Surgical Endoscopy And Other Interventional Techniques最新文献

{"title":"Making intracorporeal anastomosis easier: a practical and reproducible technique for common enterotomy closure in laparoscopic right colectomy.","authors":"Francesco Guerra, Francesco Matarazzo, Lorenzo De Franco, Giuseppe Giuliani, Andrea Coratti","doi":"10.1007/s00464-025-12250-x","DOIUrl":"https://doi.org/10.1007/s00464-025-12250-x","url":null,"abstract":"<p><strong>Background: </strong>In laparoscopic right-sided colonic resection, intracorporeal anastomosis offers several short-term advantages over the most commonly employed extracorporeal approach. Despite this, technical difficulties of execution still limit its widespread adoption. This report presents a novel technique for common enterotomy closure in pure laparoscopic surgery, which may support a more structured, consistent, and reproducible approach to anastomosis creation.</p><p><strong>Methods: </strong>The technique entails a preliminary suture stabilization of the posterior aspect of the anastomosis prior to enterotomies creation and stapler firing. This maintains the resulting common enterotomy superficial and less prone to undue traction, thereby enhancing visibility and facilitating its manual closure.</p><p><strong>Results: </strong>From August 2021 to February 2025, 39 patients underwent laparoscopic right-sided colectomy with this technique of reconstruction. No major anastomosis-related morbidity was observed.</p><p><strong>Conclusions: </strong>This technique offers a standardized and proficient approach to intracorporeal anastomosis, facilitating its creation with high reproducibility. While promising, these results warrant validation in larger groups and comparison with existing techniques.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Fully covered self-expandable metal stents versus multiple plastic stents for the treatment of post-orthotopic liver transplant anastomotic biliary strictures: An updated systematic review and meta-analysis of randomized controlled trials.","authors":"Stefano Baraldo, Gilmara Coelho Meine, Paula Arruda Espirito Santo, Eduardo Cerchi Barbosa, Angélica Luciana Nau, Margaret G Keane, Radhika Chavan, Yu-Ting Kuo, Dario Ligresti","doi":"10.1007/s00464-025-12229-8","DOIUrl":"https://doi.org/10.1007/s00464-025-12229-8","url":null,"abstract":"","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk assessment of lymph node metastasis and comparison of treatment modalities for low-risk T1b colorectal cancer: a meta-analysis.","authors":"Mengjia Tian, Kaihan Wu, Chencong Zhou, Xuan Huang","doi":"10.1007/s00464-025-12240-z","DOIUrl":"https://doi.org/10.1007/s00464-025-12240-z","url":null,"abstract":"<p><strong>Background and aims: </strong>The uncertainty surrounding the risk of recurrence and metastasis in T1 colorectal cancer (CRC) with solely deep submucosal invasion (DSI, defined as T1b, submucosal invasion exceeding 1000 μm) as a high-risk factor has led to controversial treatment strategies. This meta-analysis aims to assess the risk of lymph node metastasis in T1 CRC patients presenting with a solitary risk factor of DSI. Furthermore, it compares the effectiveness and safety of endoscopic resection, surgery after endoscopic resection, and surgical resection in this context, offering valuable insights for clinical decision-making.</p><p><strong>Methods: </strong>PubMed, Embase, and the Cochrane Library electronic databases were searched to identify available studies published up to November 30, 2024. Random- or fixed-effects models were applied in the meta-analyses. Heterogeneity and consistency were evaluated.</p><p><strong>Results: </strong>The analysis encompassed 3331 cases of low-risk T1b CRC, pooled from 22 studies. The lymph node metastasis (LNM) rate of low-risk T1b CRC is 2.5% (95% CI 1.3-3.8%). Patients of this kind treated with endoscopic resection, surgery after endoscopic resection, or surgical resection alone do not differ statistically significantly in terms of recurrence rates (P = 0.28) or disease-specific survival (DSS) rate (P = 0.66). In addition, R0 resection could be achieved with endoscopic resection in the majority of patients, without serious adverse events reported in documented cases.</p><p><strong>Conclusions: </strong>For patients with early-stage colorectal cancer presenting as DSI and devoid of other risk factors, treatment should be individualized. In such cases, given the low LNM rate, appropriately expanding the indications for endoscopic treatment and implementing rigorous follow-up post-endoscopic resection may represent a feasible strategy for selected patients, especially when balancing risks of unnecessary surgery. Otherwise, surgical resection remains the preferred treatment.