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

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A Pain Desensitization Algorithm for Phenotyping and Treating Chronic Pelvic Pain. 用于表型和治疗慢性盆腔疼痛的疼痛脱敏算法。
IF 1.4 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-04-01 DOI: 10.4293/JSLS.2024.00009
Liane Silva Rafael Rogério, Maurice K Chung, Charles W Butrick, Stanley J Antolak, Danniel Rocha Bevilaqua, Sunna Kureishy, Mariana Eiras Cardoso Conforto
{"title":"A Pain Desensitization Algorithm for Phenotyping and Treating Chronic Pelvic Pain.","authors":"Liane Silva Rafael Rogério, Maurice K Chung, Charles W Butrick, Stanley J Antolak, Danniel Rocha Bevilaqua, Sunna Kureishy, Mariana Eiras Cardoso Conforto","doi":"10.4293/JSLS.2024.00009","DOIUrl":"10.4293/JSLS.2024.00009","url":null,"abstract":"<p><strong>Background: </strong>Chronic pelvic pain remains challenging for physicians to manage due to central and peripheral sensitization and multiple pain generators including the bladder, pelvic floor, and pudendal nerve. Pain management providers have used nerve blocks for years for diagnosis and treatment. We developed a desensitization algorithm that provides a stepwise approach to improve patients pain scores.</p><p><strong>Methods: </strong>This is a prospective observational cohort study of 182 women aged 15-90 years old with chronic pelvic pain using an algorithm from 2016 to 2018. Treatment started with an Anesthetic Challenge Test of the bladder to guide us through a protocol of intravesical therapy and/or pudendal nerve blocks as a second step.</p><p><strong>Results: </strong>ACT POSITIVE patients, who received intravesical therapy: 84% had a Visual Analog Score pain improvement of at least 50%, 64% improved at least 80% (41% pain-free). Those desiring additional relief that received further Pudendal Blocks: 83% had final improvement of at least 50% (67% pain-free). ACT NEGATIVE patients received Pudendal Blocks with 80% of subjects achieving at least 50% relief, 65% improved at least 80% (35% pain-free). All final groups showed a statistically significance of <i>P</i> < .05% when compared to their initial pain scores.</p><p><strong>Conclusion: </strong>Management of women with chronic pelvic pain would ideally start with treating a specific diagnosis which, in most cases, is difficult to establish since the majority have more than one pain generator. Our algorithm simplified the approach and reduced the severity of pain scores prior to any further necessary surgical interventions.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290261","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
Current Status and Role of Artificial Intelligence in Anorectal Diseases and Pelvic Floor Disorders. 人工智能在肛门直肠疾病和盆底障碍中的现状和作用。
IF 1.4 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-04-01 DOI: 10.4293/JSLS.2024.00007
Maryam Aleissa, Tijani Osumah, Ernesto Drelichman, Vijay Mittal, Jasneet Bhullar
{"title":"Current Status and Role of Artificial Intelligence in Anorectal Diseases and Pelvic Floor Disorders.","authors":"Maryam Aleissa, Tijani Osumah, Ernesto Drelichman, Vijay Mittal, Jasneet Bhullar","doi":"10.4293/JSLS.2024.00007","DOIUrl":"10.4293/JSLS.2024.00007","url":null,"abstract":"<p><strong>Background: </strong>Anorectal diseases and pelvic floor disorders are prevalent among the general population. Patients may present with overlapping symptoms, delaying diagnosis, and lowering quality of life. Treating physicians encounter numerous challenges attributed to the complex nature of pelvic anatomy, limitations of diagnostic techniques, and lack of available resources. This article is an overview of the current state of artificial intelligence (AI) in tackling the difficulties of managing benign anorectal disorders and pelvic floor disorders.</p><p><strong>Methods: </strong>A systematic literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the PubMed database to identify all potentially relevant studies published from January 2000 to August 2023. Search queries were built using the following terms: AI, machine learning, deep learning, benign anorectal disease, pelvic floor disorder, fecal incontinence, obstructive defecation, anal fistula, rectal prolapse, and anorectal manometry. Malignant anorectal articles and abstracts were excluded. Data from selected articles were analyzed.</p><p><strong>Results: </strong>139 articles were found, 15 of which met our inclusion and exclusion criteria. The most common AI module was convolutional neural network. researchers were able to develop AI modules to optimize imaging studies for pelvis, fistula, and abscess anatomy, facilitated anorectal manometry interpretation, and improved high-definition anoscope use. None of the modules were validated in an external cohort.</p><p><strong>Conclusion: </strong>There is potential for AI to enhance the management of pelvic floor and benign anorectal diseases. Ongoing research necessitates the use of multidisciplinary approaches and collaboration between physicians and AI programmers to tackle pressing challenges.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442976","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
