Laparoscopic Endoscopic and Robotic Surgery最新文献

{"title":"Beyond pancreatitis: An extreme lipase elevation in a post laparoscopic Roux-en-Y gastric bypass","authors":"Sumawadee Boonyasurak , Panumase Hirunwidchayarat , Voraboot Taweeruthana","doi":"10.1016/j.lers.2025.04.003","DOIUrl":"10.1016/j.lers.2025.04.003","url":null,"abstract":"","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 4","pages":"Pages 207-210"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847558","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":"Research progress on carbon dioxide embolism during laparoscopic liver resection","authors":"Zhitao Xie ,&nbsp;Weiqi Li ,&nbsp;Bingzhi Dong ,&nbsp;Zihao Huang ,&nbsp;Chenqi Jin ,&nbsp;Hong Yu ,&nbsp;Xin Yu","doi":"10.1016/j.lers.2025.10.002","DOIUrl":"10.1016/j.lers.2025.10.002","url":null,"abstract":"<div><div>Laparoscopic liver resection (LLR) is currently the first-line treatment for multiple liver diseases. Although clinical data have proven its safety and effectiveness, bleeding and carbon dioxide (CO₂) embolism are still the major complications of LLR. The objective of this review was to summarize the pathogenetic mechanism, clinical manifestations, risk factors, prophylactic measures, and treatment strategies for CO₂ embolism in LLR and propose further research directions regarding these controversial issues. A narrative review of the literature from three databases, including PubMed, Embase, and Web of Science, was conducted without any date or language restrictions. The search terms included CO₂ embolism, gas embolism, laparoscopy, liver resection, and hepatectomy. The incidence of CO₂ embolism in LLR (1.2%–4.6%) is approximately 10 times greater than that in overall laparoscopic surgery (0.15%). Transesophageal echocardiogram is currently considered the gold standard for identifying CO₂ embolism. Risk factors are multifactorial and involve patient characteristics, procedural techniques, and anesthetic management. Presently, in clinical practice, a pneumoperitoneal pressure of 10–15 mmHg is typically used to balance bleeding and CO₂ embolism during LLR. The majority of observed CO₂ embolism events are benign, with no significant clinical impact on short-term or long-term outcomes. However, meticulous monitoring, timely recognition, and prompt intervention are crucial during LLR to prevent life-threatening events. Future research should further refine risk stratification, validate early detection methods, and develop standardized management protocols for CO₂ embolism in LLR.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 4","pages":"Pages 171-177"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847548","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":"Endoscopic submucosal dissection versus endoscopic mucosal resection for early esophageal neoplasia: A systematic review and meta-analysis","authors":"Hur Abbas ,&nbsp;Maria Murtaza ,&nbsp;Khadija Azeem ,&nbsp;Maryam Asad ,&nbsp;Maham Shakeel ,&nbsp;Irtaza Hassan ,&nbsp;Manail Asif ,&nbsp;Haya Kashif ,&nbsp;Lia Anwar ,&nbsp;Maham Abid ,&nbsp;Hasan Anwar ,&nbsp;Hassan Ali ,&nbsp;Satesh Kumar ,&nbsp;Mahima Khatri","doi":"10.1016/j.lers.2025.09.004","DOIUrl":"10.1016/j.lers.2025.09.004","url":null,"abstract":"<div><h3>Objective</h3><div>Esophageal carcinoma (EC) is a primary global health concern, ranking as the eighth most common cancer and the sixth leading cause of cancer-related mortality. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are widely used to manage early-stage EC and Barrett’s esophagus. However, their comparative efficacy and safety remain debated. This study aims to systematically compare the safety and efficacy of ESD and EMR in the treatment of early EC and Barrett’s esophagus.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis were conducted following the PRISMA 2020 guidelines. Databases, including MEDLINE (via PubMed), Google Scholar, and the Cochrane Library were searched for studies published up to October 2024. Twenty-two studies involving 3309 patients (1425 with ESD and 1884 with EMR) met the inclusion criteria. The outcomes assessed included en bloc resection, R0 resection, curative resection, local recurrence, bleeding, perforation, and stricture formation. Risk ratios (RR) with 95% CIs were calculated via a random-effects model via RevMan 5.4.</div></div><div><h3>Results</h3><div>ESD significantly outperformed EMR in en bloc resection (RR = 2.22, 95% CI: 1.69–2.90; <em>p</em> &lt; 0.001), R0 resection (RR = 1.93, 95% CI: 1.28–2.91; <em>p</em> = 0.002), and curative resection rates (RR = 2.29, 95% CI: 1.52–3.46; <em>p</em> &lt; 0.001). ESD was associated with lower local recurrence in patients with squamous cell carcinoma (SCC) (RR = 0.13, 95% CI: 0.06–0.30; <em>p</em> &lt; 0.001), whereas recurrence was greater in patients with Barrett’s esophagus (RR = 1.67, 95% CI: 1.30–2.14; <em>p</em> &lt; 0.001). No significant difference was observed in bleeding rates; however, ESD was associated with a greater risk of perforation (RR = 2.94, 95% CI: 1.31–6.60; <em>p</em> = 0.009).