Surgical Laparoscopy, Endoscopy & Percutaneous Techniques最新文献

{"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":"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":1.3,"publicationDate":"2026-08-01","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":"Minimally Invasive Left Pancreatectomy With the Critical View of Safety and the Caudal Approach: A Standardized Technique for Training.","authors":"Pietro Addeo, Ivan Marchitelli, Pierre de Mathelin","doi":"10.1097/SLE.0000000000001471","DOIUrl":"10.1097/SLE.0000000000001471","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive left pancreatectomy improves the postoperative outcomes compared with an open approach. Vascular dissection during this procedure can be challenging, especially in cases of large tumors or misleading anatomy.</p><p><strong>Methods: </strong>In this video article, we describe a standardized technique for MLP based on 2 technical key points: the critical view of safety (CVS) and a caudal approach. A central vascular dissection to get a critical view of safety (CVS) for splenic vessels is pursued. The left gastric vein should clearly be seen separating the common hepatic vein and the splenic (CVS for splenic artery). A caudal approach with extensive retropancreatic dissection before pancreatic neck transection is used to isolate the splenic vein (CVS for splenic vein). Splenic vessels are then sectioned (or dissected in cases of preservation).</p><p><strong>Results: </strong>The technique presented was standardized in 25 consecutive patients with borderline and malignant pancreatic tumors. Conversion to open surgery occurred in one case due to tumor infiltration of the left colic flexure. No intraoperative blood transfusions were required. The median body mass index (BMI) was 22.7 kg/m 2 (17.2 to 48.5 kg/m 2 ), and 3 patients (21.4%) had BMIs > 30 kg/m 2 . Type of resection performed included left pancreatectomy with splenectomy (n = 11), left pancreatectomy with splenic vessels preservation according to the Kimura technique (n = 11), left pancreatectomy with splenic vessels resection and spleen preservation according to the Warshaw technique (n = 3). Diagnoses included neuroendocrine tumors (n = 8), pancreatic ductal adenocarcinomas (n = 4), mucinous cystadenomas (n = 6), intraductal papillary mucinous neoplasm (n = 4), and other (n = 3). No intraoperative blood transfusions were required. The median operation time was 225 minutes (90 to 330 min). The overall morbidity rate was 30%, and there was no mortality.</p><p><strong>Conclusions: </strong>A formal standardized method for MLP is presented, entailing a caudal approach to splenic vessels and a critical view of safety before vascular ligation. This approach could be an educational aid to reduce the learning curve for trainee surgeons.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240375","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":"Re: Effects of Sugammadex on Postoperative Nausea and Vomiting in Laparoscopic Abdominal Surgery.","authors":"Ruiying Huang, Li Zhou","doi":"10.1097/SLE.0000000000001475","DOIUrl":"10.1097/SLE.0000000000001475","url":null,"abstract":"","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240404","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":"Single-Port Robotic Transanal Minimally Invasive Surgery for Rectal Cancer: A Novel Approach With FishBowl-Early Case Series.","authors":"Alfredo Mellano, Luca Pellegrino, Sara Salomone, Simona Zaffirio, Felice Borghi","doi":"10.1097/SLE.0000000000001472","DOIUrl":"10.1097/SLE.0000000000001472","url":null,"abstract":"<p><strong>Background: </strong>Transanal minimally invasive surgery (TAMIS) emerged as a validated technique for local excision of rectal adenomas and early-stage adenocarcinomas. In organ preservation protocols, TAMIS is increasingly used for mid- and low-rectal cancers, achieving complete or major clinical response (cCR/cMR) following neoadjuvant chemoradiotherapy, complementing Watch-and-Wait strategies with low morbidity and favorable outcomes. Robotic platforms, particularly the Da Vinci SP, have improved surgical dexterity and visualization in confined pelvic spaces. Despite CE approval and encouraging feasibility data, widespread adoption of SP-TAMIS remains limited due to docking constraints. This study reports the first European series of rectal cancer cases treated with SP-TAMIS (SPrTAMIS) using a novel small FishBowl docking system and evaluates its feasibility, safety, and short-term outcomes.