Digestive Surgery最新文献

{"title":"Interval Appendicectomy after Conservative Management of Complicated Appendicitis: Balancing Recurrence, Neoplasm Risk, and Surveillance Strategies.","authors":"Rathin Gosavi, Paul McMurrick, William Teoh, Geraldine Ooi, Vignesh Narasimhan","doi":"10.1159/000552093","DOIUrl":"10.1159/000552093","url":null,"abstract":"<p><strong>Background: </strong>Non-operative management (NOM) of complicated appendicitis is increasingly accepted, but the role of interval appendicectomy (IA) remains contentious. Contemporary evidence has shifted decision-making from recurrence risk alone toward age-linked neoplasm risk and radiological features.</p><p><strong>Summary: </strong>Recurrence after successful NOM is commonly reported at 12-24% and is concentrated within the first 6 months. In adults presenting with periappendiceal abscess, appendiceal tumour prevalence rises with age, reaching approximately 5-10% in patients aged 35-39 years and 14-20% in cohorts aged ≥40 years. Interval CT or MRI findings, including dilated or cystic morphology, mural abnormalities, calcification, mucin, or a base mass, identify higher risk patients in whom IA should be prioritised. Colonoscopy is best used selectively, particularly when caecal pathology is suspected, imaging is equivocal, or IA is not planned in older patients.</p><p><strong>Key messages: </strong>IA should generally be considered in patients aged ≥40 years and in those with persistent symptoms or concerning radiological findings, while recognising that decisions must be individualised and made through shared decision-making. Younger patients with complete radiological resolution and no red-flag features can usually be observed with structured imaging follow-up. A risk-stratified clinical algorithm is proposed to guide post-NOM management.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"1-5"},"PeriodicalIF":1.2,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13299124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147765442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tube Enteral Feeding-Associated Non-Occlusive Mesenteric Ischemia following Gastric Cancer Surgery: A Retrospective Case Series Analysis.","authors":"Sujit Chyau Patnaik, Thammineedi Subramanyeshwar Rao, Kalidindi Vijaya Venkata Narsimha Raju, Srijan Sandesh Shukla, Pratap Reddy, Arvind Reddy, Prasanthi Suryanarayana, Aditi Komandur, Yogesh Vashist, Syed Nusrath","doi":"10.1159/000551225","DOIUrl":"10.1159/000551225","url":null,"abstract":"<p><strong>Introduction: </strong>Non-occlusive mesenteric ischemia (NOMI) is a rare but lethal complication after gastric cancer (GC) surgery, marked by intestinal hypoperfusion without arterial occlusion. Nonspecific symptoms and rapid deterioration hinder timely diagnosis. This study evaluated outcomes, diagnostic pathways, and management.</p><p><strong>Methods: </strong>We retrospectively reviewed 8 GC patients who developed NOMI (February 2022-January 2024). Collected variables included demographics, surgical details, feeding practices, presentation, imaging, treatment, and outcomes. The primary endpoint was 30-day mortality.</p><p><strong>Results: </strong>NOMI presented a median of 3 days postoperatively (range 2-5). The median age was 63.5 years; 75% were male; all had advanced GC; and 62.5% had gastric outlet obstruction. Common signs were abdominal distension (75%), hypotension (50%), and peritonitis (25%). CT consistently showed small-bowel dilatation, pneumatosis intestinalis, and portal venous gas, mainly in distal jejunum/ileum. Seven patients underwent re-exploration: five required resection. After implementing a modified feeding protocol, cases reduced from seven to one. Thirty-day mortality was 50%, largely from sepsis and multiorgan dysfunction syndrome.</p><p><strong>Conclusion: </strong>In GC patients with feeding jejunostomy, NOMI remains a serious complication. A cautious feeding strategy - deferring feeds during vasopressor support, initiating low-strength kitchen feeds, slow escalation, and early oral intake - was associated with fewer cases. High clinical suspicion, rapid CT, and timely surgery are critical to improve outcomes.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"1-11"},"PeriodicalIF":1.2,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147455885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological Quality of Systematic Reviews on Treatments for Gastric Cancer: A Cross-Sectional Study.","authors":"Yuning Zhang, Betty H Wang, Billy Z Z Cheng, Claire C W Zhong, Faifai Ho, Vincent C H Chung","doi":"10.1159/000549851","DOIUrl":"10.1159/000549851","url":null,"abstract":"<p><p><p>Introduction: Systematic reviews (SRs) provide crucial evidence for gastric cancer interventions, but their reliability can be compromised by methodological flaws. We aimed to evaluate the methodological quality of SRs on gastric cancer interventions and identify factors affecting their quality.</p><p><strong>Methods: </strong>We searched MEDLINE, APA PsycInfo, Embase, and Cochrane Database of SRs for eligible SRs published between January 2014 and October 2023. The methodological quality was assessed using AMSTAR 2. Multivariable regression analyses were conducted to identify factors influencing quality.