Minimally Invasive Therapy & Allied Technologies最新文献

{"title":"The LeakChecker: quantitative air leakage assessment in laparoscopic intestinal anastomosis training.","authors":"A Masie Rahimi, Eline Cox, Sem Hardon, H Jaap Bonjer, Freek Daams, Tim Horeman","doi":"10.1080/13645706.2026.2636109","DOIUrl":"https://doi.org/10.1080/13645706.2026.2636109","url":null,"abstract":"<p><strong>Background: </strong>Performing an intestinal anastomosis is a challenging part of laparoscopic surgery, and ensuring adequate closure is essential to prevent anastomotic leakage. The aim of this study was to develop an objective method for quantitative assessment of laparoscopic intestinal anastomosis during simulation training.</p><p><strong>Methods: </strong>A modular intraluminal air leakage device, the LeakChecker, was designed and validated by comparing laparoscopic intestinal anastomoses performed by laparoscopic novices and experts. The MaxForce, MeanNon-zero force, PathLength and DepthPerception parameters from the Lapron box-trainer vs MaxPressure and PressureArea from the LeakChecker were used for comparison.</p><p><strong>Results: </strong>A functional prototype was built and the data of 10 laparoscopic novices and seven experts were included. Anastomoses made by the experts tolerated a higher MaxPressure (3,10(2,51-7,24)kPa vs 0,98(0,81-1,35)kPa; p=0.010) and showed a higher pressureArea (24,89(16,13-100,04)kPa*t vs 5,99(4,78-9,23)kPa*t; p=0.032). The Lapron box trainer data showed significant differences between the experts and novices for almost all including force and motion parameters.</p><p><strong>Conclusion: </strong>The LeakChecker can quantify anastomotic leakage during training as it objectively distinguishes between novices and experts. Implementing this kind of smart training task in a training program with objective skill assessment would inform participants of both their instrument handing skills and the quality of their execution.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-10"},"PeriodicalIF":2.0,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147276602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence as a diagnostic support tool in hysteroscopy: current evidence and clinical implications.","authors":"Filippo Alberto Ferrari, Giorgio Bogani, Matteo Pavone, Tullio Golia D'Augè, Nicolas Bourdel, Hooman Soleymani Majd, Federico Ferrari, Marcello Ceccaroni","doi":"10.1080/13645706.2026.2635049","DOIUrl":"https://doi.org/10.1080/13645706.2026.2635049","url":null,"abstract":"<p><strong>Background: </strong>Hysteroscopy allows direct inspection of the uterine cavity for many conditions. Despite being widely adopted, its diagnostic accuracy largely depends on surgeon expertise, leading to potentially misleading diagnoses. Artificial intelligence (AI) has shown robust performance in many areas of medical imaging. The application of AI to hysteroscopy can improve diagnostic reliability and clinical decision-making.</p><p><strong>Methods: </strong>We carried out a systematic review following PRISMA guidelines to summarize current evidence on the use of AI in hysteroscopy. Eligible studies involved human subjects undergoing hysteroscopy in which AI models were applied to image or video data for diagnostic, classification, or prognostic purposes. Literature searches were conducted in PubMed, Scopus, and Web of Science up to August 2025. We extracted details on design, patient population, AI architecture, dataset characteristics, validation approach, and performance outcomes. Study quality and risk of bias were assessed with the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Fifteen studies published between 2021 and 2025 met the inclusion criteria. Applications of AI in hysteroscopy clustered around three major domains: intrauterine adhesions (IUAs), chronic endometritis (CE), and intracavitary lesions. For IUAs, predictive models demonstrated strong performance, with AUC values up to 0.99 for fertility and recurrence outcomes, highlighting the potential for AI to support tailored postoperative care. For CE, both Convolutional Neural Network-based methods and spectroscopy-assisted approaches achieved diagnostic concordance with histopathology exceeding 80-90%, suggesting that AI could potentially reduce the need for biopsy. In lesion classification, models achieved accuracies above 85% and, in some cases, outperformed gynecologists in distinguishing benign from malignant findings. Early work on real-time video analysis also demonstrated promise for intraoperative support. Overall, the quality of the studies included was moderate to high.