Factors Influencing CRP levels in Laparoscopic and Robotic Total Hysterectomy. 影响腹腔镜和机器人全子宫切除术 CRP 水平的因素。
IF 1.4 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-04-01 DOI: 10.4293/JSLS.2024.00005
Shohei Tanabe, Shi Yutoku, Kotaro Ichida
{"title":"Factors Influencing CRP levels in Laparoscopic and Robotic Total Hysterectomy.","authors":"Shohei Tanabe, Shi Yutoku, Kotaro Ichida","doi":"10.4293/JSLS.2024.00005","DOIUrl":"https://doi.org/10.4293/JSLS.2024.00005","url":null,"abstract":"<p><strong>Background and objectives: </strong>Patients with high postoperative C-reactive protein levels are known to have a high risk of complications such as intestinal injuries than those with low levels. However, the factors that influence postoperative C-reactive protein levels in patients without complications are unknown. In this study, we aimed to determine the factors affecting postoperative C-reactive protein levels in patients undergoing laparoscopic and robotic total hysterectomy.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of patients who had undergone laparoscopic or robotic total hysterectomy for uterine fibroids, adenomyosis, or cervical neoplasia.</p><p><strong>Results: </strong>The study was conducted between July 2016 and December 2022 at our hospital. In total, 185 patients underwent laparoscopic or robotic total hysterectomy during the relevant period. Of these, 180 patients were included, excluding 3 who underwent laparotomy, 1 who developed an abscess, and 1 who did not have a postoperative blood draw. The measured outcome was the C-reactive protein level on the first postoperative day. Patient age, body mass index, operative time, blood loss, and uterine weight were deemed the possible influencing factors. Multiple regression analysis was performed to evaluate the influence of these factors on the postoperative C-reactive protein values. Statistical significance was defined as a <i>P</i> value less than .05. The median value was 1.72 (interquartile range, 1.11-2.52). Body mass index and operative time were determined to be the most significant factors.</p><p><strong>Conclusion: </strong>Patients' body mass index and operative time were found to be associated with first postoperative day C-reactive protein levels in uncomplicated cases.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290262","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 Sling Technique for Laparoscopic Liver Mobilization. 腹腔镜肝脏移动吊带技术。
IF 1.4 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-04-01 DOI: 10.4293/JSLS.2024.00011
Andrew N de la Torre, Justin Adibi, Zaineb Zubair
{"title":"The Sling Technique for Laparoscopic Liver Mobilization.","authors":"Andrew N de la Torre, Justin Adibi, Zaineb Zubair","doi":"10.4293/JSLS.2024.00011","DOIUrl":"https://doi.org/10.4293/JSLS.2024.00011","url":null,"abstract":"<p><strong>Background: </strong>As liver surgery continues to evolve, be it open, laparoscopic or robotic, it remains a procedure that can deteriorate in the blink of an eye. Liver surgery in patients with hepatoma is further complicated, as the vast majority have significant fibrosis, if not cirrhosis. Thus, parenchymal sparing resection is increasingly necessary. Effective and safe intracorporeal mobilization of the liver is essential for minimal access parenchymal-sparing and conventional resection.</p><p><strong>Methods: </strong>This retrospective review of over 150 cases performed provides a hands-on approach to laparoscopic hepatic mobilization with the use of an inexpensive technique using a 1\" packing tape to \"Sling\" the liver in-order to divide the ligaments holding the liver in place and optimally position the liver for parenchymal transection.</p><p><strong>Results: </strong>Use of a 1\" packing tape to \"Sling\" the liver intracorporeally is demonstrated to enable mobilization of the liver for tissue sparing non-anatomic, anatomic and major resections.</p><p><strong>Conclusion: </strong>Use of a 1\" packing tape to \"Sling\" the liver intracorporeally can facilitate mobilization for resection. Surgeons hoping to master minimal access resection should also be well versed in the use of laparoscopic ultrasound and liver transplant \"Piggyback\" technique.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290263","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