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Magnetic sphincter augmentation for gastroesophageal reflux after sleeve gastrectomy: a prospective study.","authors":"Martina Novia, Alberto Aiolfi, Francesco Cammarata, Gianluca Bonitta, Cristina Ogliari, Alessandro Giovanelli, Davide Bona, Luigi Bonavina","doi":"10.1007/s00464-025-12238-7","DOIUrl":"https://doi.org/10.1007/s00464-025-12238-7","url":null,"abstract":"<p><strong>Background: </strong>De-novo reflux or worsening of pre-existing gastroesophageal reflux disease (GERD) presents a major challenge after laparoscopic sleeve gastrectomy (LSG). Roux-en-Y gastric bypass is a viable treatment option, however, the procedure is complex and carries risks such as anastomotic leak and metabolic complications. Magnetic sphincter augmentation (MSA) has been introduced for the treatment of GERD in patients with normal anatomy, but clinical experience is still limited.</p><p><strong>Aim: </strong>Assess the efficacy of MSA device as GERD remedial treatment after LSG.</p><p><strong>Methods: </strong>Prospective, single-arm, multi-center study from January 2020 to January 2024. Primary outcome was post-MSA patient-reported quality of life assessed with the GERD-HRQL questionnaire. Esophageal acid exposure, endoscopic, high-resolution manometric findings, and PPI use were secondary outcomes.</p><p><strong>Results: </strong>Twelve subjects (75% females) underwent MSA for pathologic GERD after LSG. Mean baseline BMI was 28.6 ± 4.3. All procedures included hiatoplasty and were completed laparoscopically. Mean operative time was 78.5 min. No intraoperative or perioperative short-term complications occurred. Overall, 11 patients completed the 12-month follow-up with clinical and instrumental assessment. GERD-HRQL scores (38.6 vs. 10.1; p = 0.003) and daily PPI use (100% vs. 27.3%; p = 0.003) significantly improved compared to baseline. Notably, %Acid Exposure Time (AET) (14.1 vs. 7.1; p = 0.06), DeMeester score (60.7 vs. 20.5; p = 0.017), total number of reflux episodes (110 vs. 40; p = 0.012), number of re-reflux (142 vs. 63; p = 0.016), distal contractile integral (DCI) (mmHg-s-cm) (728 vs. 2040; p = 0.043), and LES basal pressure (mmHg) (7.3 vs. 26.1; p = 0.028) were improved compared to baseline. No device adverse events nor explants occurred during follow-up.</p><p><strong>Conclusions: </strong>This study shows that MSA seems to improve GERD-related symptoms and patient quality of life in patients with pathological GERD after LSG. At a mean follow-up of 22 months, PPI use, AET%, DeMeester score, total number of reflux episodes, DCI, and LES basal pressure seem to be improved compared to baseline.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145131997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting operative complexity in laparoscopic splenectomy: a validated preoperative scoring system.","authors":"Long-Jiang Chen, Su-Hang Chen, Yuan Fang, Zhi-Lin Wang, Guang-Bin Chen, Xiao-Ming Wang","doi":"10.1007/s00464-025-12180-8","DOIUrl":"https://doi.org/10.1007/s00464-025-12180-8","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic splenectomy poses significant technical challenges due to variable splenic anatomy and patient-specific factors. A robust preoperative difficulty scoring system is essential to integrate critical predictors into a unified framework. This tool enables objective risk stratification, optimizes resource allocation, and enhances procedural safety through tailored surgical strategies. This study aimed to develop and validate a novel preoperative scoring system tailored to these challenges.</p><p><strong>Methods: </strong>In this dual-center retrospective study, 181 patients undergoing laparoscopic splenectomy were divided into training (n = 118), validation 1 (n = 40), and validation 2 (n = 23) cohorts. Preoperative variables, including demographics, laboratory factors (INR, platelet count, et al.), and imaging indicators (CT-derived thickness, length, width, et al.), were analyzed. Multivariable regression identified predictors of surgical complexity (blood loss, operative time, conversion to open surgery). A difficulty score integrating regression coefficients and clinical feasibility was developed and validated using ROC curves, calibration plots, and decision curve analysis.