</p><p><strong>Conclusions: </strong>AI applied to hysteroscopy shows considerable promise for enhancing diagnostic accuracy, consistency, and intraoperative decision-making. To enable translation into practice, future research should emphasize multicenter collaborations, standardized imaging protocols, external validation, and the development of explainable models that can be trusted in clinical settings.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-9"},"PeriodicalIF":2.0,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of transcervical resection of polyp combined with levonorgestrel-releasing intrauterine system in the treatment of endometrial polyps: a randomized controlled trial.","authors":"Yu-Jie Zhang, Xiao-Dong Wang, Mei Shan, Qing-Ling Lu, Ting-Ting Tian","doi":"10.1080/13645706.2025.2542329","DOIUrl":"10.1080/13645706.2025.2542329","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to compare the clinical efficacy and prognosis of transcervical resection of polyp (TCRP) combined with levonorgestrel-releasing intrauterine system (LNG-IUS) or oral desogestrel and ethinyl estradiol tablets (DET) in patients with endometrial polyps (EMP).</p><p><strong>Methods: </strong>A total of 100 EMP patients undergoing TCRP were divided into LNG-IUS (<i>n</i> = 50) and DET (<i>n</i> = 50) groups. Hemoglobin, endometrial thickness, FSH, E2, and LH levels were monitored pre-surgery and post-surgery. Clinical symptom improvement, adverse reactions, and recurrence rates were assessed over 12 months.</p><p><strong>Results: </strong>Both treatments improved hemoglobin levels and reduced endometrial thickness, but the LNG-IUS group showed superior outcomes. At 12 months, it achieved higher improvement rates for dysmenorrhea (72.0% vs. 34.0%), abnormal cycles (60.0% vs. 24.0%), and blood loss (52.0% vs. 30.0%), with fewer adverse reactions (4.0% vs. 24.0%) and a lower recurrence rate (0% vs. 16.0%, all <i>p</i> < .05).</p><p><strong>Conclusions: </strong>LNG-IUS with TCRP outperformed DET in reducing endometrial thickness, alleviating symptoms, lowering side effects, and preventing recurrence in EMP.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"34-42"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Less invasive implantation of third-generation left ventricular assist devices: a single center experience.","authors":"Antonio Spitaleri, Giuseppe Monteleone, Paola Abbà, Barbara Parrella, Guglielmo Gallone, Simone Frea, Anna Chiara Trompeo, Massimo Boffini, Mauro Rinaldi, Antonio Loforte","doi":"10.1080/13645706.2025.2597749","DOIUrl":"10.1080/13645706.2025.2597749","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates outcomes of less invasive surgery (LIS) versus full sternotomy (FS) for left ventricular assist device (LVAD) implantation.</p><p><strong>Methods: </strong>We retrospectively analyzed 115 consecutive adult patients receiving HeartMate 3 (HM3) or HeartWare (HVAD) intrapericardial centrifugal left ventricular assist device (LVAD) implantation (2010-2023) stratified by LIS vs. FS. Primary endpoint was one-year survival; secondary endpoints included right heart failure (RHF), temporary right ventricular assist device (t-RVAD) use, rethoracotomy for bleeding, driveline infection (DLI), cerebral stroke (CS), pump thrombosis (PT), gastrointestinal bleeding (GIB), and extubation time.</p><p><strong>Results: </strong>The cohort included 24 LIS and 91 FS patients. LIS patients exhibited higher pulmonary artery pressures, pulmonary vascular resistance, and tricuspid regurgitation rate, along with lower pulmonary artery compliance index (all <i>p</i> < 0.05). LIS had significantly lower cardiopulmonary bypass (CPB) use (62.5% vs. 100%), and duration (60 vs. 92.5 min), and reduced blood product utilization (all <i>p</i> < 0.05). No cases of rethoracotomy for bleeding occurred (<i>p</i> = 0.037). A trend toward lower RHF and t-RVAD use was observed. Kaplan-Meier analysis revealed no significant differences in one-year survival and LVAD-related adverse events.</p><p><strong>Conclusions: </strong>LIS showed comparable outcomes to FS, representing a potential alternative for selected LVAD recipients.