JSLS : Journal of the Society of Laparoendoscopic Surgeons最新文献

{"title":"Risk Factors Influencing Discharge in Patients Undergoing Daytime Laparoscopic Appendectomy.","authors":"He Li, Zhengbo Yang, Shuangshuang Hou, Yaoyuan Chang, Chunyu Yang, Ju Wu, Yadong Wang","doi":"10.4293/JSLS.2025.00020","DOIUrl":"https://doi.org/10.4293/JSLS.2025.00020","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the preoperative factors influencing the discharge of patients undergoing laparoscopic appendectomy and examined the impact of intraoperative and postoperative recovery on discharge.</p><p><strong>Methods: </strong>We performed a retrospective analysis of clinical data from 158 patients who underwent laparoscopic appendectomy after admission to the emergency day-surgery ward of our hospital from January to December 2022. The patients were categorized into two groups based on the length of stay: the daytime group (length of stay ≤48 hours) and the routine group (length of stay >48 hours). We compared the effects of preoperative assessments, intraoperative variables, and postoperative outcomes on the discharge of the patients between the two groups.</p><p><strong>Results: </strong>Preoperative analysis of general data revealed that the time to discharge of patients undergoing daytime laparoscopic appendectomy (<i>P</i> < .05) were significantly influenced age; leukocyte, monocyte, neutrophil, and lymphocyte counts; systemic inflammation response index (SIRI); and appendix diameter. Multivariate logistic regression analysis identified appendix diameter (<i>P</i> = .017), SIRI (<i>P</i> = .024), and white blood cell count (<i>P</i> = .037) as independent risk factors affecting postoperative discharge in patients after daytime laparoscopic appendectomy. Receiver operating characteristic (ROC) curve analysis revealed that SIRI (ROC: 0.876; cutoff: 4.74), white blood cell count (ROC: 0.692; cutoff: 11.995), and appendix diameter (ROC: 0.760; cutoff: 9.5) could predict short-term hospital discharge, with SIRI exhibiting the highest predictive value. Intraoperative operation times, placement of drainage tubes, and pathological type also significantly influenced the discharge time (<i>P</i> < .05).</p><p><strong>Conclusion: </strong><b>:</b> SIRI, white blood cell count, and appendix diameter are key factors influencing the discharge of patients undergoing emergency day-surgery appendicitis.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"1- versus 2-Layer Renorrhaphy During Robotic Partial Nephrectomy.","authors":"Courtney Yong, Asif A Sharfuddin, Chandru P Sundaram, Clinton D Bahler","doi":"10.4293/JSLS.2024.00080","DOIUrl":"10.4293/JSLS.2024.00080","url":null,"abstract":"<p><strong>Background and objectives: </strong>To determine whether 1- versus 2-layer renorrhaphy affects renal function after partial nephrectomy.</p><p><strong>Methods: </strong>A total of 18 patients undergoing robot-assisted partial nephrectomies for renal tumors at a single center were randomized to 1-layer or 2-layer renorrhaphy. All patients received a running base layer for hemostasis and collecting system closure. The 2-layer renorrhaphy group also underwent cortical closure with running suture, sliding clip method. Demographics and surgical outcomes were collected. Three-dimensional renal models were constructed using semiautomatic segmentation and planimetry pre- and 4 months postsurgery to determine renal volume loss. Welch's t test was used with statistical significance defined as <i>P</i> < .05.</p><p><strong>Results: </strong>Of the 18 patients included in the study, 10 were randomized to 1-layer and 8 to 2-layer renorrhaphy. Demographic variables were matched. There was no difference in postoperative creatinine at 1 month (<i>P</i> = .11), 1 year (<i>P</i> = .28), or 3 years (<i>P</i> = .28) postoperatively. However, the change from pre to postoperative creatinine favored the 1-layer group at 1 month (-0.043 vs +0.11 <i>P</i> = .02) and 3 years (-0.0025 vs 0.244, <i>P</i> = .08) follow up. The 1-layer group had a smaller mean volume loss at 4 months postoperatively compared to the 2-layer group (12% vs 22%, <i>P</i> = .04).