</p><p><strong>Results: </strong>Age, INR, splenic thickness, and cirrhosis-related hypersplenism emerged as independent predictors of surgical complexity (p < 0.05). The scoring system (range: 0-23) stratified patients into low- (0-7), intermediate- (8-15), and high-risk (16-23) tiers, demonstrating strong discrimination [training cohort AUC: 0.82 (95% CI 0.74-0.90); validation 1 cohort AUC: 0.80 (95% CI 0.66-0.94); validation 2 cohort AUC: 0.78 (95% CI 0.58-0.98)]. High-risk patients exhibited significantly greater blood loss, prolonged operative time, and higher conversion to open surgery rates. Calibration and decision curve analyses confirmed clinical utility, with net benefit surpassing \"treat-all\" strategies across risk thresholds.</p><p><strong>Conclusions: </strong>This scoring system provides a validated tool for preoperative risk stratification in laparoscopic splenectomy, particularly for cirrhosis-predominant cohorts. By incorporating age, INR, splenic thickness, and pathogenesis, it attempts to account for regional epidemiological variations, potentially contributing to more tailored surgical planning in specific clinical contexts.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to interval cholecystectomy following percutaneous cholecystostomy in patients with acute calculous cholecystitis.","authors":"Sourav Podder, Kirsten Lung, George Ibrahim, Scott Koeneman, Joshua Marks, Murray Cohen, Anirudh Kohli","doi":"10.1007/s00464-025-12161-x","DOIUrl":"https://doi.org/10.1007/s00464-025-12161-x","url":null,"abstract":"<p><strong>Background: </strong>Percutaneous cholecystostomy (PCT) is an option for acute calculous cholecystitis in high-risk surgical patients. While PCT effectively manages acute episodes by providing source control, the management after PCT remains unclear. When feasible, subsequent interval cholecystectomy (IC) offers definitive disease resolution; however, clear guidelines for patient selection remain lacking. This study identifies factors that hinder the decision to proceed with IC, investigates whether IC after PCT is associated with improved survival, and assesses the incidence of subsequent biliary procedures after PCT.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using deidentified data from the TriNetX platform, encompassing over 100 million patients. Patients diagnosed with acute calculous cholecystitis who underwent PCT were identified. The primary outcome was the identification of factors associated with the failure to undergo IC after PCT. Secondary outcomes included assessing the hazard of death associated with IC, modeling IC as a time-varying covariate. Additionally, biliary interventions following PCT were quantified.</p><p><strong>Results: </strong>Among 419,102 patients with acute calculous cholecystitis, 8,483 (2.0%) underwent PCT. Of these, 43.0% subsequently underwent IC within one year. Patients with chronic ischemic heart disease, congestive heart failure, chronic obstructive pulmonary disease, ascites, diabetes, and concurrent diagnosis of septic shock were less likely to undergo IC. Additionally, 40.9% of patients required at least one additional biliary intervention within one year following PCT.</p><p><strong>Conclusion: </strong>More than half of patients do not undergo IC after PCT. Patients with comorbidities such as chronic ischemic heart disease, congestive heart failure, chronic obstructive pulmonary disease, ascites, diabetes, and concurrent diagnosis of septic shock are associated with failure to undergo IC. Moreover, patients who undergo PCT frequently require additional biliary interventions. This highlights the need for improved patient selection, structured follow-up, and optimization strategies to facilitate IC when feasible. A multidisciplinary approach is crucial for managing comorbidities, increasing surgical eligibility, and ultimately improving outcomes for patients undergoing PCT for acute calculous cholecystitis.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should occult hernia be repaired in TAPP?","authors":"Masayoshi Hirohara, Hiroyoshi Tsuchida, Shuichiro Uemura, Yuhi Ozaki, Shin Saida, Nobusada Koike","doi":"10.1007/s00464-025-12262-7","DOIUrl":"https://doi.org/10.1007/s00464-025-12262-7","url":null,"abstract":"<p><strong>Background: </strong>Occult hernias, defined as asymptomatic hernias not detectable on physical examination, are identified intraoperatively in up to 22% of patients undergoing laparoscopic inguinal hernia repair. While treatment may prevent future symptomatic herniation in approximately 21-29% of patients, the risk of complications on the occult hernia side remains unclear, especially when using the transabdominal preperitoneal (TAPP) approach, which has been widely adopted.