</p><p><strong>Results: </strong>Among 119 identified SRs (including 1,305 randomized controlled trials with 233,197 participants), only 2.5% were rated as high quality, while 89.1% were critically low quality. Higher journal impact factor was associated with better performance in addressing heterogeneity (adjusted odds ratio [AOR]: 1.37, 95% confidence interval [CI]: 1.02-1.84), investigating publication bias (AOR: 1.41, 95% CI: 1.03-1.94), reporting conflicts of interest (AOR: 2.85, 95% CI: 1.59-5.11), and establishing protocols (AOR: 3.33, 95% CI: 1.89-5.87). More review authors predicted better statistical methods (AOR: 1.20, 95% CI: 1.03-1.40) and protocol establishment (AOR: 1.31, 95% CI: 1.06-1.63). Recent publications showed improved conflict of interest reporting (AOR: 1.54, 95% CI: 1.09-2.10) and risk of bias assessment (AOR: 1.34, 95% CI: 1.03-1.75). Non-pharmacological SRs better discussed heterogeneity compared to pharmacological (AOR: 0.27, 95% CI: 0.09-0.85) or mixed interventions (AOR: 0.12, 95% CI: 0.03-0.53).</p><p><strong>Conclusion: </strong>The methodological quality of gastric cancer intervention SRs is unsatisfactory. Future SRs should focus on establishing protocols, explaining study design selection, using comprehensive search strategies, documenting excluded studies with reasons, and describing primary studies in detail. </p>.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"35-47"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12880829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145687356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Optimal Technique to Remove Visible Lesions in Barrett's Esophagus: When to Use Endoscopic Mucosal Resection or Endoscopic Submucosal Dissection?","authors":"Koen Munters, Roos E Pouw, Bas L A M Weusten, Sanne N van Munster","doi":"10.1159/000550636","DOIUrl":"10.1159/000550636","url":null,"abstract":"<p><p><p>Background: The incidence of esophageal adenocarcinoma (EAC) has risen significantly in recent decades, with Barrett's esophagus (BE) as the most important precursor. When a visible lesion is identified within BE, endoscopic resection (ER) is the preferred treatment, providing both histologic staging and curative therapy for dysplasia and low-risk EAC. Summary: Two ER techniques are commonly used: cap-based endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). EMR is an extensively studied technique considered safe, effective, and easy to learn. However, due to the cap-based approach, lesions larger than 15-20 mm need to be removed by multiple adjacent resections, so-called piecemeal resection. This may result in remnant tissue in the resection field and may compromise histopathological assessment. In contrast, ESD enables en bloc removal regardless of lesion size. While ESD has also demonstrated safety and efficacy, it is technically more demanding and associated with longer procedure times. For some lesions, there is general agreement on treatment, with ESD preferred for lesions with suspected submucosal invasion, bulky morphology, or fibrosis. Conversely, EMR remains the standard for smaller, superficial lesions without these features. Key Message: A significant grey zone persists, clinical scenarios for which comparative evidence is lacking and consensus on the optimal treatment approach remains unclear. </p>.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"81-90"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146219188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery for Locally Advanced Pancreatic Ductal Adenocarcinoma: Selection of Patients and Surgical Technique.","authors":"Savio George Barreto, Benjamin Loveday, Anubhav Mittal, Sanjay Pandanaboyana, John Albert Windsor","doi":"10.1159/000550333","DOIUrl":"10.1159/000550333","url":null,"abstract":"<p><p><p>Background: The management of locally advanced pancreatic ductal adenocarcinoma (LA-PDAC) now relies on an integrated, multidimensional assessment that goes beyond just the relationship of the tumour to vascular anatomy. Summary: By combining dynamic imaging, biomarker monitoring, genetic profiling, and thorough physiological evaluation, clinicians can more accurately select patients who are most likely to benefit from aggressive surgical intervention. These patients can then be offered NAT, singly or in combination, and preferably within the context of a clinical trial. The re-staging of patients post-NAT remains a challenge, but in patients who have shown no evidence of tumour growth or metastases and preferably with evidence of biochemical, metabolic, or radiological response and are fit enough, a trial dissection may be indicated. This evolving strategy transforms a disease once considered palliative into one with curative potential in selected patients. In this setting, surgical techniques have also evolved to include artery-first approaches to the SMA and CA, arterial divestment as an alternative to arterial resection, and the triangle operation. Patients with LA-PDAC should be managed in a high-volume centre with experience in treating this type of patient. There is no established role for minimally invasive techniques, including laparoscopic or robotic surgery, with LA-PDAC. Key Messages: Determining the role of surgery for locally advanced pancreatic cancer requires more than just an assessment of the tumour-vasculature relationship. The multidisciplinary selection integrates dynamic imaging, biomarker monitoring, genetic profiling, and physiological evaluation. For some patients, a previous palliative strategy is transformed to a potentially curative one. In this setting, new surgical techniques include an artery-first approach to avoid futile resection, periadventitial dissection instead of arterial resection, and the triangle operation for complete nodal clearance. </p>.