</p><p><strong>Conclusion: </strong>This small, randomized trial found increased creatinine and volume loss after 2-layer cortical renorrhaphy. Omitting cortical renorrhaphy may result in better preservation of renal volume and function.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12039162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective Use of Laparoscopic Simulators in Gynecological Training.","authors":"Abdurrahman Hamdi İnan, Ahkam Göksel Kanmaz, Alaattin Karabulut, Sercan Kantarcı, Emrah Töz","doi":"10.4293/JSLS.2025.00017","DOIUrl":"https://doi.org/10.4293/JSLS.2025.00017","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the effectiveness of a haptic-enabled laparoscopic simulator in improving the surgical proficiency of residents across different experience levels.</p><p><strong>Design: </strong>This prospective study was conducted to evaluate the effectiveness of a haptic laparoscopic simulator (LAP Mentor) for gynecological procedures among residents. Participants were divided into three groups based on experience: senior, midlevel, and junior residents, and completed simulations of bilateral tubal ligation and prophylactic oophorectomy, with performance metrics including time taken and instrument movements recorded.</p><p><strong>Result: </strong>While group 1 generally scored higher, no statistically significant differences were found between groups. Major bleeding incidents were rare, occurring once in group 2 during tubal ligation and twice in group 3 during prophylactic oophorectomy. Within-group analysis revealed improvements for group 2, which showed reduced duration (<i>P</i> = .006), left-hand movements (<i>P</i> = .009), and right-hand movements (<i>P</i> = .002) and group 3 also achieved statistically significant decreases in duration (<i>P</i> = .004), left-hand movements (<i>P</i> = .001), and right-hand movements (<i>P</i> = .003), indicating skill development over time.</p><p><strong>Conclusion: </strong>Limited but regular access to advanced simulators-offered two or three times annually-could empower residency programs to meet contemporary surgical training standards without incurring prohibitive costs, ensuring broader access to high-quality skills development.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Patient-Reported Outcomes of Robotic Versus Laparoscopic Inguinal Hernia Repair.","authors":"Randeep Wadhawan, Deepa Kizhakke Veetil, Priti Batra, Arun Bhardwaj, Naveen Kumar Verma","doi":"10.4293/JSLS.2025.00005","DOIUrl":"https://doi.org/10.4293/JSLS.2025.00005","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to assess the clinical and patient-reported outcomes of laparoscopic and robotic-assisted inguinal hernia repair in Indian real-world settings.</p><p><strong>Methods: </strong>This is a single-center, prospective, nonrandomized, comparative study. Consecutive patients who were 18 years of age or older, and provided informed consent were included in the study between June 2023 and May 2024.</p><p><strong>Results: </strong>In all, 83 patients were prospectively enrolled in this study: 24 patients were in the robotic-assisted surgery (RAS) group and 59 patients were in the laparoscopic surgery (LS) group. The baseline characteristics of the study cohorts were comparable. The mean total operating time for the RAS group was significantly longer than the LS group (89.83 ± 24.31 vs 67.71 ± 18.34 minutes, <i>P</i> = .0000). For the bilateral hernias, the RAS group's total operating time was significantly longer than that of the LS group; however, for the unilateral hernias, there was no discernible difference. Urine retention was the only early complication in 8.33% and 16.95% of patients, respectively, in the RAS and LS groups. The duration of hospital stay did not significantly differ between the 2 groups (<i>P</i> = .395). The pain scores of the RAS group were significantly lower on postoperative days 1, 4, and 7. Patients in the RAS group scored considerably higher on the quality of life (QoL) scale 1 month after surgery than patients in the LS group.</p><p><strong>Conclusion: </strong>This study reports encouraging preliminary clinical outcomes of RAS inguinal hernia repairs in Indian settings, in terms of postoperative pain and QoL.