Surgical Endoscopy And Other Interventional Techniques最新文献

{"title":"Comparative analysis of plane vs. telescopic dissection in totally extraperitoneal inguinal hernia repair: propensity score matching.","authors":"Shang-Jun Zhou, Hai Huang, Ping Zhan, Rui-Bin Deng, Yan-Qing Deng, Pei-Jie Zhang, Huan-Bin Zhang, Hong-Shuai Li, You-Hua Wang, Jian-Hua Luo, Xue-Lu Zhou","doi":"10.1007/s00464-025-11734-0","DOIUrl":"10.1007/s00464-025-11734-0","url":null,"abstract":"<p><strong>Objective: </strong>Totally extraperitoneal (TEP) repair involves creating a preperitoneal space. The preperitoneal space can be created by telescopic dissection (TD) or plane dissection (PD). Nevertheless, these techniques may have some complications. This study aims to assess the impact and comprehensively compare the TD and PD methods in patients undergoing laparoscopic TEP inguinal hernia repair.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 156 patients who underwent PD at the Hospital from January 2017 to December 2023. Using propensity score matching (PSM), 312 TD patients were matched at a 1:2 ratio. The primary outcomes included peritoneal injury, vascular injury, clarity of the surgical field, operation time, and intraoperative blood loss. Secondary outcomes included length of hospital stay, postoperative pain, and recurrence rate.</p><p><strong>Results: </strong>After matching, no significant differences in clinical characteristics were observed between the two groups. The PD group showed better the surgical field clarity, reduced intraoperative blood loss, and shorter operation time compared to the TD group. Additionally, the TD group had higher hospitalization costs. There were no statistically significant differences in hospital stay and follow-up duration between the two groups. There was a significant difference in the overall complication rate between the PD and TD groups, mainly in terms of peritoneal and vascular injuries. There was no statistical difference in severe complications (Clavien-Dindo classification) between the two groups. There was also no significant difference between the two groups in terms of incision infection, seroma, hematoma, chronic pain, and recurrence rate between the groups.</p><p><strong>Conclusion: </strong>Both plane dissection and telescopic dissection demonstrate efficacy and reliability in TEP surgery. The PD group showed superior performance in terms of clarity of the surgical field, reduction of peritoneal and vascular injuries, and could shorten hospital stays and reduce costs. Therefore, plane dissection has considerable potential for application in TEP surgery.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3710-3717"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pyloric drainage interventions for gastroparesis: a comparison of laparoscopic pyloroplasty and gastric peroral endoscopic myotomy (G-POEM) outcomes.","authors":"Sven E Eriksson, Marie-Lise Chrysostome, Inanc S Sarici, Johnathan Nguyen, Ping Zheng, Shahin Ayazi","doi":"10.1007/s00464-025-11731-3","DOIUrl":"10.1007/s00464-025-11731-3","url":null,"abstract":"<p><strong>Background: </strong>The endoscopic approach to the surgical management of gastroparesis is gaining popularity. However, data comparing endoscopic myotomy to traditional laparoscopic pyloroplasty are limited. This study aimed to compare outcomes between gastric-per-oral endoscopic myotomy (G-POEM) and pyloroplasty.</p><p><strong>Methods: </strong>Gastroparesis patients who underwent pyloroplasty or G-POEM from 2013 through 2023 at our institution were reviewed. Pre/postoperative gastroparesis cardinal symptom index (GCSI), resolution of the predominant gastroparesis symptom, and gastric emptying scintigraphy (GES) were assessed.</p><p><strong>Results: </strong>There were 314 patients who underwent surgical myotomy. Median (IQR) age was 51.9 (40-62) and 84.1% were female. Of these 81 underwent G-POEM and 233 underwent pyloroplasty. Age and sex were similar between surgical approaches (p > 0.05). Gastroparesis etiology was 61.8% idiopathic, 21.3% diabetic, and 16.9% postsurgical. Postsurgical etiology was more likely to undergo G-POEM (25.9% vs. 13.7%, p = 0.046). At a mean (SD) of 14.2(17) months resolution of the predominant gastroparesis symptom was achieved by 70.0% after G-POEM and 76.4% after pyloroplasty (p = 0.297). The GCSI improved after G-POEM [3.1(2-4) to 2.4 (2-3), p = 0.0498] and pyloroplasty [3.1(3-4) to 2.4(2-3), p < 0.0001]. There was no difference in postoperative GCSI (p = 0.805) or percent GCSI improvement (p = 0.976) between groups. In the 96 patients with pre- and postoperative GES, 4 h retention decreased for pyloroplasty from 29.0% (18-43) to 4.2% (1.0-18) (p < 0.0001) and for G-POEM from 23.0 (13-49) to 13 (5.0-29), (p = 0.045). Pyloroplasty showed a trend towards better emptying (p = 0.0719) with more patients achieving ≥ 50% improvement (70.3% vs. 50%, p = 0.086).