Comparative Analysis of Hemostasis and Staple-Line Integrity between Medtronic Tri-StapleTM with Preloaded Buttress Material and the AEONTM Stapler in Bariatric Surgery. 美敦力Tri-StapleTM预装对接材料和AEONTM缝合器在减肥手术中止血和缝合线完整性的比较分析。
IF 1.4 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-04-01 DOI: 10.4293/JSLS.2023.00058
Gabrielle Hogan, Ravi Rao, Aditya Rao, Faran Talebi
{"title":"Comparative Analysis of Hemostasis and Staple-Line Integrity between Medtronic Tri-Staple<sup>TM</sup> with Preloaded Buttress Material and the AEON<sup>TM</sup> Stapler in Bariatric Surgery.","authors":"Gabrielle Hogan, Ravi Rao, Aditya Rao, Faran Talebi","doi":"10.4293/JSLS.2023.00058","DOIUrl":"10.4293/JSLS.2023.00058","url":null,"abstract":"<p><strong>Background and objectives: </strong>Haemostasis-related complications associated with Medtronic Tri-staple<sup>TM</sup> with preloaded buttress material and the novel, naked AEON<sup>TM</sup> gastrointestinal staplers have not been extensively studied in bariatric surgery. The study aimed to assess and compare the 30-day haemostasis-related complications between Medtronic Tri-staple<sup>TM</sup> and AEON<sup>TM</sup> GIA staplers.</p><p><strong>Methods: </strong>A retrospective analysis was performed on data from patients who underwent primary or revision sleeve gastrectomy (SG) or the sleeve component of single anastomosis duodeno-ileal bypass with SG (SADI-S) in a private hospital in Australia between November 2021 and December 2022. The surgeries were performed by a single surgeon, using either Medtronic Tri-staple<sup>TM</sup> or AEON<sup>TM</sup> staplers.</p><p><strong>Results: </strong>The analysis included 250 patients, with the first 125 consecutive patients receiving staple line using the Medtronic Tri-staple<sup>TM</sup> GIA stapler and the subsequent 125 patients receiving staple line using the AEON<sup>TM</sup> GIA stapler. Statistical analysis revealed no significant differences in the distribution of surgical procedures between the Medtronic and AEON groups. In the AEON group, there were statistically higher numbers of diabetics and former tobacco users, while other preoperative characteristics did not significantly differ between the two groups. The AEON group had a significantly longer mean operative time, while the length of hospital stay was significantly shorter. No intraoperative or 30-day complications, deaths, emergency room visits, readmissions, or reoperations were observed in either group.</p><p><strong>Conclusion: </strong>The novel, naked AEON<sup>TM</sup> stapler demonstrated non-inferiority to the established Medtronic Tri-Staple<sup>TM</sup> with preloaded buttress material in achieving hemostasis and maintaining staple-line integrity in bariatric surgery.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 2","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11189025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442975","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
Limitations in Medical Research: Recognition, Influence, and Warning. 医学研究的局限性:认识、影响和警告。
IF 1.5 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-01-01 DOI: 10.4293/JSLS.2023.00049
Douglas E Ott
{"title":"Limitations in Medical Research: Recognition, Influence, and Warning.","authors":"Douglas E Ott","doi":"10.4293/JSLS.2023.00049","DOIUrl":"https://doi.org/10.4293/JSLS.2023.00049","url":null,"abstract":"<p><strong>Background: </strong>As the number of limitations increases in a medical research article, their consequences multiply and the validity of findings decreases. How often do limitations occur in a medical article? What are the implications of limitation interaction? How often are the conclusions hedged in their explanation?</p><p><strong>Objective: </strong>To identify the number, type, and frequency of limitations and words used to describe conclusion(s) in medical research articles.</p><p><strong>Methods: </strong>Search, analysis, and evaluation of open access research articles from 2021 and 2022 from the <i>Journal of the Society of Laparoscopic and Robotic Surgery</i> and 2022 <i>Surgical Endoscopy</i> for type(s) of limitation(s) admitted to by author(s) and the number of times they occurred. Limitations not admitted to were found, obvious, and not claimed. An automated text analysis was performed for hedging words in conclusion statements. A limitation index score is proposed to gauge the validity of statements and conclusions as the number of limitations increases.