&nbsp;Shintaro Narita,&nbsp;Shuichi Morizane,&nbsp;Toshiya Abe,&nbsp;Kenoki Ohuchida,&nbsp;Tomonori Habuchi,&nbsp;Atsushi Takenaka,&nbsp;Go Wakabayashi,&nbsp;Tomoharu Yoshizumi,&nbsp;Keiichi Akahoshi,&nbsp;Norihiko Ikeda,&nbsp;Minoru Tanabe,&nbsp;Masafumi Nakamura,&nbsp;Yuko Kitagawa,&nbsp;Masatoshi Eto","doi":"10.1111/ases.70189","DOIUrl":"10.1111/ases.70189","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Objectives</h3>\u0000 \u0000 <p>There have been no nationwide surveys on the effectiveness of 3D images, virtual reality (VR), augmented reality (AR), and mixed reality (MR) in robotic-assisted surgery for urology. This study aimed to conduct a nationwide survey of techniques for laparoscopic and robotic 3D images, VR, AR, and MR in urology, and to propose a consensus on their effectiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and Methods</h3>\u0000 \u0000 <p>In July 2024, the Japan Society for Endoscopic Surgery conducted an anonymous online survey to evaluate the effectiveness of 3D images, VR, AR, and MR among 44 certified laparoscopic technicians and qualified proctors in robotic surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-two urologists surveyed reported using 3D imaging for preoperative evaluation (84%) and to understand anatomy (75%), with 97% reporting clinical benefits and 85% indicating that it improved the quality of surgery. This widespread usage and the reported benefits of 3D imaging in urology should reassure the audience about the effectiveness of this technology. VR/AR/MR were primarily used for simulation (19%) and navigation (16%). While 63% expressed interest in these technologies, 51% reported never having used them. Among the barriers to adoption, 25% cited high cost, 24% cited the effort required for data processing, and 14% cited the difficulty of use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>3D images and VR/AR/MR technologies were expected to play a pivotal role in urological robotic surgery. These technologies have the potential to enhance precision and improve outcomes significantly. This study provided a comprehensive overview of the current usage status and challenges associated with these techniques.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145606838","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}

{"title":"The Feasibility of Telerobotic Pancreaticojejunostomy Using a Surgical Robot: A Pilot Study With Commercial Optical Networks","authors":"Yusuke Wakasa,&nbsp;Kenichi Hakamada,&nbsp;Hajime Morohashi,&nbsp;Kazuki Yokoyama,&nbsp;Yuma Ebihara,&nbsp;Satoshi Hirano,&nbsp;Eiji Oki,&nbsp;Norihiko Ikeda,&nbsp;Akinobu Taketomi,&nbsp;Masaki Mori","doi":"10.1111/ases.70181","DOIUrl":"10.1111/ases.70181","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In recent years, the practical application of remote robotic surgery has become a reality, and is expected to be applied to difficult surgeries. The purpose of this study is to demonstrate whether the pancreaticojejunostomy in a pancreaticoduodenectomy, a difficult surgery, can be performed through a remote surgery-assisted robotic operation, as well as to verify the feasibility of remote surgery-assisted pancreaticojejunostomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Hirosaki city and Goshogawara city (about 30 km) were connected via a commercial communication line using the hinotori surgical robot, and five surgeons performed remote surgery on an artificial organ model for pancreaticojejunostomy. Four local surgeons were instructed remotely. Each procedure was repeated 3–5 times in sets of 8 min, and communication latency, Image Quality Score, System Usability Scale (mSUS), and Robot Usability Score were all evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The communication latency was stable at less than 12 msec, and there were no problems in performing the surgery. No significant differences were noted in Image Quality Score, System Usability Scale (mSUS), or Robot Usability Score. Pancreaticojejunostomy was performed using the Blumgart anastomosis technique, and all procedures were completed without any issues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We demonstrated that pancreaticojejunostomy can be performed in a telesurgical environment. This system can be applied to remote surgical guidance and support in the future and it is expected to correct regional disparities in medical care, improve surgical education, and enhance the implementation of remote surgery in society.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12640768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588784","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}

{"title":"Cross-Sectional Survey on Mediastinal Lymph Node Dissection in Lung and Esophageal Cancer: A Project of the Anatomy of the Border Consensus Meeting at the 37th Annual Meeting of the Japan Society for Endoscopic Surgery","authors":"Kentaro Miura,&nbsp;Koji Shindo,&nbsp;Yukihiro Terada,&nbsp;Toshiya Abe,&nbsp;Kenoki Ohuchida,&nbsp;Koichi Suda,&nbsp;Mingyon Mun,&nbsp;Kazutaka Obama,&nbsp;Masato Watanabe,&nbsp;Hisashi Iwata,&nbsp;Hisashi Shinohara,&nbsp;Ichiro Uyama,&nbsp;Hirokazu Noshiro,&nbsp;Norihiko Ikeda,&nbsp;Masafumi Nakamura,&nbsp;Yuko Kitagawa,&nbsp;Kimihiro Shimizu","doi":"10.1111/ases.70187","DOIUrl":"10.1111/ases.70187","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although mediastinal lymph node dissection is performed in both lung and esophageal cancer surgeries, the underlying concepts and indications may differ between these fields. This study aimed to clarify these differences through a nationwide questionnaire survey initiated by the 37th Annual Meeting of the Japan Society for Endoscopic Surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A joint task force from the lung and esophageal surgery divisions developed a questionnaire focusing on four key areas: (i) lymph node dissection around the left recurrent nerve, (ii) subcarinal lymph node dissection, (iii) pulmonary ligament lymph node dissection, and (iv) en bloc lymph node dissection. The survey was distributed to certified core institutions across Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The response rates were 50.4% for lung cancer institutions and 57.0% for esophageal cancer institutions. In the esophageal division, dissection of the aforementioned lymph nodes was routinely performed in most core institutions. In contrast, practices in the lung division varied widely, particularly depending on tumor location. The concept of “sampling” was rarely recognized in esophageal surgery but was partially accepted in lung surgery. Furthermore, there was no uniform definition of “en bloc dissection” across either field.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This cross-sectional survey revealed notable conceptual differences between lung and esophageal cancer divisions regarding mediastinal lymph node dissection, despite targeting the same anatomical regions. Additionally, significant variability was observed even within the lung division. These findings indicate a lack of standardized consensus in Japan and highlight the need for ongoing cross-disciplinary dialog and consensus building.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12640797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145588705","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}

