Minimally Invasive Surgery最新文献

{"title":"Comparison of Mortality and Postoperative Complications Between Open and Laparoscopic Repair of Perforated Peptic Ulcer: An Umbrella Review.","authors":"Foolad Eghbali, Mahdi Banijamali, Fatemeh Jahanshahi, Adnan Tizmaghz, Hamid Rezvani, Parmida Ghadimi, Ahmad Madankan, Homan Alipour, Hamed Vaseghi, Meisam Haghmoradi, Mansour Bahardoust, Hesam Mosavari","doi":"10.1155/2024/5521798","DOIUrl":"10.1155/2024/5521798","url":null,"abstract":"<p><p><b>Background:</b> Perforated peptic ulcer (PPU) is one of the common complications of peptic ulcers. Open repair (OR) is the traditional surgical treatment for this condition, but with advances in laparoscopic and minimally invasive surgery, laparoscopic repair (LR) has gained popularity. Many studies have compared the effectiveness of OR vs. LR for PPU. However, the superiority of one method over the other remains a topic of debate. We conducted this review to investigate the advantages and disadvantages of LR over OR. <b>Methods:</b> PubMed, Scopus, Google Scholar, and Web of Science were searched from 2000 to 2022 for systematic reviews and meta-analyses comparing OR and LR for PPU. Previous studies included seven postoperative outcomes, including mortality, reoperation, postoperative ileus, intra-abdominal abscess, leakage, pneumonia, and wound infection. Two researchers independently extracted data and assessed the quality of the eligible studies using the AMSTAR 2 tool. <b>Results:</b> Five systematic reviews and meta-analyses were included, involving 36 studies. The pooled estimate showed that the risks for mortality, postoperative ileus, and wound infection were significantly lower with LR. In comparison, the risks for reoperation and leakage were less with OR. Based on the pooled estimate, no significant relationship was noted between the surgical method and intraabdominal abscess or postoperative pneumonia. <b>Conclusion:</b> Evidence suggests that in stable patients with PPU, LR is better than OR in terms of mortality. However, more high-quality evidence is needed to determine which is more appropriate for different circumstances (e.g., unstable or high-risk patients).</p>","PeriodicalId":45110,"journal":{"name":"Minimally Invasive Surgery","volume":"2024 ","pages":"5521798"},"PeriodicalIF":1.3,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11568887/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649264","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":"Initial Experience of Robot-Assisted Nephroureterectomy without Intraoperative Repositioning Using a New Robotic Surgical System (KD-SR-01TM).","authors":"Jie Dong, Weifeng Xu, Zhigang Ji","doi":"10.1155/2024/2466828","DOIUrl":"10.1155/2024/2466828","url":null,"abstract":"<p><strong>Background: </strong>Robot-assisted nephroureterectomy (RANU) has been more and more applied since 21st century. However, the high cost limits the widespread use of robot system. A relatively low-cost new robotic surgical system (KD-SR-01™) has recently been developed in China.</p><p><strong>Objective: </strong>To assess the safety and efficacy of the KD-SR-01™ Surgical System in RANU.</p><p><strong>Methods: </strong>Patients with upper-tract urothelial tumor and undergoing RANU with the KD-SR-01™ Robotic System were prospectively included. Surgeries were all performed by a single surgeon. Patients' demographic and clinical characteristics, perioperative data, pathology findings, and follow-up data were collected. <i>Key Findings</i>. 9 patients were enrolled in this study, and the surgeries went smoothly with no conversion to open. The 1^st docking time, the 2^nd docking time, and the operation time were 222 s, 169 s, and 202 min respectively. No equipment-related adverse events occurred. All patients were followed up for at least 3 months, and one patient experienced bladder recurrences. <i>Conclusions and Clinical Implications</i>. This study is the first to verify that the KD-SR-01™ robot system is effective and safe in RANU and has advantages in terms of its rotation boom during redocking and its price. This trial is registered with ChiCTR2200056672.