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

筛选
英文 中文
Implementation of a Safe Cost Reduction Strategy for Laparoscopic Sleeve Gastrectomy. 腹腔镜袖式胃切除术安全降本策略的实施。
IF 1.8 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2026-01-01 Epub Date: 2026-01-30 DOI: 10.4293/JSLS.2025.00099
Scott Z Mu, Moamena El-Matbouly, Hector M Lopez, Alan A Saber
{"title":"Implementation of a Safe Cost Reduction Strategy for Laparoscopic Sleeve Gastrectomy.","authors":"Scott Z Mu, Moamena El-Matbouly, Hector M Lopez, Alan A Saber","doi":"10.4293/JSLS.2025.00099","DOIUrl":"10.4293/JSLS.2025.00099","url":null,"abstract":"<p><strong>Background: </strong>We conducted a quality improvement initiative aimed at reducing operating room disposable supply costs during sleeve gastrectomy.</p><p><strong>Methods: </strong>We implemented a cost reduction strategy for all sleeve gastrectomy operations at a single center which involved switching from ECHELON+ stapler with routine use staple line buttressing to a single-fire stapler (Titan SGS) to standardize the amount of staple reloads and afterwards, switching to the easyEndoLite stapler with shorter staple heights and selective use of staple line reinforcements and clip appliers.</p><p><strong>Results: </strong>We included 638 cases of primary laparoscopic sleeve gastrectomy performed from January 2020 to June 2024. There were no significant differences in the total operating room supply costs after switching to a single-fire stapler, but after switching to a less costly stapler and selectively using staple line reinforcements and clip appliers, we demonstrated a cost savings of $1,283 (95% confidence interval [CI]: $1,216 to $1,351) per case (<i>P</i> < .001), without any differences in length of stay or 30-day weight loss or risk of reoperation or readmission.</p><p><strong>Conclusion: </strong>During sleeve gastrectomy, surgeons should consider adopting operating room cost-reduction strategies such as selective use of clip appliers, judicious usage of staple line reinforcement material, and choosing less costly stapler devices.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146105946","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}
引用次数: 0
Homemade Glove-Port Platform for Ovarian Teratoma Resection in Laparoscopic Single-Site Surgery. 腹腔镜单部位卵巢畸胎瘤切除术的自制手套口平台。
IF 1.8 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2026-01-01 Epub Date: 2026-02-18 DOI: 10.4293/JSLS.2025.00101
Dayuan Huang, Wenchen Huang, Haiyan Chen, Qiong Yang
{"title":"Homemade Glove-Port Platform for Ovarian Teratoma Resection in Laparoscopic Single-Site Surgery.","authors":"Dayuan Huang, Wenchen Huang, Haiyan Chen, Qiong Yang","doi":"10.4293/JSLS.2025.00101","DOIUrl":"https://doi.org/10.4293/JSLS.2025.00101","url":null,"abstract":"<p><strong>Background: </strong>The adoption of laparoscopic single-site surgery (LESS) is limited by the high cost of commercial platforms. We present a self-designed glove-port for LESS ovarian teratoma resection.</p><p><strong>Technique: </strong>A single-port platform was constructed from a surgical glove and rings from a disposable suction tube. A specimen retrieval bag was modified with a silk drawstring and a secondary opening to create a closed system. The teratoma was dissected within the closed bag and all contents were removed via the umbilicus.</p><p><strong>Results: </strong>The procedure was successfully performed. The self-assembled port provided stable access, and the modified bag enabled complete specimen containment and extraction without spillage or auxiliary incisions.</p><p><strong>Conclusion: </strong>This technique demonstrates a safe, feasible, and low-cost alternative for LESS. Utilizing ubiquitous materials improves the accessibility of minimally invasive, cosmetically favorable surgery in resource-constrained settings.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227126","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}
引用次数: 0
Comparing Laparoscopic Skills Training for Gynecologic Residents Across Two Established Curricula. 妇科住院医师腹腔镜技能培训在两种既定课程中的比较。
IF 1.8 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2026-01-01 Epub Date: 2026-03-18 DOI: 10.4293/JSLS.2025.00124
Jacqueline Early, Skylar Gill, Nicole C Brzozowski, Linus T Chuang
