G. Capelli, I. Frigerio, Daunia Verdi, G. Spolverato
{"title":"Better together: the experience of Women in Surgery Italia","authors":"G. Capelli, I. Frigerio, Daunia Verdi, G. Spolverato","doi":"10.21037/ls-2020-03","DOIUrl":"https://doi.org/10.21037/ls-2020-03","url":null,"abstract":"","PeriodicalId":92818,"journal":{"name":"Laparoscopic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41884815","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":"Clinical applications of fluorescence imaging in laparoscopic surgery","authors":"Hendrik A. Marsman, Martin C. Boonstra","doi":"10.21037/LS-21-11","DOIUrl":"https://doi.org/10.21037/LS-21-11","url":null,"abstract":"","PeriodicalId":92818,"journal":{"name":"Laparoscopic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43281510","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}
Pub Date : 2021-07-01Epub Date: 2021-07-25DOI: 10.21037/ls-20-98
Yu-Jin Lee, Nynke S van den Berg, Ryan K Orosco, Eben L Rosenthal, Jonathan M Sorger
Objective: In this review, we provide examples of applications of fluorescence imaging in urologic, gynecologic, general, and endocrine surgeries.
Background: While robotic-assisted surgery has helped increase the availability of minimally invasive procedures across surgical specialties, there remains an opportunity to reduce adverse events associated with open, laparoscopic, and robotic-assisted methods. In 2011, fluorescence imaging was introduced as an option to the da Vinci Surgical System, and has been standard equipment since 2014. Without interfering with surgical workflow, this fluorescence technology named Firefly® allows for acquisition and display of near-infrared fluorescent signals that are co-registered with white light endoscopic images. As a result, robotic surgeons of all specialties have been able to explore the clinical utility of fluorescence guided surgery.
Methods: Literature searches were performed using the PubMed and MEDLINE databases using the keywords "robotic-assisted fluorescence surgery", "ICG robotic surgery", and "fluorescence guided surgery" covering the years 2011-2020.
Conclusions: Real-time intraoperative fluorescence guidance has shown great potential in helping guide surgeons in both simple and complex surgical interventions. Indocyanine green is one of the most widely-used imaging agents in fluorescence guided surgery, and other targeted, near-infrared imaging agents are in various stages of development. Fluorescence is becoming a reliable tool that can help surgeons in their decision-making process in some specialties, while explorations continue in others.
{"title":"A narrative review of fluorescence imaging in robotic-assisted surgery.","authors":"Yu-Jin Lee, Nynke S van den Berg, Ryan K Orosco, Eben L Rosenthal, Jonathan M Sorger","doi":"10.21037/ls-20-98","DOIUrl":"https://doi.org/10.21037/ls-20-98","url":null,"abstract":"<p><strong>Objective: </strong>In this review, we provide examples of applications of fluorescence imaging in urologic, gynecologic, general, and endocrine surgeries.</p><p><strong>Background: </strong>While robotic-assisted surgery has helped increase the availability of minimally invasive procedures across surgical specialties, there remains an opportunity to reduce adverse events associated with open, laparoscopic, and robotic-assisted methods. In 2011, fluorescence imaging was introduced as an option to the da Vinci Surgical System, and has been standard equipment since 2014. Without interfering with surgical workflow, this fluorescence technology named Firefly<sup>®</sup> allows for acquisition and display of near-infrared fluorescent signals that are co-registered with white light endoscopic images. As a result, robotic surgeons of all specialties have been able to explore the clinical utility of fluorescence guided surgery.</p><p><strong>Methods: </strong>Literature searches were performed using the PubMed and MEDLINE databases using the keywords \"robotic-assisted fluorescence surgery\", \"ICG robotic surgery\", and \"fluorescence guided surgery\" covering the years 2011-2020.</p><p><strong>Conclusions: </strong>Real-time intraoperative fluorescence guidance has shown great potential in helping guide surgeons in both simple and complex surgical interventions. Indocyanine green is one of the most widely-used imaging agents in fluorescence guided surgery, and other targeted, near-infrared imaging agents are in various stages of development. Fluorescence is becoming a reliable tool that can help surgeons in their decision-making process in some specialties, while explorations continue in others.</p>","PeriodicalId":92818,"journal":{"name":"Laparoscopic surgery","volume":"5 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2a/e2/nihms-1726530.PMC8452263.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39440065","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}
