Laparoscopic Endoscopic and Robotic Surgery最新文献

{"title":"Extended-view totally extraperitoneal approach for midline primary and incisional ventral hernia repair: Initial results and experience from a single institution in Vietnam","authors":"Van Phu La ,&nbsp;Vinh Phuc La ,&nbsp;Hai Duong Tong ,&nbsp;Minh Dien Tran ,&nbsp;Tuan Tu Duong ,&nbsp;Vimal Kumar Vasudeavan ,&nbsp;Hadinata Prana ,&nbsp;Anh Vu Doan","doi":"10.1016/j.lers.2025.07.002","DOIUrl":"10.1016/j.lers.2025.07.002","url":null,"abstract":"<div><h3>Objective</h3><div>Abdominal wall hernias, particularly midline primary and incisional types, represent a common and challenging surgical condition. The extended-view totally extraperitoneal (e-TEP) technique has recently been adapted for ventral hernia repair, offering potential advantages over other approaches. This study aimed to evaluate the initial outcomes and institutional experience of the e-TEP technique for midline primary and incisional ventral hernia repair at a tertiary center in Vietnam.</div></div><div><h3>Methods</h3><div>This prospective descriptive study was conducted on 65 patients with midline primary or incisional ventral hernias who underwent e-TEP repair between June 2022 and August 2024. All procedures were performed by two experienced surgeons at the Department of General Surgery, Can Tho General Hospital, Vietnam. Follow-up continued until February 2025. Data were collected and analyzed on demographics, clinical characteristics, surgical details, postoperative outcomes, and recurrence.</div></div><div><h3>Results</h3><div>A total of 65 patients, with a mean age of 57.9 ± 12.6 years, a mean BMI of 25.0 ± 3.3 kg/m², and 47 (72.3%) female, were included. The types of hernias included primary hernias in 63.1% (41 patients) and incisional hernias in 36.9% (24 patients). Among the incisional hernias, 3 cases were recurrences. The median defect area was 9 cm² (range, 1–50 cm²). A 15 cm × 15 cm mesh was used in nearly all cases (98.5%). The mean operating time was 131.9 ± 51.8 min, with no conversions to open repair or other procedures, and no intraoperative complications were observed. Nine patients (13%) experienced postoperative complications, with seroma being the most common (5 cases). Two patients sustained intestinal injuries that required reoperation, one developed a wound infection and one reported postoperative skin paresthesia. The mean visual analogue scale pain scores at postoperative 24 hours, 48 hours, and at discharge were 4.3 ± 1.3, 3.0 ± 1.5, and 1.0 ± 0.4, respectively. The mean postoperative hospital stay was 4.52 ± 2.24 d. Only one case of recurrence (1.5%) was observed, and no patient reported chronic pain during the mean follow-up period of 14.5 ± 7.6 m.</div></div><div><h3>Conclusion</h3><div>The e-TEP technique for midline primary and incisional ventral hernia repair is a feasible and safe option when performed by experienced surgeons. It offers a low rate of complications, short hospital stay, and minimal recurrence rates. This technique can be considered a viable alternative for the management of midline ventral hernias, with promising short-term outcomes.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 3","pages":"Pages 146-152"},"PeriodicalIF":2.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cost–efficiency of preoperative phenazopyridine use in ureteral jet visualization at time of cystoscopy following minimally invasive hysterectomy","authors":"Caitlin H. Waters ,&nbsp;Maame Yaa Brako ,&nbsp;Heidi Preis ,&nbsp;Lokesh Patil ,&nbsp;Nicole Massad ,&nbsp;Jennifer Blaber ,&nbsp;Sara Kim ,&nbsp;Xun Lian","doi":"10.1016/j.lers.2025.07.001","DOIUrl":"10.1016/j.lers.2025.07.001","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the impact of planned preoperative phenazopyridine administration on operative times and costs compared with as-needed intravenous agent use during routine cystoscopy following minimally invasive hysterectomy for benign indications.</div></div><div><h3>Method</h3><div>This prospective cohort study examined patients who underwent laparoscopic or robotic-assisted total or supracervical hysterectomy for benign indications between January 27, 2023 and March 11, 2024, with one of our minimally invasive gynecologic surgeons at Stony Brook University Hospital. Patients were assigned to the non-phenazopyridine group or the phenazopyridine group. The time needed to visualize the ureteral jets during cystoscopy and the total surgery duration were recorded. A cost analysis was then performed.