</p>","PeriodicalId":45110,"journal":{"name":"Minimally Invasive Surgery","volume":"2024 ","pages":"2466828"},"PeriodicalIF":1.3,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142000968","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 Perioperative, Functional, and Oncological Outcomes of Transperitoneal and Extraperitoneal Laparoscopic Radical Prostatectomy.","authors":"Tanan Bejrananda, Watid Karnjanawanichkul, Monthira Tanthanuch","doi":"10.1155/2023/3263286","DOIUrl":"10.1155/2023/3263286","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;This study aimed to compare the oncological, functional, and perioperative outcomes of localized and locally advanced prostate cancer treated with intraperitoneal or extraperitoneal laparoscopic radical prostatectomy (LRP).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;From April, 2008, through December, 2020, 266 patients underwent laparoscopic radical prostatectomy, 168 cases with an extraperitoneal approach (E-LRP) and 98 cases using a transperitoneal approach (T-LRP). The clinical, perioperative, functional, and oncological outcomes were collected and compared between these groups. At the 3-, 12- and 24-monthfollow-ups, the functional outcomes tested were urinary function (urinary domain of EPIC) and sexual function (sexual domain of EPIC). The oncological outcomes of biochemical recurrence, biochemical recurrence-free survival, and positive surgical margin status were evaluated. Univariable and multivariable Cox regression analyses were used to identify factors predictive for biochemical recurrence. All statistical analyses used the R program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The patient characteristics were similar between the E-LRP and T-LRP groups except for higher prostatic-specific antigen (PSA) in the T-LRP group. The T-LRP had lower overall operative time (222.5 min vs. 290 min, &lt;i&gt;p&lt;/i&gt; 0.001), decreased blood loss (400 ml vs. 800 ml, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and shorter hospital stays (4 days vs. 7 days, &lt;i&gt;p&lt;/i&gt; &lt; 0.001) compared to the E-LRP. Early sexual intercourse with penetration at 3 months was higher in the T-LRP group (36.7% vs. 15.5%, &lt;i&gt;p&lt;/i&gt; 0.001). Urinary continence (no pads) was not different between the T-LRP and E-LRP groups at 3 and 24 months after surgery but higher in the E-LRP group at 12 months (1% vs. 3%; &lt;i&gt;p&lt;/i&gt;=0.419, 85.1 vs. 83.7%; &lt;i&gt;p&lt;/i&gt;=0.889, 47.4% vs. 34.6%; &lt;i&gt;p&lt;/i&gt;=0.028, respectively). The EPIC questionnaire was used to assess functional outcomes at 3, 12, and 24 months after surgery and found that urinary function was significantly higher in the T-LRP group at 3 and 12 months (&lt;i&gt;p&lt;/i&gt; &lt; 0.001) but did not show a difference at 24 months (&lt;i&gt;p&lt;/i&gt;=0.734), and sexual function scores were higher in the T-LRP group at 12 and 24 months (&lt;i&gt;p&lt;/i&gt;=0.001). The positive surgical margin rate was higher in the E-LRP (38.7% vs. 21.4%; &lt;i&gt;p&lt;/i&gt;=0.006). The BCR rate was not different between the groups (36.3% in the E-LRP group and 27.6% in the E-LRP group; &lt;i&gt;p&lt;/i&gt;=0.184).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Transperitoneal laparoscopic radical prostatectomy (T-LRP) was found to be superior to extraperitoneal radical prostatectomy (E-LRP) in perioperative outcomes such as decreased operative time, decreased blood loss, shorter hospital stay, lower positive surgical margin, and improved early sexual intercourse and sexual function. The urinary functional outcome was better in the T-LRP group at 3 and 12 months. These findings support the use of transperitoneal laparoscopic radical prostatectomy, as our","PeriodicalId":45110,"journal":{"name":"Minimally Invasive Surgery","volume":"2023 ","pages":"3263286"},"PeriodicalIF":1.3,"publicationDate":"2023-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9928507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10742013","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":"Clinical Factors to Predict Difficult Ureter during Ureteroscopic Lithotripsy.","authors":"Masashi Imano,&nbsp;Tadashi Tabei,&nbsp;Hiroki Ito,&nbsp;Junichi Ota,&nbsp;Kazuki Kobayashi","doi":"10.1155/2023/2584499","DOIUrl":"https://doi.org/10.1155/2023/2584499","url":null,"abstract":"<p><strong>Objective: </strong>To identify risk factors for difficult ureters during ureteroscopic lithotripsy and to determine the appropriate indications for preoperative stenting.