</p><p><strong>Materials and methods: </strong>Five patients with rectal adenocarcinoma, selected based on organ preservation criteria, underwent SPrTAMIS using the Da Vinci SP system. Preoperative assessment included endoscopy, MRI, CT, and bowel preparation. Procedures were performed under general anesthesia with CO 2 pneumorectum (12 mm Hg) and robotic instrumentation via the FishBowl docking system. Data collected included tumor characteristics, surgical duration, estimated blood loss (EBL), morbidity, mortality, length of stay (LOS), and functional outcomes (LARS and MSKCC scores).</p><p><strong>Results: </strong>All procedures were completed robotically without conversion. The mean lesion size was 8.8 mm, located 50 mm from the anal verge and 16 mm from the anorectal junction. Mean operative time was 85 minutes. No intraoperative complications or mortality occurred. GI function resumed by postoperative day (POD) 1; all patients were discharged by POD 2. One minor, asymptomatic suture dehiscence was observed. Histology confirmed complete excision with negative margins. The median follow-up was 68 days, and functional and quality-of-life outcomes were favorable.</p><p><strong>Conclusions: </strong>SPrTAMIS using Da Vinci SP and the FishBowl system is feasible and safe for rectal excision, offering ergonomic advantages and minimal anal canal trauma. Further studies are warranted to assess long-term oncologic and functional outcomes.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148284611","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":"Surgeon-Performed Ultrasound-Guided Microwave Ablation for Benign Thyroid Nodules: A Single-Surgeon Clinical Experience.","authors":"Mehmet Ilker Turan","doi":"10.1097/SLE.0000000000001458","DOIUrl":"10.1097/SLE.0000000000001458","url":null,"abstract":"<p><strong>Background: </strong>Benign thyroid nodules are common and may cause compressive symptoms, cosmetic concerns, or hyperthyroidism. Ultrasound (US)-guided thermal ablation has emerged as a minimally invasive alternative to surgery. This study aimed to evaluate the efficacy and safety of surgeon-performed US-guided microwave ablation (MWA) for benign thyroid nodules.</p><p><strong>Methods: </strong>A retrospective analysis of prospectively collected data was performed on 32 patients who underwent US-guided MWA between May 2023 and May 2024. All procedures were performed by a single surgeon. Nodule volume, volume reduction ratio (VRR), thyroid function tests, and complications were evaluated at baseline and at 6- and 12-month follow-up. Technical success was defined as VRR >50% at 12 months.</p><p><strong>Results: </strong>The mean baseline nodule volume was 17.73±11.70 cm 3 , which decreased significantly to 7.40±4.92 cm 3 at 6 months and to 2.31±1.61 cm 3 at 12 months ( P <0.001). Mean VRR was 58.5% at 6 months and 87.1% at 12 months, with technical success achieved in all patients. VRR was not significantly affected by nodule composition, size, vascularity, or location. Among 3 patients with toxic adenoma, euthyroidism was achieved in 2 patients with complete discontinuation of antithyroid medications, while 1 patient improved from overt to subclinical hyperthyroidism with reduced medication dosage. No major complications were observed.</p><p><strong>Conclusions: </strong>Surgeon-performed US-guided MWA is a safe and highly effective minimally invasive treatment for benign thyroid nodules, providing substantial and durable volume reduction with excellent clinical outcomes in appropriately selected patients.