Laparoscopic Endoscopic and Robotic Surgery最新文献

{"title":"A comparison of laparoscopic to open pancreaticoduodenectomy for pancreatic adenocarcinoma by propensity score matching analysis","authors":"Jared Mount ,&nbsp;Brandon Mount ,&nbsp;Katherine Poruk ,&nbsp;Mary Tice ,&nbsp;John A. Stauffer","doi":"10.1016/j.lers.2024.08.001","DOIUrl":"10.1016/j.lers.2024.08.001","url":null,"abstract":"<div><h3>Objective</h3><div>In previous studies, laparoscopic pancreaticoduodenectomy (LPD) has demonstrated safety and potential benefits over open pancreaticoduodenectomy (OPD) for pancreatic adenocarcinoma (PDAC). After performing both LPD and OPD procedures interchangeably in routine practice for a decade, the outcomes of LPD versus OPD for PDAC were analyzed and compared at a single institution. Our primary aim was to compare features of LPD and OPD in PDAC patients so that the suitable surgical approach may be chosen for each individual.</div></div><div><h3>Methods</h3><div>From January 2010 through December 2020, all patients undergoing pancreaticoduodenectomy (PD) were identified, and information was collected prospectively. At a single institution, PD was performed on 589 patients, of whom 347 were OPD patients and 242 were LPD patients. After excluding those who underwent pancreatectomy for indications other than PDAC, total pancreatectomy, major vascular or concomitant organ resection, there were 237 patients (OPD = 157, LPD = 80). Then propensity score matching was completed to analyze 77 OPD patients versus 77 LPD patients to create a similar group of patients who underwent either LPD or OPD for PDAC. A comparison of perioperative data and 90-day outcomes with subsequent statistical analysis was performed.</div></div><div><h3>Results</h3><div>Operative time (491 min vs. 281 min, <em>p</em> &lt; 0.001) was longer for LPD than OPD. The rates of pancreatic fistula (11.7% vs. 0.0%, <em>p</em> &lt; 0.001) and delayed gastric emptying (15.6% vs. 3.9%, <em>p</em> = 0.027) were higher for LPD than OPD respectively but overall morbidity was similar. Blood loss, mortality and post-pancreatectomy hemorrhage were also similar for both groups, but total costs ($60,245 vs. $50,900, <em>p</em> = 0.002) were significantly higher for LPD than OPD. Recurrence and overall survival were similar for the two groups.</div></div><div><h3>Conclusion</h3><div>In our experience, LPD does not offer any advantages over OPD for PDAC and is associated with a higher rate of complications and costs.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 4","pages":"Pages 141-146"},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revised in-depth meta-analysis on the efficacy of robot-assisted versus traditional free-hand pedicle screw insertion","authors":"Sorayouth Chumnanvej ,&nbsp;Branesh M. Pillai ,&nbsp;Jackrit Suthakorn ,&nbsp;Siriluk Chumnanvej","doi":"10.1016/j.lers.2024.08.002","DOIUrl":"10.1016/j.lers.2024.08.002","url":null,"abstract":"<div><h3>Objective</h3><div>Robot-assisted pedicle screw insertion has recently emerged as an alternative to the traditional free-hand technique. However, discrepancies in the accuracy of screw placement between the 2 methods have been highlighted by some comparative studies. This meta-analysis was conducted to synthesize evidence comparing these techniques.</div></div><div><h3>Methods</h3><div>Searches were conducted in 5 electronic databases adhering to specific eligibility criteria for randomized and observational studies. The data were analyzed using RevMan software and the results are presented as odds ratios (ORs), mean differences, or standard mean differences (SMDs) with 95% confidence intervals (CIs). Our analysis included 12 studies (7 randomized trials and 5 observational studies, involving 883 patients and 4903 screws).</div></div><div><h3>Results</h3><div>The results demonstrated a higher rate of Grade A Gertzbein and Robbins pedicle placement score (OR: 1.77; 95% CI: 1.10–2.87), a lower rate of revision surgeries (OR: 0.21; 95% CI: 0.09–0.52), and a shorter radiation exposure duration (SMD = −1.38, 95% CI: −2.32 to −0.44) in the robot-assisted group compared with the free-hand group. Nonetheless, the length of hospital stay, volume of intraoperative blood loss, postoperative visual analogue scale scores for back pain, and rate of wound infection were similar between the 2 groups. Significant heterogeneity was observed in some outcomes.</div></div><div><h3>Conclusion</h3><div>Compared with the free-hand method, the robot-assisted technique provides greater accuracy and reduced radiation exposure. The efficacy of the robot-assisted technique is expected to improve further as experience with its use in surgery grows.