Updates in Surgery最新文献

{"title":"A new surgical technique for robotic hysterectomy using the da Vinci SP^® system.","authors":"Motoki Matsuura, Masato Tamate, Shutaro Habata, Tsuyoshi Saito","doi":"10.1007/s13304-025-02282-2","DOIUrl":"https://doi.org/10.1007/s13304-025-02282-2","url":null,"abstract":"<p><p>This is the first report to describe a novel surgical technique for single-port (SP) hysterectomy performed through a mini-Pfannenstiel incision using the da Vinci SP^® surgical system (Intuitive Surgical, Sunnyvale, CA). Hysterectomy was performed using the SP surgical system. A 2.7 cm mini-Pfannenstiel incision was created, through which a wound retractor (Intuitive Surgical, Sunnyvale, CA) was inserted. The access port of the da Vinci SP^® system (Intuitive Surgical, Sunnyvale, CA) was then connected. Side docking of the da Vinci SP^® system was performed on the patient's left side. No additional ports were inserted. Following docking, the procedure was conducted from the surgeon's console. The surgical steps for Hysterectomy were as follows: (1) incision of the broad ligament; (2) bladder dissection; (3) incision of the cardinal ligament; (4) incision of the vagina; and (5) vaginal cuff closure. The hysterectomy was completed without complications. Total operative time was 90 min, with an estimated intraoperative blood loss of 5 ml. The median surgical time for previous transumbilical hysterectomies performed by the same surgeon was 94 min, indicating comparable duration. This technique demonstrates the feasibility performing robotic hysterectomy using the da Vinci SP^® system through a mini-Pfannenstiel incision. Further evaluation in clinical settings is warranted.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Analysis of intra- and postoperative interventional endoscopic measures in 3000 bariatric surgical procedures over 15 years: a single-center study\".","authors":"Saraswati Sah, Renu Sah","doi":"10.1007/s13304-025-02283-1","DOIUrl":"https://doi.org/10.1007/s13304-025-02283-1","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic left gastric vein reimplantation to prevent gastric venous congestion in total pancreatectomy.","authors":"Allegra Ripolli, Virginia Viti, Emanuele Federico Kauffmann, Ugo Boggi","doi":"10.1007/s13304-025-02297-9","DOIUrl":"https://doi.org/10.1007/s13304-025-02297-9","url":null,"abstract":"<p><p>Gastric venous congestion (GVC) is a significant but often underrecognized complication of total pancreatectomy (TP). Although left gastric vein (LGV) reimplantation can prevent GVC, its feasibility in robotic surgery has not previously been described. We report our initial experience with LGV reimplantation in three TP cases. In one case, conversion to open surgery was required prior to LGV reimplantation. In this patient, despite patency of the reconstructed LGV, GVC developed and necessitated total gastrectomy due to rapidly worsening lactate acidosis and hemodynamic instability. In the remaining two cases, robotic LGV reimplantation was completed successfully, with immediate gastric decompression and uneventful postoperative recovery. These findings highlight the potential clinical relevance of GVC and demonstrate that robotic assistance enables LGV reimplantation, even in anatomically challenging settings. This experience broadens the scope of vascular reconstruction in robotic pancreatic surgery and supports the expanding role of minimally invasive approaches in managing complex surgical scenarios.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding difficulties of the use of GLP-1 analogues: patient reported obstacles.","authors":"Emiliano G Manueli Laos, Andie Bolton, Cameron Pedersen, Julia Xie, Francisco Schlottmann, Mario A Masrur","doi":"10.1007/s13304-025-02290-2","DOIUrl":"https://doi.org/10.1007/s13304-025-02290-2","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary on \"Combined general and neuraxial anesthesia versus general anesthesia alone for laparoscopic cholecystectomy: a meta-analysis of pain control and hemodynamic stability\".","authors":"Rachana Mehta, Ranjana Sah","doi":"10.1007/s13304-025-02299-7","DOIUrl":"https://doi.org/10.1007/s13304-025-02299-7","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Protective ileostomy creation after anterior resection of the rectum (PICARR): a decision-making exploring international survey.","authors":"Andrea Balla, Federica Saraceno, Marika Rullo, Salvador Morales-Conde, Eduardo M Targarona