</p><p><strong>Conclusions: </strong>Gastroparesis symptom improvement was similar after pyloroplasty and G-POEM; however, there was a trend towards better improvement in gastric emptying after pyloroplasty.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3514-3524"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116998/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pilot study of metallic clip-assisted through-the-scope twin clip technique for defect closure after endoscopic full-thickness resection of small gastric subepithelial tumors.","authors":"Gaofei Shen, Zhenzhen Liu, Fei Zhu, Junyi Zheng, Jinpeng Li, Baozhen Guo, Rui Huang","doi":"10.1007/s00464-025-11704-6","DOIUrl":"10.1007/s00464-025-11704-6","url":null,"abstract":"<p><strong>Background: </strong>This pilot study aimed to evaluate the feasibility and efficacy of metallic clips assisted by through-the-scope twin clips (TTS-TC) for closing gastric wall defects following endoscopic full-thickness resection (EFR) for small gastric submucosal tumors (SMTs).</p><p><strong>Methods: </strong>Nineteen patients with gastric SMTs originated from the muscularis propria were treated by EFR between May 2022 and July 2024. Twelve patients underwent endoscopic closure of the gastric wall defects after EFR with metallic clips and seven patients with TTS-TC and metallic clips.</p><p><strong>Results: </strong>No significant differences existed between the two groups in terms of demographics, clinical characteristics, and the size of the gastric wall defects. The average time to close gastric wall defects was shorter in the TTS-TC group (6.3 ± 0.8 min) compared to the metallic clip group (9.9 ± 2.9 min). Closure costs were higher for the TTS-TC group than for the metallic clip group. The hospitalization time of the two groups had no statistical significance. No single case had surgical intervention or complications, such as gastric bleeding, perforation, peritonitis, or abdominal abscess. A follow-up EGD at the second month after surgery indicated that no postoperative complications occurred.</p><p><strong>Conclusion: </strong>The metallic clips assisted with or without TTS-TC are safe and effective techniques for gastric defect closure after EFR for gastric SMTs. Because of the \"kissing close,\" the TTS-TC more suitable for the lesions located at the gastric fundus, the greater curvature or anterior wall of the gastric body.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3769-3774"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12116684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transoral septotomy versus Z-POEM in the treatment of Zenker diverticulum: a multicenter case-matched comparative study.","authors":"Luca Provenzano, Stefano Siboni, Giovanni Capovilla, Pamela Milito, Cesare Cutrone, Matteo Pittacolo, Lucia Moletta, Michele Valmasoni, Emanuele Luigi Giuseppe Asti, Renato Salvador","doi":"10.1007/s00464-025-11746-w","DOIUrl":"10.1007/s00464-025-11746-w","url":null,"abstract":"<p><strong>Introduction: </strong>Transoral septotomy has become the favored treatment of Zenker Diverticulum (ZD), with POEM becoming a mini-invasive option also in ZD. The gold-standard treatment of ZD is still debated. We designed a case-matched comparative study to evaluate whether POEM (Z-POEM) could be as effective as stapler, traction-assisted Transoral Septotomy (TS) as first-line treatment of ZD.</p><p><strong>Materials and methods: </strong>Consecutive naïve patients between 2015 and 2022 were enrolled in two high-volume centers. Barium-swallow and endoscopy were performed before and after surgery. Symptoms were assessed using a dedicated questionnaire. A control group was generated by matching patients who underwent Z-POEM with those who underwent TS. For matching the patients, a one-to-one nearest neighbor approach was used. Patients were matched for: septum length, symptoms duration, age, and sex.</p><p><strong>Results: </strong>After matching, 26 patients in each group were enrolled. The procedures were completed successfully in all patients in both groups, and mortality was null. TS required a shorter operative time. One leakage was detected in the Z-POEM group while one mucosal tear was detected in the TS group, both treated conservatively. At a median follow-up of 45 months (IQR: 27-68) for TS and 66 months (IQR: 58-76) for Z-POEM, a successful outcome was achieved in 96.2% in both groups. Post-operative symptom scores decreased in all patients in both groups.</p><p><strong>Conclusions: </strong>This is the first study comparing Z-POEM and TS. Both the minimally invasive treatments are effective for naïve Zenker Diverticulum. TS provides a lower rate of intraoperative complications and a shorter operative time.