{"title":"Single Incision Laparoscopic Local Resection for Gastric Gastrointestinal Stromal Tumors Compared to Multiport Laparoscopic Local Resection: A Single-Center Retrospective Study","authors":"Shotaro Nagano,&nbsp;Junya Kitadani,&nbsp;Keiji Hayata,&nbsp;Taro Goda,&nbsp;Shinta Tominaga,&nbsp;Naoki Fukuda,&nbsp;Tomoki Nakai,&nbsp;Manabu Kawai","doi":"10.1111/ases.70191","DOIUrl":"10.1111/ases.70191","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gastric gastrointestinal stromal tumors are generally treated via local resection. Single-incision laparoscopic surgery has recently been reported as minimally invasive surgery. This study aimed to evaluate the safety and short-term and long-term outcomes of single incision laparoscopic local resection compared with those of multiport laparoscopic local resection for gastric gastrointestinal stromal tumors with extraluminal growth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Laparoscopic local resection of the stomach was used for 71 patients with gastric gastrointestinal stromal tumors between January 2010 and March 2025 at Wakayama Medical University Hospital. Short-term and long-term outcomes were compared between those who underwent single incision laparoscopic local resection and those who underwent multiport laparoscopic local resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Single incision laparoscopic local resection and multiport laparoscopic local resection were performed for 24 and 47 patients, respectively. Patient characteristics including tumor location and tumor size were not significantly different between the two groups. Further, there was no significant difference in operation time, blood loss, time to oral intake, postoperative hospital stays, or risk classification of recurrence. The postoperative max CRP of the single incision laparoscopic local resection group was significantly lower than that of the multiport laparoscopic local resection group. No postoperative complications were found in those who underwent single incision laparoscopic local resection. There was no recurrence in those who underwent single incision laparoscopic local resection, but two patients who underwent multiport laparoscopic local resection had recurrences: one with liver metastasis, the other with peritoneal metastasis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Single incision laparoscopic local resection is considered to be a safe and feasible surgical technique for gastric gastrointestinal stromal tumors with extraluminal growth. Furthermore, long-term outcomes were also acceptable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565832","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}

{"title":"Current Practices for Preventing Inguinal Hernia During Radical Prostatectomy: Findings From the “Anatomy on the Border” Consensus Survey by the Japan Society for Endoscopic Surgery","authors":"Shuichi Morizane,&nbsp;Satoshi Kobayashi,&nbsp;Shintaro Narita,&nbsp;Kei Fujii,&nbsp;Toshiya Abe,&nbsp;Kenoki Ohuchida,&nbsp;Masatoshi Eto,&nbsp;Tomonori Habuchi,&nbsp;Toru Eguchi,&nbsp;Masafumi Nakamura,&nbsp;Yuko Kitagawa,&nbsp;Atsushi Takenaka","doi":"10.1111/ases.70185","DOIUrl":"10.1111/ases.70185","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Inguinal hernia (IH) occurs relatively frequently after radical prostatectomy (RP) and can impair patients' quality of life. In recent years, most RPs in Japan have been performed robotically; however, strategies for preventing postoperative IH remain diverse and are not clearly defined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In July 2024, the Japan Society for Endoscopic Surgery conducted an anonymous, web-based survey of 114 members of the Japanese Urological Association to assess intraoperative IH prevention practices during RP. Twenty-seven urologists responded (response rate: 24%), providing information on their clinical experience, estimated IH incidence, recognized risk factors, and prevention techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most respondents were highly experienced: 85% had more than 20 years of practice, 78% had performed over 100 RPs, and 96% routinely used robotic surgery. Seventy-four percent identified both patient- and surgeon-related factors as contributors to IH, and 52% estimated the incidence of IH to be 5%–10%. Preventive measures were used routinely by 22% of respondents, selectively by 33%, and not at all by 45%. Common preventive techniques included ligation and transection of the patent processus vaginalis with peritoneal closure (89%), mobilization of the vas deferens and spermatic cord (70%), and circumferential incision of the internal inguinal ring (70%). Mesh reinforcement was rarely employed (4%), although 74% reported documenting IH risk in the informed consent process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite limited high-level evidence, Japanese urologists implement diverse intraoperative IH prevention strategies during RP. Prospective multicenter studies and standardized protocols are needed to validate these techniques and reduce postoperative IH rates.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565797","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}