JSLS : Journal of the Society of Laparoendoscopic Surgeons最新文献_第5页

Resident Satisfaction with Laparoscopic Training in Saudi Arabia. 沙特阿拉伯居民对腹腔镜培训的满意度。

IF 2 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2026-04-01 Epub Date: 2026-05-07 DOI: 10.4293/JSLS.2026.00005

Rashad M Nassar, Faris M Allaf, Mohammed M Abualgasem, Hatan K Alghamdi, Mohammad S Almosa, Rayan Alqarni, Hisham M Ghabbani, Hossam S El-Tholoth, Ahmed Y Alzahrani, Abdulrahman F Alruwaily

{"title":"Resident Satisfaction with Laparoscopic Training in Saudi Arabia.","authors":"Rashad M Nassar, Faris M Allaf, Mohammed M Abualgasem, Hatan K Alghamdi, Mohammad S Almosa, Rayan Alqarni, Hisham M Ghabbani, Hossam S El-Tholoth, Ahmed Y Alzahrani, Abdulrahman F Alruwaily","doi":"10.4293/JSLS.2026.00005","DOIUrl":"10.4293/JSLS.2026.00005","url":null,"abstract":"Background and objectives: Resident satisfaction with laparoscopic training is a proxy for program quality, yet national data from Saudi Arabia are limited. We assessed satisfaction and its relationship with self-rated laparoscopic skill among surgical residents.Methods: We conducted a cross-sectional questionnaire study (January-June 2025) across training centers in Saudi Arabia including residents in general surgery, obstetrics and gynecology, pediatric surgery, and urology. A composite skills score (0-25; tissue handling, autonomy, bimanual dexterity, depth perception, suturing) was calculated; internal consistency was evaluated. Associations between skills and trainee factors were tested using t-tests and analysis of variance with post hoc comparisons (two-sided, significance set at 0.05).Results: Among 203 residents, self-rated ability clustered at intermediate levels, with suturing the weakest domain. Higher composite scores were associated with seniority, more frequent exposure (at least twice weekly), overall program satisfaction, and operative confidence. Sex, region, hospital type, and simple simulator access showed no association.Conclusion: In this national cohort, self-rated laparoscopic skill was intermediate with a clear suturing gap. Skills tracked with practice frequency and learner confidence and satisfaction, rather than mere access to equipment. Programs should embed protected, twice-weekly, proficiency-based practice with coaching and objective assessment to accelerate autonomy and standardize competence.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868886","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

The Sakarya Technique for Safer Laparoscopic Access. Sakarya技术用于更安全的腹腔镜访问。

IF 2 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2026-04-01 Epub Date: 2026-04-06 DOI: 10.4293/JSLS.2026.00004

Deniz Gul, Haci Ibrahim Cimen, Esat Unal, Anıl Erdik, Yavuz Tarik Atik, Recep Burak Degirmentepe, Bayram Dogan, Hasan Salih Saglam

{"title":"The Sakarya Technique for Safer Laparoscopic Access.","authors":"Deniz Gul, Haci Ibrahim Cimen, Esat Unal, Anıl Erdik, Yavuz Tarik Atik, Recep Burak Degirmentepe, Bayram Dogan, Hasan Salih Saglam","doi":"10.4293/JSLS.2026.00004","DOIUrl":"10.4293/JSLS.2026.00004","url":null,"abstract":"Background: Abdominal access is the crucial step for laparoscopic surgery, and there is no consensus for the ideal technique for initial trocar placement. We aim to introduce our new technique used for safe initial entry to create pneumoperitoneum in transabdominal laparoscopic surgery and compare it with the Veress needle technique.Methods: We retrospectively reviewed 317 consecutive patients who underwent urological laparoscopic surgery between January 2016 and January 2025. For the initial trocar insertion, 98 patients with the Veress needle technique and 182 patients with our Sakarya technique were included in the study. All procedures were performed by a single experienced surgeon. Patients' characteristics, time from skin incision to camera entry, gas leakage, and complications were recorded.Results: The median age was 58 years (interquartile range [IQR]: 45-66), the median body mass index (BMI) was 27.68 (25.06-29.96), and 128 (40.4%) of patients were female. In our Sakarya technique, no major vascular complications were observed, but renal cyst rupture occurred in one patient, and the gas leakage rate was 5.5%. No significant difference was found in complications and gas leakage rates between the Sakarya technique and the Veress needle technique (P > .05). The time from skin incision to camera entry was 27 seconds (IQR: 23-32) with the Sakarya technique, significantly less than the 105 seconds (IQR: 96-124) with the Veress needle technique (P < .001).Conclusions: The Sakarya technique is an easy, safe, and fast method for initial trocar insertion in laparoscopic surgery.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775367","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