D. Ribero, Federica Mento, V. Sega, Domenico Lo Conte, A. Mellano, G. Spinoglio
Objective: To review and discuss the rationale, technique and results of indocyanine green (ICG)-guided lymphadenectomy Background: In recent years, more radical surgeries such as complete mesocolic excision with central vascular ligation and the Japanese D3 lymphadenectomy have been increasingly adopted as the optimal approach for colorectal cancer. These approaches share a specific focus on the extent of lymphadenectomy. While lymph node metastases are a major determinant of prognosis and a key factor for deciding further management, it has been recognized that the extent of lymphadenectomy, which in turns affect the number of lymph node harvested, might have a therapeutic effect with improved survival in patients with a higher number of dissected lymph nodes. However, individual variations of the lymphatic flow pattern, with possible extramesocolic diffusion, have been described for all colonic area, in particular for tumors of the hepatic and splenic flexures. In addition, the definition of the area to dissect, in particular the D3 area, is based on anatomical landmarks that might vary due to frequent vascular variants. Therefore, the possibility of directly visualize the regional nodal basin might increase the precision of an individualized lymphadenectomy. ICG is a fluorescent fluorophore that, after direct tissue injection, migrates in lymphatics and lymph nodes providing an intraoperative map of the tumor-specific draining area. Methods: A through literature search was done to identify pertinent articles. Conclusions: Although few studies exist, data indicate the potential of using this technique to guide the lymphadenectomy: complex surgical procedures seem facilitated and the extent of resection is tailored to include, in up to 34% of patients, lymph nodes that otherwise would not be harvested, resulting in a higher lymph nodes yield. real-time visualization of the lymphatic map during CME CVL may help to prevent iatrogenic rupture of the lymph vessels and/or lymph nodes with consequent tumor spillage
{"title":"Indocyanine green (ICG)-guided lymphadenectomy during complete mesocolic excision of colorectal cancer: a narrative overview","authors":"D. Ribero, Federica Mento, V. Sega, Domenico Lo Conte, A. Mellano, G. Spinoglio","doi":"10.21037/LS-21-5","DOIUrl":"https://doi.org/10.21037/LS-21-5","url":null,"abstract":"Objective: To review and discuss the rationale, technique and results of indocyanine green (ICG)-guided lymphadenectomy Background: In recent years, more radical surgeries such as complete mesocolic excision with central vascular ligation and the Japanese D3 lymphadenectomy have been increasingly adopted as the optimal approach for colorectal cancer. These approaches share a specific focus on the extent of lymphadenectomy. While lymph node metastases are a major determinant of prognosis and a key factor for deciding further management, it has been recognized that the extent of lymphadenectomy, which in turns affect the number of lymph node harvested, might have a therapeutic effect with improved survival in patients with a higher number of dissected lymph nodes. However, individual variations of the lymphatic flow pattern, with possible extramesocolic diffusion, have been described for all colonic area, in particular for tumors of the hepatic and splenic flexures. In addition, the definition of the area to dissect, in particular the D3 area, is based on anatomical landmarks that might vary due to frequent vascular variants. Therefore, the possibility of directly visualize the regional nodal basin might increase the precision of an individualized lymphadenectomy. ICG is a fluorescent fluorophore that, after direct tissue