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"61-71"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the learning effect for ArtiSential^® articulating laparoscopic instrument: back to the manual laparoscopic forceps.","authors":"Kenichi Ishibayashi, Hiroshi Saito, Daisuke Fujimori, Hiroto Saito, Takahisa Yamaguchi, Yoshinao Ohbatake, Koichiro Sawada, Toshikatsu Tsuji, Shiro Terai, Hirotaka Kitamura, Daisuke Yamamoto, Hideki Moriyama, Jun Kinoshita, Noriyuki Inaki","doi":"10.1080/13645706.2025.2582210","DOIUrl":"10.1080/13645706.2025.2582210","url":null,"abstract":"<p><strong>Background: </strong>Robotic systems offer the great advantage of articulation; however, high cost is a limitation. ArtiSential^® is a laparoscopic forceps that combines the advantages of low cost and articulation. This study was conducted to determine the learning effect of ArtiSential^®.</p><p><strong>Methods: </strong>Participants were divided into two groups: those who had performed >100 laparoscopic surgeries (experts) and those who had not (novices). The participants were assigned the task of peg transfer three times a day, for a total of 15 times over five days. The time spent on the task and the number of pegs that dropped during the transfer were recorded.</p><p><strong>Results: </strong>Thirty surgeons (15 experts and 15 novices) participated in the study. Both the average time and the number of pegs dropped decreased progressively with practice. The learning effect for task completion time reached a plateau after 11 tasks (<i>p</i> < 0.05). There was no significant difference between experts and novices in either the time or the number of pegs dropped.</p><p><strong>Conclusions: </strong>ArtiSential^® can be learned in a relatively short period of time and prior laparoscopic experience does not significantly affect the learning curve. Articulating forceps are inexpensive, easy to learn, and provide a valuable alternative to achieve greater freedom in surgery.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-7"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning-driven inverse design of puncture needles with tailored mechanics.","authors":"Yaozong Huang, Fan Zhang, Fanyang Zhang, Xin Wu, Yufei Xinye","doi":"10.1080/13645706.2025.2537927","DOIUrl":"10.1080/13645706.2025.2537927","url":null,"abstract":"<p><strong>Background: </strong>In minimally invasive surgery, designing puncture needles with customizable structures to achieve personalized puncture performance is a significant challenge. Existing reverse design methods struggle to capture the complex nonlinear behavior of needle-tissue interactions.</p><p><strong>Methods: </strong>This study proposes a machine-learning-based reverse design method aimed at achieving precise customization of needle mechanical behavior. We developed a rapid reverse design framework integrating machine learning and finite element analysis, capable of directly generating optimal structural parameters from target puncture force-penetration depth curves. Through training on large-scale finite element simulation data, deep learning neural network models captured the complex mapping relationship between needle structure and mechanical response.</p><p><strong>Results: </strong>In rigorous cross-validation, the prediction results showed normalized root mean square errors (NRMSE) of 0.06381 and 0.06234 compared to the target curves and finite element analysis, respectively. The model achieved 98.2% classification accuracy for curve types, with loss functions converging to optimal values after sufficient training epochs.</p><p><strong>Conclusion: </strong>This approach demonstrates high accuracy and robustness in needle-design customization. It not only opens new avenues for rapid, customized design of puncture needles but also provides an innovative paradigm for intelligent design of complex medical devices, potentially advancing precision medicine technologies and shortening design cycles.