Long-Term Outcomes and Safety of Robotic Bariatric Surgery. 机器人减肥手术的长期疗效和安全性。

IF 2 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2026-04-01 Epub Date: 2026-05-04 DOI: 10.4293/JSLS.2026.00011

Vivek Bindal, Dhananjay Pandey, Vijay S Pandey, Amir Iqbal, Aakash Patel, Lakshay Goel, Deepak Kumar

{"title":"Long-Term Outcomes and Safety of Robotic Bariatric Surgery.","authors":"Vivek Bindal, Dhananjay Pandey, Vijay S Pandey, Amir Iqbal, Aakash Patel, Lakshay Goel, Deepak Kumar","doi":"10.4293/JSLS.2026.00011","DOIUrl":"10.4293/JSLS.2026.00011","url":null,"abstract":"Background: Bariatric surgery (BS) is the most effective treatment for sustained weight loss and improvement of obesity-related comorbidities. Robotic BS (RBS) offers enhanced precision and ergonomics; however, local data remain limited.Methods: This retrospective real-world study included consecutive adults (≥18 years) who underwent single-surgeon robotic-assisted primary BS using the da Vinci® Surgical System (October 2012-December 2024), with complete perioperative and follow-up data.Results: A total of 545 patients were analyzed with a mean age of 42.98 ± 11.15 years and a mean body mass index (BMI) of 44.55 ± 6.66 kg/m2). Sleeve gastrectomy (SG) was the most common procedure (72.48%), followed by Roux-en-Y gastric bypass (RYGB, 17.61%) and one-anastomosis gastric bypass (OAGB, 9.91%). Mean docking and operative times were 6.25 ± 2.29 and 99.84 ± 29.21 minutes, respectively. Intraoperative events were infrequent (console-related 2.57%, bedside-related 4.04%, instrument-related 3.12%), with no conversions. Mean intensive care unit (ICU) and hospital stays were 0.25 ± 0.45 and 2.42 ± 0.56 days. Thirty-day complications occurred in 2.02% of patients, comprising grade I (1.10%), grade II (0.73%), and grade III (0.18%) events. Between 1 month and 1 year, 1.28% experienced minor (grade I) complications. At 1 year, mean BMI decreased to 32.68 ± 4.02 kg/m2, with no mortality. Outcomes in patients with BMI ≥ 50 kg/m2 were comparable, supporting the safety and feasibility of RBS in grade IV obesity.Conclusions: RBS proved safe, efficient, and effective, with low complications and consistent outcomes, supporting its use for obesity management in high-volume centers.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839773","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

Pancreatic Fistula after Distal Pancreatectomy with Stapler. 吻合器胰远端切除术后胰瘘的研究。

IF 2 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2026-04-01 Epub Date: 2026-05-07 DOI: 10.4293/JSLS.2026.00006

