Surgical Laparoscopy, Endoscopy & Percutaneous Techniques最新文献

{"title":"Complication of Internal Herniation-related Bowel Obstruction Post-Single Anastomosis Sleeve Ileal (SASI) Bypass and Management: Series Case Sharing (Video Report).","authors":"Yi-Jie Wang, Hsin-Mei Pan, Kong-Han Ser, Kuo-Feng Hsu","doi":"10.1097/SLE.0000000000001376","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001376","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a global health concern associated with multiple comorbidities, and bariatric surgery remains one of the most effective interventions for sustained weight loss and metabolic improvement. The Single Anastomosis Sleeve Ileal (SASI) bypass is a novel procedure that offers a simplified surgical approach while maintaining efficacy. However, despite its advantages, SASI bypass carries a risk of postoperative complications, including internal herniation-related bowel obstruction-a rare but potentially life-threatening condition requiring prompt recognition and intervention.</p><p><strong>Method: </strong>We report 3 cases of internal herniation following SASI bypass, 2 performed robotically and 1 laparoscopically. Despite uneventful surgical procedures, all 3 patients developed postoperative internal herniation, with symptom onset ranging from 1 week to 16 months after surgery. A comparative summary of their clinical presentations and outcomes is provided in the accompanying table. Due to timely diagnosis and prompt surgical intervention, all patients had favorable outcomes. In addition, we compiled and edited a surgical video from the third case to illustrate the operative management of this complication.</p><p><strong>Results: </strong>Computed tomography (CT) emerged as the gold standard for diagnosis, although immediate surgical exploration was necessary in cases of peritonitis or hemodynamic instability. Notably, 1 patient (Case 2) experienced rapid weight loss, a factor previously implicated as a potential risk for internal herniation. Petersen's defect was the most common herniation site in SASI bypass, resembling the pattern seen in One Anastomosis Gastric Bypass (OAGB) but differing from Roux-en-Y Gastric Bypass (RYGB), where multiple mesenteric defects increase the risk. While a longer biliopancreatic limb may predispose SASI and OAGB patients to herniation, consensus on routine defect closure remains lacking.</p><p><strong>Conclusion: </strong>Internal herniation is a rare but serious complication of SASI bypass, with delayed diagnosis potentially leading to bowel ischemia or perforation. CT is essential for early detection, while timely surgical intervention is critical in symptomatic cases. The necessity of routine Petersen's defect closure remains debated, highlighting the need for further studies to determine the true incidence and optimal prevention strategies.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047264","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":"Impact of Ursodiol on Number of Cholecystectomies Performed After Bariatric Surgery.","authors":"Romulo Lind, Estela Abich, Rodrigo Neves, Icaro Barreto, Kareem Jawad, Muhammad Ghanem, Muhammad A Jawad, Andre F Teixeira, Graziella Galvao Goncalves","doi":"10.1097/SLE.0000000000001354","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001354","url":null,"abstract":"<p><strong>Background: </strong>The risk of gallstone formation is greater in obese patients; paradoxically, the rapid weight loss after bariatric surgery (BS) is also a great contributor to cholelithiasis and biliary disease. While concomitant cholecystectomy has been used to mitigate this issue, the demand for a less invasive prophylaxis was met by ursodeoxycholic acid (UDCA). This study aims to evaluate the impact of UDCA on the incidence of cholecystectomies after BS.</p><p><strong>Methods: </strong>This retrospective chart review included all primary and revisional bariatric procedures. Patients were divided into 2 groups based on the postoperative use of daily 600 mg UDCA for 6 months (group 2) or no UDCA use (group 1) to assess its impact on the incidence of cholecystectomy. A subanalysis compared baseline demographics, weight loss performance, and the number of cholecystectomies between groups.