</div></div><div><h3>Results</h3><div>In total, 106 patients were included, with 53 patients in each group. Compared with the non-phenazopyridine group, the phenazopyridine group had significantly shorter times from the start of cystoscopy to visualization of the first ureteral jet (31 s vs. 42 s, <em>p</em> &lt; 0.05). However, there were no significant differences observed for visualization of the second jet, total jet time, or surgery duration. Two patients in the non-phenazopyridine group required the administration of intravenous agents intraoperatively. Routine phenazopyridine was found to be more cost-efficient when medication costs and operative times were examined.</div></div><div><h3>Conclusion</h3><div>Routine phenazopyridine use does not significantly shorten overall cystoscopy times, but it is the more cost-efficient option given increased rates of costly intravenous medication use in the non-phenazopyridine group.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 3","pages":"Pages 128-133"},"PeriodicalIF":2.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic use excluded part of the stomach to prevent negative consequences after gastric bypass","authors":"Oral Ospanov ,&nbsp;Shakhizada Ospanova","doi":"10.1016/j.lers.2025.06.002","DOIUrl":"10.1016/j.lers.2025.06.002","url":null,"abstract":"","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 3","pages":"Pages 156-159"},"PeriodicalIF":2.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘Surgery-by-wire’: A new cross-domain perspective on robotic control","authors":"Atanu Pal","doi":"10.1016/j.lers.2025.05.002","DOIUrl":"10.1016/j.lers.2025.05.002","url":null,"abstract":"<div><div>As robotic surgery provides clinical benefits and increases on a global scale, it also signifies the transition from direct manual control of surgical instruments to digital connectivity and teleoperation. The digital coupling between human control inputs and surgical motion replaces the previous physical link. Robotic surgery is therefore in effect ‘surgery-by-wire’, the term capturing the engineering phenomenon that has also occurred in the ‘fly-by-wire’ of aviation and ‘drive-by-wire’ of cars. This paper reviews the fundamental commonality across domains. Intrinsic to ‘by-wire’ control is digital processing, which generates the control signal to the effector. This processing enables a progressive spectrum of motion modulation, from precision and stability of motion, through assistance and envelope protection, to automation. Precision now manifests in all three domains. In modern aircraft and cars, higher-order assistance is commonplace, such as flight envelope protection, with analogous support in driving, as well as significant automation. In robotic surgery, such assistance and automation have not yet entered wider clinical practice, with concepts such as envelope protection requiring further definition. The digital interface combined with telecommunication has also enabled teleoperation in all domains. Therefore, motion ‘by-wire’ has enhanced performance across industries. A cross-domain perspective will be increasingly useful to facilitate technology transfer and catalyse progress in robotic surgery. As the pan-industry digital transformation evolves, important principles can be derived for application in robotic surgery.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 3","pages":"Pages 123-127"},"PeriodicalIF":2.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of a predictive nomogram for the pregnancy rate after tubal anastomosis in women with tubal ligation","authors":"Shanliang Shang ,&nbsp;Wenhua Liu ,&nbsp;Xiaona Lin","doi":"10.1016/j.lers.2025.05.001","DOIUrl":"10.1016/j.lers.2025.05.001","url":null,"abstract":"<div><h3>Objective</h3><div>Female sterilization is a common contraceptive method, but with changing family dynamics, an increasing number of women seek to restore fertility after tubal sterilization. Current clinical practice lacks effective tools for predicting pregnancy rates in this population after tubal anastomosis. This study aims to develop and internally validate a novel nomogram for predicting the pregnancy rate in women with tubal ligation after tubal anastomosis.</div></div><div><h3>Methods</h3><div>We developed a prediction model based on a training dataset of 208 patients with tubal ligation after undergoing tubal anastomosis between January 2012 and August 2020 at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. The follow-up period for all patients was one year postsurgery, during which pregnancy outcomes were recorded. The LASSO regression model was used to optimize feature selection for the pregnancy rate risk model. The performance of the nomogram was assessed for its calibration, discrimination, and clinical usefulness. Internal validation was assessed.