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Resection and Anastomosis in Bowel Endometriosis: Single Stapler Surgical Technique.","authors":"Dipak Limbachiya, Mahan Gowda, Ayush Heda","doi":"10.4293/JSLS.2025.00004","DOIUrl":"https://doi.org/10.4293/JSLS.2025.00004","url":null,"abstract":"<p><strong>Background and objectives: </strong>Endometriosis affects 10% of reproductive-age women globally, with bowel endometriosis in 3.8%-37% of cases, primarily involving the rectum and sigmoid. Surgical excision is the gold-standard treatment for deep infiltrating endometriosis (DIE). Our objective was to evaluate the feasibility, safety, and efficacy of a single-stapler laparoscopic resection and anastomosis technique for bowel DIE.</p><p><strong>Methods: </strong>This retrospective study analyzed 17 cases managed from January 2023 to June 2024. Clinical presentation, surgical outcomes, and follow-up data were reviewed. Symptom improvement and complications were assessed during a minimum 3-month postoperative period.</p><p><strong>Results: </strong>Patients primarily presented with preoperative symptoms, including progressive dysmenorrhea, dyspareunia, and dyschezia. All anastomoses were tension-free with negative margins; no diversion stomas were needed. Postoperative recovery was smooth, with significant symptom relief and no complications.</p><p><strong>Conclusion: </strong>The single-stapler technique for laparoscopic rectosigmoid resection is a safe, effective approach for bowel DIE, offering excellent outcomes with significant symptom relief and minimal severe complications.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Electrosurgery versus Conventional Instrumentation (Scissors) during Hysteroscopic Resection of Intrauterine Adhesions in Infertile Patients Undergoing Embryo Transfer.","authors":"Anna Vanderhoff, Zachary Walker, Serene Srouji, Andrea Lanes, Elizabeth Ginsburg, Roisin Mortimer","doi":"10.4293/JSLS.2024.00070","DOIUrl":"https://doi.org/10.4293/JSLS.2024.00070","url":null,"abstract":"<p><strong>Background/objectives: </strong>To evaluate the impact of use of electrosurgery at the time of hysteroscopic resection of intrauterine adhesions on the need, if any, for repeat operative resection and embryo transfer outcomes in an infertile patient population.</p><p><strong>Methods: </strong>Retrospective cohort study completed at a single academic center in which a total of 110 infertile patients underwent an operative hysteroscopic resection of intrauterine adhesions with (hot) or without (cold) the use of electrosurgery and subsequent embryo transfer between 2005 and 2019.</p><p><strong>Results: </strong>A total of 85 patients underwent cold dissection, and 25 patients had hot dissection. There was no difference in the need for repeat hysteroscopy between groups (cold: n = 21 [24.71%], hot: n = 8 [32.00%]; adjusted relative risk [aRR]: 0.76, 95% confidence interval [CI]: 0.33-1.74), the number of repeat hysteroscopies performed in each group (cold: 1.52, hot: 1.50; aRR: 1.50, 95% CI: 0.37-6.05) and endometrial thickness prior to embryo transfer between groups (cold: 7.80 ± 2.42 mm, hot: 9.02 ± 5.54 mm; aRR: 1.13, 95% CI: 0.92-1.39). Lastly, there was no difference in implantation rate (RR 1.03, 95% CI 0.68-1.58), ongoing pregnancy rate (aRR 0.90, 95% CI 0.49-1.65) and live birth rate (aRR 1.00, 95% CI 0.52-1.89) at the time of first embryo transfer after adhesion resection.</p><p><strong>Conclusion: </strong>The use of electrosurgery for surgical management of Asherman's syndrome in patients with infertility does not appear to have detrimental downstream effects on the need for repeat hysteroscopic adhesiolysis, endometrial thickness, or in vitro fertilization embryo transfer outcomes when compared to cold hysteroscopic adhesiolysis.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143999750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Immersive Virtual Reality as Learning Tool for Surgical Trainees.","authors":"Trevor Dorey, Jilian Nicholas, Steven Daniel Leydorf, Samantha Scarola, Andrew Broda, Justin Turcotte, Terri Ridel, Alex Gandsas","doi":"10.4293/JSLS.2025.00021","DOIUrl":"10.4293/JSLS.2025.00021","url":null,"abstract":"<p><strong>Background and objectives: </strong>As the availability of consumer-level virtual reality (VR) technology increases, an opportunity to enhance surgical education emerges. This study sought to evaluate the performance of immersive VR (iVR) against standard 2-dimensional (2D) training videos, vis-à-vis procedure knowledge, procedural confidence, and first-time hands-on performance, along with assessment of the user experience with iVR.