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3832-3838"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047453","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":"SAGES white paper on antibiotic omission in the management of acute uncomplicated diverticulitis: why, when, who, and most importantly, how.","authors":"Richard Garfinkle, Robert D Bennett, Siva Dantu, Alessandra Gasior, Alexander T Hawkins, Jessica Holland, Ana Sofia Ore, Virginia O Shaffer, James P Taylor, Patricia Sylla, Elisabeth C McLemore, Marylise Boutros","doi":"10.1007/s00464-025-11738-w","DOIUrl":"10.1007/s00464-025-11738-w","url":null,"abstract":"<p><strong>Background: </strong>Historically, the management of acute uncomplicated diverticulitis was centered on antibiotics. However, modern theories regarding the pathogenesis of diverticulitis have challenged the notion that antibiotics are necessary in all cases. Despite major reform in many societal guidelines, the adoption of non-antibiotic therapy for uncomplicated diverticulitis has been limited, especially in North America. The purpose of this SAGES White Paper was to review the available evidence on antibiotic omission in uncomplicated diverticulitis and to explore methods of safe implementation.</p><p><strong>Methods: </strong>A task force within the SAGES Colorectal Surgery Committee was formed to work on this White Paper. The committee and its leadership approved an outline that would focus on the following topics: (1) Defining the problem with unnecessary antibiotic exposure; (2) Evaluating the evidence on antibiotic omission in uncomplicated diverticulitis; (3) Identifying the appropriate patient for antibiotic omission; (4) Outlining how to counsel patients who are treated without antibiotics; (5) Reviewing methods to safely implement this practice in both the hospital and community setting. These topics were divided up among members of the task force who performed a structured literature search in preparation for their assignments.</p><p><strong>Results: </strong>Antibiotics are associated with several patient and societal adverse effects, including the rising problem of antimicrobial resistance. Randomized controlled trials have demonstrated no superiority to the routine administration of antibiotics in acute uncomplicated diverticulitis. Appropriate patients for antibiotic omission include those who are immunocompetent, non-septic, and have mild symptoms/disease severity on imaging. Existing frameworks for the safe implementation of new practices can be referenced to help increase adoption of non-antibiotic therapy.</p><p><strong>Conclusion: </strong>The existing body of evidence supports antibiotic omission in appropriate cases of acute uncomplicated diverticulitis. In order to increase the widespread adoption of this practice, buy-in from key stakeholders (both healthcare professionals and patients) is necessary.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3456-3465"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048794","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":"Comparison of a novel endoscopic approach versus laparoscopic deroofing for symptomatic simple hepatic cysts.","authors":"Congying Chen, Ge Yu, Junwei Fan, Yijia Guo, Yinshi Huang, Xiao Han, Rong Wan","doi":"10.1007/s00464-025-11711-7","DOIUrl":"10.1007/s00464-025-11711-7","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic hepatic cyst deroofing (LHCD) stands as the preferred treatment modality for simple hepatic cysts (SHCs), but it has limitations. This study aimed to introduce endoscopic transgastric hepatic cyst deroofing (ETGHCD) as a minimally invasive alternative and to compare its safety and efficacy with LHCD in treating SHCs.</p><p><strong>Methods: </strong>We retrospectively enrolled 10 patients with 15 symptomatic SHCs treated by ETGHCD and 53 patients with 72 SHCs treated by LHCD at Shanghai General Hospital from June 2021 to August 2024. Based on anatomical complexity, patients were categorized into a standard-difficulty laparoscopy group (S2, S3, S5, S6, S4-inferior) and a high-difficulty laparoscopy group (S1, S7, S8, S4-superior). Comparisons were performed in patient characteristics, treatment outcomes, and follow-up data in each group.</p><p><strong>Results: </strong>ETGHCD and LHCD were comparable in safety and both achieved a 100% success rate with complete symptom relief, with no serious complications reported. Notably, the ETGHCD group exhibited significantly lower post-procedure pain scores (0.40 ± 0.52) than the LHCD group (5.81 ± 2.94). During a median follow-up of 22.4 months, no symptom recurrences occurred in the ETGHCD group, whereas 3 patients (5.7%) in the LHCD group experienced recurrences. Both treatments significantly reduced cyst volume (ETGHCD: 85.97 ± 10.93%, LHCD: 77.28 ± 27.22%). Stratified analysis by liver segment revealed that ETGHCD achieved more favorable outcomes for the patients in the high-difficulty laparoscopy group, but no difference for the patients in the standard-difficulty laparoscopy group.