: Minimally invasive surgery (MIS) in ulcerative colitis (UC) remains an important part of the surgical arsenal despite advances in biologic treatments for UC. There remains a need for operative intervention in approximately 30% of patients, even with advanced medical therapies. Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the preferred surgery for UC patients with medically refractory disease, refractory bleeding, or dysplasia/cancer. As in most surgical procedures, the move toward MIS has improved overall patient outcomes and UC is no exception. Historically patients have undergone laparotomy for total abdominal colectomy (TAC) and IPAA with the frequent need for multistage surgery as well as multiquadrant abdominopelvic surgery presenting a challenge in the adoption of MIS surgery for UC. However, advances in minimally invasive techniques over the last two decades from hand-assist laparoscopy, to totally laparoscopic surgery, robotic surgery, and transanal approaches have facilitated the gradual move toward MIS. With clear advantages in short-term surgical outcomes including reduced pain, shorter hospital stay, faster return of bowel function, improved cosmesis as well as some potential long-term benefits in bowel function, female fertility, and male sexual function it is clear that MIS for UC is here to stay. Even in an urgent setting with fulminant colitis, laparoscopy is safe and should be preferred over midline laparotomy except in unstable patient. Here, we will discuss the various approaches for MIS surgery in UC including potential advantages and pitfalls of each approach.
{"title":"A review of minimally invasive surgery in ulcerative colitis: more than one way to skin a cat","authors":"Charles Browning, Karen Zaghiyan","doi":"10.21037/ales-23-7","DOIUrl":"https://doi.org/10.21037/ales-23-7","url":null,"abstract":": Minimally invasive surgery (MIS) in ulcerative colitis (UC) remains an important part of the surgical arsenal despite advances in biologic treatments for UC. There remains a need for operative intervention in approximately 30% of patients, even with advanced medical therapies. Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the preferred surgery for UC patients with medically refractory disease, refractory bleeding, or dysplasia/cancer. As in most surgical procedures, the move toward MIS has improved overall patient outcomes and UC is no exception. Historically patients have undergone laparotomy for total abdominal colectomy (TAC) and IPAA with the frequent need for multistage surgery as well as multiquadrant abdominopelvic surgery presenting a challenge in the adoption of MIS surgery for UC. However, advances in minimally invasive techniques over the last two decades from hand-assist laparoscopy, to totally laparoscopic surgery, robotic surgery, and transanal approaches have facilitated the gradual move toward MIS. With clear advantages in short-term surgical outcomes including reduced pain, shorter hospital stay, faster return of bowel function, improved cosmesis as well as some potential long-term benefits in bowel function, female fertility, and male sexual function it is clear that MIS for UC is here to stay. Even in an urgent setting with fulminant colitis, laparoscopy is safe and should be preferred over midline laparotomy except in unstable patient. Here, we will discuss the various approaches for MIS surgery in UC including potential advantages and pitfalls of each approach.","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karan Sachdeva, Lovekirat Dhaliwal, Prasad G. Iyer
: Esophageal cancer is the eighth most common cancer in the world, with high mortality rates. The two main histological subtypes of esophageal cancer are esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC). Both EAC/ESCC are generally preceded by a stepwise progression of precursor metaplastic [Barrett’s esophagus (BE)] and dysplastic lesions, which increase the risk of developing cancer by several folds. Despite advances in management techniques, esophageal cancer continues to have a grim prognosis because it is often detected after the emergence of alarm symptoms. This highlights the need for intensive screening and surveillance with an aim to detect precursor lesions and early-stage esophageal cancer. Multiple international society guidelines recommend screening high-risk populations for BE/EAC, but ESCC screening is not widely recommended. Endoscopic screening remains the gold standard but is not feasible for large-scale application due to associated cost, invasiveness, and required expertise. Ongoing innovations in developing minimally invasive non-endoscopic screening tools combined with molecular biomarkers have fueled further interest in screening and surveillance of high-risk populations. Advanced endoscopic imaging techniques help enhance the surveillance-based detection of precursor lesions, guide targeted tissue acquisition, and stratify the risk of progression to advanced dysplasia/cancer. Multimodal endoscopic eradication therapies have been shown to eradicate dysplasia and reduce progression to EAC/ESCC with minimal adverse effects. Future implementation of minimally invasive screening tools, identification of the prognostic clinical and biomarker tools and adherence to the quality metrics for BE detection will potentially result in significant improvement in the mortality and morbidity related to esophageal cancer.