</p><p><strong>Methods: </strong>Participants naïve to the procedure for insertion of a central venous catheter underwent baseline assessment of their knowledge and confidence related to that procedure. They were then randomly assigned, in a 1:1:1 fashion, to 1 of 3 formats of a central line training video; standard 2D, desktop VR and iVR. Participants completed a postintervention knowledge and confidence assessment, as well as a live, hands-on simulation of the procedure. The simulation was scored by 2 blinded observers. Participants were also asked about their subjective experience with VR.</p><p><strong>Results: </strong>Forty-three participants completed the full study protocol. With regard to knowledge and confidence assessment, using an immersive format was deemed more engaging by all participants, and did not negatively impact knowledge acquisition or procedural confidence. There was a trend toward significantly higher performance on hands-on simulation for participants training using an iVR format (<i>P</i> = .054).</p><p><strong>Conclusions: </strong>iVR is a useful adjunct in procedural training. It is well-tolerated by users and more engaging than 2D video. It may improve hands-on skills acquisition without negatively impacting knowledge acquisition or artificially inflating procedural confidence. Larger scale studies are needed to assess this technology more thoroughly.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Emulsification Suction Irrigator for High-Viscosity Fluids.","authors":"Takuya Yokoe, Masato Kita, Hidetaka Okada","doi":"10.4293/JSLS.2025.00010","DOIUrl":"10.4293/JSLS.2025.00010","url":null,"abstract":"<p><strong>Background and objectives: </strong>With the continued development of advancements in minimally invasive surgery, aspirators have become increasingly slenderer to enable smooth insertion into narrow access ports. However, high-viscosity fluids, such as ovarian cyst contents and blood clots, may be difficult to aspirate using slender aspirators. Therefore, we developed a novel emulsification suction irrigator. This study aimed to verify the feasibility of this suction device and compare its suction efficiency with that of conventional devices.</p><p><strong>Methods: </strong>The newly developed emulsification suction irrigator consists of a spoon-shaped tip and double-lumen shafts for water delivery and suction, which enable the aspiration of emulsified contents. We evaluated the aspiration efficiency by comparing the aspiration rates between the emulsification suction irrigator and conventional single-lumen suction irrigator. Three types of content were compared: viscous (mucinous cyst), highly fibrotic (blood clots), and content containing fat and debris (dermoid cysts). Each of the 3 types of fluids was examined in an artificial model.</p><p><strong>Results: </strong>The emulsification suction irrigator significantly improved the suction efficiency compared with that of the single-lumen suction irrigator. For the 3 types of content, a significant difference in the median aspirated mass was found between the emulsification suction irrigator with water supply and single-lumen suction irrigator (<i>P </i><<i> </i>.001).</p><p><strong>Conclusion: </strong>Our new emulsification suction irrigator improved the removal efficiency of highly viscous liquids in artificial models.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Market Clinical Follow-Up Study of the LevaLap 1.0 during Laparoscopic Access.","authors":"Xavier Deffieux, Jean-Louis Benifla, Ingolf Juhasz-Böss, Moritz Breitbach, Olaf Buchweitz, Nassir Habib, Kirsten Hald, Bashar Haj Hamoud, Cyrille Huchon, Vibeke Lysdal, Meletios P Nigdelis, Martin Rudnicki, Erich-Franz Solomayer, Florin-Andrei Taran, Henrik Michelsen-Wahl, Ricardo Azziz, Vincenzo Bagnardi, Andreas Hackethal","doi":"10.4293/JSLS.2025.00014","DOIUrl":"10.4293/JSLS.2025.00014","url":null,"abstract":"<p><strong>Background and objectives: </strong>The LevaLap 1.0 (Core Access Surgical Technologies, Atlanta, GA) was designed to promote safer, more stable, and more predictable abdominal access when using the Veress needle for insufflation. We report on the first postmarket clinical study (PMCF) assessing experience with the use of the LevaLap 1.0 during gynecologic laparoscopic surgery.