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594816","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 Prospective Trial on Operability and Safety of a Simplified Robot-Assisted System (FASTER) for Colorectal Endoscopic Submucosal Dissection.","authors":"Han Bu, Xinyu Zhang, Ciliang Jin, Zhenghao Chen, Rui Hu, Yang Liu, Mengjun Chen, Feng Gao, Tanzhou Chen","doi":"10.1097/SLE.0000000000001468","DOIUrl":"10.1097/SLE.0000000000001468","url":null,"abstract":"<p><strong>Background and aims: </strong>One of the key challenges in endoscopic submucosal dissection (ESD) is achieving effective intraoperative mucosal traction. Although numerous countertraction technologies have been developed, there is still room for optimization. This randomized controlled trial was designed to assess the comparative effectiveness of a novel robotic assistance system (FASTER) versus conventional ESD techniques for managing colorectal neoplasia.</p><p><strong>Methods: </strong>A total of 24 ESD procedures were performed on 6 different anatomic sites (rectum and sigmoid colon) of 4 pigs. Twelve procedures were performed with the FASTER-assisted method and 12 with the conventional method. Key efficacy outcomes consisted of total procedure time, submucosal dissection time, submucosal dissection speed, and direct visual dissection rate. Secondary outcomes evaluated the complete resection rate and perioperative adverse events.</p><p><strong>Results: </strong>Compared with the conventional ESD group (C-ESD), the total procedure time of the FASTER-assisted ESD group (F-ESD) was significantly lower (11.5 vs. 18.0 min; P <0.001). Compared with the conventional ESD, FASTER-assisted ESD significantly increased the submucosal dissection speed (0.7 vs. 0.4 cm 2 /min; P <0.001), shortened the submucosal dissection time (4.9 vs. 10.7 min; P <0.001), and improved the rate of direct vision dissection (99.0% vs. 83.2%; P <0.001). The operation difficulty score of the F-ESD group was significantly lower than that of the C-ESD group (1.0 vs. 3.0; P <0.001). FASTER-assisted ESD significantly optimized the primary outcome measures in the treatment of sigmoid and rectal lesions.</p><p><strong>Conclusions: </strong>The FASTER system reliably provided continuous visual feedback and dynamic tissue manipulation throughout the ESD procedure. In this prospective preclinical animal investigation, it significantly shortened operation time and reduced surgical adverse events, offering an innovative solution for optimizing ESD procedures in colorectal treatment.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148240389","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":"Optimal Surgical Approach for Peri-Portal Vein Pancreatic Body Cancer: From the Pancreatic Tail or Head Side?","authors":"Shohei Yoshiya, Yo-Ichi Yamashita, Naotaka Inomata, Sota Nakamura, Kazuhiro Tada, Yosuke Kuroda, Kentaro Iwaki, Shoji Hiroshige, Kengo Fukuzawa, Tomoharu Yoshizumi","doi":"10.1097/SLE.0000000000001461","DOIUrl":"10.1097/SLE.0000000000001461","url":null,"abstract":"<p><strong>Objective: </strong>For peri-portal vein (PV) pancreatic body (Pb) cancer, we have often encountered difficulties in selecting the appropriate surgical approach-whether from the pancreatic tail side or the head side. This study aimed to clarify which procedure is more suitable for peri-PV Pb cancer.</p><p><strong>Methods: </strong>We reviewed 30 cases of peri-PV Pb cancer. The resected status of lymph nodes, their positivity rates in each procedure, and postoperative recurrence patterns were analyzed.</p><p><strong>Results: </strong>Among the 30 patients, 26 underwent distal pancreatectomy (DP), 3 underwent pancreatoduodenectomy, and 1 underwent total pancreatectomy. In the DP group, the gastroduodenal artery (GDA) was dissected to secure resection margins in 4 cases. The pancreatic transection lines were as follows: 1 to the right of the GDA, 3 at the GDA, 8 to the left of the GDA, and 14 to the right of the PV. Pathologic findings revealed the highest rate of lymph node metastasis in the splenic lymph nodes (#11, 32.1%), followed by the common hepatic lymph nodes (#8, 30.0%) and subpancreatic lymph nodes (#18, 18.5%). Only 1 case involved metastasis outside the regional Pb nodes-posterior pancreatic head (#13)-in a patient with suspected preoperative GDA invasion. Postoperative recurrence analysis showed no critical lymph node recurrence in nodes not resected during the initial procedure.</p><p><strong>Conclusions: </strong>This study suggests that DP may be an optimal option for peri-PV pancreatic body cancer without invasion of the pancreatic head region.