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 4","pages":"Pages 155-165"},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142554066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large language models in laparoscopic surgery: A transformative opportunity","authors":"Partha Pratim Ray","doi":"10.1016/j.lers.2024.07.002","DOIUrl":"10.1016/j.lers.2024.07.002","url":null,"abstract":"<div><div>This opinion paper explores the transformative potential of large language models (LLMs) in laparoscopic surgery and argues for their integration to enhance surgical education, decision support, reporting, and patient care. LLMs can revolutionize surgical education by providing personalized learning experiences and accelerating skill acquisition. Intelligent decision support systems powered by LLMs can assist surgeons in making complex decisions, optimizing surgical workflows, and improving patient outcomes. Moreover, LLMs can automate surgical reporting and generate personalized patient education materials, streamlining documentation and improving patient engagement. However, challenges such as data scarcity, surgical semantic capture, real-time inference, and integration with existing systems need to be addressed for successful LLM integration. The future of laparoscopic surgery lies in the seamless integration of LLMs, enabling autonomous robotic surgery, predictive surgical planning, intraoperative decision support, virtual surgical assistants, and continuous learning. By harnessing the power of LLMs, laparoscopic surgery can be transformed, empowering surgeons and ultimately benefiting patients.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 4","pages":"Pages 174-180"},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapy for benign rectal anastomotic stricture after surgery for colorectal cancer: A systematic review","authors":"Gaoyang Cao ,&nbsp;Songtao Wu ,&nbsp;Li Zhang ,&nbsp;Xinjie Zhang ,&nbsp;Wei Zhou","doi":"10.1016/j.lers.2024.06.004","DOIUrl":"10.1016/j.lers.2024.06.004","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate various treatment methods for benign rectal anastomotic stricture (AS) following surgery for colorectal cancer.</div></div><div><h3>Method</h3><div>A systematic review of the literature was conducted, focusing on studies that reported outcomes of different treatment modalities for benign AS. The PubMed, Embase, Scopus, China National Knowledge Infrastructure, and Cochrane Library databases were searched from January 2000 to December 2023. The inclusion criteria were studies involving human subjects, published in English, and reporting on therapeutic outcomes for benign AS.</div></div><div><h3>Results</h3><div>A total of 19 papers identified a range of therapeutic strategies, including nonoperative anastomotic dilation, endoscopic balloon dilation (EBD), transanal minimally invasive surgery (TAMIS), self-expandable metal stents (SEMS), endoscopic incision (EI) and newer techniques such as prostate resection instrumentation. Nonoperative anastomotic dilation can serve as an initial treatment for lower AS. EI demonstrated promise in cases where EBD was ineffective, providing an alternative method for managing AS. TAMIS and SEMS showed higher efficacy in refractory cases, with TAMIS being particularly effective for severe fibrotic or completely closed AS. The use of rigid instrumentation with an electric knife for transanal incisions demonstrated precision but lacked the flexibility needed for complex procedures.</div></div><div><h3>Conclusion</h3><div>While traditional methods such as nonoperative anastomotic dilation and EBD remain first-line treatments for benign AS, advanced techniques such as EI, TAMIS, and SEMS offer promising alternatives, particularly in refractory cases. The choice of treatment should be tailored to individual patient conditions, with consideration for the technical expertise required and the potential for complications.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 4","pages":"Pages 166-173"},"PeriodicalIF":0.0,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141694897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing a complex patient with both colorectal cancer and diverticulitis of the sigmoid colon: A case report and literature review","authors":"","doi":"10.1016/j.lers.2024.06.002","DOIUrl":"10.1016/j.lers.2024.06.002","url":null,"abstract":"","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 4","pages":"Pages 181-185"},"PeriodicalIF":0.0,"publicationDate":"2024-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141415029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interlayer repair with porcine small intestinal submucosa versus internal repair with tragus cartilage in endoscopic tympanoplasty","authors":"Lina Zhao,&nbsp;Wenya Li,&nbsp;Lei Zhang","doi":"10.1016/j.lers.2024.05.001","DOIUrl":"10.1016/j.lers.2024.05.001","url":null,"abstract":"<div><h3>Objective</h3><p>Endoscopic tympanoplasty includes various surgical methods, such as internal repair, interlayer repair, and external overlay. This technique requires autologous materials, allografts, and xenografts, which are used to repair tympanic membrane (TM) perforation. To obtain good results, appropriate surgical methods and repair materials should be selected. This study aims to assess the efficacy of repairing refractory TM perforations in the porcine small intestinal submucosa (SIS) during transcanal endoscopic type I tympanoplasty.