injection, migrates in lymphatics and lymph nodes providing an intraoperative map of the tumor-specific draining area. Methods: A through literature search was done to identify pertinent articles. Conclusions: Although few studies exist, data indicate the potential of using this technique to guide the lymphadenectomy: complex surgical procedures seem facilitated and the extent of resection is tailored to include, in up to 34% of patients, lymph nodes that otherwise would not be harvested, resulting in a higher lymph nodes yield. real-time visualization of the lymphatic map during CME CVL may help to prevent iatrogenic rupture of the lymph vessels and/or lymph nodes with consequent tumor spillage","PeriodicalId":92818,"journal":{"name":"Laparoscopic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46574265","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}
A. Soyama, K. Natsuda, M. Hidaka, T. Adachi, S. Ono, T. Hamada, T. Kugiyama, T. Hara, S. Eguchi
Laparoscopic liver resection (LLR) has been becoming widely accepted (1,2). In Japan, national health insurance has covered the medical fee for anatomical liver resection since 2016, in addition to left lateral sectionectomy and local liver resection, which have been covered since 2010 (3). LLR can be performed as a pure laparoscopic procedure, hand-assisted laparoscopic surgery (HALS) or hybrid procedure (4,5). Each procedure has its own merits and drawbacks (6-9). Pneumoperitoneum is accepted as a procedure associated with a reduced intraoperative blood loss. However, since parenchymal transection is performed under direct vision during the hybrid procedure, these Original Article
{"title":"Pure laparoscopic major hepatectomy facilitated with an application of GelportTM: a single-center case series","authors":"A. Soyama, K. Natsuda, M. Hidaka, T. Adachi, S. Ono, T. Hamada, T. Kugiyama, T. Hara, S. Eguchi","doi":"10.21037/LS-20-17","DOIUrl":"https://doi.org/10.21037/LS-20-17","url":null,"abstract":"Laparoscopic liver resection (LLR) has been becoming widely accepted (1,2). In Japan, national health insurance has covered the medical fee for anatomical liver resection since 2016, in addition to left lateral sectionectomy and local liver resection, which have been covered since 2010 (3). LLR can be performed as a pure laparoscopic procedure, hand-assisted laparoscopic surgery (HALS) or hybrid procedure (4,5). Each procedure has its own merits and drawbacks (6-9). Pneumoperitoneum is accepted as a procedure associated with a reduced intraoperative blood loss. However, since parenchymal transection is performed under direct vision during the hybrid procedure, these Original Article","PeriodicalId":92818,"journal":{"name":"Laparoscopic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43586174","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}
: Hepatic cysts are a common and often asymptomatic finding. In this review we will discuss the diagnosis and treatment of hepatic cysts with a specific focus on minimally invasive surgical approaches. Most simple cysts are asymptomatic and do not require intervention. As cysts increase in size they may cause a range of symptoms including satiety, fullness, a palpable mass, and rarely bleeding or secondary infection. Surgical approaches are reserved for symptomatic lesions, and hydatid disease. It is important to rule out bacterial infection (abscess) and neoplasm in the work up of hepatic cysts. While cysts are often detected by ultrasound, Computed tomography and Magnetic Resonance Imaging are the primary modes of assessment for these lesions. Most cysts can be managed by unroofing or marsupialization alone, with formal liver resection rarely required. Minimally invasive surgery (MIS) techniques have been described for many years including laparoscopic and recently, robotic approaches. Hydatid cysts require special attention to control of contents to avoid anaphylaxis but can also be managed laparoscopically. Laparoscopic and/ or robotic surgery can be performed safely and is effective in the treatment of cystic disease of the liver. Mortality should be below 1%, and overall morbidity less than 10%. Recurrence rates for simple cysts are generally below 10%, however polycystic liver disease (PLD) does have a higher recurrence rate after marsupialization than simple cysts.
