Surgical Laparoscopy, Endoscopy & Percutaneous Techniques最新文献

{"title":"Effective Closure of Peritoneal Tears During Totally Extraperitoneal Inguinal Hernia Repair With Bipolar Energy Devices: One-Year Follow-Up Results.","authors":"Fatih Yanar, Berke Sengun, Hasan Basoglu, İbrahim F Azamat, Hakan Yanar","doi":"10.1097/SLE.0000000000001464","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001464","url":null,"abstract":"<p><strong>Backgrounds: </strong>This study aimed to present the clinical experience and long-term outcomes of managing small peritoneal tears (PT) during totally extraperitoneal (TEP) inguinal hernia repair using bipolar energy devices.</p><p><strong>Methods: </strong>Patients who underwent TEP inguinal hernia repair at a tertiary center were retrospectively reviewed. Those with peritoneal tears managed using bipolar energy devices and at least 1 year of follow-up were included in the PT group, while patients treated with alternative closure methods were excluded. Demographic, operative, and postoperative data were retrieved from a prospectively maintained database and compared with those of patients without PTs.</p><p><strong>Results: </strong>Among the 571 patients, the PT group (n=86) and the No-PT group (n=485), no significant demographic differences were found. The PT group had longer operative times (50 vs. 45 min, P<0.01), more bilateral repairs (39.5% vs. 28.5%, P=0.04), and higher lateral hernia rates (64% vs. 44.5%, P<0.01). In the PT group, 7 patients (8.1%) required Veres needle decompression, with no conversions to other approaches. Postoperative outcomes showed no significant differences in recurrence, seroma, or hematoma, with a median follow-up of 36 months for both groups.</p><p><strong>Conclusion: </strong>Sealing peritoneal tears with bipolar energy devices during TEP hernia repair is an effective and efficient technique, offering favorable long-term clinical outcomes without the need for additional instruments or conversion to other surgical approaches.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842949","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":"Modified Management of Giant Hiatal Hernia: Laparoscopic Hiatoplasty With Sac Excision and PosteriorMediastinal Drainage.","authors":"Haicheng Yuan, Guoqiang Dong, Nan Zhang","doi":"10.1097/SLE.0000000000001427","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001427","url":null,"abstract":"<p><strong>Background: </strong>The standard laparoscopic hiatoplasty with Toupet fundoplication is widely regarded as a safe treatment for giant hiatal hernia; however, it is often associated with a high incidence of posterior mediastinal seroma. To address this issue, a modified approach combining sac excision and negative pressure posterior mediastinal drainage has recently been introduced. This study compares clinical outcomes between the conventional and modified techniques to identify the optimal surgical strategy for managing giant hiatal hernia.</p><p><strong>Methods: </strong>Patients who underwent laparoscopic hiatoplasty with sac excision and posterior mediastinal drainage between January 2013 and September 2020 were included. Demographic information, operative time, intraoperative blood loss, complication rates, length of hospital stay, and treatment outcomes were prospectively collected and assessed during follow-up.</p><p><strong>Results: </strong>A total of 68 patients with giant hiatal hernia underwent the modified procedure without any conversions to open surgery or intraoperative complications. Compared with a historical cohort of 66 patients treated with the conventional approach (laparoscopic hiatoplasty with Toupet fundoplication), the modified group had significantly lower rates of postoperative posterior mediastinal seroma, as well as shorter overall and postoperative hospital stays. No significant differences were observed between the 2 groups regarding operative time, blood loss, ICU transfers, or incidence of postoperative pulmonary atelectasis. Median duration of long-term follow-up was comparable between the groups. There were no significant differences in the rates of early satiety, anatomic recurrence, diarrhea, acid regurgitation, or proton pump inhibitor (PPI) usage. In addition, no cases of dysphagia or reoperation occurred in either group.</p><p><strong>Conclusions: </strong>Laparoscopic hiatoplasty with sac excision and posterior mediastinal drainage is a safe and effective minimally invasive technique for treating giant hiatal hernia. This approach significantly reduces the risk of mediastinal seroma without increasing complication rates.