Soler, Salomone Di Saverio, Mario Guerrieri, Pasquale Lepiane, Nicola Di Lorenzo, Michel Adamina, Isaias Alarcón, Alberto Arezzo, Jesus Bollo Rodriguez, Luigi Boni, Sebastiano Biondo, Francesco Maria Carrano, Manish Chand, John T Jenkins, Justin Davies, Salvadora Delgado Rivilla, Paolo Delrio, Ugo Elmore, Eloy Espin-Basany, Alessandro Fichera, Blas Flor Lorente, Nader Francis, Marcos Gómez Ruiz, Dieter Hahnloser, Eugenio Licardie, Carmen Martinez, Monica Ortenzi, Yves Panis, Carlos Pastor Idoate, Alessandro M Paganini, Miguel Pera, Roberto Perinotti, Daniel A Popowich, Timothy Rockall, Riccardo Rosati, Alberto Sartori, Daniele Scoglio, Mostafa Shalaby, Vicente Simó Fernández, Neil J Smart, Antonino Spinelli, Patricia Sylla, Pieter J Tanis, Javier Valdes Hernandez, Steven D Wexner, Pierpaolo Sileri","doi":"10.1007/s13304-025-02277-z","DOIUrl":"https://doi.org/10.1007/s13304-025-02277-z","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-enhanced medical writing: facing unavoidable innovation, between pitfalls and opportunities.","authors":"Luca Viganò, Aldo Rocca","doi":"10.1007/s13304-025-02278-y","DOIUrl":"https://doi.org/10.1007/s13304-025-02278-y","url":null,"abstract":"","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DNA methylation changes in thyroid cancer patients infected with SARS-CoV-2.","authors":"Jong-Hyuk Ahn, Jin Wook Yi","doi":"10.1007/s13304-025-02233-x","DOIUrl":"https://doi.org/10.1007/s13304-025-02233-x","url":null,"abstract":"<p><p>The impact of SARS-CoV-2 infection on thyroid cancer at the genomic level remains poorly understood. The purpose of our study was to determine whether significant DNA methylation changes occur in thyroid cancer tissues from patients with recent SARS-CoV-2 infection. Surgically resected normal thyroid and Papillary (PTC) tissues from three COVID-19-infected PTC patients (Cases) and three prepandemic PTC patients (Controls) were analyzed using DNA methylation EPIC arrays. Differentially methylated probes (DMPs) and differentially methylated regions (DMRs) were identified in normal thyroid and PTC tissues. Functional enrichment analysis was subsequently performed to explore the affected pathways. COVID-19-infected PTC tissues presented distinct DNA methylation profiles, with 6,848 DMPs in PTC tissues compared with 140 in normal thyroid tissues. SARS-CoV-2 infection did not significantly affect normal thyroid tissue by methylation. SARS-CoV-2 infection in PTC tissues was associated with hypermethylation of tumor suppressor genes (RUNX3, PAOX), the Wnt signaling pathway, the HOX gene family, cell adhesion-related genes and hypomethylation in response to virus-related genes. The key DMRs identified in PTC included GPR75, CCDC80, and ENTPD3, suggesting altered cell adhesion, tumor proliferation, and immune evasion. SARS-CoV-2 infection is linked to significant DNA methylation alterations in PTC tissues, with potential implications for tumor progression and aggressiveness. These findings suggest that COVID-19 may influence thyroid cancer biology. Further research is needed to validate these epigenetic modifications, establish causal relationships and determine their clinical relevance.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world use of polidocanol foam sclerotherapy for hemorrhoidal disease: insights from an international survey and systematic review with clinical practice recommendations.","authors":"Gaetano Gallo, Ugo Grossi, Veronica De Simone, Arcangelo Picciariello, Elia Diaco, Pin Fan, Hongbo He, Jun Li, Hongcheng Lin, Marco La Torre, Rita Laforgia, Pierluigi Lobascio, Hui Ma, Francesco Pata, Roberto Perinotti, Vincent Parades, Mauro Pozzo, Alberto Realis Luc, Paulo Salgueiro, Adam Skowronski, Pingliang Sun, Mario Trompetto, Roberta Tutino, Chen Wang, Zhenyi Wang, Zhenquan Wang, Jiong Wu, Yuru Zhang, Shipeng Zhao, Xiandong Zeng, Vitor Fernandes, Karl-Heinz Moser, Donglin Ren, Pierpaolo Sileri, Gianpiero Gravante","doi":"10.1007/s13304-025-02258-2","DOIUrl":"https://doi.org/10.1007/s13304-025-02258-2","url":null,"abstract":"<p><p>Polidocanol foam sclerotherapy has gained increasing attention as a minimally invasive treatment for hemorrhoidal disease (HD). However, significant variability exists in its clinical application regarding patient selection, procedural techniques, and postoperative management. This study aimed to assess real-world practice patterns among international experts, summarize existing evidence through a systematic literature