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594876","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":"Nonlinear Association of Preoperative HbA1c With 30‑Day Complications After Inguinal Hernia Mesh Repair and Effect Modification by Day‑of‑Surgery Hyperglycemia.","authors":"Zongxu Liu, Yang Liu","doi":"10.1097/SLE.0000000000001467","DOIUrl":"10.1097/SLE.0000000000001467","url":null,"abstract":"<p><strong>Background: </strong>Whether chronic glycemic control relates nonlinearly to outcomes after inguinal hernia mesh repair and whether day-of-surgery hyperglycemia modifies risk remains uncertain. We assessed the continuous hemoglobin A1c (HbA1c)-risk curve for 30-day complications and 1-year recurrence.</p><p><strong>Methods: </strong>We performed a single-center prospective cohort of adults undergoing elective inguinal hernia mesh repair from January 2017 to December 2023. Exposures were preoperative HbA1c within 30 days (continuous; <5.7%, 5.7% to 6.4%, 6.5% to 7.9%, ≥8.0%) and day-of-surgery glucose (DOS-BG) ≥180 versus <180 mg/dL. Analyses used multivariable logistic regression with restricted cubic splines, HbA1c×DOS-BG interaction testing, prespecified confounder adjustment, and multiple imputation, and Cox models for recurrence.</p><p><strong>Results: </strong>We analyzed 3420 procedures; DOS-BG ≥180 mg/dL occurred in 22.0%. The 30-day composite occurred in 315 (9.2%). HbA1c was nonlinearly associated with risk ( p _nonlin=0.008): relative to <5.7%, aORs were 1.11 (95% CI: 0.89-1.38), 1.38 (1.04-1.83), and 1.92 (1.31-2.81) for 5.7% to 6.4%, 6.5% to 7.9%, and ≥8.0%, respectively. DOS-BG ≥180 mg/dL was associated with higher modeled risk (aOR: 1.41, 1.14-1.74) and modified the HbA1c effect ( p _interaction=0.03). Adjusted risks were 6.8% at HbA1c 5.5% and 11.6% at 8.5% with DOS-BG <180 mg/dL, versus 10.2% and 17.5% with DOS-BG ≥180 mg/dL. At 1 year, 55 recurrences/reoperation events (1.6%) occurred (KM: 1.7%, 95% CI: 1.3-2.2); adjusted hazards increased modestly with HbA1c (ordered trend P =0.08).</p><p><strong>Conclusions: </strong>Preoperative HbA1c relates nonlinearly to 30-day complications, and day-of-surgery hyperglycemia was associated with higher modeled risk across the HbA1c range. Findings support continuous HbA1c-based risk stratification. However, specific optimization thresholds require external validation.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043818","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":"Technical Description of Percutaneous Neo-hepaticojejunostomy: A Case Series.","authors":"Eduardo Javier Houghton, Miluska María Del Pilar Aliaga Ramos, José De Jesús Marín López, Pablo Acquafresca, Ana Belén Fernández, Damián Simonelli, Cecilia Cilfone, Carlos Guillermo Eisele, Mariano Eduardo Giménez","doi":"10.1097/SLE.0000000000001462","DOIUrl":"10.1097/SLE.0000000000001462","url":null,"abstract":"<p><strong>Objective: </strong>To present a multicentric experience using percutaneous techniques for neo-hepaticojejunostomy in complex cases with disconnected bile ducts.</p><p><strong>Methods: </strong>We retrospectively analyzed 4 complex cases in which percutaneous neo-hepaticojejunostomy was performed to address complications such as anastomotic stenosis and bile duct disconnection following Roux-en-Y hepaticojejunostomy (RYHJ). Patient selection, technique details, and short-term outcomes were evaluated.</p><p><strong>Results: </strong>All patients had successful percutaneous reconstruction without the need for surgical reintervention. No major complications were observed. Bile flow was restored, and clinical improvement was noted in all cases.</p><p><strong>Conclusions: </strong>Percutaneous approaches for neo-hepaticojejunostomy represent a feasible and minimally invasive alternative to traditional surgery in select cases of disconnected bile ducts. Larger prospective studies are needed to validate these findings.</p>","PeriodicalId":22092,"journal":{"name":"Surgical Laparoscopy, Endoscopy & Percutaneous Techniques","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043722","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":"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":"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":1.3,"publicationDate":"2026-08-01","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}