</p></div><div><h3>Method</h3><p>A retrospective chart review was performed on patients who underwent TM perforation repair with porcine SIS and tragus cartilage between January 2022 and September 2022 at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine. Perforation size, tympanic status, pre- and postoperative symptoms, follow-up data, wound healing rates, and hearing improvement were analysed.</p></div><div><h3>Results</h3><p>Of the 115 patients included in the study, 56 underwent interlayer repair with porcine SIS of the TM, and 59 patients underwent internal repair with tragus cartilage. No significant difference was found between the two groups at baseline in terms of age, sex, disease course, perforation side, tympanic status, underlying disease, or preoperative infection. The total postoperative effective rate of interlayer implantation with porcine SIS was 91.07% (51 patients), and that of internal implantation with tragus cartilage was 88.14% (52 patients). No significant difference was found in terms of the graft success rate between the two surgical methods (<em>p =</em> 0.887). Postoperative pure tone auditory (PTA) and air-bone gap (ABG) density significantly increased in both groups compared with before surgery (<em>p</em> &lt; 0.05). However, the postoperative PTA and ABG density were not significantly different 3 months post-surgery between the two groups (<em>p</em> &gt; 0.05). Compared to those in the internal implantation group, the patients in the interlayer group had a shorter operation duration (51.36 ± 6.76 min vs. 59.71 ± 7.45 min, t = 6.298, <em>p</em> &lt; 0.001) and less blood loss (11.91 ± 2.61 mL vs. 15.27 ± 2.57 mL, t = 7.019, <em>p</em> &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>Our study suggests that the porcine SIS, as well as the tragus cartilage, has a high success rate in repairing irreversible TM perforation. Endoscopic tympanoplasty via interlayer implantation with porcine SIS offers distinct advantages, including the absence of donor-site incision and scar formation, and ease of graft modification and manipulation.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 2","pages":"Pages 79-86"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S246890092400029X/pdfft?md5=2a7eac7e9f74b3c2505076ef03f8744d&pid=1-s2.0-S246890092400029X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141032919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic complete mesocolic excision for right colon cancer: Learning curve, training, techniques, approach, platforms, and future perspectives","authors":"Guglielmo Niccolò Piozzi ,&nbsp;Sentilnathan Subramaniam ,&nbsp;Rauand Duhoky ,&nbsp;Werner Hohenberger ,&nbsp;Jim S. Khan","doi":"10.1016/j.lers.2024.04.001","DOIUrl":"10.1016/j.lers.2024.04.001","url":null,"abstract":"<div><p>Colon cancer has the fifth highest incidence worldwide and has the sixth highest mortality. Compared with rectal cancer, colon cancer currently has the worst 5-year overall survival for patients with stage II and III disease. Complete mesocolic excision has been developed as a standardized and optimized surgical technique for the excision of colon cancers. This technique has traditionally been performed through an open approach since laparoscopy is generally considered technically challenging. The robotic approach has been slowly implemented for colon cancer, but the newest robotic platforms allow for a safer and optimized approach for right colon cancer. Several robotic approaches have been developed and explored. The expansion of the current robotic platform ecosystem is gradually providing new outputs in the application of the robotic approach to complete mesocolic excision. This review gains an oversight of existing literature on robotic complete mesocolic excision for right colon cancer (learning curve, training, techniques, approach, platforms, and future perspectives).</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 2","pages":"Pages 53-59"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900924000239/pdfft?md5=3e626acb3eb17337b6574c5f20e30ea2&pid=1-s2.0-S2468900924000239-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140767895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results of selective decontamination with oral neomycin and metronidazole for major colorectal surgery in Australia: A cohort study","authors":"James Wei Tatt Toh ,&nbsp;Devansh Shah ,&nbsp;Henry Wang ,&nbsp;Charlotte Kwik ,&nbsp;Joseph Do Woong Choi ,&nbsp;Chelsie Leonie Beinke ,&nbsp;Paul Morris ,&nbsp;Eleni Baird-Gunning ,&nbsp;Geoffrey Peter Collins ,&nbsp;Fiona Gavegan ,&nbsp;Karen Shedden ,&nbsp;Toufic El-Khoury ,&nbsp;Nimalan Pathma-Nathan ,&nbsp;Kerry Hitos","doi":"10.1016/j.lers.2024.03.002","DOIUrl":"10.1016/j.lers.2024.03.002","url":null,"abstract":"<div><h3>Objective</h3><p>The role of selective decontamination with oral antibiotics (OABs) and mechanical bowel preparation (MBP) prior to elective colorectal surgery is still widely debated. The objective of this study was to compare the outcomes of selective decontamination with neomycin, metronidazole and MBP compared to those of decontamination with MBP alone or with no preparation.