{"title":"Narrative review of laparoscopic management of hepatic cysts","authors":"P. Shah","doi":"10.21037/LS-20-36","DOIUrl":"https://doi.org/10.21037/LS-20-36","url":null,"abstract":": Hepatic cysts are a common and often asymptomatic finding. In this review we will discuss the diagnosis and treatment of hepatic cysts with a specific focus on minimally invasive surgical approaches. Most simple cysts are asymptomatic and do not require intervention. As cysts increase in size they may cause a range of symptoms including satiety, fullness, a palpable mass, and rarely bleeding or secondary infection. Surgical approaches are reserved for symptomatic lesions, and hydatid disease. It is important to rule out bacterial infection (abscess) and neoplasm in the work up of hepatic cysts. While cysts are often detected by ultrasound, Computed tomography and Magnetic Resonance Imaging are the primary modes of assessment for these lesions. Most cysts can be managed by unroofing or marsupialization alone, with formal liver resection rarely required. Minimally invasive surgery (MIS) techniques have been described for many years including laparoscopic and recently, robotic approaches. Hydatid cysts require special attention to control of contents to avoid anaphylaxis but can also be managed laparoscopically. Laparoscopic and/ or robotic surgery can be performed safely and is effective in the treatment of cystic disease of the liver. Mortality should be below 1%, and overall morbidity less than 10%. Recurrence rates for simple cysts are generally below 10%, however polycystic liver disease (PLD) does have a higher recurrence rate after marsupialization than simple cysts.","PeriodicalId":92818,"journal":{"name":"Laparoscopic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49165921","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}
A. Francescato, B. Mullineris, F. Pecchini, D. Gozzo, M. Piccoli
: A correct localization of pancreatic neuroendocrine tumors is the goal for a minimally invasive pancreatic procedure. Recently, the application of green indocyanine fluorescence is used to identify an intraoperative target pancreatic hypervascular lesion, that represents the most challenging aspect of the surgical procedure. Intraoperative ultrasonography represents the most common tool for pancreatic insulinoma recognition; in recent years, especially in the field of minimally invasive surgery, both robotic and laparoscopic, the application of indocyanine green fluorescence established its role to improve the success of identification also for small or undetected intrapancreatic lesions. Few authors reported their results about the application of green indocyanine fluorescence to intraoperative detection of pancreatic insulinoma and in our study, we describe a preliminary experience with the presentation of first two cases: 1 laparoscopic and 1 robotic spleen preserving distal pancreatectomy for insulinoma with the intraoperative use of green indocyanine fluorescence. We noticed that the intravenous administration of 25 mg green indocyanine allowed us to visualize an intrapancreatic hyperfluorescent area corresponding to the insulinoma, already recognized also by intraoperative ultrasound. Our aim was to investigate the safety and feasibility of green indocyanine fluorescence technique for the proper localization of pancreatic functional lesions during minimally invasive pancreatic surgery, and a brief comparison with published series was conducted.
{"title":"Green indocyanine in minimally invasive spleen preserving distal pancreatectomy for insulinoma: report of two cases","authors":"A. Francescato, B. Mullineris, F. Pecchini, D. Gozzo, M. Piccoli","doi":"10.21037/LS-20-128","DOIUrl":"https://doi.org/10.21037/LS-20-128","url":null,"abstract":": A correct localization of pancreatic neuroendocrine tumors is the goal for a minimally invasive pancreatic procedure. Recently, the application of green indocyanine fluorescence is used to identify an intraoperative target pancreatic hypervascular lesion, that represents the most challenging aspect of the surgical procedure. Intraoperative ultrasonography represents the most common tool for pancreatic insulinoma recognition; in recent years, especially in the field of minimally invasive surgery, both robotic and laparoscopic, the application of indocyanine green fluorescence established its role to improve the success of identification also for small or undetected intrapancreatic lesions. Few authors reported their results about the application of green indocyanine fluorescence to intraoperative detection of pancreatic insulinoma and in our study, we describe a preliminary experience with the presentation of first two cases: 1 laparoscopic and 1 robotic spleen preserving distal pancreatectomy for insulinoma with the intraoperative use of green indocyanine fluorescence. We noticed that the intravenous administration of 25 mg green indocyanine allowed us to visualize an intrapancreatic hyperfluorescent area corresponding to the insulinoma, already recognized also by intraoperative ultrasound. Our aim was to investigate the safety and feasibility of green indocyanine fluorescence technique for the proper localization of pancreatic functional lesions during minimally invasive pancreatic surgery, and a brief comparison with published series was conducted.","PeriodicalId":92818,"journal":{"name":"Laparoscopic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45137646","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}