</p><p><strong>Methods: </strong>We retrospectively analyzed 156 ureteroscopic procedures for upper urinary tract stones after excluding those with preoperative stenting or percutaneous nephrostomy. Traceability of the ureter was assessed by two urologists. Traceability was defined as positive if either or both urologists discerned the ureter in all slices on preoperative plain computed tomography. Patients' backgrounds were compared between the nondifficult ureter and difficult ureter groups. A multivariate logistic regression model was used to evaluate the relationships between difficult ureters and other clinical factors.</p><p><strong>Results: </strong>Of 156 patients, 31 (19.9%) were classified into the difficult ureter group. The positive traceability was higher in the nondifficult ureter group (48.3% vs. 83.2%, <i>P</i> < 0.001). The major axis was smaller in the difficult ureter group than in the nondifficult ureter group (8.8 ± 3.9 mm vs. 10.9 ± 4.5 mm, <i>P</i> < 0.018). A major axis <8 mm (odds ratio: 4.495, 95% confidence interval: 1.791-11.278, and <i>P</i>=0.001), negative traceability (odds ratio: 7.565, 95% confidence interval: 2.693-21.248, and <i>P</i> < 0.001), smoking status (odds ratio: 3.196, 95% confidence interval: 1.164-8.773, and <i>P</i>=0.024), and absence of diabetes mellitus (odds ratio: 5.813, 95% confidence interval: 1.121-30.142, and <i>P</i>=0.036) were identified as independent predictors of difficult ureters on multivariate logistic regression analysis.</p><p><strong>Conclusion: </strong>Patients with smaller stones, negative traceability, ongoing tobacco consumption, and absence of diabetes mellitus were at higher risk of difficult ureters. In these patients, preoperative stenting may be considered.</p>","PeriodicalId":45110,"journal":{"name":"Minimally Invasive Surgery","volume":"2023 ","pages":"2584499"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9911238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9275282","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":"Minimally Invasive Plating of Distal Radius Fracture: A Series of 42 Cases and Review of Current Literature.","authors":"Oryza Satria,&nbsp;Rio Wikanjaya,&nbsp;Christa Adriane Tenges,&nbsp;Muslich Idris Al Mashur","doi":"10.1155/2023/3534849","DOIUrl":"https://doi.org/10.1155/2023/3534849","url":null,"abstract":"<p><p>Surgical techniques developed for distal radius fracture fixation have become increasingly advanced, including minimally invasive plate osteosynthesis (MIPO). This study aimed to introduce and evaluate the functional outcome of a novel MIPO technique that differs from previous reports. This study included 42 patients with distal radius fractures who underwent minimally invasive surgical plating of the distal radius. All patients were treated with closed reduction, fixation using K-wire, and subsequent insertion of a volar anatomical stable angle short plate on the distal radius. An arthroscopy-assisted evaluation and repair procedure were performed to correct intra-articular involvement, triangular fibrocartilage complex tears, and scapholunate injuries. Functional outcomes were assessed using a visual analog scale score; quick disabilities of the arm, shoulder, and hand score; and postoperative range of motion of flexion, extension, supination, and pronation at the 3-month follow-up, showing significant improvement in all parameters (all <i>p</i> ≤ 0.05). This study provides a simpler yet reliable method with reproducible and consistent results to treat distal radius fractures using minimally invasive plating with closed reduction and plate insertion, resulting in satisfactory clinical outcomes in all patients.</p>","PeriodicalId":45110,"journal":{"name":"Minimally Invasive Surgery","volume":"2023 ","pages":"3534849"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9981297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10854715","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 vs. Robotic Gastrectomy in Patients with Situs Inversus Totalis: A Systematic Review.","authors":"Anmol Multani,&nbsp;Simran Parmar,&nbsp;Elijah Dixon","doi":"10.1155/2023/3894561","DOIUrl":"https://doi.org/10.1155/2023/3894561","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Situs inversus totalis (SIT) is a rare genetic anomaly involving the mirror-image transposition of organs. This transposition can potentially make surgical treatments difficult because of the reversed anatomy and intraoperative confusion. The aim of this