{"title":"Comparing Laparoscopic Skills Training for Gynecologic Residents Across Two Established Curricula.","authors":"Jacqueline Early, Skylar Gill, Nicole C Brzozowski, Linus T Chuang","doi":"10.4293/JSLS.2025.00124","DOIUrl":"https://doi.org/10.4293/JSLS.2025.00124","url":null,"abstract":"<p><strong>Background and objectives: </strong>To compare the effectiveness of the Fundamentals of Laparoscopic Surgery (FLS) and Essentials in Minimally Invasive Gynecologic Surgery (EMIGS) manual skills curricula in preparing obstetrics and gynecology residents for laparoscopic vaginal cuff closure, using both objective performance metrics and subjective assessments.</p><p><strong>Methods: </strong>A randomized, blinded, and controlled study was conducted in a single institution with an obstetrics and gynecology residency program. Nine residents without prior FLS or EMIGS certification were randomized to complete either the FLS or EMIGS manual skills curriculum over 28 days. Participants were video-recorded completing five curriculum-specific tasks, the opposing curriculum without prior practice, and a laparoscopic vaginal cuff closure using barbed suture. The primary outcome was performance on the cuff closure task, assessed using a modified Global Operative Assessment of Laparoscopic Skills (GOALS) questionnaire. Secondary outcomes included individual task scores, total manual skill scores, and post-training survey responses.</p><p><strong>Results: </strong>There were no significant differences in total manual skills scores between groups (<i>P</i> = .62). FLS-trained participants scored significantly higher on intracorporeal knot tying (<i>P</i> = .0085). However, EMIGS-trained residents achieved higher scores on the vaginal cuff closure task across all postgraduate year (PGY) levels. Subjectively, though most participants found the programs dissimilar, all participants reported skill improvement. EMIGS trainees expressed lower confidence in knot tying, but most agreed EMIGS more closely resembled real-world laparoscopic surgery.</p><p><strong>Conclusions: </strong>These findings support the use of EMIGS as a gynecologic-specific simulation tool in surgical education, although further research with larger numbers of participants are needed to confirm these observations.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12999069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486550","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}
引用次数: 0
Thyroxine as a Parameter of Stress during Minimally Invasive Surgery. 甲状腺素作为微创手术中应激的一个参数。
IF 1.8 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2026-01-01 Epub Date: 2026-03-12 DOI: 10.4293/JSLS.2025.00127
Ervin Matovic, Samir Delibegović
{"title":"Thyroxine as a Parameter of Stress during Minimally Invasive Surgery.","authors":"Ervin Matovic, Samir Delibegović","doi":"10.4293/JSLS.2025.00127","DOIUrl":"https://doi.org/10.4293/JSLS.2025.00127","url":null,"abstract":"<p><strong>Aim: </strong>The body's hormonal response to stress during minimally invasive surgery has not yet been completely researched in all its aspects, so the aim of this study was to test the body's hormonal response by monitoring the thyroid hormone thyroxine (T4) during laparoscopic cholecystectomy (LC) using standard (12-15 mm/Hg) and low (6-8 mm/Hg) intraabdominal pressure, and in open cholecystectomy (OC).</p><p><strong>Patients and methods: </strong>This cohort, observational study was conducted in the period from July 2022 to December 2024 and included 110 patients divided into 2 groups: 70 patients who underwent LC, and 40 patients who underwent OC. The first group of patients were divided into 2 subgroups of 35 patients each on the basis of the level of intraabdominal pressure during cholecystectomy (LC with standard, or LC with low intraabdominal pressure). T4 was monitored as the parameter of stress.</p><p><strong>Results: </strong>The comparison between the LC and OC groups in terms of the concentrations of T4 in the postoperative days showed statistically significant higher values of this hormone in the group of patients treated using the open method (OC). Moreover, the body's response to stress was less intense during LC than during OC. The body's response to stress during LC with low insufflation pressure (6-8 mmHg) was lower than during LC with standard insufflation pressure (12-15 mmHg).</p><p><strong>Conclusion: </strong>This study confirms from hormonal aspects the advantages of minimally invasive surgery in comparison with open surgery, and in particular the advantages of LC with low intraabdominal pressure in comparison with standard pressure.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12981365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147468845","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}
引用次数: 0
Prospective Evaluation of Conventional and Novel Factors Influencing Gastric Wall Thickness in Bariatric Surgery Patients. 影响减肥手术患者胃壁厚度的传统和新型因素的前瞻性评价。