</p><p><strong>Conclusion: </strong>ETGHCD demonstrated comparable safety and efficacy to LHCD in treating SHCs, with reduced post-procedure pain and potential benefits for treating SHCs in S1, S7, S8, S4-superior.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3947-3958"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064744","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":"Trends in bariatric surgery revisions: a 25-year single-institution experience.","authors":"Jack W Sample, Noura Jawhar, Sara Bocchinfuso, Tala Abedalqader, Richard S Betancourt, Simon Laplante, Eric J Vargas, Andrew C Storm, Michael L Kendrick, Barham K Abu Dayyeh, Omar M Ghanem","doi":"10.1007/s00464-025-11765-7","DOIUrl":"10.1007/s00464-025-11765-7","url":null,"abstract":"<p><strong>Background: </strong>Revisional bariatric surgery (RBS) is now the third most performed metabolic and bariatric surgery (MBS) in the USA. This study aims to describe trends in MBS revisions at a single large academic institution over 25 years.</p><p><strong>Methods: </strong>We identified patients who underwent an MBS revision between 2000 and 2024 at a single large quaternary referral center from a prospectively maintained database. We retrospectively reviewed the electronic medical records to collect pertinent data related to MBS history and conducted a descriptive review of the data to evaluate trends.</p><p><strong>Results: </strong>A total of 667 patients underwent a first-time bariatric surgery revision; 364 (54.5%) performed surgically and 303 (45.5%) endoscopically. There was a noticeable trend toward endoscopic revisions indicated for weight-related indications, particularly over the past decade. For surgical revisions, Roux-en-Y gastric bypass (RYGB) was the most revised primary MBS operation overall, surpassed by sleeve gastrectomy (SG) in recent years. A greater diversity of indications was observed for surgical compared with endoscopic revisions. Additionally, 14.9% of patients required more than one bariatric revision procedure.</p><p><strong>Conclusion: </strong>Bariatric surgery revisions are increasingly common, highlighting the chronicity of obesity and the need for long-term management. We identified general trends over time toward therapeutic interventions increasingly utilizing minimally invasive surgery and transoral endoscopic techniques. Transoral endoscopic revisions were primarily used for weight-related indications after RYGB, with many other indications managed exclusively through surgery.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3797-3806"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064763","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":"Diverticular disease complicated by colovesical and colovaginal fistulas: not so complex robotically.","authors":"Richard Sassun, Annaclara Sileo, Jyi Cheng Ng, Giulio Mari, Kevin T Behm, Sherief F Shawki, David W Larson","doi":"10.1007/s00464-025-11754-w","DOIUrl":"10.1007/s00464-025-11754-w","url":null,"abstract":"<p><strong>Introduction: </strong>Fistulizing diverticulitis occurs in only 2% of diverticular disease cases, but its symptoms, such as urinary tract infections (UTI), pneumaturia, fecaluria, or vaginal discharge, are highly disruptive to patients. Therefore, surgery is commonly recommended. Laparoscopy has been proven feasible and safe for fistulizing diverticulitis, although revealing a conversion rate of 36%. Robotic surgery might reduce the conversion rate due to advanced instrumentation and improved optics.</p><p><strong>Methods: </strong>All consecutive patients diagnosed with diverticulitis complicated by a colovesical or/and colovaginal fistula who underwent robotic surgical resection at Mayo Clinic Rochester (January 2018-June 2024) were included. Exclusion criteria were concurrent Crohn's disease, colorectal cancer, isolated coloovarian fistula, and less than one month of follow-up.</p><p><strong>Results: </strong>Eighty-nine patients were included in the study: fifty-eight (65%) patients presented with a colovesical fistula, 26 (29%) patients with a colovaginal fistula, and 5 (6%) patients with both. Ureteral ICG was utilized in 44% of cases. There were no intraoperative complications and one conversion secondary to loss of planes. Fourteen (16%) and 8 (9%) received an end colostomy or a loop ileostomy, respectively. Overall, 30-days complications were 35%, with anastomotic leak and abscess occurring in 3% and 6% of cases, respectively. One patient experienced a postoperative bladder leak, managed with a Foley catheter for 14 days, leaving no sequelae. With a median follow-up of 16.5 months, one (1%) fistula recurred after 14 days.