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"48-60"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12890265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Anatomical S7 Segmentectomy: A Standardized Combined Dorsal and Ventral Method.","authors":"Wuqiang Chen, Yingjian Hou, Yuan Jiang, Youzhao He, Wen Xiang, Youyi Liu, Cheng Jin","doi":"10.1159/000550334","DOIUrl":"10.1159/000550334","url":null,"abstract":"<p><strong>Introduction: </strong>Anatomical resection of tumor in liver segment S7 is the most technically challenging procedure in laparoscopic liver hepatectomy due to its deep location and complex vascular structures, which results in a steep learning curve for beginners. We explored a simple and feasible approach: a dorsal approach combined with a dorsoventral method for liver segment S7 resection.</p><p><strong>Methods: </strong>The key innovations we propose through the dorsal approach combined with a dorsoventral method include the following: (1) systematic dissection of the S7 hepatic pedicle through Rouviere's sulcus; (2) parenchymal transection guided by the dorsal ischemic demarcation line of segment S7; (3) advance along the right hepatic vein toward the ventral aspect of segment S7. By decomposing complex maneuvers into three standardized steps (steps 1-3), this protocol significantly reduces technical barriers. The procedural details are meticulously demonstrated in this report to enhance reproducibility.</p><p><strong>Results: </strong>In the preliminary phase of this study, 20 patients were included. All patients underwent surgery smoothly, with no conversion to open surgery and no deaths, and all patients achieved R0 resection. The operation time was 190.0 (178.0-210.0) min, and intraoperative blood loss was 200.0 (150.0-280.0) mL.</p><p><strong>Conclusions: </strong>This method standardizes the laparoscopic S7 segment resection, which, while ensuring precise removal, is expected to reduce the learning curve for surgeons.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"91-99"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Usefulness of the Serum Fibrinogen-to-Albumin Ratio as a Preoperative Predictor of High-Grade Dysplasia or Invasive Carcinoma in Intraductal Papillary Mucinous Neoplasm of the Pancreas.","authors":"Shigeto Ochiai, Naokazu Chiba, Hiroki Yamaguchi, Ryota Suda, Yoshihiro Nagae, Takumi Seichi, Masashi Nakagawa, Takahiro Gunji, Toshimichi Kobayashi, Toru Sano, Yuji Kikuchi, Satoshi Tabuchi, Tetsuo Ishizaki, Shigeyuki Kawachi","doi":"10.1159/000550596","DOIUrl":"10.1159/000550596","url":null,"abstract":"<p><strong>Introduction: </strong>The indications for resection of intraductal papillary mucinous neoplasms (IPMNs) have been optimized according to the high-risk stigmata (HRS) and worrisome features (WFs). However, the proportion of resected IPMNs diagnosed as low grade is not insignificant. This study aimed to investigate whether fibrinogen-to-albumin ratio (FAR) improves the diagnostic ability of high-grade dysplasia (HGD) or invasive carcinoma (IC) in IPMN.</p><p><strong>Methods: </strong>This study included 47 patients who underwent surgery between April 2008 and July 2024. Clinical factors were examined to determine HGD or IC. We also compared the accuracy of predicting HGD or IC between HRS alone and HRS plus FAR.</p><p><strong>Results: </strong>A total of 23 were diagnosed with HGD or IC based on pathological diagnosis. On multivariable analysis, contrasted walled nodules ≥5 mm and FAR ≥0.0833 were significant predictors of HGD or IC. Moreover, the HRS and high FAR (≥0.0833) group had better the positive predictive value and diagnostic accuracy rate.</p><p><strong>Conclusions: </strong>FAR may be a significant predictor of HGD or IC in IPMN. In addition, when combined with HRS, its diagnostic ability as a predictor of HGD or IC may be further improved.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"61-68"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146084848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Blood Product Transfusions in Gastric Cancer Surgery in Finland.","authors":"Jukka-Pekka Lammi, Mika Ukkonen, Matti Eskelinen, Juha Saarnio, Pirjo Käkelä, Tuomo Rantanen","doi":"10.1159/000549881","DOIUrl":"10.1159/000549881","url":null,"abstract":"<p><strong>Introduction: </strong>Preoperative anaemia is common in gastric cancer patients. Although restrictive blood product transfusion strategies have been introduced, their use in standard practice is not well known. This national register study investigated the perioperative haemoglobin and platelet levels and the use of blood product transfusions in gastric cancer surgery.