IF 1.8 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2025-10-01 Epub Date: 2025-12-31 DOI: 10.4293/JSLS.2025.00106
Elçi Muhsin, Ali Melik Mehmet
{"title":"Prospective Evaluation of Conventional and Novel Factors Influencing Gastric Wall Thickness in Bariatric Surgery Patients.","authors":"Elçi Muhsin, Ali Melik Mehmet","doi":"10.4293/JSLS.2025.00106","DOIUrl":"10.4293/JSLS.2025.00106","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity prevalence has nearly doubled globally in the past 30 years. Among treatment options, surgery remains the most effective. Staple line leaks are a major complication in bariatric surgery, often linked to mismatched stapler cartridge and gastric wall thickness (GWT). Understanding factors influencing this thickness is critical. This study evaluates previously known variables and additionally investigates waist circumference, duration of obesity, alcohol use, and asthma.</p><p><strong>Methods: </strong>Between December 2024 and July 2025, patients who underwent bariatric surgery for obesity were evaluated. A total of 58 patients were included in the study. Immediately following laparoscopic sleeve gastrectomy (LSG), the freshly resected gastric specimens were assessed in the operating room. Prior to measurement, a standardized pressure of 8 g/mm<sup>2</sup> was applied to the gastric tissue for 15 seconds.</p><p><strong>Results: </strong>Male sex was associated with increased thickness in the corpus and fundus, smoking with the fundus, and body mass index (BMI) with the antrum. Height affected all regions, while weight influenced the antrum and fundus. Waist circumference increased thickness in all areas. Overall, thickness decreased from antrum to fundus, but in 10% of patients, the corpus was thicker than the antrum.</p><p><strong>Conclusion: </strong>There are few and conflicting studies in the literature regarding factors affecting GWT. In this study, waist circumference was found to increase GWT in all regions, while duration of obesity, alcohol consumption, and asthma had no significant effects. It may be reasonable for surgeons to consider waist circumference, in addition to BMI, height, weight, and male sex, when selecting staplers.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12754818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145889455","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}
引用次数: 0
Acronyms by any other name. 任何其他名字的缩写。
IF 1.8 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2025-10-01 Epub Date: 2025-11-25 DOI: 10.4293/JSLS.2025.00115
Douglas E Ott
{"title":"Acronyms by any other name.","authors":"Douglas E Ott","doi":"10.4293/JSLS.2025.00115","DOIUrl":"10.4293/JSLS.2025.00115","url":null,"abstract":"","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12668383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661511","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}
引用次数: 0
Falciform Ligament Laparoscopic Approach for Preperitoneal Ventral Hernia Repair. 镰状韧带腹腔镜下腹膜前腹疝修补术。
IF 1.8 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2025-10-01 Epub Date: 2025-10-31 DOI: 10.4293/JSLS.2025.00085
Jagpreet S Deed
{"title":"Falciform Ligament Laparoscopic Approach for Preperitoneal Ventral Hernia Repair.","authors":"Jagpreet S Deed","doi":"10.4293/JSLS.2025.00085","DOIUrl":"10.4293/JSLS.2025.00085","url":null,"abstract":"<p><strong>Background and objectives: </strong>To overcome the limitations of intraperitoneal mesh and technically demanding extraperitoneal techniques, the \"Falciform Ligament Laparoscopic Approach for Preperitoneal Ventral Hernia Repair\" method, enables direct optical entry into the preperitoneal space using the falciform fat as a safety buffer. This approach avoids fascial division to maintain structural integrity.</p><p><strong>Methods: </strong>Between December 2018 and December 2024, 50 patients with primary, midline, medium-sized ventral hernias underwent repair using the technique. Primary outcomes included operative duration, complication rate and recurrence. Preperitoneal entry was achieved by a 5-mm optical trocar in the epigastrium. Upon space creation and hernia reduction, mesh was placed without fixation.</p><p><strong>Results: </strong>Fifty patients (mean age 41.2 ±7.6 years; body mass index [BMI] 29.4 ±4.7 kg/m<sup>2</sup>) with umbilical/paraumbilical hernia (M3-European Hernia Society classification) and mean defect size 2.9 ±0.6 cm underwent repair using the technique. All surgeries were completed laparoscopically without intraoperative complications. Median operative time was 85 minutes; median hospital stay was 1 day. Pain scores (visual analogue scale) were low: 1.7 (evening), 1.3 (day 1), 0.8 (day 7). No complications occurred, except one hematoma-resolved after aspiration; two seromas-no intervention needed; no recurrences observed over a 41-month median follow-up.</p><p><strong>Conclusion: </strong>It is a feasible, safe, structurally preserving technique with favorable outcomes. By eliminating mesh fixation and enabling early discharge with minimal postoperative pain, it offers a potential cost advantage. Further multicenter validation is warranted.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12668370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661515","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}