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842987","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":"Preliminary Experience of Circular Stapler-based Lower Mediastinal Reconstruction in Robotic Total and Proximal Gastrectomy.","authors":"Shinsuke Usui, Kenichi Iwasaki, Ryota Sakon, Kimihiko Nakamura, Yusuke Abe, Kenta Kitamura, Tomonori Matsumura, Takeshi Natori, Motoi Koyama, Kazuhiro Karikomi, Tatsushi Suwa","doi":"10.1097/SLE.0000000000001457","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001457","url":null,"abstract":"<p><strong>Background: </strong>In minimally invasive surgery for upper gastric and esophagogastric junction cancers, linear staplers are commonly used, and reports of circular‑stapled reconstruction have declined in parallel with the decrease in open surgery. Lower mediastinal reconstruction during robot‑assisted gastrectomy also remains technically challenging. This study describes our surgical technique and preliminary experience with transhiatal lower mediastinal anastomosis using a circular stapler.</p><p><strong>Methods: </strong>Twelve patients who underwent robot‑assisted total or proximal gastrectomy with lower mediastinal reconstruction between March 2023 and December 2025 were included. Total operative time, blood loss, reconstruction time, length of hospital stay, postoperative complications, and esophageal transection length were evaluated separately for robot‑assisted total gastrectomy (RTG) and robot‑assisted proximal gastrectomy (RPG).</p><p><strong>Results: </strong>No patient required conversion to open surgery.In the RTG group (n=6), the operative time, reconstruction time, blood loss, and hospital stay were 498.0 ± 61.1 minutes, 36.2 ± 8.4 minutes, 175 ± 117.3 g, and 14.3 ± 2.7 days, respectively.In the RPG group (n=6), these values were 345.8 ± 51.5 minutes, 75.6 ± 14.0 minutes, 75.0 ± 98.7 g, and 14.3 ± 2.7 days.Postoperative complications included one anastomotic stricture and one Grade B pancreatic fistula, both in the RPG group. No anastomotic leakage occurred in either group. The esophageal transection length was 35.2 ± 14.0 mm in the RTG group and 25.5 ± 7.9 mm in the RPG group, and all resection margins were negative.</p><p><strong>Conclusion: </strong>Circular staplers are feasible and safe for lower mediastinal reconstruction in robot‑assisted total and proximal gastrectomy.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842971","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":"Laparoscopic Liver Resections: Are Postero-Superior Liver Segments Really the Last Step of the Learning Curve?","authors":"Alessandro Fogliati, Cristina M Ciulli, Francesca Carissimi, Andrea Scacchi, Mauro A Scotti, Stella K Adjei Antwi, Federica Ferraina, Fabrizio Romano, Mattia Garancini","doi":"10.1097/SLE.0000000000001460","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001460","url":null,"abstract":"<p><strong>Background: </strong>Posterior-superior (PS) laparoscopic liver resections (LLR) are generally considered the last step of the learning curve (LC). Current literature supports the approach of PS LLR after the completion of a long anterolateral (AL) LC. However, the skills needed for PS LLR are not all achievable with AL LLR. The aim of this study is to explore a new concept of LC for LLR in which AL and PS resection are approached simultaneously.</p><p><strong>Methods: </strong>This is a retrospective study analyzing LLR performed between 2017 and 2024. PS and AL LLR were approached simultaneously. Two groups of PS and AL LLR were compared, using the textbook outcomes (TO) as the primary outcome. Secondary outcomes were morbidity, conversion, and vascular accidents.</p><p><strong>Results: </strong>The study compares 2 similar groups of 69 PS LLR and 146 AL LLR. PS LLR proved to be longer operations with a higher rate of conversion, but equal in major complications. No significant difference in TO achievement and no major vascular accidents in the PS group were recorded.</p><p><strong>Discussion: </strong>In conclusion, in LLR LC, the simultaneous approach of PS and AL liver resections is safe and feasible. PS LLR are challenging procedures but the achievement of optimal textbook outcome is noninferior to their AL counterpart.