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"18-27"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaginal natural orifice transluminal endoscopic surgery versus conventional laparoscopy for salpingectomy: a comparative analysis of sexual function, dyspareunia, and perioperative outcomes.","authors":"Yaşam Kemal Akpak, Ahkam Göksel Kanmaz, Emrah Töz, Mehmet Ferdi Kıncı, Jan Baekelandt","doi":"10.1080/13645706.2025.2597755","DOIUrl":"10.1080/13645706.2025.2597755","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the clinical feasibility and perioperative outcomes of vaginal natural orifice transluminal endoscopic surgery (vNOTES) for adnexal procedures, with particular emphasis on postoperative sexual function and dyspareunia.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at İzmir City Hospital between October 2023 and June 2025, including reproductive-aged patients without future fertility desire, an intact uterus, and indications for bilateral salpingectomy for gynecologic cancer prophylaxis. Patients underwent either vNOTES or conventional laparoscopic salpingectomy. Perioperative outcomes-including operative time, blood loss, complications, analgesic use, hospital stay, conversion to laparotomy, hemoglobin change, and pain scores at six and 24 hours-were compared. Postoperative sexual function was assessed using the Female Sexual Function Index (FSFI) and Couple Satisfaction Index-16 (CSI-16) at three and six months. Dyspareunia was evaluated using a standardized surgeon-designed questionnaire.</p><p><strong>Results: </strong>A total of 467 patients were analyzed (vNOTES: 233; laparoscopy: 234). vNOTES was associated with significantly shorter operative time, reduced intraoperative blood loss, lower postoperative pain scores, and decreased analgesic requirements. No conversions to laparotomy occurred in either group. FSFI and CSI-16 scores showed no significant differences between groups at six months, and dyspareunia rates were comparable.</p><p><strong>Conclusion: </strong>vNOTES salpingectomy demonstrates perioperative advantages over laparoscopy without adversely affecting sexual function. It represents a safe and effective alternative for appropriately selected patients.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"72-78"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145701338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and clinical outcomes of CT-guided percutaneous gastrostomy with non-guidewire device.","authors":"Masao Takahashi, Ken Nakazawa, Yoko Usami, Kaho Mori, Jun Suzuki, Shiho Asami, Yoshitaka Okada, Hiroyuki Tajima, Eito Kozawa, Yasutaka Baba","doi":"10.1080/13645706.2025.2539473","DOIUrl":"10.1080/13645706.2025.2539473","url":null,"abstract":"<p><strong>Background: </strong>A new type of percutaneous gastrostomy device, designed not to use any guidewires during the procedure, is now available. This study aimed to evaluate the feasibility and clinical outcomes of this device for computer tomography-guided percutaneous gastrostomy (CT-PG).</p><p><strong>Methods: </strong>Retrospective, single-center study reviewed patients who underwent CT-PG with the non-guidewire gastrostomy device between September 2020 and August 2024. CT-PG was indicated only for patients who had previously experienced failure of percutaneous endoscopic gastrostomy (PEG). The study assessed technical outcomes during the CT-PG procedure with the non-guidewire device and clinical outcomes following the CT-PG.</p><p><strong>Results: </strong>A total of 24 patients were enrolled in this study. Technical success was achieved in all cases. The mean procedural time was 30.2 min, and the mean radiation dose was 548.9 mGy·cm. Minor hematoma in the greater omentum occurred in four cases, but none of them required transfusion or invasive intervention. No major complications were observed. The mean follow-up period after CT-PG was 253.6 days, with no gastrostomy-related complications affecting its function as a feeding route.</p><p><strong>Conclusions: </strong>The non-guidewire gastrostomy device is a feasible option for gastrostomy formation under CT fluoroscopy, offering favorable clinical outcomes.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"28-33"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of a non-water-cooled microwave ablation needle based on a vacuum needle rod to achieve carbonization-free operation: design, simulation, and experimental research.","authors":"Wei Wei, Chen Li, Weitao Li, Mengwei Jiang, Xiao Zhang, Lidong Xing, Zhiyu Qian, Xiaofei Jin","doi":"10.1080/13645706.2025.2543894","DOIUrl":"10.1080/13645706.2025.2543894","url":null,"abstract":"<p><strong>Background: </strong>At present, the microwave ablation needle used in clinic needs to add water circulation in the needle rod to reduce the rod temperature. However, the water circulation will take away a lot of heat during the ablation process, which requires increasing the ablation dose to achieve the expected thermal coagulation target volume. This undoubtedly increases the risk of carbonization.