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

{"title":"Thyroxine as a Parameter of Stress during Minimally Invasive Surgery.","authors":"Ervin Matovic, Samir Delibegović","doi":"10.4293/JSLS.2025.00127","DOIUrl":"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":2.0,"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}

{"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/mm² 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}

{"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}

{"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/m²) 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}

{"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}

{"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}

{"title":"Efficiency and Diagnostic Utility of CO₂ 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 (CO₂) 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 CO₂ 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 (CO₂ group: 270; 51.1%; saline group: 259; 48.9%). Cystoscopy duration was significantly shorter in the CO₂ group compared to the saline group (150 vs 120 seconds; <i>P</i> < .001). Time to visualize ureteral jets was also reduced in the CO₂ 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 CO₂ eliminated the need for diuretics or chromatic dyes, streamlining the diagnostic process and potentially reducing costs.</p><p><strong>Conclusion: </strong>CO₂ 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 CO₂ 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}

{"title":"Reproductive Outcomes After Laparoscopic Treatment of Endometriosis in Women with Infertility.","authors":"Yaas Azmoudeh, Farr R Nezhat, Sheeva Talebian, Steven Palter, Drew Tortoriello, Aliyah Ali, Esra Demirel, Meredith Akerman, Ceana Nezhat, Camran Nezhat","doi":"10.4293/JSLS.2025.00081","DOIUrl":"10.4293/JSLS.2025.00081","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of laparoscopic treatment of endometriosis on pregnancy outcomes in women with infertility, performed either before or after failed fertility enhancement technology (FET). Secondary aims included evaluating the influence of age, body mass index (BMI), prior pregnancies, endometriosis stage, and the presence of endometriomas on reproductive outcomes.</p><p><strong>Design: </strong>Retrospective cohort study of 95 women aged 18-45 with primary or secondary infertility who underwent treatment of endometriosis laparoscopically with or without robotic assistance between January 2015 and January 2023. All surgeries were performed by a single gynecologic surgeon. Patients were grouped based on whether they had prior FET failure or no prior FET. Comparisons were made between pregnant and nonpregnant patients across both groups.</p><p><strong>Main outcome measures: </strong>Postsurgical pregnancy rates (spontaneous vs assisted reproductive technology [ART]) and factors associated with pregnancy outcomes, including age, BMI, endometriosis stage, and presence of endometriomas.</p><p><strong>Results: </strong>Of 44 patients with prior failed FET, 82% conceived postsurgery, with 97% requiring ART. In the 51 patients without prior FET, 78% conceived, and 31% did so spontaneously. Younger age was significantly associated with pregnancy in the nonprior FET group (<i>P</i> = .011). Endometriosis stage did not significantly influence outcomes. Patients with endometriomas were more likely to be referred for surgery before FET.</p><p><strong>Conclusions: </strong>Laparoscopic surgery for endometriosis is associated with high pregnancy rates, regardless of prior FET status. These findings support the role of surgery as a key component in fertility management for women with endometriosis, especially prior to initiating FET.</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/PMC12668380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661179","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":"Impact of Pneumoperitoneum Pressure on Post-Cholecystectomy Pain.","authors":"Wei Lu, Shuai Yue, Jie Xie, Zhiyuan Li, Yilin Wang, Zhiming Yang, Jingcheng Hao, Weiwei Chen","doi":"10.4293/JSLS.2025.00082","DOIUrl":"10.4293/JSLS.2025.00082","url":null,"abstract":"<p><strong>Background and aims: </strong>Laparoscopic cholecystectomy (LC) often causes significant postoperative pain. While low-pressure pneumoperitoneum (8 mmHg) may reduce pain, optimal patient selection remains unclear. This trial compared pain outcomes between low-pressure (LPLC) and standard-pressure (SPLC) LC and identified predictors for pressure conversion.</p><p><strong>Methods: </strong>This prospective randomized controlled trial (June 2023 to September 2024) randomized 200 elective LC patients 1:1 to 8 or 12 mmHg groups. Postoperative pain was assessed using a facial visual analog scale at 1-72 hours and analyzed by both intention-to-treat (ITT) and per-protocol (PP) approaches. Intraoperative parameters, recovery outcomes, and biochemical markers were also compared. Risk factors for pressure conversion were analyzed using univariate/multivariate methods.</p><p><strong>Results: </strong>LPLC significantly reduced: visceral pain at 12 hours (ITT: <i>P</i> = .046, PP: <i>P</i> = .005), incisional pain at 48 hours (ITT: <i>P</i> = .017, PP: <i>P</i> = .003), postoperative aspartate aminotransferase (AST)/alanine aminotransferase (ALT) elevation (<i>P</i> < .05). Preoperative C-reactive protein (CRP) ≥12.70 mg/L predicted intraoperative conversion from 8 to 12 mmHg (odds ratio [OR] 1.053, area under the curve [AUC] = 0.704).</p><p><strong>Conclusion: </strong>The use of low-pressure pneumoperitoneum (8 mmHg) for LC significantly reduces postoperative pain and decreases the impact on liver function. LPLC demonstrates comparable safety and feasibility to SPLC. To achieve maximum benefit in patients with LC, we recommend that patients with preoperative CRP ≥12.70 mg/L carefully choose LPLC as the initial procedure.</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/PMC12668376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145661545","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":"Suturing Method Using LapraTy® Clips Is Effective for Intraoperative Bile Leaks in Laparoscopic Hepatectomy.","authors":"Masahiro Shiihara, Mitsugi Shimoda, Ryoichi Miyamoto, Shuji Suzuki","doi":"10.4293/JSLS.2025.00016","DOIUrl":"10.4293/JSLS.2025.00016","url":null,"abstract":"<p><strong>Technique: </strong>Troubleshooting unexpected complications during laparoscopic surgery demands a wealth of experience and skills. Importantly, a rapid and accurate suture technique is essential when addressing intraoperative issues such as bile leakage or bleeding. The LapraTy® suture clip, an absorbable clip that eliminates the need for ligation, has been recognized for its effectiveness. Here, we present a versatile suturing technique with LapraTy® suture clip for intraoperative accidental bile leakage (ABL). Our technique consists of 2 steps: suturing the hole of ABL using a LapraTy® suture clip and covering with the omentum.</p><p><strong>Results: </strong>The suturing technique using LapraTy® suture clip could offer rapid suture without applying excessive tension. Therefore, it is not only suitable for fragile tissues such as bile ducts but also could prevent Glissonial stenosis. Omental coverage may partly help to prevent postoperative bile leakage.</p><p><strong>Conclusion: </strong>This report highlights a closure technique utilizing LapraTy® suture clips with omental covering for ABL following Laparoscopic hepatectomy. Our findings revealed that the LapraTy® suture clip allows for suturing or anastomosis, even in emergent or difficult situations. Particularly, its advantage lies in the absence of ligation requirements, allowing for adjustable tightening without compromising tension in cases involving thickened or fragile tissues.</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/PMC12716456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145804794","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}