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594814","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":"The Impact of Gender, Videogaming and Music Playing on Robotic Surgery Simulation Performance.","authors":"Giovanni D Tebala, Francesca Duro, Isabella Tató, Chiara De Bonis Cristalli, Luca Properzi, Stefano Avenia, Roberto Cirocchi","doi":"10.1097/SLE.0000000000001420","DOIUrl":"10.1097/SLE.0000000000001420","url":null,"abstract":"<p><strong>Introduction: </strong>Virtual reality simulation is a fundamental adjunct to robotic surgery training. It is not clear if individual performance at the simulator can be affected by predisposing factors such as gender, video gaming, and instrument playing.</p><p><strong>Methods: </strong>Sixty-three volunteering medical students performed five times the same exercise at the DaVinci Simulator, and performance scores were collected for each participant (Overall Score, Time to Complete, Economy of Motion, Penalty Score) along with their demographics. Data were collected and analyzed within an electronic database. The difference (delta) between the highest score obtained in tests 2 to 5 and the score obtained in test 1 was calculated for each of the 4 scores and for each participant.</p><p><strong>Results: </strong>All participants showed a significant improvement in their scores with practice (deltas were always positive). Median PS was significantly lower in women, but PSdelta was significantly higher in women than in men. Median TC and median PS were significantly lower in non-video game users. No significant difference of performance scores was found between music players and non-music players. Multivariable analysis confirmed that female gender was an independent prognostic variable towards PSdelta, that is, women showed a steeper improvement in their performance.</p><p><strong>Conclusion: </strong>Repeated simulation improves the performance of surgically naïve medical students. Women and non-video gamers had higher penalty scores, but women tend to improve their skills quickly. As videogaming is much more frequent within the group of men, it is possible that videogaming itself, and not gender, can have a positive effect by enhancing eye-hand coordination.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114320","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":"Modified POEM With Radial Extension for Achalasia: Short-Term Outcomes of a Prospective Single-Center Study.","authors":"Bahtiyar Muhammedoglu, Mehmet Y Pektezel, Vehbi Sirikci, Fatih Dolu, Aydin H Küpeli, Oğuzhan F Ay","doi":"10.1097/SLE.0000000000001422","DOIUrl":"10.1097/SLE.0000000000001422","url":null,"abstract":"<p><strong>Background: </strong>Achalasia is a rare esophageal motility disorder that causes dysphagia owing to impaired lower esophageal sphincter (LES) relaxation. This study aimed to evaluate a modified dissection and radial myotomy technique during peroral endoscopic myotomy (POEM) and to compare its outcomes with those of the standard approach.</p><p><strong>Methods: </strong>This prospective, single-center study was conducted between February 2022 and December 2022. Eighty total with 80 achalasia patients undergoing POEM were divided into 2 groups: Group A (n=40), treated with the novel technique, and Group B (n=40), treated with the standard approach. Demographics, Eckardt score (ES), submucosal tunnel (ST), myotomy length, intervention duration, and adverse events were recorded. The follow-up period ranged from 3 to 20 months.</p><p><strong>Results: </strong>Patients who underwent the novel radial myotomy technique (Group A) had significantly longer myotomy lengths (11.8±2.4 vs. 8.1±2.0 cm, P <0.001), greater myotomy extension beyond the esophagogastric junction (4.2±0.8 vs. 2.7±0.6 cm, P <0.001), and improved postoperative Eckardt scores (median 1 [0-1] vs. 2, 1-3P =0.006) compared with the conventional POEM group (Group B). Subgroup analysis revealed that in Type III achalasia patients, the novel approach yielded longer submucosal tunnel lengths (15.6±0.8 cm, P =0.038) and favorable symptom relief. Despite extended dissection, there was no increase in gastroesophageal reflux disease (GERD)-related symptoms.</p><p><strong>Conclusion: </strong>The novel dissection and radial myotomy technique demonstrated superior outcomes in reducing dysphagia symptoms and LES resistance compared with the standard approach. Tailoring ST and myotomy lengths based on the achalasia type and EGJ involvement may optimize outcomes without increasing the risk of GERD.