</div></div><div><h3>Results</h3><div>Predictors included in the prediction nomogram were age, type of anastomosis, sterilization duration, time of conception, and anti-Mullerian hormone (AMH) levels. The model displayed good discrimination, with a C-index of 0.924 (95% CI: 0.876–0.971), and good calibration. A high C-index value of 0.879 was still reached in the interval validation. Decision curve analysis revealed that the pregnancy rate nomogram was clinically useful when intervention was selected at the pregnancy rate possibility threshold of 1%.</div></div><div><h3>Conclusion</h3><div>This novel pregnancy rate nomogram incorporating age, type of anastomosis, sterilization duration, time of conception, and AMH could be conveniently used to predict the pregnancy rate in women with tubal ligation after tubal anastomosis.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 3","pages":"Pages 140-145"},"PeriodicalIF":2.0,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combining traditional laparoscopic box practice with video gaming: A randomized control trial","authors":"Simon Byrns,&nbsp;Yun Wu,&nbsp;Bin Zheng","doi":"10.1016/j.lers.2025.04.002","DOIUrl":"10.1016/j.lers.2025.04.002","url":null,"abstract":"<div><h3>Objective</h3><div>While there is consensus regarding a positive effect of video gaming on dexterity, little is known regarding how much traditional laparoscopic practice can or should be substituted with video gaming. This study was designed to assess the effects of varying the amount of traditional practice in a lap box trainer and video gaming on performance in two fundamentals of laparoscopic surgery core tasks.</div></div><div><h3>Methods</h3><div>Undergraduate and medical students were recruited and randomized into one of four groups: a control group, a lap box group, a video game group, and a combined group with 50% of the time allocated to each modality. Performance in the peg transfer and precision cutting tasks was assessed both prior to and following the 6 training sessions.</div></div><div><h3>Results</h3><div>Peg transfer performance significantly improved in the lap box group (168.4 ± 70.6 s vs. 332.9 ± 178.2 s, <em>p</em> &lt; 0.001), video game group (176.7 ± 53.3 s vs. 300.0 ± 101.2 s, <em>p</em> &lt; 0.001) and combined group (214.2 ± 86.9 s vs. 406.8 ± 239.5 s, <em>p</em> = 0.002) after training. Similar improvements were also observed in precision cutting performance in the lap box group (413.1 ± 138.4 s vs. 614.3 ± 211.4 s, <em>p</em> = 0.002), video game group (434.1 ± 150.8 s vs. 609.2 ± 233.2 s, <em>p</em> = 0.007) and combined group (469.2 ± 185.3 s vs. 663.8 ± 296.3 s, <em>p</em> = 0.020). When analyzing improvements in performance across three different training groups compared with the control group, we found that both the lap box group (<em>p</em> &lt; 0.001) and the combined group (<em>p</em> &lt; 0.001) showed better improvement in both tasks, and the video game group had significantly better outcomes in the precision cutting task (<em>p</em> = 0.003).</div></div><div><h3>Conclusion</h3><div>Traditional lap box training remains the most effective method for improving the performance of simulated laparoscopic surgery. Video games can be encouraged to enhance skills retention and supplement simulated practice outside of a formal training curriculum.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 3","pages":"Pages 134-139"},"PeriodicalIF":2.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144830915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peri- and postoperative complications of laparoscopic tubal ligation versus salpingectomy for permanent contraception: An ACS-NSQIP analysis","authors":"Vaishnavi J. Patel ,&nbsp;Devki Patel ,&nbsp;Kimberly Toumazos ,&nbsp;Young Son ,&nbsp;Komal Sharma ,&nbsp;Virgil Kevin DeMario ,&nbsp;Shelby Boock ,&nbsp;Grace Lara ,&nbsp;Alexandra McQuillen ,&nbsp;Brianna Clark","doi":"10.1016/j.lers.2025.04.001","DOIUrl":"10.1016/j.lers.2025.04.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Salpingectomy and tubal ligation are commonly performed for permanent contraception in women. Salpingectomy has been suggested to reduce the risk of ovarian cancer, but its comparative operative and perioperative risks have not been well established. The objective of this study is to compare the peri- and postoperative complications of laparoscopic tubal ligation with those of salpingectomy for permanent contraception.</div></div><div><h3>Methods</h3><div>A retrospective review of 49,445 patients who underwent laparoscopic salpingectomy or tubal ligation for permanent contraception between 2017 and 2021 was conducted using data from the American College of Surgeons National Surgical Quality Improvement Program database. Statistical analysis involved <em>t</em> test, chi-square test, and logistic regression analysis with the use of the random forest algorithm. The primary outcomes were perioperative and postoperative complications.