</p><p><strong>Methods: </strong>We retrospectively analyzed 350 patients who underwent elective TAPP repair between January 2020 and December 2024. Patients were divided into two groups: the occult hernia group (n = 51), who underwent bilateral repair, including occult hernia treatment, and the non-occult hernia group (n = 299), who received unilateral repair without occult hernia identification. Postoperative complications were assessed at the first outpatient visit (median, 19 days postoperatively), compared between groups, and analyzed by occult and symptomatic sides.</p><p><strong>Results: </strong>The overall complication rates, defined as the occurrence of seroma; surgical site infection; and acute postoperative inguinal pain (APIP), which is pain requiring analgesics, were 13.7% and 16.4% in the occult and non-occult hernia groups, respectively (p = 0.84). On the occult hernia side (n = 51), the complication rate (seroma and APIP) was significantly lower than on the symptomatic side (n = 350) (2.0% vs. 12.3%, p = 0.03), with only one seroma and no APIP observed.</p><p><strong>Conclusion: </strong>Based on prior reports, the number needed to treat to prevent one symptomatic hernia was estimated to be 4.6 (95% credible interval: 3.1-7.3), while the number needed to harm for occult hernia side complications was 51. Treatment of occult hernias during TAPP repair was associated with a low incidence of complications on the occult hernia side and a favorable benefit-to-risk balance. These findings support the safety and rationale for treating occult hernias in TAPP procedures.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic-assisted cholecystectomy with DEXTER^®: the first prospective multicenter study.","authors":"Nico Seeger, Hubert Mignot, Hanno Matthaei, Lukas Gantner, Natalie Kuchen, Odile O'Sullivan, Stefan Breitenstein","doi":"10.1007/s00464-025-12174-6","DOIUrl":"https://doi.org/10.1007/s00464-025-12174-6","url":null,"abstract":"<p><strong>Introduction: </strong>Despite advancements in minimally invasive surgery, access to robotic-assisted cholecystectomy remains limited, largely due to robot availability and high costs for this procedure. The DEXTER^® Robotic Surgery System offers a small, mobile, and cost-effective alternative designed for ease of use and seamless integration into routine surgical workflows. The present study aimed to confirm the safety and performance of robotic-assisted cholecystectomy using DEXTER^®.</p><p><strong>Methods: </strong>A prospective study of robotic-assisted cholecystectomy was conducted by six surgeons across four centers in three countries. The primary objectives were to document the successful completion of the surgeries without conversion to laparoscopic or open surgery and the occurrence of serious adverse events (Clavien-Dindo grade ≥ III) up to 30 days post-surgery. Secondary endpoints included surgical performance metrics such as operative time.</p><p><strong>Results: </strong>A total of 51 patients underwent surgical intervention for the management of symptomatic Cholecystolithiasis, Cholecystitis, choledocholithiasis, and biliary pancreatitis. The median patient age was 59 years (IQR 42-65), and BMI was 28.0 kg/m² (IQR 24.9-29.6). All procedures were completed successfully without device deficiencies or conversions to open surgery. The median operative time was 58 min (IQR 49-78), including a median docking time of 3 min (IQR 2-5) and a median console time of 25 min (IQR 21-36). The median estimated blood loss was 5 mL (IQR 0-10) and no blood transfusions were required. One Clavien-Dindo grade IIIa event occurred in one patient requiring an ERCP for postoperative Choledocholithiasis, which was resolved without the need for reoperation. 26 patients (51%) were discharged within 24 h of the surgery.</p><p><strong>Conclusion: </strong>This study confirmed that DEXTER^® enables safe and effective cholecystectomy in a non-emergent setting, including in outpatient sites of care.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Presence of type 1 hiatal hernia affects the clinical efficacy of per-oral endoscopic myotomy.","authors":"Matthew F Mikulski, Zachary R Stickney, Giulia S Rizzo, David J Desilets, John R Romanelli","doi":"10.1007/s00464-025-12215-0","DOIUrl":"https://doi.org/10.1007/s00464-025-12215-0","url":null,"abstract":"<p><strong>Background: </strong>Per-oral endoscopic myotomy (POEM) is a valuable treatment option for achalasia and non-achalasia esophageal motility disorders, but little is known about the effect of type 1 hiatal hernias (T1HH) on POEM outcomes. We hypothesized there would be no difference in technical success or pre- or post-POEM Eckardt scores between those with and without T1HH.