Wen Yao Yin, Chun Ming Chang, Guo-Fang Tseng

{"title":"Pancreatic Fistula after Distal Pancreatectomy with Stapler.","authors":"Wen Yao Yin, Chun Ming Chang, Guo-Fang Tseng","doi":"10.4293/JSLS.2026.00006","DOIUrl":"10.4293/JSLS.2026.00006","url":null,"abstract":"Objective: To identify a distal pancreatectomy (DP) surgical procedure with a low risk for fistula.Summary background data: Common use of computed tomography (CT) increases detection of pancreatic lesions early or incidentally.Methods: We retrospectively analyzed data from 63 patients with DP between 2000 and 2021. Fifty-three patients were diagnosed with tumors and 10 without. The pancreatic thickness at the resection site was measured on CT before surgery. We compared the postoperative outcomes of patients with and without postoperative pancreatic fistula (POPF).Results: Twenty-six patients (41%) were male, and the mean age was 54 ± 15 years. Patients with severe POPF had poorer outcomes, including severe complications, readmission, resurgery, and longer hospital stays than did those without (P ≤ .05). The pancreas thickness cutoff for discriminating severe pancreatic fistula was 13.2 mm, with an area under the curve of 71.4% (95% confidence interval [CI], 56.0-86.7%). Multivariable analysis showed that a thickness >13.2 mm (odds ratio [OR], 11.11; 95% CI, 1.92-64.12), more recent surgery (OR, 5.86; 95% CI, 1.29-26.51), and use of suture only (OR, 5; 95% CI, 1.12-20) were significantly associated with severe POPF.Conclusions: DP has a high leakage rate, with some morbidity and mortality. DP thickness >13.2 mm was associated with a higher risk of POPF. Gastrointestinal anastomosis stapling, especially using the double clamping technique, is safe and results in less POPF, as shown in both clinical and cadaveric studies.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868842","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

Surgical Treatment Experience of Intestinal Endometriosis. 肠道子宫内膜异位症的手术治疗体会。

IF 2 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2026-04-01 Epub Date: 2026-06-01 DOI: 10.4293/JSLS.2025.00113

Henry Octavio Rodríguez, Javier Alejandro Garcia Salazar, Diana Carolina Andrade Rodriguez, Milena Gomez, María Camila Restrepo

{"title":"Surgical Treatment Experience of Intestinal Endometriosis.","authors":"Henry Octavio Rodríguez, Javier Alejandro Garcia Salazar, Diana Carolina Andrade Rodriguez, Milena Gomez, María Camila Restrepo","doi":"10.4293/JSLS.2025.00113","DOIUrl":"10.4293/JSLS.2025.00113","url":null,"abstract":"Study design: Retrospective descriptive cohort.Population: Patients who underwent endometriosis resection with colorectal intervention between January 2019 and December 2023. A total of 36 patients met the inclusion criteria at San José Hospital, Bogotá, Colombia.Objectives: To describe the demographic and clinical characteristics, surgical procedures, and intra- and postoperative complications.Main results: Ten patients (27.7%) presented gastrointestinal symptoms that were not associated with lesion size. Six patients (16.6%) had positive findings on physical examination, whereas abnormal imaging results were documented in 25 patients (69.4%). Lesions were most frequently located in the rectum (91.6%), followed by the sigmoid colon, appendix, and cecum. More than half of the lesions (52%) measured less than 3 cm. The intraoperative complication rate was 13.9%, and postoperative complications occurred in 16.7% of cases.Conclusion: The management of intestinal endometriosis requires a multidisciplinary approach involving expert gynecological endoscopists in collaboration with colorectal surgeons to minimize complications. Our findings highlight the importance of individualized surgical strategies, with a focus on fertility preservation whenever possible.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13224333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150045","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

Direct Vision Entry with Integrated Insufflation. 直接视觉入口与集成的充气。

IF 2 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2026-04-01 Epub Date: 2026-05-07 DOI: 10.4293/JSLS.2025.00129

Colton J Bohonos, Patrick M Collins, Lucy O'Gorman, Ibrahim Haidaran, Derek B Hennessey