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285189","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":"A Suggestion for an Easy Laparoscopic Technique to Avoid Difficulties in Nonmidline Ventral Hernia Repair: Transabdominal Partial Extraperitoneal (TAPE) Approach.","authors":"Huseyin Kilavuz, Murat Demir, Feyyaz Gungor, Muhammed F Arslan, Idris Kurtulus","doi":"10.1097/SLE.0000000000001429","DOIUrl":"10.1097/SLE.0000000000001429","url":null,"abstract":"<p><strong>Background: </strong>Nonmidline ventral hernias (NMVH) are encountered less frequently than midline ventral hernias. Laparoscopic NMVH repairs are considered technically more difficult than midline hernias. For this reason, various intraperitoneal and extraperitoneal approach methods have been defined in the surgery of this group of hernias. In this study, we aimed to present the clinical data and follow-up results of patients who underwent laparoscopic repair of NMVH using the transabdominal partial extraperitoneal (TAPE) technique.</p><p><strong>Methods: </strong>In this single-center and retrospective study, demographic information, hernia characteristics, operative findings, and follow-up data of laparoscopic NMVH surgeries performed by a hernia-specific general surgery unit between January 2022 and June 2024 were scanned and analyzed.</p><p><strong>Results: </strong>Data from 26 patients with NMVH who underwent laparoscopic repair using the TAPE technique were analyzed. The mean age of the patients was 52.9±13.5 years. No intraoperative complications or conversion to open surgery were observed in any case. The median operative time was 100 (82.5 to 120) minutes. The median VAS score on the first postoperative day was 5 (3.75 to 6). Complications developed in 38.5% of patients during hospitalization; 26.9% were Clavien-Dindo class 1 and 11.5% were class 3a. The median hospital stay was 3 (3 to 5) days. The mean follow-up period was 17.8 (9 to 48) months, during which 2 patients (7.7%) experienced recurrence.</p><p><strong>Conclusions: </strong>The TAPE technique is among the reliable techniques that can be applied in the laparoscopic repair of NMVH with low complication and recurrence rates.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145805805","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":"Analysis of Risk Factors for Postoperative Delayed Perforation Following Endoscopic Submucosal Dissection of Gastrointestinal Stromal Tumors.","authors":"Chaoshu Guo, Linyun Xue, Guofeng Pan, Sijie Chen, Xiongbo Wu, Suping Li","doi":"10.1097/SLE.0000000000001438","DOIUrl":"10.1097/SLE.0000000000001438","url":null,"abstract":"<p><strong>Background: </strong>Delayed perforation is a serious complication after endoscopic submucosal dissection (ESD) for gastrointestinal stromal tumors (GISTs). Understanding its incidence, associated risk factors, and clinical outcomes can guide preventative measures. This study aimed to determine the incidence of delayed perforation, identify independent risk factors, and describe the clinical course and management outcomes.</p><p><strong>Methods: </strong>We retrospectively identified 57 patients who developed delayed perforation (\"cases\"). Each case was matched 1:1 by key variables (eg, age, tumor location) with 57 controls who did not experience delayed perforation. Baseline characteristics and the timing of delayed perforation were collected. We compared clinical and procedural factors in univariate analysis and conducted multivariate conditional logistic regression. Clinical course and management outcomes for delayed perforation, and subgroup analyses were assessed robustness.</p><p><strong>Results: </strong>A total of 57 patients developed delayed perforation at a median of 2 days postprocedure (IQR 1 to 7). In univariate analysis, larger tumor size ( P =0.02) and operator inexperience (<80 ESDs, P =0.03) were associated with an increased risk. In multivariate analysis, tumor size (adjusted OR 1.45 per cm, 95% CI: 1.04-2.02, P =0.03) and operator inexperience (adjusted OR 2.88, 95% CI: 1.21-6.81, P =0.02) remained significant risk factors. Most patients with delayed perforation presented with abdominal pain (61.4%), and diagnosis was primarily made via CT (66.7%). Management strategies included endoscopic closure (31.6%), surgical repair (35.1%), and conservative treatment (33.3%), with a mean hospital stay of 7.5±2.3 days. Sensitivity analyses confirmed the robustness of these findings.</p><p><strong>Conclusions: </strong>Larger tumor size and limited operator experience were independent risk factors. Endoscopic or surgical interventions resulted in satisfactory outcomes. These results highlight the need for standardized preventive measures and operator training to mitigate this complication.