</div></div><div><h3>Results</h3><div>Of the total cohort, 45,307 (91.6%) underwent laparoscopic salpingectomy, and 4138 (8.4%) received laparoscopic tubal ligation. There were significant differences between the salpingectomy and tubal ligation groups with respect to several demographic characteristics, including age, BMI, minority status, and variations in past medical history. These demographic characteristics were controlled for in the multivariate regression analysis. Salpingectomy had a higher rate of operative and postoperative complications than did tubal ligation (OR = 1.78, 95% CI: 1.46–2.20, <em>p</em> &lt; 0.001). Salpingectomy was associated with a greater risk of longer operation time (OR = 2.03, 95% CI: 2.02–2.04, <em>p</em> &lt; 0.001), longer hospital stay (OR = 5.26, 95% CI: 4.57–6.09, <em>p</em> &lt; 0.001), increased readmission (OR = 3.15, 95% CI: 1.92–5.65, <em>p</em> &lt; 0.001), and increased unplanned reoperation (OR = 2.42, 95% CI: 1.32–5.12, <em>p</em> = 0.010). In addition, the occurrence rates of organ space surgical site infection (OR = 2.68, 95% CI: 1.21–7.59, <em>p</em> = 0.032) and sepsis (OR = 3.93, 95% CI: 1.48–16.02, <em>p</em> = 0.020) were significantly greater in the salpingectomy group than in the tubal ligation group.</div></div><div><h3>Conclusions</h3><div>Laparoscopic tubal ligation and salpingectomy are both safe and effective procedures for permanent contraception; however, salpingectomy is more likely to be associated with peri- and postoperative complications. These findings may help guide clinical decision-making when selecting the optimal permanent contraception method for women.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 2","pages":"Pages 84-89"},"PeriodicalIF":0.0,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognition and experience of surgical incisions in patients undergoing laparoscopic surgery with enhanced recovery after surgery protocol: A qualitative study","authors":"Hongxia Xu ,&nbsp;Yihong Xu ,&nbsp;Gongjie Shi ,&nbsp;Jiaqi Lu ,&nbsp;Liping Zhu ,&nbsp;Guibing He ,&nbsp;Xiao Liang","doi":"10.1016/j.lers.2025.03.003","DOIUrl":"10.1016/j.lers.2025.03.003","url":null,"abstract":"<div><h3>Objective</h3><div>Enhanced recovery after surgery (ERAS) protocols have revolutionized postoperative care by integrating minimally invasive techniques and patient-centered strategies to reduce physical and psychological trauma. However, the cognitive and experiential dimensions of surgical incisions under ERAS remain underexplored, particularly in non-Western populations. This study aims to explore patients’ perceptions and preferences regarding laparoscopic incisions under ERAS, providing evidence to optimize incision planning and perioperative education.</div></div><div><h3>Methods</h3><div>A qualitative descriptive study was conducted at the Department of Surgery, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, between November 2022 and February 2023. The participants were adults (≥18 years) who underwent elective laparoscopic abdominal surgery under ERAS, excluding those with cognitive impairments, language barriers, or emergency procedures. Semi-structured interviews, covering physical function, social function, emotional function, self and others’ acceptance, and confidence in the nature and treatment of the disease, were audio-recorded and transcribed verbatim and guided by a thematic framework co-developed by surgeons, nurses, and psychologists. The data were analyzed via the framework method to identify themes related to incision experiences.</div></div><div><h3>Results</h3><div>This qualitative study included 16 participants, 8 (50%) females and 6 (37.5%) cancer patients, with a mean age of 41.5 ± 12.2 years. Qualitative analysis revealed that the participants experienced minimal psychological distress and great emphasis on pain management and expressed specific concerns regarding the location, size, and cosmetic appearance of the incision. They also voiced high expectations for preventing incision complications and sought information regarding postoperative care. There was notable variation in preferences regarding the choice of incision site before surgery. Participants with cancer focused on disease cure rather than aesthetics.</div></div><div><h3>Conclusion</h3><div>Personalized preoperative discussions, incision site selection, and postoperative education are critical for increasing patient satisfaction. Laparoscopic incisions under ERAS minimally impact psychological well-being, but location-specific discomfort and aesthetic preferences require attention.