{"title":"Direct Vision Entry with Integrated Insufflation.","authors":"Colton J Bohonos, Patrick M Collins, Lucy O'Gorman, Ibrahim Haidaran, Derek B Hennessey","doi":"10.4293/JSLS.2025.00129","DOIUrl":"10.4293/JSLS.2025.00129","url":null,"abstract":"Introduction: The Veress and Hasson methods for establishing a pneumoperitoneum for laparoscopic surgery have recognized limitations and risks. The use of a direct vision entry port with insufflation, however, is less widely described. This study aimed to assess the success, safety, and efficiency of this technique.Methods: The Kii Fios First Entry system was used in 100 consecutive cases of renal surgery. The camera is placed within the trocar and advanced under direct vision through the abdominal wall layers with simultaneous insufflation. Patient body mass index (BMI), time to pneumoperitoneum, and complications were recorded.Results: The cohort consisted of 59% females, a mean BMI of 31.2 kg/m2, and 19% with a history of previous abdominal surgery. The primary indications were pelvic ureteric junction obstruction (49%) and nonfunctioning kidney (26%). The mean time to pneumoperitoneum was 29.4 seconds (range 5-180 seconds). First-attempt success occurred in 90 cases, with 10 cases requiring more than one attempt. Entries were performed by consultants (65%) and by trainees (35%). When stratified by operator grade, there was no significant difference in entry time between consultants and trainees (median 25 vs 26 seconds; Mann-Whitney P = .35) or in first-attempt success rates. Prior abdominal surgery did not affect the success rate of the first attempt. BMI group (<30 vs ≥30) and American Society of Anesthesiologists (ASA) grade were also not associated with success.Conclusion: The Kii Fios First Entry system represents a safe, easy, and inexpensive alternative for establishing pneumoperitoneum in laparoscopic surgery, with very short entry times in this series.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868868","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

Thoracoscopic Intrathoracic Double-Flap Technique for EGJC. 胸腔镜胸内双瓣技术治疗EGJC。

IF 2 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2026-04-01 Epub Date: 2026-06-10 DOI: 10.4293/JSLS.2026.00035

Takeshi Ono, Yorito Tamaki, Takano Ohta, Keigo Hayashi, Tomofumi Orokawa, Hiroki Sunagawa

{"title":"Thoracoscopic Intrathoracic Double-Flap Technique for EGJC.","authors":"Takeshi Ono, Yorito Tamaki, Takano Ohta, Keigo Hayashi, Tomofumi Orokawa, Hiroki Sunagawa","doi":"10.4293/JSLS.2026.00035","DOIUrl":"10.4293/JSLS.2026.00035","url":null,"abstract":"Background: Valvuloplastic esophagogastrostomy using the double-flap technique (DFT) after proximal gastrectomy and lower esophagectomy for esophagogastric junction cancer (EGJC) is effective for reflux prevention and has a low anastomotic leakage rate, making it suitable for mediastinal reconstruction. When the transhiatal approach becomes difficult, intrathoracic reconstruction provides a safer option. Although several reports have described robot-assisted intrathoracic DFT, thoracoscopic intrathoracic DFT has been reported only in isolated cases, and its technical feasibility and reproducibility have not been evaluated as a case series.Methods: We present a consecutive six-patient case series of thoracoscopic intrathoracic DFT following laparoscopic proximal gastrectomy and lower esophagectomy. After preparation of a seromuscular flap, the remnant stomach was elevated into the thoracic cavity without torsion. The posterior esophageal wall was fixed to the flap using a single barbed suture placed in a continuous fashion with four bites, followed by 90° rotation of the esophagogastric axis to bring the anastomotic site into direct view. A full-circumference hand-sewn esophagogastrostomy using single-knot sutures was then completed, and the flap was closed.Results: All procedures were completed thoracoscopically without conversion. The median reconstruction time was 78 minutes, and no anastomosis-related complications were observed.Conclusions: This case series demonstrates the technical feasibility and reproducibility of thoracoscopic intrathoracic DFT for mediastinal esophagogastrostomy. Standardized exposure using posterior fixation and 90° rotation allows stable intracavitary suturing and supports the safe application of this valve-forming reconstruction in the thoracic cavity.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13251314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148226345","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

Correspondence on. Effect of Drains on Complications in Laparoscopic Repair of Unilateral Inguinal Hernia. 对应。引流管对腹腔镜单侧腹股沟疝修补术并发症的影响。

IF 2 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2026-04-01 Epub Date: 2026-04-27 DOI: 10.4293/JSLS.2026.00029

Birol Agca, Iksan Tasdelen, Kemal Memisoglu, Yalin Iscan

引用次数: 0

Elements Affecting Quality of Life in Individuals With Gastroesophagel Reflux Disease. 影响胃食管反流病患者生活质量的因素

IF 2 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2026-04-01 Epub Date: 2025-05-19 DOI: 10.4293/JSLS.2025.00091