{"title":"Detection and surveillance of neoplastic lesions of the esophagus: application of guidelines and techniques","authors":"Karan Sachdeva, Lovekirat Dhaliwal, Prasad G. Iyer","doi":"10.21037/ales-23-11","DOIUrl":"https://doi.org/10.21037/ales-23-11","url":null,"abstract":": Esophageal cancer is the eighth most common cancer in the world, with high mortality rates. The two main histological subtypes of esophageal cancer are esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC). Both EAC/ESCC are generally preceded by a stepwise progression of precursor metaplastic [Barrett’s esophagus (BE)] and dysplastic lesions, which increase the risk of developing cancer by several folds. Despite advances in management techniques, esophageal cancer continues to have a grim prognosis because it is often detected after the emergence of alarm symptoms. This highlights the need for intensive screening and surveillance with an aim to detect precursor lesions and early-stage esophageal cancer. Multiple international society guidelines recommend screening high-risk populations for BE/EAC, but ESCC screening is not widely recommended. Endoscopic screening remains the gold standard but is not feasible for large-scale application due to associated cost, invasiveness, and required expertise. Ongoing innovations in developing minimally invasive non-endoscopic screening tools combined with molecular biomarkers have fueled further interest in screening and surveillance of high-risk populations. Advanced endoscopic imaging techniques help enhance the surveillance-based detection of precursor lesions, guide targeted tissue acquisition, and stratify the risk of progression to advanced dysplasia/cancer. Multimodal endoscopic eradication therapies have been shown to eradicate dysplasia and reduce progression to EAC/ESCC with minimal adverse effects. Future implementation of minimally invasive screening tools, identification of the prognostic clinical and biomarker tools and adherence to the quality metrics for BE detection will potentially result in significant improvement in the mortality and morbidity related to esophageal cancer.","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136054806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current applications of indocyanine green fluorescence in colorectal surgery: a narrative review","authors":"J. S. Uppal, Eric Meng, A. Caycedo-Marulanda","doi":"10.21037/ales-22-84","DOIUrl":"https://doi.org/10.21037/ales-22-84","url":null,"abstract":"","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42375464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erin Briggs, Sunjay Kumar, F. Palazzo, Talar Tatarian
{"title":"Revisional bariatric surgery for weight recurrence or surgical nonresponse","authors":"Erin Briggs, Sunjay Kumar, F. Palazzo, Talar Tatarian","doi":"10.21037/ales-23-15","DOIUrl":"https://doi.org/10.21037/ales-23-15","url":null,"abstract":"","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48526251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Biloslavo, M. Mastronardi, Margherita Sandano, Alice Gabrieli, M. Troian
{"title":"Laparoscopic treatment for perforated gastroduodenal ulcer: direct repair surgical technique","authors":"A. Biloslavo, M. Mastronardi, Margherita Sandano, Alice Gabrieli, M. Troian","doi":"10.21037/ales-23-17","DOIUrl":"https://doi.org/10.21037/ales-23-17","url":null,"abstract":"","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42744658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara Palomares Casasús, M. Fernández-Moreno, Fernando López Mozos, María Barrios Carvajal, R. Martí Obiol, J. Ortega
{"title":"Esophageal adenocarcinoma after laparoscopic adjustable gastric banding: a case report and literature review","authors":"Sara Palomares Casasús, M. Fernández-Moreno, Fernando López Mozos, María Barrios Carvajal, R. Martí Obiol, J. Ortega","doi":"10.21037/ales-22-62","DOIUrl":"https://doi.org/10.21037/ales-22-62","url":null,"abstract":"","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44614996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Crohn’s disease: is minimally invasive surgery the gold standard? A narrative review","authors":"G. Luglio, M. Cricrì, F. Tropeano, G. D. De Palma","doi":"10.21037/ales-22-75","DOIUrl":"https://doi.org/10.21037/ales-22-75","url":null,"abstract":"","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42578596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Umbilical Littre’s hernia—lessons from a rare case","authors":"I. Sadien","doi":"10.21037/ales-23-22","DOIUrl":"https://doi.org/10.21037/ales-23-22","url":null,"abstract":"","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43358266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Wikiel, B. McConnell, D. Bollinger, Danielle Abbitt, S. Ahrendt, M. McCarter, Alexander P. Morton, Fredric M. Pierraci, E. Jones
{"title":"Endoluminal wound vacuum therapy for gastrointestinal leaks: current state and future directions","authors":"K. Wikiel, B. McConnell, D. Bollinger, Danielle Abbitt, S. Ahrendt, M. McCarter, Alexander P. Morton, Fredric M. Pierraci, E. Jones","doi":"10.21037/ales-22-79","DOIUrl":"https://doi.org/10.21037/ales-22-79","url":null,"abstract":"","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41438747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Soleimani-Nouri, Olivia Holtermann Entwistle, M. Fehervari, D. Spalding
{"title":"A novel framework for surgical reflection","authors":"P. Soleimani-Nouri, Olivia Holtermann Entwistle, M. Fehervari, D. Spalding","doi":"10.21037/ales-23-8","DOIUrl":"https://doi.org/10.21037/ales-23-8","url":null,"abstract":"","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44278059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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