</p><p><strong>Results: </strong>A total of 298 articles were reviewed and analyzed, finding 1,764 limitations. Four articles had no limitations. The average was between 3.7% and 6.9% per article. Hedging, weasel words and words of estimative probability description was found in 95.6% of the conclusions.</p><p><strong>Conclusions: </strong>Limitations and their number matter. The greater the number of limitations and ramifications of their effects, the more outcomes and conclusions are affected. Wording ambiguity using hedging or weasel words shows that limitations affect the uncertainty of claims. The limitation index scoring method shows the diminished validity of finding(s) and conclusion(s).</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10882193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972463","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
Laparoscopic-Assisted Transvaginal Cholecystectomy - the US Military Experience With Long-Term Follow Up. 腹腔镜辅助经阴道胆囊切除术--美国军队的长期随访经验。
IF 1.5 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-01-01 DOI: 10.4293/JSLS.2023.00059
Carolyn Judge, Jesse Bandle, Andrew Wang, Kyle Gadbois, Amanda Simsiman, Robin Wood, Gordon Wisbach
{"title":"Laparoscopic-Assisted Transvaginal Cholecystectomy - the US Military Experience With Long-Term Follow Up.","authors":"Carolyn Judge, Jesse Bandle, Andrew Wang, Kyle Gadbois, Amanda Simsiman, Robin Wood, Gordon Wisbach","doi":"10.4293/JSLS.2023.00059","DOIUrl":"10.4293/JSLS.2023.00059","url":null,"abstract":"<p><strong>Objectives: </strong>We present our initial clinical experience applying Natural Orifice Transluminal Endoscopic Surgical (NOTES) technique to perform cholecystectomy in ten patients at a military institution.</p><p><strong>Methods: </strong>A posterior colpotomy was created to accommodate a single site working port used to facilitate dissection and gallbladder mobilization under direct visualization via an infraumbilical port. The specimen was retrieved through the vagina and the colpotomy was closed with absorbable suture under direct visualization. Long-term follow up was performed over the phone to assess quality of life with 2 widely used health-related quality of life (HRQoL) surveys including RAND-36 Health Item Survey (Version 1.0),<sup>1</sup> and the Female Sexual Function Index (FSFI).<sup>2</sup>.</p><p><strong>Results: </strong>Ten women underwent a laparoscopic-assisted transvaginal cholecystectomy (TVC) with 7 available for long-term follow-up. The average age was 28.9 years (20-37) and the indications for surgery included symptomatic cholelithiasis (9) and biliary dyskinesia (1). The mean operative time was 129 mins (95-180), and median blood loss was 34 ml (5-400). There were no conversions and the average length of stay was 9.98 hours (2.4-28.8). Pain (analogue scale 1-10) on postoperative day three was minimal (mean 2.3) and was limited to the infraumbilical incision. On average patients returned to work by postoperative day six and resumed normal daily activities at seven days. Immediate postoperative complications included one incident of postoperative urinary retention requiring bladder catheterization. One intra-operative cholangiogram was successfully performed due to elevated preoperative liver enzymes without significant findings. Long-term complications included one asymptomatic incisional hernia repair at the infraumbilical port site. The RAND-36 survey demonstrated an average physical and mental health summary score of 82.2 and 63.7 with an average general health score of 63.6. The average FSFI total score was 21.8.</p><p><strong>Conclusion: </strong>TVC is safe and effective. Implementation may improve operational readiness by returning service members to normal activities more expeditiously than conventional laparoscopy.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336178","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
Artificial Intelligence and Scientific Publication. 人工智能与科学出版。
IF 1.5 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-01-01 DOI: 10.4293/JSLS.2024.00006
Michael S Kavic, Raymond J Lanzafame
{"title":"Artificial Intelligence and Scientific Publication.","authors":"Michael S Kavic, Raymond J Lanzafame","doi":"10.4293/JSLS.2024.00006","DOIUrl":"10.4293/JSLS.2024.00006","url":null,"abstract":"","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336094","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
Bilateral Spigelian Hernias Robotic Repair: A Novel Approach to a Rare Surgical Entity. 双侧斯皮格疝机器人修复术:罕见手术实体的新方法。
IF 1.5 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-01-01 DOI: 10.4293/JSLS.2023.00055
Jaime A Aponte-Ortiz, Isabel Mayorga Pérez, Luis Alamo Irizarry, Josean M Rosado Rivera, Jose E Romero Gines, Jorge Pelet-Mejías