systematic review is to compare the perioperative outcomes and safety of robotic and laparoscopic gastrectomy in patients with SIT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We included full-text case reports with brief reviews and standalone case studies on SIT patients age ≥21, undergoing laparoscopic or robotic gastrectomy. We excluded case studies focusing on procedures other than laparoscopic and robotic gastrectomy, namely, open gastrectomy, gastric banding, and gastric bypass. English was selected as the language and articles published in the last 10 years were selected with a date range from Jan, 2011, to Aug, 2021. We focused on intraoperative and postoperative outcomes including blood loss, vascular aberrancy, operation duration, mortality, operative complications, duration of hospitalization, and follow-up interval. Online databases included Clinical Key, Embase, ScienceDirect, Ovid, and Google Scholar. The last search was conducted on Aug 15, 2021. For all eligible articles, risk of bias assessment was carried out using JBI critical appraisal checklist (Table 1). Continuous data were analyzed using &lt;i&gt;t&lt;/i&gt;-test with &lt;i&gt;p&lt;/i&gt; value of 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;From our search, we retained 29 case reports which reported information from 30 cases. The results reported in each study were summarized (Table 2). The laparoscopic procedure was used in 21 cases and robot-assisted surgery was used in 9 cases. Operative time was mentioned in 24 out of the 30 cases and the average operative time was 205.67 min. Blood loss was reported in 16 out of the 30 cases, with an average blood loss of 51.9 mL. Hospital stay information was provided in 26 out of the 30 cases, with an average length of stay of 8.5 days. A statistically significant difference was not found for the operative time, length of hospitalization, or age of the patient. However, intraoperative blood loss in robot-assisted gastrectomy was lower compared to laparoscopic gastrectomy, with a &lt;i&gt;p&lt;/i&gt; value of 0.0293. Perioperative death was not reported in any of the cases. Only three cases of postoperative complications were reported in laparoscopic surgery. Only one of the three cases suggested that the complication was due to an anomaly, whereas the other two of them reported complications due to procedural errors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Laparoscopic and robotic gastrectomy can be safely used for SIT patients if performed cautiously. Some precautions include thoroughly assessing anatomical aberrations using preoperative imaging, adjusting the operative set up, and having experienced surgeons. The robotic approach may have a few advantages over laparoscopic procedures that may enhance the s","PeriodicalId":45110,"journal":{"name":"Minimally Invasive Surgery","volume":"2023 ","pages":"3894561"},"PeriodicalIF":1.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9998161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9155750","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":"In Which Patients and Why Is Laparoscopy Helpful for the Impalpable Testis?","authors":"Alfonso Papparella, Giuseppina Rosaria Umano, Mercedes Romano, Giulia Delehaye, Salvatore Cascone, Letizia Trotta, Carmine Noviello","doi":"10.1155/2022/1564830","DOIUrl":"10.1155/2022/1564830","url":null,"abstract":"<p><p>Since laparoscopy has been proposed in the management of the nonpalpable testis (NPT), this technique has been widely diffused among pediatric surgeons and urologists, but its application is still debated. We conducted a retrospective review to highlight how diagnostic and surgical indications for laparoscopy are selective and should be targeted to individual patients. From 2015 to 2019, 135 patients with NPT were admitted to our surgical division. Of these, 35 were palpable on clinical examination under anesthesia and 95 underwent laparoscopy. The main laparoscopic findings considered were: intra-abdominal testis (IAT), cord structures that are blind-ending, completely absent, or entering the abdominal ring. The patients' mean age was 22 months. In 48 cases, an IAT was found, and 42 of these underwent primary orchidopexy while 6 had the Fowler-Stephens (FS) laparoscopic procedure. Of the first group one patient experienced a testicular atrophy while two a reascent of the testis. In the FS