</p><p><strong>Results: </strong>In a cohort of 8433 patients, 5061 were in group 1, and 3372 were in group 2 who received UDCA. The total number of cholecystectomies after BS was 164 (1.9% of the cohort): 146 in group 1 (2.9%) and 18 in group 2 (0.5%) (P<0.00). A subanalysis revealed no significant differences in preoperative weight, body mass index (BMI), and postoperative total body weight loss (TBWL%) between the groups. Nonetheless, incidences of cholecystectomy after biliopancreatic diversion with duodenal switch (BPD-DS), Roux-en-Y Gastric Bypass (RYGB), and sleeve gastrectomy (SG) were greater in group 1, 8% versus 1.4%, 4.4% versus 0.1%, and 1.7% versus 0.4%, respectively (all P<0.05).</p><p><strong>Conclusion: </strong>UDCA is associated with lower incidence rates of cholecystectomy after BS.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042716","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":"Advantages of a Point-of-care Digital Rectoscope for Colorectal Surgical Practice: A Video-supported Case Series.","authors":"David J Nijssen, Roel Hompes, Wytze Laméris","doi":"10.1097/SLE.0000000000001372","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001372","url":null,"abstract":"<p><strong>Purpose: </strong>Point-of-care (POC) diagnostic tools can support timely and efficient clinical decision-making. The introduction of a POC digital rectoscope has the potential to enhance colorectal surgical practice by enabling immediate bedside endoscopic evaluation in different settings.</p><p><strong>Methods: </strong>This case series describes 5 cases, with video documentation illustrating the potential benefits of using a portable digital rectoscope in outpatient follow-up, inpatient postoperative care, and emergency settings.</p><p><strong>Results: </strong>In a tertiary referral center, POC rectoscopy effectively supported the detection of anastomotic leakage and rectal perforation, response evaluation after neoadjuvant treatment for rectal cancer, and facilitated follow-up after treatment for anastomotic leakage.</p><p><strong>Conclusions: </strong>POC digital rectoscopy shows promise in enhancing the diagnostic efficiency of colorectal care. Further studies are warranted to evaluate its clinical impact and cost-effectiveness for the illustrated indications.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052621","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":"Transcystic Laparoscopic Common Bile Duct Exploration: When to Bail.","authors":"Victoria Jenkins, David Bird, Nezor Houli, Tuck Yong, Russell Hodgson","doi":"10.1097/SLE.0000000000001374","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001374","url":null,"abstract":"<p><strong>Background: </strong>Transcystic laparoscopic common bile duct exploration (LCBDE) is a procedure considered in the management of common bile duct stones. In many ways it is superior to alternatives such as endoscopic retrograde cholangiopancreatography (ERCP); however, surgeons who have limited experience in CBDE are often reluctant to persist in difficult cases with concerns regarding increasing complication rates and waste of theater time. This study aims to provide an evidence-based approach to identify points to aid early abandonment (\"bail\").</p><p><strong>Methods: </strong>Review of all LCBDE performed in a single center from September 2008 to September 2022 was performed. Statistical analysis was performed on success and failure groups, with relevant undesirable outcomes chosen for further analysis to identify factors to be used as a guide to bail.</p><p><strong>Results: </strong>A total of 952 patients were identified for analysis. Females represented 63.8% (609) of the cohort. Success was reported in 89.2% (849) of procedures. Those in whom the cystic duct could not be cannulated with the choledochoscope, those that progressed to choledochotomy, those with a prolonged operative time, and those who had adverse outcomes were selected as undesired outcomes. Factors of age, higher ASA, preoperative ERCP, and those with preoperatively identified stones or larger stones at operation were associated with higher rates of an undesired outcome.</p><p><strong>Conclusion: </strong>Older and more comorbid patients, those who underwent preoperative ERCP, and those with preoperatively or operatively identified large stones are factors that should prompt those surgeons who are developing their LCBDE experience to consider bailing early.