引用次数: 0
Indocyanine Green Fluorescence to Assess Parathyroid Glands Function during MIVAT. 吲哚菁绿荧光评价MIVAT期间甲状旁腺功能。
IF 1.8 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2025-10-01 Epub Date: 2025-11-05 DOI: 10.4293/JSLS.2025.00088
Paolo Gisonni, Casimiro Nigro, Serena Elisa Tempera, Giulia Salvi, Luca Sessa, Rosa Maria Paragliola, Pietro Princi
{"title":"Indocyanine Green Fluorescence to Assess Parathyroid Glands Function during MIVAT.","authors":"Paolo Gisonni, Casimiro Nigro, Serena Elisa Tempera, Giulia Salvi, Luca Sessa, Rosa Maria Paragliola, Pietro Princi","doi":"10.4293/JSLS.2025.00088","DOIUrl":"10.4293/JSLS.2025.00088","url":null,"abstract":"<p><strong>Background: </strong>Postoperative hypoparathyroidism is the most common complication of total thyroidectomy, often resulting from injury or devascularization of the parathyroid glands.</p><p><strong>Objective: </strong>Indocyanine green fluorescence (ICG) technique has been applied in the last 10 years in different kinds of surgery including colorectal, oncological lymph node and endocrine surgery. Minimally invasive thyroidectomy, introduced more than 25 years ago, is a valid surgical option for selected benign and malignant thyroid disease with advantages in terms of cosmetic results and postoperative pain. Aim of this study is to evaluate the feasibility and safety of ICG during minimally invasive thyroidectomy to assess and predict parathyroid gland perfusion and guide preservation.</p><p><strong>Methods: </strong>We report the initial experience in our center of ICG during minimally invasive video-assisted total thyroidectomy in a case series of 9 patients, using the Striker System® to assess parathyroid perfusion and guide preservation. Demographic and surgical data were registered with special attention to hypoparathyroidism.</p><p><strong>Results: </strong>All patients underwent standard minimally invasive video-assisted total thyroidectomy; a standardized dose of ICG was administered intravenously. Real-time near-infrared imaging allowed for clear visualization of parathyroid vascularization, enabling the preservation of well-perfused glands and the auto transplantation of those removed into the sternothyroid muscle. Postoperative assessments, including serial measurements of serum calcium and parathyroid hormone levels, revealed a transient drop in two patients with overall correspondence to indocyanine green evaluation.</p><p><strong>Conclusion: </strong>These findings suggest that ICG angiographic imaging is a valuable adjunct in thyroid surgery, potentially reducing the risk of hypocalcemia by optimizing parathyroid preservation. Further studies are needed to standardize the technique and the evaluation score to confirm preliminary results on definitive hypoparathyroidism.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12668367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661569","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}
引用次数: 0
Learning Curve in Robotic Colorectal Surgery. 机器人结直肠手术的学习曲线。
IF 1.8 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2025-10-01 Epub Date: 2025-11-03 DOI: 10.4293/JSLS.2025.00077
Antarip Bhattacharya, Supratim Bhattacharyya, Prosenjit Das
{"title":"Learning Curve in Robotic Colorectal Surgery.","authors":"Antarip Bhattacharya, Supratim Bhattacharyya, Prosenjit Das","doi":"10.4293/JSLS.2025.00077","DOIUrl":"10.4293/JSLS.2025.00077","url":null,"abstract":"<p><strong>Background and objectives: </strong>Robotic platforms are increasingly employed in colorectal surgery for their technical and ergonomic benefits. However, surgeons face a significant learning curve, and there is no standardized definition or threshold to proficiency. This systematic review aimed to evaluate published evidence on learning curves in robotic colorectal surgery, focusing on proficiency thresholds, analytic methodologies, and the effect of experience on clinical and oncological outcomes.