orchidopexy group, one patient had testicular atrophy. Cord structures entering the internal inguinal ring were observed in 35 children, and all were surgically open explored. In 3 cases of these, a hypotrophic testis was revealed and an open orchidopexy was executed. In the remaining the histological examination revealed viable testicular cells in four patients and fibrosis, calcifications, and hemosiderin deposits in the others. Eleven patients presented with intrabdominal blind-ending vessels and one a testicular agenesia. A careful clinical examination is important to select patients to submit to laparoscopy. Diagnostic laparoscopy, and therefore, the anatomical observation of the testis and cord structures are strictly related to develop a treatment plan. In IAT, many surgical strategies can be applied with good results. Laparoscopy offers a concrete benefit to the patient.</p>","PeriodicalId":45110,"journal":{"name":"Minimally Invasive Surgery","volume":"2022 ","pages":"1564830"},"PeriodicalIF":1.8,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9553680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33518378","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":"Analysis of Different Routes of Hysterectomy Based on a Prospective Algorithm and Their Complications in a Tertiary Care Institute.","authors":"Subrat Panda, Ananya Das, Rituparna Das, Nalini Sharma, Wansalan Shullai, Vinayak Jante, Anusuya Sharma, Kaushiki Singh, Prateeti Baruah, Ruksana Makakmayum","doi":"10.1155/2022/6034113","DOIUrl":"10.1155/2022/6034113","url":null,"abstract":"<p><strong>Introduction: </strong>Hysterectomy is the most common gynaecological operation worldwide. The objective of the study is to analyze the various routes of hysterectomy and its complications when the decision of route is based on using a prospective algorithm tree. <i>Methodology</i>. It is an observational study to analyze the route of hysterectomy based on using a prospective algorithm. The decision tree is based on pelvic pathology, uterine size, vaginal access, pelvic adhesion, competency of the surgeon, choice of the patient, and complication of different routes of hysterectomy. Data were collected from preoperative, intraoperative, and postoperative records. Demographic factors, indications, routes of hysterectomy, and complications were recorded and analyzed by using SPSS software version 22. <i>Observation</i>. Among the malignant or suspected malignant pathology groups, TAH was performed in 89 cases and TLH was performed in 3 cases. Among the benign disease groups, VH was performed in 137(38.2%) cases, TAH was performed in 118(32.9%) cases, and TLH was performed in 104 (28.9%) cases. Operative time and a number of blood transfusions were significantly less with VH (<i>p</i> value < 0.0001 and 0.004) compared to abdominal and total laparoscopic hysterectomy. Postoperative complication such as fever was more with abdominal hysterectomy (<i><i>p</i>-</i>value<0.00001) compared to VH and TLH. Vaginal discharge was more with VH and TLH compared to TAH (<i>p</i> value -0.004) and wound infection was more in the abdominal route (<i>p</i> value 0.001).</p><p><strong>Conclusion: </strong>The abdominal route was the route of choice for surgery in malignancy or suspected malignant pathology. In benign pathology, VH was the most common and preferable route of surgery. Complications were found to be minimal with vaginal hysterectomy.</p>","PeriodicalId":45110,"journal":{"name":"Minimally Invasive Surgery","volume":"2022 ","pages":"6034113"},"PeriodicalIF":1.3,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9499797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33485669","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":"Single Incision Cholecystectomies for Acute Cholecystitis: A Single Surgeon Series from the Caribbean","authors":"S. Cawich, S. Mohanty, O. Felix, G. Dapri","doi":"10.1155/2022/6781544","DOIUrl":"https://doi.org/10.1155/2022/6781544","url":null,"abstract":"Introduction Single incision laparoscopic surgery (SILS) is accepted as a safe alternative to conventional multiport laparoscopic (MPL) cholecystectomy for benign gallbladder disease. Since many surgeons carefully select patients without inflammation, there are limited data on SILS for acute cholecystitis. We report a single surgeon experience with SILS cholecystectomy for patients with acute