Pub Date : 2021-03-16DOI: 10.21037/LS-2020-MIRLM-08
G. Berardi
laparoscopic hepatectomies 3 wedge resections for benign lesions with one conversion and a 24-hour discharge (1); first left lateral sectionectomy and the first hepatectomy case series, comparative studies, and multicenter laparoscopic liver resections (LLRs) advantages the initial reports the was compared to the other surgical specialties. The steepness of the learning curve, the challenges in controlling a potential major bleeding, and the unknown risk for gas embolism and for inadequate surgical margins were impeding its worldwide validation the advantages were clear: less abdominal wall trauma, the earlier return to daily activities, the reduced postoperative pain, improved cosmetic results, decreased blood loss, less postoperative ascites in cirrhotics, fewer pulmonary complications and facilitation of subsequent surgery or liver transplantation were reported by most authors and later validated in many publications, and the interest soon started to rise
{"title":"Minimally invasive liver resections for cancer: moving forward","authors":"G. Berardi","doi":"10.21037/LS-2020-MIRLM-08","DOIUrl":"https://doi.org/10.21037/LS-2020-MIRLM-08","url":null,"abstract":"laparoscopic hepatectomies 3 wedge resections for benign lesions with one conversion and a 24-hour discharge (1); first left lateral sectionectomy and the first hepatectomy case series, comparative studies, and multicenter laparoscopic liver resections (LLRs) advantages the initial reports the was compared to the other surgical specialties. The steepness of the learning curve, the challenges in controlling a potential major bleeding, and the unknown risk for gas embolism and for inadequate surgical margins were impeding its worldwide validation the advantages were clear: less abdominal wall trauma, the earlier return to daily activities, the reduced postoperative pain, improved cosmetic results, decreased blood loss, less postoperative ascites in cirrhotics, fewer pulmonary complications and facilitation of subsequent surgery or liver transplantation were reported by most authors and later validated in many publications, and the interest soon started to rise","PeriodicalId":92818,"journal":{"name":"Laparoscopic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43646166","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}
Background: There is a change in the use of surgical methods for the repair of inguinal hernias. In Denmark, the national guidelines recommend either the Lichtenstein or the laparoscopic repair. The laparoscopic repair has gained popularity over the last years. The aim of the current study was to report trends in techniques for the repair of elective inguinal hernias, with focus on the Lichtenstein repair, the laparoscopic repair, and reoperation rates. Methods: This cohort study was based on data from the Danish Inguinal Hernia Database from January 1, 1998, until December 31, 2019. The outcome in this study was trends in the use of surgical methods for the repair of groin hernias in Denmark. Results were divided on patients with unilateral and bilateral groin hernia repairs. Patients were also divided into six groups depending on which year they were operated. The first group consisted of patients operated from 1998 to 2002, the second group was operated from 2003 to 2006, the third group from 2007 to 2010, the fourth group from 2011 to 2014, and the last group was operated from 2015 to 2019. Results: In total 173,302 patients initially operated electively for a groin hernia were included. There were several different methods being used for unilateral hernia repairs; however, there seems to be fewer methods in use compared with earlier. The laparoscopic repairs accounted for 96% of the bilateral inguinal hernias and 51% of the unilateral hernias. There has been a decrease in the use of the Lichtenstein method through the years. After 2017, the majority of patients received a laparoscopic repair for a primary unilateral inguinal hernia. Conclusions: In conclusion, this study demonstrated that over the last 21 years there has been an increase in the use of laparoscopic repair for bilateral inguinal hernia that now covers almost 100%. For primary unilateral hernias, the laparoscopic approach is increasingly being used now covering more than half of the operations. Basic surgical training might need to include laparoscopic repair of inguinal hernias in the future.