</p><p><strong>Methods: </strong>A systematic literature search of PubMed was performed through April 7, 2025. Studies reporting learning curve data for robotic colorectal procedures were included. Screening and selection were conducted using Rayyan. Extracted data included operative time, case numbers to proficiency, conversion and complication rates, and oncological metrics. Study quality was assessed using the Newcastle-Ottawa Scale. A narrative synthesis was undertaken due to heterogeneity in study design and outcomes.</p><p><strong>Results: </strong>Nineteen studies met inclusion criteria. The number of cases required to reach proficiency ranged from 15-55, with operative time being the most analyzed parameter. CUSUM and RA-CUSUM were the predominant analytic methods. Improved outcomes such as reduced complications, lower conversion rates, and enhanced oncological quality were generally observed in the post-proficiency phase. Variability in learning curve definitions and analytic approaches was significant across studies.</p><p><strong>Conclusion: </strong>Robotic colorectal surgery involves a measurable learning curve that impacts both technical and patient-centered outcomes. While most studies demonstrate improved metrics with experience, the lack of standardized methodology limits cross-study comparisons. Structured training pathways and consensus on learning curve analysis are needed to support safe adoption and credentialing in robotic colorectal surgery.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12668378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145660989","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}
引用次数: 0
Efficiency and Diagnostic Utility of CO2 Cystoscopy After Laparoscopic Gynecologic Surgery. 妇科腹腔镜手术后CO2膀胱镜检查的效率和诊断价值。
IF 1.8 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2025-10-01 Epub Date: 2025-10-31 DOI: 10.4293/JSLS.2025.00094
Abdurrahman Hamdi İnan, Ahkam Göksel Kanmaz, Sercan Kantarcı, Alaattin Karabulut, Orcun Celik, Emrah Töz
{"title":"Efficiency and Diagnostic Utility of CO<sub>2</sub> Cystoscopy After Laparoscopic Gynecologic Surgery.","authors":"Abdurrahman Hamdi İnan, Ahkam Göksel Kanmaz, Sercan Kantarcı, Alaattin Karabulut, Orcun Celik, Emrah Töz","doi":"10.4293/JSLS.2025.00094","DOIUrl":"10.4293/JSLS.2025.00094","url":null,"abstract":"<p><strong>Background and objectives: </strong>This study aimed to compare the efficiency and diagnostic performance of carbon dioxide (CO<sub>2</sub>) versus saline as a distension medium during routine cystoscopy performed after laparoscopic gynecologic surgery.</p><p><strong>Methods: </strong>We conducted a prospective, comparative study involving patients undergoing total laparoscopic hysterectomy for benign indications. Participants were randomly assigned to undergo diagnostic cystoscopy using either CO<sub>2</sub> or saline for bladder distension. Primary outcomes included total cystoscopy duration and time to visualize bilateral ureteral jets. Secondary outcomes were intraoperative detection rates of lower urinary tract injuries and any postoperative urinary complications.</p><p><strong>Results: </strong>A total of 529 patients were included (CO<sub>2</sub> group: 270; 51.1%; saline group: 259; 48.9%). Cystoscopy duration was significantly shorter in the CO<sub>2</sub> group compared to the saline group (150 vs 120 seconds; <i>P</i> < .001). Time to visualize ureteral jets was also reduced in the CO<sub>2</sub> group (43 seconds; <i>P</i> < .001). One bladder injury and 1 ureteral obstruction were identified intraoperatively and successfully repaired in the same surgical session. The use of CO<sub>2</sub> eliminated the need for diuretics or chromatic dyes, streamlining the diagnostic process and potentially reducing costs.</p><p><strong>Conclusion: </strong>CO<sub>2</sub> cystoscopy is a safe, efficient, and diagnostically effective alternative to conventional saline cystoscopy following gynecologic laparoscopy. Its use significantly reduces procedural time without compromising the detection of urinary tract injuries and avoids the need for additional agents such as dyes or diuretics. These findings support the integration of CO<sub>2</sub> cystoscopy into routine intraoperative surveillance protocols during minimally invasive gynecologic surgery.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"29 4","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12668374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661571","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}
引用次数: 0
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
相关产品
×
本文献相关产品
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信
小红书