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012411","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":"EUS-TD With Multiple Plastic Stents for Postoperative Pancreatic Fistula: A Retrospective Evaluation of Early Postsurgery Management.","authors":"Koichiro Miyagawa, Shinji Oe, Yasuhisa Mori, Tsuyoshi Ueda, Nobuhiko Shinohara, Kosuke Hideshima, Yudai Koya, Yuichi Honma, Masaru Harada","doi":"10.1097/SLE.0000000000001430","DOIUrl":"10.1097/SLE.0000000000001430","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative pancreatic fistula (POPF) is a serious complication that can lead to potentially fatal outcomes; therefore, early intervention with drainage is warranted whenever clinically feasible. Endoscopic ultrasound-guided transmural drainage (EUS-TD) is becoming an alternative to percutaneous drainage for managing POPF. While EUS-TD is increasingly used, there is no consensus on stent type or the need for external drainage in early postoperative EUS-TD for POPF. This study aimed to evaluate the feasibility of EUS-TD using multiple plastic stents (PSs) without external drainage for managing POPF within postoperative day 15.</p><p><strong>Methods: </strong>This retrospective case series included 11 patients who developed POPF and underwent EUS-TD within postoperative day 15 between January 2021 and June 2024. The primary outcome was clinical success of EUS-TD with multiple PSs without external drainage. Secondary outcomes included technical success, complications, length of hospital stay, and recurrence rate.</p><p><strong>Results: </strong>Eleven POPF patients underwent EUS-TD. Two or more PSs were successfully placed in all cases, with clinical success achieved in 10 of 11 cases. One case required additional percutaneous drainage. A pseudoaneurysm rupture occurred in one case and was successfully managed with interventional radiology. The mean length of hospital stay was 19.1 days. No recurrences were observed during a median follow-up period of 26.0 months. Stents were removed after 6 months or later.</p><p><strong>Conclusions: </strong>EUS-TD using multiple PSs without external drainage may be a feasible approach for managing POPF within postoperative day 15. Further prospective studies are needed to validate these findings and optimize early postoperative management strategies for POPF.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820661","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":"Endoscopic Totally Extraperitoneal Release and Reinforce (TEP-RRT) With Structured Rehabilitation Program for Sportsman's Hernia and Athletic Pubalgia: Surgical Technique and 9-Year Clinical Series of 461 Athletes.","authors":"Moshe Dudai, Marah Ganiem, Rut Meruham","doi":"10.1097/SLE.0000000000001432","DOIUrl":"10.1097/SLE.0000000000001432","url":null,"abstract":"<p><strong>Objective: </strong>To describe a refined endoscopic Totally Extraperitoneal Release & Reinforce (TEP-RRT) technique for sportsman's hernia and athletic pubalgia (SH/AP) with structured rehabilitation program and to present descriptive long-term results from a nine-year clinical series.</p><p><strong>Methods: </strong>Between January 2016 and April 2024, a consecutive series of 461 athletes with chronic SH/AP grade 4 to 5 underwent bilateral TEP-RRT by a single surgeon after failure of conservative treatment. The technique involves endoscopic extraperitoneal access, meticulous release of pubic bone (PB) complex adhesions and inflamed inguinal ligament (IL) responsible for neural entrapment, followed by pre-peritoneal reinforcement with a mid-weight mesh. A standardized postoperative structured rehabilitation program (PSRP) was initiated seven days postoperatively. Nine years long-term outcomes were assessed retrospectively using a standardized telephone survey conducted between September 2024 and March 2025.</p><p><strong>Results: </strong>All 461 athletes (447 primary cases and 14 revision cases following failed SH/AP surgery performed at other centers) completed a survey-based postoperative follow-up, ranging from 6 months to 9 years. Overall, 98.5% (454/461) returned to sports activity and remained active, 75% resumed activity within 8 weeks, including all revision cases. No recurrences were reported during the follow-up period. Complications were infrequent (1.5%).</p><p><strong>Conclusions: </strong>TEP-RRT combined with a PSRP is a feasible, safe, and durable technique for primary and revision SH/AP cases.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012321","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}