</div></div><div><h3>Conclusion</h3><div>ESD is more effective than EMR in achieving complete and curative resections for early EC and SCC, particularly for lesions &gt;20 mm. However, it has a higher complication rate, especially perforation. Careful patient selection and procedural expertise are essential when choosing between the two techniques.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 4","pages":"Pages 191-200"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847556","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":"Minimally invasive management of lung metastases using robotic bronchoscopy: First French experience","authors":"Ilaria Ceccarelli ,&nbsp;Hasnain Bawaadam ,&nbsp;Christine Lorut ,&nbsp;Nouha Chaaban ,&nbsp;Marion Durand ,&nbsp;Agathe Seguin-Givelet","doi":"10.1016/j.lers.2025.07.003","DOIUrl":"10.1016/j.lers.2025.07.003","url":null,"abstract":"","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 4","pages":"Pages 201-206"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847557","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":"Enhancing surgical training through cognitive load assessment","authors":"Yun Wu,&nbsp;Yile Zhu,&nbsp;Bin Zheng","doi":"10.1016/j.lers.2025.06.001","DOIUrl":"10.1016/j.lers.2025.06.001","url":null,"abstract":"<div><div>The cognitive load plays a key role in surgical education, influencing task performance and skill acquisition. This review explores three primary approaches to assessing cognitive load in the surgical context—paper-based measures, physiological measures, and performance-based measures—and highlights their relevance and applications in surgical education. Paper-based tools, such as the NASA Task Load Index and its surgical adaptation, the Surgery Task Load Index, offer simplicity but lack real-time insight. Physiological measures, including heart rate, eye tracking, and electrodermal activity, provide objective and timely data. Neuroimaging techniques, such as electroencephalography and functional near-infrared spectroscopy, provide direct evidence of brain activity but face challenges such as cost and complexity. Performance-based metrics, such as secondary tasks, infer cognitive load from working memory capacity. Accurate assessment of cognitive load can improve training outcomes by adapting demands to cognitive capacity. Future directions include the development of more accurate, multimodal, and user-friendly tools for dynamic, timely assessment, ultimately advancing personalized surgical training and improving patient care.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 4","pages":"Pages 161-165"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847583","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":"Comparison of outcomes in robot-assisted colon cancer surgery using Da Vinci Xi, Hugo™ RAS, and Versius®: The COMPAR-CRC multiplatform study","authors":"Corrado Pedrazzani ,&nbsp;Giulia Turri ,&nbsp;Michele Genna ,&nbsp;Alessandro Valdegamberi ,&nbsp;Andrea Ballarin ,&nbsp;Ernesto De Giulio ,&nbsp;Ruben Sciortino ,&nbsp;Simone Priolo ,&nbsp;Callisto Marco Bravi ,&nbsp;Andrea Ruzzenente","doi":"10.1016/j.lers.2025.10.001","DOIUrl":"10.1016/j.lers.2025.10.001","url":null,"abstract":"<div><h3>Objective</h3><div>Since the introduction of the Da Vinci® robotic system, robot-assisted colon resection has gained popularity because of its the potential technical advantages. Recently, two new CE-marked platforms have become available in Europe: Hugo™ RAS and Versius®. We present the first prospective case series comparing these three robotic systems.</div></div><div><h3>Methods</h3><div>This exploratory, prospective study enrolled 45 consecutive adult patients undergoing robotic colon resection between February and December 2024, as part of the COMPAR trial. Two experienced colorectal surgeons performed all procedures across two surgical units. Each robotic platform was used in 15 cases. The primary outcomes were conversion to laparoscopy or open surgery and intra-operative complications. The secondary outcomes included post-operative recovery, oncological results, and platform-specific technical parameters.</div></div><div><h3>Results</h3><div>The mean age was 66.8 years and 68.9% of patients underwent surgery for colon cancer. No conversions occurred in the Da Vinci group, whereas 2 and 3 conversions to laparoscopy were recorded with Hugo™ RAS and Versius®, respectively. One intra-operative instrument malfunction occurred with Hugo™ RAS, and one surgical complication was reported in each group. No significant differences emerged in post-operative recovery or oncological outcomes. Versius® cases required more frequent use of laparoscopic energy devices (<em>p</em> &lt; 0.001). Hugo™ RAS was associated with a longer total operating room time (<em>p</em> = 0.022) and longer incision length (<em>p</em> = 0.005).