{"title":"Decreasing use of open procedures in elective inguinal hernia surgery","authors":"K. Andresen, J. Rosenberg","doi":"10.21037/LS-20-126","DOIUrl":"https://doi.org/10.21037/LS-20-126","url":null,"abstract":"Background: There is a change in the use of surgical methods for the repair of inguinal hernias. In Denmark, the national guidelines recommend either the Lichtenstein or the laparoscopic repair. The laparoscopic repair has gained popularity over the last years. The aim of the current study was to report trends in techniques for the repair of elective inguinal hernias, with focus on the Lichtenstein repair, the laparoscopic repair, and reoperation rates. Methods: This cohort study was based on data from the Danish Inguinal Hernia Database from January 1, 1998, until December 31, 2019. The outcome in this study was trends in the use of surgical methods for the repair of groin hernias in Denmark. Results were divided on patients with unilateral and bilateral groin hernia repairs. Patients were also divided into six groups depending on which year they were operated. The first group consisted of patients operated from 1998 to 2002, the second group was operated from 2003 to 2006, the third group from 2007 to 2010, the fourth group from 2011 to 2014, and the last group was operated from 2015 to 2019. Results: In total 173,302 patients initially operated electively for a groin hernia were included. There were several different methods being used for unilateral hernia repairs; however, there seems to be fewer methods in use compared with earlier. The laparoscopic repairs accounted for 96% of the bilateral inguinal hernias and 51% of the unilateral hernias. There has been a decrease in the use of the Lichtenstein method through the years. After 2017, the majority of patients received a laparoscopic repair for a primary unilateral inguinal hernia. Conclusions: In conclusion, this study demonstrated that over the last 21 years there has been an increase in the use of laparoscopic repair for bilateral inguinal hernia that now covers almost 100%. For primary unilateral hernias, the laparoscopic approach is increasingly being used now covering more than half of the operations. Basic surgical training might need to include laparoscopic repair of inguinal hernias in the future.","PeriodicalId":92818,"journal":{"name":"Laparoscopic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42179626","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}
O. Bijlstra, F. Achterberg, L. Grosheide, A. Vahrmeijer, R. Swijnenburg
Approximately 25–30% of patients with colorectal cancer (CRC) develop liver metastases (CRLM) over the course of the disease. To achieve curation surgical treatment of liver metastases is still considered as the gold standard. A shift from open to laparoscopic and robot-assisted surgery has occurred over the past decades. Extensive research has been performed using both preoperative as well as intraoperative imaging techniques to improve treatment planning, intraoperative tumor detection and evaluation of resection margins. Recently, increasing interest in near-infrared fluorescence (NIRF) imaging emerged as an intraoperative imaging modality in liver surgery. NIRF-guided liver surgery with the fluorescent dye indocyanine green (ICG) has been implemented as standard-of-care in various centers across the globe to aid in lesion differentiation and guidance of surgical margins. However, the low specificity and high false-positive rates of ICG in intraoperatively found lesions have led to the demand and development of tumor-specific fluorescent probes and improved camera systems. Here, we present a systematic review of available literature on intraoperative fluorescence imaging for minimally invasive CRLM surgery. Furthermore, we emphasize on fluorescent enhancement patterns, recent developments and future perspectives concerning fluorescent dyes and imaging techniques to optimize clinical application.
{"title":"Fluorescence-guided minimally-invasive surgery for colorectal liver metastases, a systematic review","authors":"O. Bijlstra, F. Achterberg, L. Grosheide, A. Vahrmeijer, R. Swijnenburg","doi":"10.21037/LS-20-108","DOIUrl":"https://doi.org/10.21037/LS-20-108","url":null,"abstract":"Approximately 25–30% of patients with colorectal cancer (CRC) develop liver metastases (CRLM) over the course of the disease. To achieve curation surgical treatment of liver metastases is still considered as the gold standard. A shift from open to laparoscopic and robot-assisted surgery has occurred over the past decades. Extensive research has been performed using both preoperative as well as intraoperative imaging techniques to improve treatment planning, intraoperative tumor detection and evaluation of resection margins. Recently, increasing interest in near-infrared fluorescence (NIRF) imaging emerged as an intraoperative imaging modality in liver surgery. NIRF-guided liver surgery with the fluorescent dye indocyanine green (ICG) has been implemented as standard-of-care in various centers across the globe to aid in lesion differentiation and guidance of surgical margins. However, the low specificity and high false-positive rates of ICG in intraoperatively found lesions have led to the demand and development of tumor-specific fluorescent probes and improved camera systems. Here, we present a systematic review of available literature on intraoperative fluorescence imaging for minimally invasive CRLM surgery. Furthermore, we emphasize on fluorescent enhancement patterns, recent developments and future perspectives concerning fluorescent dyes and imaging techniques to optimize clinical application.","PeriodicalId":92818,"journal":{"name":"Laparoscopic surgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48472866","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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