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 2","pages":"Pages 96-101"},"PeriodicalIF":0.0,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123662","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new approach to laparoscopic skill assessment: Motion smoothness and bimanual coordination","authors":"Farzad Aghazadeh ,&nbsp;Bin Zheng","doi":"10.1016/j.lers.2025.03.002","DOIUrl":"10.1016/j.lers.2025.03.002","url":null,"abstract":"<div><h3>Objective</h3><div>Reliable and objective methods for assessing surgical skill are essential for improving surgical skills and clinical outcomes. While conventional methods rely on subjective evaluations, motion analysis can offer a quantitative alternative. This study aims to use motion tracking data to analyze the motion smoothness and bimanual coordination of various surgical skill levels during laparoscopic surgery.</div></div><div><h3>Methods</h3><div>The participants were recruited and grouped into an expert group, an intermediate group, and a novice group on the basis of their experience with laparoscopic surgery. They completed peg transfer, bimanual peg transfer, and rubber band translocation tasks. Motion smoothness was assessed via logarithmic dimensionless tooltip motion jerk, and the dynamic time warping metric of tooltips velocities was employed to assess bimanual coordination.</div></div><div><h3>Results</h3><div>Seventeen participants, with four experts, five intermediates, and eight novices, were included. Compared with novices, the experts exhibited smoother motion in both the dominant hand (peg transfer: 16.30 vs. 18.05, <em>p</em> = 0.004; bimanual peg transfer: 15.21 vs. 17.45, <em>p</em> = 0.004; rubber band translocation: 14.32 vs. 15.87, <em>p</em> = 0.004) and non-dominant hand (peg transfer: 16.32 vs. 18.22, <em>p</em> = 0.004; bimanual peg transfer: 15.32 vs. 17.52, <em>p</em> = 0.004; rubber band translocation: 14.33 vs. 15.77, <em>p</em> = 0.004), and superior bimanual coordination (peg transfer: 8.77 m/s vs. 13.28 m/s, <em>p</em> = 0.004; bimanual peg transfer: 6.29 m/s vs. 11.13 m/s, <em>p</em> = 0.004; rubber band translocation: 4.50 m/s vs. 7.13 m/s, <em>p</em> = 0.004) across all tasks. They also outperformed intermediates in motion smoothness in the non-dominant hand and bimanual coordination in the peg transfer (16.32 vs. 17.35, <em>p</em> = 0.016; 8.77 m/s vs. 11.89 m/s, <em>p</em> = 0.016) and bimanual peg transfer (15.32 vs. 16.22, <em>p</em> = 0.016; 6.29 m/s vs. 8.63 m/s, <em>p</em> = 0.032) tasks. Similarly, intermediates demonstrated smoother motion in the non-dominant hand (peg transfer: 17.35 vs. 18.22, <em>p</em> = 0.002; bimanual peg transfer: 16.22 vs. 17.52, <em>p</em> = 0.002) and dominant hand (bimanual peg transfer: 16.06 vs. 17.45, <em>p</em> = 0.011), and better bimanual coordination (peg transfer: 11.89 m/s vs. 13.28 m/s, <em>p</em> = 0.002; bimanual peg transfer: 8.63 m/s vs. 11.13 m/s, <em>p</em> = 0.002) than novices did in these tasks.</div></div><div><h3>Conclusion</h3><div>This study revealed that motion smoothness and bimanual coordination are capable of facilitating surgical skill differentiation across various skill levels. These findings underscore the utility of motion metrics for objective surgical skill assessment, potentially reducing the subjectivity, bias, and associated costs of conventional assessment approaches.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 2","pages":"Pages 90-95"},"PeriodicalIF":0.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary major abdominal surgical management of Crohn’s disease in the era of biologics and minimally invasive surgery","authors":"Joseph Do Woong Choi ,&nbsp;Talia Shepherd ,&nbsp;Amy Cao ,&nbsp;Nimalan Pathma-Nathan ,&nbsp;Toufic El-Khoury ,&nbsp;James Wei Tatt Toh","doi":"10.1016/j.lers.2025.03.001","DOIUrl":"10.1016/j.lers.2025.03.001","url":null,"abstract":"<div><div>Surgery for ileocolic and colonic Crohn’s disease (CD) remains challenging. Over the past decade, there have been significant advances in surgical techniques, and the timing of surgery for CD patients has been debated. With advances in biological agents, the rate of surgery has significantly decreased, but early ileocolic resection has been advocated. Recently, there has been significant interest in the role of the mesentery in the pathogenesis of CD, with Kono-S mesenteric exclusion anastomosis and extended mesenteric excision advocated by various groups to minimise CD recurrence. There have also been controversies regarding the utility of ileal pouch anal anastomosis after total proctocolectomy. Compared with open surgery, most CD surgeries are now minimally invasive, with increasing evidence for improving short-term outcomes with conventional laparoscopic techniques. The evidence for robotic-assisted surgery in patients with CD is limited at present.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 2","pages":"Pages 73-79"},"PeriodicalIF":0.0,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}