</p><p><strong>Methods: </strong>In order to improve and unify blood transfusion policies, the Finnish Red Cross Blood Service carried out a project concerning the optimal use of blood products (VOK project). These register data were used to form the patient population containing 70% of blood product transfusions in Finland. Patients undergoing open surgery for gastric cancers were included.</p><p><strong>Results: </strong>A total of 500 patients were included. Perioperative anaemia was observed in 75% of males and 52% of females. Fifty-one percent of patients received blood transfusions, with a median transfusion trigger point of 91 g/L [IQR 84-98 g/L] and a median 3 units transfused [IQR 2-4 units]. Seven percent received platelet transfusion (median trigger 77, IQR 15-146; median 4 units, IQR 2-8), and 6.5% received either fresh frozen plasma or pooled human plasma products. At discharge, the median haemoglobin level was 109 g/L in non-transfused patients and 114 g/L in transfused patients. If restrictive strategies had been applied, only 1.7% (n = 9) had required blood and 0.5% (n = 3) had a platelet transfusion.</p><p><strong>Conclusion: </strong>Anaemia is common among patients undergoing gastric cancer surgery. We encourage clinicians to follow restrictive transfusion policies in gastric cancer patients as Hb levels seem to recover after gastric surgery without blood transfusions.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"16-22"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145843597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response Rate Correlates with the Conversion Rate in Patients with Advanced Hepatocellular Carcinoma Treated with Systemic or Hepatic Artery Infusion Chemotherapy: A Systematic Review.","authors":"Masayuki Okuno, Hiroto Nishino, Keisuke Okura, Takamichi Ishii, Hiroki Hashida, Etsuro Hatano","doi":"10.1159/000550237","DOIUrl":"10.1159/000550237","url":null,"abstract":"<p><p><p>Introduction: The appropriate regimen for induction therapy with the intent of conversion therapy for advanced hepatocellular carcinoma (HCC) is unknown. This study aimed to evaluate whether the overall response rate (ORR) of chemotherapy correlates with the conversion rate.</p><p><strong>Methods: </strong>The studies of phase 2/3 trials of systemic or hepatic artery infusion chemotherapy (HAIC) for patients with advanced HCC were searched. Spearman's correlation coefficient was calculated to measure the strength of the relationship between the conversion rate and the ORR.</p><p><strong>Results: </strong>A total of 42 patient groups from 32 trials were included in the analysis. The ORR and conversion rates in a total of 3,516 patients were 24.7% and 8.3%, respectively. The analysis of only the patient groups treated with 1st-line immune checkpoint inhibitors, tyrosine kinase inhibitors or HAIC revealed a strong correlation between the ORR and the conversion rate (ρ = 0.647, p = 0.0003). In addition, strong correlations between the ORR and median progression-free survival (PFS)/overall survival (OS) were observed (ρ = 0.772, p < 0.0001 and ρ = 0.754, p < 0.0001, respectively).</p><p><strong>Conclusion: </strong>Because of the strong correlations of the ORR with the conversion rate and PFS/OS, regimens with high ORRs may be used for patients with advanced HCC who are potential candidates for conversion therapy. </p>.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"23-34"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12854685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145817970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotically Assisted Gastric Resections Using the hinotori™: A Cadaveric Feasibility Study.","authors":"Christoph Wandhöfer, Franco Roviello, Vladimir J Lozanovski, Evangelos Tagkalos, Peter P Grimminger, Hauke Lang, Suzanne S Gisbertz","doi":"10.1159/000548938","DOIUrl":"10.1159/000548938","url":null,"abstract":"<p><p><p>Introduction: In this first preclinical evaluation study of the hinotori™ system in gastric resection procedure, its capabilities to perform distal and total gastrectomy while using human cadaver models were evaluated.</p><p><strong>Methods: </strong>Three robotic distal gastrectomies (RADGs) and one total gastrectomy were performed in human cadavers using the same setup. A delta-shaped anastomosis in the RADG procedures were performed with a manual stapler.</p><p><strong>Results: </strong>The mean operative time for three distal gastrectomies was 118 min, while the total gastrectomy procedure focused on the resection only. The dissection could be made up to pulmonary veins, while the entire setup was kept. The procedures were done safely according to the surgical standards with smooth instrument and overall performance without any complications seen. An ergonomic surgeon cockpit and head rest supported the outcome.</p><p><strong>Conclusion: </strong>Docking-free design and human arm-like movement with a high degree of operation arm mobility showed a wide range of motion of the wristed robotic instruments. This could be beneficial for multiquadrant procedures resulting in potential shorter procedures times with smother performance, which should be evaluated in further studies. </p>.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"10-15"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12716846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145631167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}