</p><p><strong>Methods: </strong>A design scheme of non-water-cooled microwave ablation needle based on double-layer vacuum structure was proposed. Two types of non-water-cooled microwave ablation needles with long and short needles were designed, and the ablation simulation was carried out by establishing the finite element simulation model.</p><p><strong>Results: </strong>Simulation and experimental results indicate that, at 20 W power, the long-needle vacuum tube ablation needle can create a carbonization-free solidification zone with a length of 34 mm after 180 s of ablation, whereas the short-needle vacuum tube ablation needle requires 300 s to form a similar zone with a length of 30 mm. Additionally, the axial ratio of the solidification zone created by the long-needle vacuum tube ablation needle exceeds that of the short-needle one. Consequently, the long-needle vacuum tube ablation needle is more apt for creating a larger solidification zone with minimal carbonization, while also achieving a more spherical shape.By comparing the ablation effects of long needle vacuum tube ablation needle and ky-2450b1 under low power,It is verified that the vacuum tube non-water-cooled ablation needle can ensure the effective ablation volume and non carbonization ablation under low-power and short-time ablation, which provides an important technical scheme for clinical optimization of the therapeutic effect of microwave ablation.</p><p><strong>Conclusions: </strong>The LPH-W-F-MWA is more adept at creating a larger coagulation zone with minimal carbonization, achieving a more spherical shape to a greater extent. This ensures both an effective ablation volume and char-free ablation, offering a crucial technical solution for optimizing the therapeutic effect of MWA in clinical settings.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"43-54"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reposition-free thoraco-laparoscopic surgery for EGJ cancer in the right hemilateral position.","authors":"Toshikatsu Tsuji, Noriyuki Inaki, Jun Kinoshita, Hideki Moriyama, Daisuke Yamamoto, Hiroto Saito, Ryota Matsui, Saki Hayashi, Kengo Hayashi, Kenta Doden","doi":"10.1080/13645706.2025.2584282","DOIUrl":"10.1080/13645706.2025.2584282","url":null,"abstract":"<p><strong>Background: </strong>Esophagogastric junction (EGJ) cancer is becoming increasingly prevalent worldwide. Among surgical challenges, anastomotic leakage remains a significant concern. The optimal approach for Siewert type II tumors with an esophageal invasion of 2.1-4.0 cm is still debated. We employed a combined left thoracoscopic and laparoscopic approach with the patient in the right hemilateral position, enabling simultaneous thoracic and abdominal procedures without intraoperative repositioning.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with EGJ cancer and an esophageal invasion length of 2.1 to 4.0 cm who underwent the combined left thoracoscopic and laparoscopic approach between January 2021 and December 2024. Clinicopathological characteristics and surgical outcomes were evaluated and compared with those of patients treated with conventional laparoscopic transhiatal surgery during the same period.</p><p><strong>Results: </strong>Eight patients underwent the combined approach. Surgical procedures included six proximal gastrectomies with single-flap esophagogastrostomy and two total gastrectomies. Compared with 12 patients who underwent conventional laparoscopic surgery, no anastomotic leakage was observed in the combined group, whereas leakage occurred in the conventional group.</p><p><strong>Conclusions: </strong>The combined left thoracoscopic and laparoscopic approach appears to be a feasible and safe option for EGJ cancer with esophageal invasion of 2.1-4.0 cm. No anastomotic leakage was observed, and this approach allows for stable anastomosis under direct visualization without repositioning.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"55-60"},"PeriodicalIF":2.0,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}