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032435","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 Effects of Machine-Based and Manual Hand Massage on Pain, Anxiety, and Gastrointestinal Function Following Laparoscopic Cholecystectomy.","authors":"Münevver Şengül, Sevim Çelik","doi":"10.1097/SLE.0000000000001375","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001375","url":null,"abstract":"<p><strong>Background: </strong>Inadequate management of pain, anxiety, and gastrointestinal function after laparoscopic cholecystectomy can lead to an increase in the incidence of nausea and vomiting, disruption of gastric functions, delayed postoperative recovery, prolonged hospital stay, increased risk of mortality, opioid use, and unwanted side effects. To evaluate the impact of manual and machine-based hand massage following laparoscopic cholecystectomy on pain, anxiety, and gastrointestinal function.</p><p><strong>Methods: </strong>This randomized controlled trial study was conducted with 171 patients. Patients were divided into 2 intervention (manual hand massage and machine-based hand massage) groups (n=57), and a control group (n=57). Data were collected at 0, 4, and 8 hours postoperatively using the survey form, Numerical Rating Scale, State-Trait Anxiety Inventory, and Gastrointestinal Function Monitoring Form.</p><p><strong>Results: </strong>The severity of pain in the manual hand massage group decreased statistically significantly after massage ( P <0.05). Anxiety levels in the intervention groups were lower at all time intervals postoperatively ( P <0.001). The severity of nausea in the massage groups was lower at 8 hours ( P <0.05). The number of bowel sounds at 8 hours in the massage groups showed a greater increase ( P <0.05).</p><p><strong>Conclusion: </strong>Both manual and machine-based hand massage positively affected pain, anxiety, nausea intensity, and bowel sounds following laparoscopic cholecystectomy. Manual hand massage was more effective than machine-based hand massage in reducing pain intensity and increasing bowel sounds.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042960","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 Effects of Erector Spinae Plane Block Versus Incision Site Local Anesthetic Infiltration on Stress Hormone Response in Patients Undergoing Laparoscopic Cholecystectomy: Randomized Controlled Study.","authors":"Murat Sahin, Cinar A Surhan, Altinay Mustafa, Cetiner Ilay, Uyanikoglu Ozge, Omeroglu Sinan","doi":"10.1097/SLE.0000000000001373","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001373","url":null,"abstract":"<p><strong>Background: </strong>After laparoscopic cholecystectomy surgery, an increase in stress hormones and moderate-to-severe pain occur in the postoperative period. The aim is to compare the effects of unilateral erector spinae plane block (ESPB) and port site local anesthetic (LA) infiltration methods on stress hormone response and postoperative pain in laparoscopic cholecystectomy operations.</p><p><strong>Methods: </strong>This study was a prospective, randomized controlled, single-blind trial that divided laparoscopic cholecystectomy patients into 3 groups. In group I, local anesthetic infiltration was administered at 4 trocar sites; group E underwent unilateral ESPB guided by ultrasound; and group C was the control group with no intervention. Stress hormones were measured preoperatively and postoperatively, and postoperative VAS scores were recorded. The primary outcome was to compare the effects of LA infiltration and ESPB on stress hormone response, while the secondary outcome was the efficacy of postoperative analgesia.</p><p><strong>Results: </strong>A total of 90 patients were included in the study. The duration of analgesia was significantly longer in group I compared with group C (P<0.05). Postoperative VAS scores were significantly lower in group E and group I than in group C (P<0.05). Group E significantly suppressed prolactin levels compared with the other 2 groups (P<0.05). In addition, group E significantly reduced glucose levels compared with group C (P<0.05).</p><p><strong>Conclusion: </strong>Unilateral ESPB and infiltration have similar effects on pain and stress hormones after laparoscopic cholecystectomy. Infiltration may be preferred due to its easier application.