</p><p><strong>Methods: </strong>Prospective multicenter study, including women ≥18 years old, excluding pregnancy, access site surgery in prior 10 days, abdominal hernia, contraindication to Veress needle or laparoscopy use, body mass index (BMI) >30 kg/m², and inability/unwillingness to provide consent.</p><p><strong>Results: </strong>A total of 158 subjects were included, involving nine surgeons. Mean age was 43.6 ± 14.6 years and mean BMI: 24.7 ± 3.8 kg/m². Access site was 83.5% transumbilical, 15.2% periumbilical, and 1.2% other. Using the device 96.8% (95% confidence interval [CI]: 92.8-99.0%, n = 152/157) of patients' access was successfully achieved at first attempt and 99.4% (95% CI: 96.5-100.0, n = 156/157) within the first 2 attempts. One minor device-related adverse event was reported: a circular redness on the skin at the site of device application, resolving spontaneously. Surgeons noted easier access in 59.5%, increased confidence in 68.3%, increased access control in 67.1%, and increased access efficiency in 66.4% of cases.</p><p><strong>Conclusion: </strong>This PMCF study indicates that the use of the LevaLap 1.0 resulted in easier, greater control and greater efficiency during abdominal access using the Veress needle. In 96.8% access was achieved at first attempt and in 99.4% within the first 2 attempts. The use of the LevaLap 1.0 may facilitate abdominal access when using the Veress needle for insufflation.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12061069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes Following Surgery As the Main Intervention for Endometriosis in a Low Socioeconomic Setting.","authors":"Salma Moustafa, Liaisan Uzianbaeva, Swati Kumari, Oksana Pylypiv, Alireza Mehdizadeh, Daniel T Farkas, Pengfei Wang","doi":"10.4293/JSLS.2025.00003","DOIUrl":"https://doi.org/10.4293/JSLS.2025.00003","url":null,"abstract":"<p><strong>Background and objective: </strong>To evaluate the perioperative and long-term outcomes of surgical management of patients with endometriosis at a community hospital in a low socioeconomic district.</p><p><strong>Methods: </strong>A total of 39 patients underwent surgical management for endometriosis between October 2022 and November 2024. Thirty-six patients were followed up for 1-24 months.</p><p><strong>Results: </strong>Among the 39 cases, 18 (42.6%) were identified incidentally in operations for other indications, while 21 (53.8%) were clinically diagnosed or confirmed with previous laparoscopy. Twelve (30.8%) cases were classified as stage I-II and 27 (69.2%) as stage III-IV. Surgical approaches included laparoscopy in 23 (59.0%) cases, robotic assistance in 13 (33.3%), and 2 cases were converted from laparoscopy to laparotomy. Advanced techniques utilized included ureterolysis, enterolysis, diaphragm resection, bowel shaving, bowel disc resection, segmental bowel resection, appendectomy, partial bladder cystectomy, and hypogastric nerve sparing. Intraoperative complications included 1 ureteral thermal injury and 1 bladder laceration. Postoperative complications consisted of 1 pyelonephritis and 1 incisional cellulitis. No complications related to urinary or bowel functional disorders occurred postoperatively. Among the 19 patients who regularly used pain medication before surgery, 16 patients discontinued pain medications, while 3 patients reduced their usage after surgery. Eight patients are actively trying to conceive, and 1 patient conceived spontaneously. Sixteen patients are receiving various forms of hormonal suppression.</p><p><strong>Conclusion: </strong>With excellent skills and collaboration, the surgical management of endometriosis resulted in minimal complications and optimal postoperative outcomes, significantly benefiting patients in low socioeconomic areas.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057729/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}