Laparoscopic Endoscopic and Robotic Surgery最新文献

{"title":"Recent patterns in minimally invasive colectomies: Where are we now?","authors":"Jonathan A. Laredo,&nbsp;Sofia Torres-Small,&nbsp;Devanshi Patel,&nbsp;Saskya Byerly,&nbsp;Dina M. Filiberto,&nbsp;Elizabeth H. Wood","doi":"10.1016/j.lers.2024.09.003","DOIUrl":"10.1016/j.lers.2024.09.003","url":null,"abstract":"<div><h3>Objective</h3><div>Minimally invasive surgery (MIS) techniques such as laparoscopy and robotic surgery for colorectal resection have been cited as superior to traditional open surgery because of their associations with decreased operating room time, hospital stay length, and postoperative morbidity. Despite these benefits, the open approach remains a common surgical method for colorectal resection procedures. We aim to evaluate the most recent yearly trends in open, laparoscopic, and robotic approaches to provide insight into uptake and present the status of MIS in the field of colorectal surgery.</div></div><div><h3>Methods</h3><div>Data were collected from the American College of Surgeons National Surgical Quality Improvement Program targeted colectomy database for the years 2014–2020. The surgical approach was classified as either open, laparoscopic, or robotic. Analysis was performed to identify trends in colorectal surgery categorized by year, patient age, American Society of Anesthesiologists (ASA) classification, body mass index (BMI), and emergency status.</div></div><div><h3>Results</h3><div>There was an overall decline in both open and laparoscopic surgery cases (from 38.4% to 34.4% and from 57.4% to 50.8%, respectively) and an overall increase in robotic surgery cases (from 4.2% to 14.8%) from 2014 through 2020. Open surgery was the most common approach for the lowest BMI category (&lt;18.5 kg/m²), highest risk ASA classes (4–5) and most emergent surgeries, whereas robotic surgery rates were negligible for these groups. Laparoscopy was the most prevalent approach for all other categories.</div></div><div><h3>Conclusion</h3><div>Laparoscopy was the most prevalent approach in colorectal surgery, although the total case proportions generally tended to decrease. While open surgery remains the approach of choice for emergent procedures, laparoscopic case proportions increased marginally in this category, likely owing to increases in surgeon comfort and continued expansion of laparoscopic training efforts. Importantly, the total prevalence of robotic surgery increased significantly between 2014 and 2020, which may be attributable to advancements in the robotic platform and increases in familiarity and competence with the technology. We anticipate a continuation of these trends in the future and recommend the creation of a national robotic surgery training standard.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 1","pages":"Pages 23-27"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511552","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":"A comprehensive step-by-step approach for the implementation of target trial emulation: Evaluating fluid resuscitation strategies in post-laparoscopic septic shock as an example","authors":"Jie Yang ,&nbsp;Lihui Wang ,&nbsp;Lin Chen ,&nbsp;Pengmin Zhou ,&nbsp;Suibi Yang ,&nbsp;Hongjie Shen ,&nbsp;Lifeng Xing ,&nbsp;Pengpeng Chen ,&nbsp;Yuetian Yu ,&nbsp;Hongying Ni ,&nbsp;Zhongheng Zhang","doi":"10.1016/j.lers.2025.01.001","DOIUrl":"10.1016/j.lers.2025.01.001","url":null,"abstract":"<div><h3>Objective</h3><div>To develop and demonstrate a comprehensive methodological framework for target trial emulation (TTE) implementation via post-laparoscopic septic shock fluid management as a clinical case study.</div></div><div><h3>Methods</h3><div>We designed a simulated study of 10,000 patients in which colloid resuscitation was compared with crystalloid resuscitation. The framework incorporated precise eligibility criteria, standardized intervention protocols, and balanced treatment allocation with temporal anchoring. The primary analyses focused on 28-day mortality and were evaluated through survival analysis and comparative statistics.</div></div><div><h3>Results</h3><div>The methodological framework successfully demonstrated the systematic implementation of TTE principles, providing reproducible protocols for eligibility determination, intervention standardization, and outcome assessment in observational studies.</div></div><div><h3>Conclusion</h3><div>This work bridges the gap between TTE theory and practice by providing a detailed technical roadmap that enhances methodological transparency and reproducibility in comparative effectiveness research.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 1","pages":"Pages 28-44"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511673","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":"Fully endoscopic microvascular decompression for trigeminal neuralgia: A retrospective study","authors":"Hongxing Ye,&nbsp;Chao Zhang,&nbsp;Ping Lan,&nbsp;Renya Zhan,&nbsp;Xiujue Zheng","doi":"10.1016/j.lers.2024.11.001","DOIUrl":"10.1016/j.lers.2024.11.001","url":null,"abstract":"<div><h3>Objective</h3><div>Microvascular decompression (MVD) is the gold standard for treating drug-resistant classic trigeminal neuralgia (dcTN), with endoscopy enhancing surgical precision through improved visualization. This study evaluates the efficacy of fully endoscopic MVD for dcTN and presents our early experience.