</p><p><strong>Conclusions: </strong>Robotic surgery for fistulizing diverticulitis is feasible, with an acceptable complication rate and extremely low conversion and recurrence rates.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3941-3946"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011601","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":"Feasibility of the hinotori™ surgical robot system in right colectomy: a propensity score matching study.","authors":"Yoshiaki Fujii, Hiroyuki Asai, Shuhei Uehara, Akira Kato, Kaori Watanabe, Takuya Suzuki, Hajime Ushigome, Yushi Yamakawa, Hiroki Takahashi, Shuji Takiguchi","doi":"10.1007/s00464-025-11771-9","DOIUrl":"10.1007/s00464-025-11771-9","url":null,"abstract":"<p><strong>Background: </strong>Robotic surgery, represented by the da Vinci™ system (hereafter da Vinci), has been adopted worldwide owing to its high precision and improved surgical outcomes. After key patents for da Vinci expired, the hinotori™ system (hereafter hinotori), Japan's first domestically developed surgical robot system, was introduced and received clinical approval in November 2022. Although hinotori is introduced as an alternative to da Vinci, its clinical performance in gastrointestinal surgery, particularly in colectomy, remains unclear. This study provided an overview of the surgical techniques for right colectomy using hinotori and retrospectively compared its short-term clinical outcomes with those of da Vinci, post-adjusting for background factors using propensity score matching (PSM).</p><p><strong>Methods: </strong>Data from 88 consecutive patients who underwent robotic right colectomy at our institute between 2020 and 2024 were retrospectively reviewed. Patients were classified into the hinotori (n = 28) and da Vinci (n = 60) groups. PSM resulted in 26 patients being assigned to each group. Patient demographics, perioperative outcomes, pathological findings, and complication rates were analyzed and compared between the groups. Patients in both groups underwent standardized surgical procedures performed by the same surgeons using intracorporeal anastomosis. Role switching between the assistant and primary surgeon was required for some procedural steps owing to instrumentation limitations of hinotori.</p><p><strong>Results: </strong>No significant differences were observed in patient demographics between the propensity score-matched groups. Operative (277.5 vs. 242.5 min, p = 0.044) and console (210 vs. 184.5 min, p = 0.047) times were significantly longer in the hinotori group than in the da Vinci group. No significant differences in blood loss, Clavien-Dindo grade III or higher complications, or postoperative hospital stay were found between the groups. Both groups had comparable histopathological outcomes, including lymph node yield and resection margins.</p><p><strong>Conclusion: </strong>Our findings suggest that perioperative outcomes in robotic right colectomy using hinotori are comparable to those of da Vinci.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"4006-4016"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032409","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":"Application of a \"4-steps\" approach for management of Henle's Trunk in right hemicolectomy.","authors":"Yihang Wu, Feiyu Bai, Xiaojian Wu, Zerong Cai","doi":"10.1007/s00464-025-11750-0","DOIUrl":"10.1007/s00464-025-11750-0","url":null,"abstract":"<p><strong>Background: </strong>The management of Henle's Trunk is a critical step in right hemicolectomy. However, there are few reports detailing standardized methods for safe vascular ligation. In this study, we will introduce a 4-step method for safe handling of Henle's Trunk.</p><p><strong>Methods: </strong>We retrospectively analyzed laparoscopic videos of the right hemicolectomy for Henle's Trunk, and classified the key procedure steps into the four steps. Operative time spent on the management of Henle's Trunk, intraoperative bleeding and operative outcomes were analyzed by reviewing the surgical videos and clinical information.</p><p><strong>Results: </strong>A total of 25 patients completed the management of Henle's Trunk successfully, and the average operative time for Henle's trunk was 25.13 min. The median intraoperative blood loss with interquartile ranges was 3(2) ml and no patient had uncontrollable bleeding or accidental injury during the procedure. Learning curve analysis suggested that 12 cases could be familiarized with the 4-step procedure.</p><p><strong>Conclusion: </strong>The 4-step procedure is safe and effective for management of Henle's Trunk branches in right hemicolectomy, and the method has a short learning curve, which can be appropriately promoted.</p>","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":"3986-3992"},"PeriodicalIF":2.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987969","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}