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047267","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 and Safety of Robotic Bilateral Axillo-Breast Approach Versus Robotic Gasless Axillary Approach for Thyroidectomy: A Systematic Review and Meta-Analysis.","authors":"Abdulkreem A Al Juhani, Faisal Alzahrani, Aya K Esmail, Raghad F AlRasheed, Abdullah Esmail, Hasan M Alnakhli, Lujain B Alotaibi, Bayan M Alturki, Mohammed A Borah, Ghala S Alahmari","doi":"10.1097/SLE.0000000000001370","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001370","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the comparative efficacy and safety of robotic thyroidectomy techniques, including the robotic bilateral axillo-breast approach (BABA) and the robotic gasless axillary approach (GAA).</p><p><strong>Data sources: </strong>A comprehensive literature search was conducted across 5 major electronic databases (PubMed, Embase, Cochrane Library, Web of Science, and Scopus) to identify relevant studies published until May 2024.</p><p><strong>Review methods: </strong>Analysis was conducted using RevMan 5.4 software with pooled mean and rate ratios calculated with 95% CIs.</p><p><strong>Results: </strong>A total of 73 studies, comprising 70 eligible for meta-analysis, were included. Compared with robotic GAA, robotic BABA was associated with significantly longer operative time (pooled mean: 64.65 min, 95% CI: 51.77-77.53, P<0.00001), increased hospital stay (pooled mean: 1.24 d, 95% CI: 0.92-1.56, P<0.00001), and higher intraoperative bleeding (pooled mean: 44.90 mL, 95% CI: 26.99-62.81, P<0.00001). While no significant differences were observed in the rates of hypoparathyroidism, recurrent laryngeal nerve palsy, chyle leakage, seroma, hematoma, or infection, the incidence of Horner syndrome was significantly higher in the BABA group (pooled risk ratio: 0.01, 95% CI: 0.00-0.05, P=0.003).</p><p><strong>Conclusions: </strong>Robotic BABA was associated with longer operative times, increased hospital stays, and higher intraoperative bleeding compared with Robotic GAA, although both techniques demonstrated comparable safety profiles for most outcomes. The higher incidence of Horner syndrome with BABA should be considered when selecting the optimal surgical approach for thyroidectomy.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019677","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":"Posterior Retroperitoneoscopic Approach to Extra-Adrenal Paragangliomas: A Single Center Experience.","authors":"Nihat Aksakal, Berke Sengun, Yalin Iscan, Ismail C Sormaz, Fatih Tunca, Yasemin Giles Senyurek","doi":"10.1097/SLE.0000000000001367","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001367","url":null,"abstract":"<p><strong>Background: </strong>Resections performed using the commonly applied minimally invasive transperitoneal approach for extra-adrenal paragangliomas (ePGLs) require a broader dissection area compared with the posterior retroperitoneoscopic approach (PRA) due to the location of the masses, which can elongate the operative time and increase the risk of injury to the adjacent structures. The aim of this case series was to evaluate the feasibility and safety of the PRA method, which has very few examples reported in the literature, for the treatment of abdominal paragangliomas.</p><p><strong>Methods: </strong>Eight patients who underwent ePGL resection with PRA in a tertiary center between April 2018 and August 2024 were included. Demographic data, localization relative to the renal vein, operative time, tumor size, perioperative and postoperative complications, and length of hospital stay were assessed.</p><p><strong>Results: </strong>Of the patients, 4 were male, and 4 were female. The mean age was 49±10.3 years, and the mean body mass index was 27±2.7 kg/m². Tumors were located on the left side in 6 patients and on the right side in 2 patients. Relative to the renal vein, 6 tumors were located superiorly and 2 inferiorly. One patient who had previously undergone surgery through an open anterior approach underwent PRA due to recurrence. The mean operative time was 108.4±20.5 minutes, with perioperative hypotensive episodes observed in 2 patients. No complications were noted during the postoperative follow-up. The mean length of hospital stay was 3.6±1.4 days. The mean tumor size was 34.9±18.6 mm, and the mean follow-up period was 30.5±25.5 months. Disease-related mortality was observed in 1 patient.</p><p><strong>Conclusion: </strong>PRA is a safe and feasible minimally invasive method for the treatment of ePGLs.