</div></div><div><h3>Conclusion</h3><div>Robotic colorectal surgery with all three platforms is feasible when performed by expert surgeons. While early outcomes are encouraging, larger comparative trials are needed to confirm differences in recovery and oncological efficacy.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 4","pages":"Pages 178-184"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847549","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":"Machine learning-guided prevention and management of low anterior resection syndrome: Development of an XGBoost prediction model and validation via SHAP","authors":"Yangtao Pan ,&nbsp;Chaojie Huang ,&nbsp;Xinjie Zhang ,&nbsp;Zhentian Xu ,&nbsp;Bingjun Bai ,&nbsp;Min Chen ,&nbsp;Weifeng Lao","doi":"10.1016/j.lers.2025.09.002","DOIUrl":"10.1016/j.lers.2025.09.002","url":null,"abstract":"<div><h3>Objective</h3><div>Colorectal cancer is among the top three cancers in terms of incidence and mortality worldwide. Although laparoscopic and robotic-assisted sphincter-preserving surgeries reduce permanent colostomy rates to under 20%, 60%–80% of patients develop postoperative low anterior resection syndrome (LARS), nearly half of whom progress to major LARS. This study aims to develop a high-precision machine learning model for predicting LARS, thereby optimizing the early identification, prevention, and management of major LARS in rectal cancer patients, providing a reliable tool for personalized clinical decision-making.</div></div><div><h3>Methods</h3><div>This retrospective study screened 3,986 rectal cancer patients who underwent laparoscopic and robotic-assisted sphincter-preserving surgeries from January 2012 to January 2022. Key predictors were identified via LASSO regression to develop an XGBoost machine learning model for major LARS prediction, which was validated via SHapley additive exPlanations (SHAP).</div></div><div><h3>Results</h3><div>The XGBoost model achieved 93% accuracy for major LARS prediction, with 84% precision, 74% recall, and an F1 score of 0.78, outperforming POLARS (69% accuracy, 82% precision, 36% recall, F1 score of 0.5). SHAP analysis confirmed that tumor height was the strongest predictor, followed by age at surgery, stoma status, preoperative radiotherapy, and gender. The model enabled real-time risk stratification, reducing overtreatment in non-LARS and minor LARS patients in clinical application. The model has been integrated into a user-friendly offline software (XGBoostLARS) and has been applied to the early clinical identification, prediction, and management of LARS.</div></div><div><h3>Conclusion</h3><div>This high-precision XGBoost model optimizes the early identification, prevention, and management of major LARS, leading to new progress in personalized treatment for rectal cancer survivors.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 4","pages":"Pages 185-190"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847555","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 feasibility and early outcomes of fully robotic recipient adult living donor liver transplantation: A narrative review","authors":"Ahmad Mahamid","doi":"10.1016/j.lers.2025.11.002","DOIUrl":"10.1016/j.lers.2025.11.002","url":null,"abstract":"<div><div>Robotic surgery has emerged as a new frontier in liver transplantation. Given the novelty of its application to recipient procedures, a comprehensive overview is crucial. This narrative review synthesizes the fragmented, foundational data on fully robotic recipient adult living donor liver transplantation (LDLT) on the basis of an appraisal of initial case reports and preliminary comparative studies. The literature was identified via PubMed. The literature demonstrates the technical feasibility and favorable safety profile of the robotic approach. A significant reduction in morbidity was observed, as evidenced by a lower comprehensive complication index, reduced blood loss and transfusion need, and a lower incidence of postoperative infections. These benefits were reflected in significantly shorter intensive care unit and hospital stays. While the robotic approach was associated with prolonged operative and ischemia times, the studies revealed that these approaches did not compromise outcomes, with higher 6-month recipient survival noted in the robotic group. Fully robotic recipient LDLT is a groundbreaking technique, although the current evidence consists of initial case reports and non-randomized comparative data from a single center. The available literature suggests a promising safety profile and significant short-term benefits, but these preliminary findings require validation through multicenter, high-level research.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 4","pages":"Pages 166-170"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847584","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":"2025-09-01","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":"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":"2025-09-01","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}