</p></div><div><h3>Methods</h3><p>Selective decontamination with neomycin and metronidazole combined with bowel preparation was introduced prior to elective colorectal surgery as part of an enhanced recovery after surgery program at Westmead Hospital, a major Australian tertiary referral hospital, between June 2017 and January 2023. Comparisons between short-term outcomes of OAB + MBP and MBP/no preparation were made using prospectively collected data on length of stay (LOS), readmission, mortality within 30 days, anastomotic leakage (AL), surgical site infection (SSI), urinary tract infection, deep venous thrombosis and/or pulmonary embolism, pneumonia, and ileus. Follow-up was limited to hospital stays and subsequent presentations within the health district within thirty days of surgery. The Mann–Whitney U test was used to analyse continuous data, and the chi-square test was used for categorical data. Univariate and multivariate regression modelling was performed to identify risk factors associated with an increased likelihood of SSI and AL.</p></div><div><h3>Results</h3><p>Patients with oral neomycin and metronidazole combined with bowel preparation had reduced superficial SSI (2.7% vs. 7.6%, <em>p</em> = 0.043) and overall complications (32.7% vs. 44.6%, <em>p</em> = 0.020), particularly Clavien–Dindo 1 complications (7.3% vs. 16.5%, <em>p</em> = 0.009). However, the differences in AL (2.7% vs. 4.5%, <em>p</em> = 0.369) and organ/space SSI (1.3% vs. 3.7%, <em>p</em> = 0.327) were not statistically significant. The median LOS (6 d vs. 6 d, <em>p</em> = 0.370) was not different between the groups.</p></div><div><h3>Conclusion</h3><p>Selective decontamination with neomycin and metronidazole reduces the risk of SSIs and overall complications. There was a trend to toward a lower AL, but this difference was not statistically significant.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 2","pages":"Pages 72-78"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900924000215/pdfft?md5=b8de5e3010c70e4193b935e8ec2cb78a&pid=1-s2.0-S2468900924000215-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140275613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic plication for diaphragmatic eventration in adults: Unveiling the mystery of eventration","authors":"Balika Mahesan ,&nbsp;Prasanna Kumar Reddy ,&nbsp;K.S. Santhosh Anand ,&nbsp;Muvva Sri Harsha M ,&nbsp;Vijay N ,&nbsp;Sudarsan Srikanth","doi":"10.1016/j.lers.2024.01.001","DOIUrl":"10.1016/j.lers.2024.01.001","url":null,"abstract":"<div><p>Diaphragm eventration is the permanent elevation of a hemidiaphragm and can be due to congenital or acquired causes. It is a rather uncommon condition in adults and causes a spectrum of symptoms, ranging from asymptomatic incidental findings on imaging to life-threatening respiratory distress. Asymptomatic patients do not require any treatment, but plication is the conventional, well-known method for treating symptomatic patients. Management varies depending on the symptoms. In this article, we discuss two rare cases of diaphragmatic eventration that were treated with minimal access surgery.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 2","pages":"Pages 92-96"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S246890092400001X/pdfft?md5=1595a79c93aab90d02ed0adb34c46c6b&pid=1-s2.0-S246890092400001X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139394218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of da Vinci 5 with previous versions of da Vinci and Sina: A review","authors":"Arya Asadizeidabadi,&nbsp;Seyedmohammadamin Hosseini,&nbsp;Fedor Vetshev,&nbsp;Sergey Osminin,&nbsp;Seyedali Hosseini","doi":"10.1016/j.lers.2024.04.006","DOIUrl":"https://doi.org/10.1016/j.lers.2024.04.006","url":null,"abstract":"<div><p>Robotic systems have become popular in modern surgical procedures. The option of telesurgery has effectively addressed geographic limitations. These systems are offered by numerous companies worldwide. In this review article, we discuss four models of robotic systems to determine their advantages: the Sina flex system from Iran and the da Vinci Xi, SP, and 5 systems from the USA. We compared aspects such as architecture, instruments, visualizations, clinical use, and costs. Our findings suggest that the da Vinci robot, which was introduced earlier than the Sina system, utilizes proprietary and limited-use EndoWrist instruments with diameters ranging from 8 to 12 mm and features advanced imaging capabilities, including three-dimensional optical, tomographic, and fluorescence imaging. It is well established and widely utilized in various surgical procedures. Conversely, the Sina flex system employs single-use 5 mm instruments and is equipped with two-dimensional optical imaging as a standard, with optional three-dimensional and fluorescence imaging upgrades available. Despite its affordability, the Sina flex system is relatively new and has not yet been clinically tested. Additionally, the Sina flex system is more user-friendly.</p></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"7 2","pages":"Pages 60-65"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2468900924000288/pdfft?md5=d12f53eb6ad404d68e741739771f4bcd&pid=1-s2.0-S2468900924000288-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141294158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}