</p><p><strong>Methods: </strong>This single-institution, retrospective review analyzed consecutive POEM cases from 6/10/2011-7/16/2024. T1HH were defined by esophagogastroduodenoscopy, manometry, contrast esophagram, or computed tomography imaging. Technical success included an 8 cm myotomy including the esophagogastric junction and extending 2 cm distal. Clinical success was defined as post-POEM Eckardt score ≤ 3. Demographics, T1HH, and pre- and post-procedural Eckardt scores were analyzed using descriptive, univariate, and multivariable logistic regression statistics.</p><p><strong>Results: </strong>There were 173 POEM cases. Of these, 95(55%) were female, 34(20%) had T1HH, 148(86%) were performed for achalasia, median Eckardt scores were 7[IQR:5.3-9] pre-POEM and 0[IQR:0-1] post-POEM, with clinical success in 146(86%), length of myotomy was median 12[IQR:12-13]cm with technical success in 170(98%). There were no differences found between those with and without T1HH in terms of sex, achalasia diagnosis, previous interventions, pre-POEM Eckardt scores, length of myotomy, or technical success. Compared to those without T1HH, those with T1HH had higher median post-POEM Eckardt scores (median 0[IQR:0-1] vs. 0[IQR:0-0], p = 0.043), lower rates of clinical success (n = 26(76%) vs n = 120(86%), p = 0.01), and had a shorter distance from incisors to EGJ (40[IQR:38.3-41] vs 41[39-43]cm, p = 0.044). After adjustment, presence of T1HH was the only significant factor, conferring 0.13 odds (95%CI: 0.02-0.93, p = 0.042) of clinical success.</p><p><strong>Conclusions: </strong>POEM produces excellent outcomes in patients with and without T1HH. T1HH did not affect technical success of POEM, but decreased clinical success rate and was associated with higher post-POEM Eckardt scores. POEM practitioners should be cognizant of T1HH and advise patients of its potential implications in their treatment plan.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fellowship of the European Board of Surgery in the specialty of Minimally Invasive Surgery (F.E.B.S./MIS): a continuous evaluation.","authors":"Adisa Poljo, Jennifer M Klasen, Nathan J Curtis, Marek Soltes, Nader K Francis, Dorin Popa, Milos Bjelovic, Predrag Andrejevic, Beat P Müller, Felix Nickel, Georg Bischof, Lars Fischer","doi":"10.1007/s00464-025-12204-3","DOIUrl":"https://doi.org/10.1007/s00464-025-12204-3","url":null,"abstract":"<p><strong>Background: </strong>Minimally Invasive Surgery (MIS) has become the standard approach for many procedures, driving rapid changes in training pathways and challenging traditional assessment and accreditation methods. To address this, the European Union of Medical Specialists (UEMS), in collaboration with the European Association for Endoscopic Surgery (EAES), established a working group in 2015 to develop a MIS-specific board fellowship exam (Fellow of European Board of Surgery in Minimally Invasive Surgery (F.E.B.S./MIS)). This rigorous, multi-modality examination assesses surgeons' knowledge and skills to ensure high-quality independent practice. This study provides an overview of the exam's development, structure, and quality assurance, with a focus on participant evaluation.</p><p><strong>Methods: </strong>Eligibility followed UEMS criteria, including certified MIS training, case logbook documentation, and English proficiency. The exam comprised a 100-item multiple-choice test (MCQ) and an objective structured clinical examination (OSCE) with clinical scenarios and validated technical skill tasks. Participants completed evaluation questionnaires on exam experience. Data were analyzed using descriptive statistics, linear regression, and independent-samples t-tests to examine associations between experience, performance, and total scores.</p><p><strong>Results: </strong>Between 2018 and 2024, 119 participants from 28 countries undertook the exam in seven European countries. Most were experienced attending surgeons, with pass rates of 61-88%. Higher credit scores were linked to passing, though not directly correlated, indicating experience alone did not ensure success. Fellowships were considered as the optimal exam time, with motivations including certification and knowledge updates. Feedback was highly positive, especially for oral case-based stations, and nearly all recommended the exam. Suggested improvements included streamlining the application process, enhancing practical training opportunities, offering flexible dates, and enabling exams in candidates' home countries or languages.</p><p><strong>Conclusion: </strong>The UEMS/EAES MIS Board exam is firmly established as a specialized certification for MIS and has been well received by participants. Nevertheless, its broader influence and professional recognition still require systematic assessment.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}