{"title":"Bilateral Spigelian Hernias Robotic Repair: A Novel Approach to a Rare Surgical Entity.","authors":"Jaime A Aponte-Ortiz, Isabel Mayorga Pérez, Luis Alamo Irizarry, Josean M Rosado Rivera, Jose E Romero Gines, Jorge Pelet-Mejías","doi":"10.4293/JSLS.2023.00055","DOIUrl":"10.4293/JSLS.2023.00055","url":null,"abstract":"<p><p>Spigelian hernias are an uncommon protrusion defect noted between the rectus abdominis and the transversus abdominis muscles, at the semilunar line, with a low incidence of approximately 0.12% to 2% of all ventral hernias. Furthermore, the incidence of bilateral cases is noted to be even lower in the general population. They are associated with bowel incarceration and strangulation; hence surgical repair is indicated. Therapeutic alternatives for Spigelian hernias include open repair, however laparoscopic repair stands as the standard of care in these cases. Feasible and successful robotic repair has been reported, with associated advantages in terms of visualization and surgical instrument dexterity. We present the first ever reported cases of bilateral Spigelian hernias repaired using robotic approach. Two female Puerto Rican patients referred to our institution complaining of abdominal pain, where imaging studies found bilateral Spigelian hernias. In both cases, a transabdominal preperitoneal repair was performed using the Da Vinci Surgical System. Both patients were discharged home tolerating oral intake with adequate wound healing. On follow up visits, patients denied abdominal discomfort and had adequate wound healing. Robotic surgery for Spigelian hernias poses an advantage over laparoscopic repair as improved visualization, mobility, and precision in movements allow for more gentle tissue manipulation. Furthermore, this is the first evidence of safe and effective repair in the uncommon entity of bilateral cases, providing a newer alternative in the setting of such presentation.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10984373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336176","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
Early Experience with the Senhance Surgical System in Bariatric Surgery. 减肥手术中使用 Senhance 手术系统的早期经验。
IF 1.5 4区 医学
JSLS : Journal of the Society of Laparoendoscopic Surgeons Pub Date : 2024-01-01 DOI: 10.4293/JSLS.2023.00031
Tuan Tran, Francisco Irizarry, Shreya Gunda, Denise Danos, Michael Cook
{"title":"Early Experience with the Senhance Surgical System in Bariatric Surgery.","authors":"Tuan Tran, Francisco Irizarry, Shreya Gunda, Denise Danos, Michael Cook","doi":"10.4293/JSLS.2023.00031","DOIUrl":"https://doi.org/10.4293/JSLS.2023.00031","url":null,"abstract":"<p><strong>Background and objectives: </strong>Robotic-assisted surgery advancements have paralleled growing bariatric surgery demands. The Senhance robotic platform offers an alternative to the da Vinci surgical system but there are limited studies evaluating the Senhance system in bariatric surgery. This study aims to review a single surgeon's experience comparing outcomes between traditional laparoscopic and Senhance-assisted sleeve gastrectomy.</p><p><strong>Materials and methods: </strong>All sleeve gastrectomies performed laparoscopically, Senhance-assisted, or da Vinci-assisted by a single surgeon at an academic center from January 2019 to July 2021 were retrospectively reviewed. Primary outcomes and quality measures were 30-day complications, operative times and length of stay.</p><p><strong>Results: </strong>A total of 268 patients, including 162 laparoscopic, 92 Senhance, and 14 da Vinci cases, were included. Operative times were significantly longer with Senhance (115.7 min) and da Vinci (122.7 min), compared to laparoscopic (94.8 min, <i>P</i> < .0001). Length of stay (measured in days) was significantly longer in the Senhance (1.8) and da Vinci (2.2) groups compared to laparoscopic cases (1.5, <i>P</i> < .0001). These differences remained significant after controlling for age, sex and body mass index. 30-day complication rates were 8.7% (n = 8) in the Senhance group, 7.1% (n = 1) in the da Vinci group and 2.5% (n = 4) in the laparoscopic group (<i>P</i> = .0567).</p><p><strong>Conclusion: </strong>Senhance-assisted sleeve gastrectomy is safe in bariatric surgery and comparable to laparoscopic sleeve gastrectomy with respect to 30-day complications.</p>","PeriodicalId":17679,"journal":{"name":"JSLS : Journal of the Society of Laparoendoscopic Surgeons","volume":"28 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10882192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972462","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}
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