review, and develop evidence-based clinical practice recommendations. A systematic review was conducted in MEDLINE, EMBASE, and CENTRAL to identify studies evaluating polidocanol foam sclerotherapy for HD. A total of 20 studies met the inclusion criteria. Additionally, an international survey was distributed to 30 experts in proctology and colorectal surgery to explore variations in indications, perioperative management, technique, and follow-up. Survey responses were analyzed descriptively to identify common trends and areas of divergence. Subsequently, based on both the experts' opinions and the results of the survey, a Delphi method was employed to produce clinical practice recommendations. The questions for the Delphi process were developed by the authors leading the project, followed by a detailed discussion with the whole panel of experts. Most experts (90%) reported using polidocanol foam sclerotherapy primarily for Goligher grade II HD, with 67% extending its use to grade III cases. Preoperative bowel preparation and anesthesia use varied widely. The preferred concentration was 3% polidocanol, with 2 mL injected per hemorrhoidal pile in most cases. Post-procedural care lacked standardization, though stool softeners and flavonoids were commonly recommended. Compared to rubber band ligation, polidocanol foam was perceived as having higher success rates (88.3% vs. 66.7%) and lower recurrence rates (16.1% vs. 41.2%). Adverse events were infrequent. The present article offers a comprehensive suite of clinical practice expert-based recommendations concerning the use of polidocanol foam sclerotherapy for HD. However, there is still significant variation in its application. These findings highlight the need for standardized guidelines and further research to optimize procedural strategies and long-term outcomes.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic management of subglottic stenosis with innovative transcordal stent.","authors":"Leonardo Teodonio, Beatrice Trabalza Marinucci, Valentina Peritore, Francesco Cassiano, Amir Hanna, Giacomo Argento, Gaetana Messina, Beatrice Leonardi, Alfonso Fiorelli, Claudio Andreetti","doi":"10.1007/s13304-025-02235-9","DOIUrl":"https://doi.org/10.1007/s13304-025-02235-9","url":null,"abstract":"<p><p>Single-stage tracheal resection and anastomosis represents the gold standard for benign subglottic stenosis' management. Nevertheless, also considering the complexity of the surgical procedure, some patients are considered unfit for tracheal surgery (stenosis involving vocal cords, comorbidities, and relapse after surgery). Until now, the only alternative was tracheostomy which represents the only real alternative to secure the patency of the airway. Thanks to the creation of \"transcordal stents\", patients considered unfit for surgery have a valid alternative to tracheostomy and the conformation of the stent reduces the risk of stent migration, preserving airway patency, swallowing, and phonation. This study aims to evaluate the use of a new custom-made transcordal stent, comparing its safeness with traditional transcordal stent. Between 2017 and 2021, 28 consecutive patients underwent transcordal stenting for benign tracheal stenosis in 3 centers. Patients were divided into 2 groups: 16 treated with the new custom-made stent (Group 1) and 12 treated with conventional stents (Group 2). Intra-, post-operative complications, swallowing capacity, quality of voice, granulation tissue, stent migration, and quality of life (QoL) were compared between the two groups. Group 2 showed reduced swallowing capacity (p = 0.0001), higher rate of stent migration (p = 0.0003), higher rate of granulation tissue (p = 0.0044), and higher rate of stent replacement (p = 0.0001). Voice reduction was not significantly different between the two groups. QoL was better in Group 1. Despite this represent the largest study analyzing transcordal stenting as definitive treatment of subglottic stenosis in patients unfit for surgery, results could not draw definitive conclusions because of the small number of patients, the lack of randomization, and the small follow-up. Nevertheless, the use of the new custom-made transcordal stent could be considered safe and effective, guaranteeing stable results with low rate of long-term complications and better QoL compared to the traditional stents.</p>","PeriodicalId":23391,"journal":{"name":"Updates in Surgery","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}