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027538","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":"Mechanisms of Gastroesophageal Reflux Post-Roux-en-Y Gastric Bypass: Universal Alteration of the Antireflux Barrier is the Culprit.","authors":"Barham K Abu Dayyeh, Karim Al Annan, Razan Aburumman, Tala Abedalqader, Rudy Mrad, Khushboo Gala, Vitor Brunaldi, Omar M Ghanem","doi":"10.1097/SLE.0000000000001366","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001366","url":null,"abstract":"<p><strong>Introduction: </strong>Gastroesophageal reflux disease (GERD) symptoms and the use of proton pump inhibitors (PPIs) remain prevalent after Roux-en-Y Gastric Bypass (RYGB), despite it being known to alleviate reflux. The physiological changes behind long-term GERD and hiatal hernia (HH) prevalence post-RYGB are not commonly investigated.</p><p><strong>Methods: </strong>In this consecutive cohort study, we examined patients who underwent RYGB and subsequent upper endoscopy, conducted by an expert bariatric endoscopist. The primary focus was on pouch endoscopic retrosflexion to evaluate the antireflux barrier (ARB). We gathered data encompassing patient demographics, anthropometrics, comorbidities, and findings from esophagogastroduodenoscopy (EGD) at the time of surgery and during follow-up EGD.</p><p><strong>Results: </strong>Our study included a total of 42 patients, predominantly female (97.5%) and White (100%), with an average age of 53.6±10.6 years and a body mass index (BMI) of 32.9±9.4 kg/m2. In our findings, all EGDs revealed the presence of a HH of varying sizes. The average HH size was 2.07±0.87 cm. The esophagogastric junction (EGJ) flap was also effaced in all patients with the majority (90.4%, 38 patients) classified as Hill grade IV and a smaller proportion (9.6%, 4 patients) as Hill grade III. Notably, PPI usage increased from the time of surgery to the time of EGD (69.0% vs. 42.9%, P=0.06).</p><p><strong>Conclusion: </strong>This research highlights the high incidence of HH and EGJ flap effacement in patients after RYGB, potentially elucidating the persistence of reflux symptoms, including weakly acidic or alkaline reflux, post-RYGB.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812445","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":"Surgical Technique of Robotic Distal Gastrectomy for Gastric Cancer Using the Hinotori Surgical System.","authors":"Masaaki Nishi, Chie Takasu, Yuma Wada, Takuya Tokunaga, Hideya Kashihara, Daichi Ishikawa, Toshiaki Yoshimoto, Chiharu Nakasu, Mistuo Shimada","doi":"10.1097/SLE.0000000000001369","DOIUrl":"https://doi.org/10.1097/SLE.0000000000001369","url":null,"abstract":"<p><strong>Aim: </strong>The da Vinci Surgical System (Intuitive Surgical) currently dominates robotic gastrectomy for gastric cancer. The hinotori Surgical Robot System (Medicaroid Corporation) is a newly developed, Japan-made surgical assist robot. This study aimed to introduce the initial experience of robotic gastrectomy using the hinotori and discuss key techniques and challenges.</p><p><strong>Methods: </strong>This single-center retrospective study involved 10 eligible patients who underwent curative robotic distal gastrectomy using the hinotori for primary Stage I to III gastric cancer. Short-term surgical outcomes were evaluated. Lymph node dissection was mainly performed using the conventional double bipolar technique, left-handed double bipolar technique, or laparoscopic coagulation shears from the assist port.</p><p><strong>Results: </strong>No patients developed intraoperative complications, and all procedures were successfully completed without conversion to open or laparoscopic surgery. All patients achieved R0 resection. The median operation time was 275 minutes (range, 252 to 336 min), and the estimated blood loss was 5 mL (range, 3 to 20 mL). The drain amylase content on postoperative day 1 was 220.5 IU/L (range, 66 to 1207 IU/L). The median number of retrieved lymph nodes was 29.5 (range, 11 to 58). No patients developed postoperative Clavien-Dindo grade ≥IIIa complications, and there was no mortality.</p><p><strong>Conclusion: </strong>Robotic gastrectomy using the hinotori shows potential benefits for gastric cancer. Further studies are needed to validate these advantages.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803532","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}