Lingling Kong, Yulin Zheng, Yifan Cui, Mingming Zhang, Jing Guo, Xuemin Liu, Xinran Wang

{"title":"Elements Affecting Quality of Life in Individuals With Gastroesophagel Reflux Disease.","authors":"Lingling Kong, Yulin Zheng, Yifan Cui, Mingming Zhang, Jing Guo, Xuemin Liu, Xinran Wang","doi":"10.4293/JSLS.2025.00091","DOIUrl":"10.4293/JSLS.2025.00091","url":null,"abstract":"Purpose: To ascertain the paths of mental and physical life quality and the elements affecting them in individuals with gastroesophageal reflux disease (GERD) receiving fundoplication.Methods: A forward-looking cohort analysis involved 207 GERD patients, monitored before 1, 2, and 3 months following their fundoplication. The quality-of-life trajectory categories were aligned using latent class analysis. Analyses involving both single and multiple factors were conducted to identify elements that affect the quality-of-life trajectory classifications. For groups without heterogeneity, a latent growth model was used to analyze and further determine the factors affecting the intercept and slope of the trajectory.Results: Two categories of psychological quality-of-life trajectories were distinguished: the group experiencing continuous decline and the group with continuous increase. The predictive factors for the constant decline group were low levels of family support and smoking. No population heterogeneity was observed in terms of the physical quality of life, and the predictive factors for the mean trajectory intercept were sex, marital status, disease type, support outside the patient's family, sleep quality, and depression. Disease type was the only predictive factor for the trajectory slope.Conclusion: The research pinpointed 2 categories of psychological quality-of-life trajectories: those of continuous decline and those of constant increase, revealing that insufficient family support and smoking habits predict adverse trajectory categories. Early preoperative identification of these predictive factors can help identify patients at risk of adverse trajectory categories, thereby guiding their early postoperative recovery.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13185793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147982318","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

Assessing Perioperative Risk According to Surgical Route in Hysterectomy for Very Large Uteri. 根据手术路径评估超大子宫切除术围手术期风险。

IF 2 4区医学

JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2026-04-01 Epub Date: 2026-06-30 DOI: 10.4293/JSLS.2026.00024

Alison C Fitzgerald, Parmida Maghsoudlou, Shabnam Gupta, Louise P King, Jon I Einarsson, Mobolaji O Ajao

{"title":"Assessing Perioperative Risk According to Surgical Route in Hysterectomy for Very Large Uteri.","authors":"Alison C Fitzgerald, Parmida Maghsoudlou, Shabnam Gupta, Louise P King, Jon I Einarsson, Mobolaji O Ajao","doi":"10.4293/JSLS.2026.00024","DOIUrl":"10.4293/JSLS.2026.00024","url":null,"abstract":"Background and objectives: The benefits of minimally invasive hysterectomy are widely recognized. However, laparoscopic hysterectomy is more technically difficult in patients with enlarged uteri. In this study, we sought to compare surgical outcomes for patients with large uteri (greater than 1 kg) undergoing laparoscopic versus open hysterectomy.Methods: This was a retrospective cohort study performed at a tertiary-care academic center, including all patients who underwent laparoscopic or open hysterectomy for a benign indication between January 1, 2009 and December 31, 2024. The primary outcome was a composite measure of intraoperative and postoperative complications, readmissions, and reoperations.Results: A total of 509 patients underwent hysterectomy for uteri larger than 1 kg: 268 via laparotomy and 241 via laparoscopy. After controlling for confounding variables, the risk of any complication, readmission or reoperation was similar in the laparoscopy and laparotomy groups (OR 1.09 [0.68-1.77], P = .7119). Median estimated blood loss was lower in the laparoscopy group as compared to the laparotomy group (100 vs 300 mL, P < .001). Mean operative time was longer in the laparoscopy group by 24 minutes (188 vs 164 minutes, P < .001). The median length of stay was 0 days for the laparoscopy group, versus 2 days for the laparotomy group (P < .001).Discussion: Our results suggest that laparoscopic hysterectomy is feasible even for patients with uterine weight exceeding 1 kg. While operative time was longer in the laparoscopy group, this increase in operative time was not associated with an increase in perioperative complications.","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"30 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13317057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148361328","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