</div></div><div><h3>Methods</h3><div>This retrospective study included patients with dcTN who underwent fully endoscopic MVD in the Department of Neurosurgery, the First Affiliated Hospital, Zhejiang University School of Medicine from November 2020 to February 2023. We recorded basic patient clinical information, clinical outcomes, offending vessels, complications, and recurrences, and assessed outcomes via the Barrow Neurological Institute (BNI) pain intensity score and the numeric rating scale (NRS) score.</div></div><div><h3>Results</h3><div>All 42 patients had dcTN with preoperative BNI scores of V and NRS scores of 8–10. Endoscopic visualization enabled the precise identification of neurovascular conflicts, including small and deeply located vessels. Immediately after surgery, 90.5% of patients achieved complete pain relief (BNI score of I, NRS score of 0). At the final follow-up, 85.7% of patients had complete pain relief. All patients’ pain was significantly relieved at immediate after surgery (0 vs. 9, <em>p</em> &lt; 0.001) and at the final follow-up (0 vs. 9, <em>p</em> &lt; 0.001), with lower NRS scores. Complications, including vertigo, headache, and transient facial numbness, occurred in 14.4% of patients and were manageable.</div></div><div><h3>Conclusion</h3><div>Fully endoscopic MVD is a safe and effective treatment for dcTN.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 1","pages":"Pages 53-57"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511554","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":"The outcomes of magnetic sphincter augmentation in patients with gastroesophageal reflux disease post bariatric surgery: A systemic review and meta-analysis","authors":"Turki Alkully ,&nbsp;Sara Mahfoud Alghamdi ,&nbsp;Najla Khalid A. Alzahrani ,&nbsp;Raghad Saeed S. Alghamdi ,&nbsp;Sarah Ibrahim Alghamdi ,&nbsp;Hassan Mahfouz H. Alghamdi ,&nbsp;Afaf Safar E. Alzahrani","doi":"10.1016/j.lers.2025.01.002","DOIUrl":"10.1016/j.lers.2025.01.002","url":null,"abstract":"<div><h3>Objective</h3><div>Although bariatric surgeries are widely performed around the world, patients frequently experience the recurrence of pre-existing gastroesophageal reflux disease (GERD) symptoms or develop new symptoms, some of which are resistant to medical treatment. This study investigates the effect and outcome of magnetic sphincter augmentation (MSA), a minimally invasive treatment for GERD, in this population.</div></div><div><h3>Methods</h3><div>A thorough search of the PubMed, Cochrane, Scopus, Web of Science, and Google Scholar databases from inception until June 6, 2024 was performed to retrieve relevant studies that evaluated the effects of MSA on the GERD health-related quality of life (GERD-HRQL) score and the reduction in proton pump inhibitor (PPI) use in patients who underwent bariatric surgery. The “meta” package in RStudio version 2023.12.0 + 369 was used.</div></div><div><h3>Results</h3><div>A total of eight studies were included in the systematic review and seven studies were included in the meta-analysis. MSA significantly reduced the GERD-HRQL score (MD = −27.55 [95% CI: −30.99 to −24.11], <em>p</em> &lt; 0.01) and PPI use (RR = 0.23 [95% CI: 0.16 to 0.33], <em>p</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>MSA is a viable treatment option for patients with GERD symptoms who undergo bariatric surgery. This approach showed promising results in terms of reducing the GERD-HRQL score and reducing the use of PPI.</div></div>","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 1","pages":"Pages 45-52"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511553","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":"Thank you to Laparoscopic, Endoscopic and Robotic Surgery peer reviewers","authors":"","doi":"10.1016/j.lers.2024.09.004","DOIUrl":"10.1016/j.lers.2024.09.004","url":null,"abstract":"","PeriodicalId":32893,"journal":{"name":"Laparoscopic Endoscopic and Robotic Surgery","volume":"8 1","pages":"Page 65"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511718","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":"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":"2024-12-01","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":"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":"2024-12-01","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":"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":"2024-12-01","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":"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":"2024-12-01","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":"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":"2024-12-01","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}