cholecystitis. Materials and Methods After securing ethical approval, we performed an audit of all SILS cholecystectomies for acute cholecystitis by a single surgeon from January 1, 2009, to December 31, 2019. The following data were extracted: patient demographics, intraoperative details, surgical techniques, specialized equipment utilized, conversions (additional port placement), morbidity, and mortality. Data were analyzed using SPSS 12.0. Results SILS cholecystectomy was performed in 25 females at a mean age of 35 ± 4.1 (SD) years and a mean BMI of 31.9 ± 3.8 (SD) using a direct fascial puncture technique without access platforms. The operations were completed in 83 ± 29.4 minutes (mean ± SD) with an estimated blood loss of 76.9 ± 105 (mean + SD). Three (12%) patients required additional 5 mm port placement (conversions), but no open operations were performed. The patients were hospitalized for 1.96 ± 0.9 days (mean ± SD). There were 2 complications: postoperative superficial SSI (grade I) and a diaphragmatic laceration (grade III). No bile duct injuries were reported. There were 9 patients with complicated acute cholecystitis, and this sub-group had longer mean operating times (109.2 ± 27.3 minutes) and mean postoperative hospital stay (1.3 ± 0.87 days). Conclusion The SILS technique is a feasible and safe approach to perform cholecystectomy for acute cholecystitis. We advocate a low threshold to place additional ports to assist with difficult dissections for patient safety.","PeriodicalId":45110,"journal":{"name":"Minimally Invasive Surgery","volume":"2022 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2022-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47302222","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":"Application of Design Structure Matrix to Simulate Surgical Procedures and Predict Surgery Duration.","authors":"Zhaoxuan Li,&nbsp;Derrick Tate,&nbsp;Thomas McGill,&nbsp;John Griswold,&nbsp;Ming-Chien Chyu","doi":"10.1155/2021/6340754","DOIUrl":"https://doi.org/10.1155/2021/6340754","url":null,"abstract":"<p><strong>Background: </strong>The complexities of surgery require an efficient and explicit method to evaluate and standardize surgical procedures. A reliable surgical evaluation tool will be able to serve various purposes such as development of surgery training programs and improvement of surgical skills.</p><p><strong>Objectives: </strong>(a) To develop a modeling framework based on integration of dexterity analysis and design structure matrix (DSM), to be generally applicable to predict total duration of a surgical procedure, and (b) to validate the model by comparing its results with laparoscopic cholecystectomy surgery protocol.</p><p><strong>Method: </strong>A modeling framework is developed through DSM, a tool used in engineering design, systems engineering and management, to hierarchically decompose and describe relationships among individual surgical activities. Individual decomposed activities are assumed to have uncertain parameters so that a rework probability is introduced. The simulation produces a distribution of the duration of the modeled procedure. A statistical approach is then taken to evaluate surgery duration through integrated numerical parameters. The modeling framework is applied for the first time to analyze a surgery; laparoscopic cholecystectomy, a common surgical procedure, is selected for the analysis.</p><p><strong>Results: </strong>The present simulation model is validated by comparing its results of predicted surgery duration with the standard laparoscopic cholecystectomy protocols from the <i>Atlas of Minimally Invasive Surgery</i> with 2.5% error and that from the <i>Atlas of Pediatric Laparoscopy and Thoracoscopy</i> with 4% error.</p><p><strong>Conclusion: </strong>The present model, developed based on dexterity analysis and DSM, demonstrates a validated capability of predicting laparoscopic cholecystectomy surgery duration. Future studies will explore its potential applications to other surgery procedures and in improving surgeons' performance and training novices.</p>","PeriodicalId":45110,"journal":{"name":"Minimally Invasive Surgery","volume":"2021 ","pages":"6340754"},"PeriodicalIF":1.8,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8668307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39729397","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}