Asian Journal of Endoscopic Surgery最新文献

{"title":"Optimal Intracorporeal Anastomosis for Colectomy: A Comparative Experimental Evaluation Using 3D Anastomosis Models","authors":"Yoshiaki Fujii,&nbsp;Seiya Yamamoto,&nbsp;Sho Kimura,&nbsp;Shogo Suzuki,&nbsp;Hirotaka Miyai,&nbsp;Hiroki Takahashi,&nbsp;Yoichi Matsuo,&nbsp;Kenji Kobayashi,&nbsp;Shuji Takiguchi","doi":"10.1111/ases.70048","DOIUrl":"https://doi.org/10.1111/ases.70048","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Application of intracorporeal anastomosis is gradually becoming widespread; however, there are no detailed reports on its configuration. We aimed to create three-dimensional intracorporeal anastomosis models and compare their configurations in detail.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Three types of intracorporeal anastomosis models were used: overlap anastomosis, delta-shaped anastomosis, and functional end-to-end anastomosis. In experiment 1, three-dimensional images of each anastomosis model were created. Additionally, the length of each staple line comprising the anastomotic site was measured. In experiment 2, the lengths of intestinal mobilization required for different anastomoses were compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The circumference of the anastomosis in overlap anastomosis (141.5 ± 3.3 mm) was significantly greater than that in delta-shaped anastomosis (87.9 ± 0.9 mm; <i>p</i> &lt; 0.001) and functional end-to-end anastomosis (89.6 ± 10 mm; <i>p</i> &lt; 0.0001). The length of the intestinal tract after anastomosis in delta-shaped anastomosis (33 ± 6.9 mm) was significantly shorter than that in functional end-to-end anastomosis (76 ± 2 mm; <i>p</i> &lt; 0.0001) and overlap anastomosis (60 ± 5 mm; <i>p</i> &lt; 0.002).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We successfully constructed three-dimensional images of intracorporeal anastomosis models. These results suggest that overlap anastomosis led to the formation of the largest anastomotic site, while minimal bowel mobilization was required in the delta-shaped anastomosis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639067","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 Between Robotic and Conventional Laparoscopic Hysterectomy Performed Using Single-Port Approach","authors":"Akiko Ohwaki,&nbsp;Kyohei Takada,&nbsp;Arata Kobayashi,&nbsp;Mayuko Ito,&nbsp;Ryoko Ichikawa,&nbsp;Hironori Miyamura,&nbsp;Haruki Nishizawa","doi":"10.1111/ases.70044","DOIUrl":"https://doi.org/10.1111/ases.70044","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Robotic surgery is being rapidly implemented globally, and new robotic surgery techniques are being developed. The da Vinci SP surgical system, a new robotic surgery system using a single-port approach, was introduced for the first time in Japan, and its surgical results were compared with those of the conventional single-port plus one-port laparoscopic hysterectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 20 patients who underwent single-port robotic hysterectomy using the da Vinci SP surgical system (SP-RH) between March 2023 and December 2023, and 37 patients who underwent single-port plus one-port laparoscopic hysterectomy (SP + 1-LH) between March 2018 and December 2023. The surgical outcomes and complications were retrospectively compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>When the SP-RH group was compared with the SP + 1-LH group, intraoperative blood loss was observed to be significantly lower in the SP-RH group. However, no difference in the incidence of intraoperative complications between the two groups was observed. Furthermore, when comparing postoperative inflammatory responses, C-reactive protein levels were significantly lower in the SP + 1-LH group on the third day after surgery, but no other differences were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrated that single-port robotic hysterectomy using the da Vinci SP surgical system can be safely introduced and performed in clinical settings. The da Vinci SP surgical system, which uses a single-port platform, can be used in minimally invasive surgeries as a novel operational system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632783","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":"Usefulness of Bidirectional Barbed Sutures for Temporary Closure of Entry Hole for Delta-Shaped Anastomosis in Minimally Invasive Gastrectomy","authors":"Hironori Tsujimoto,&nbsp;Hiroyuki Horiguchi,&nbsp;Yoshihisa Yaguchi,&nbsp;Naoyuki Uehata,&nbsp;Risa Kariya,&nbsp;Asuma Ide,&nbsp;Keita Kouzu,&nbsp;Hideki Ueno","doi":"10.1111/ases.70046","DOIUrl":"https://doi.org/10.1111/ases.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Laparoscopic and robotic gastrectomies have become standard procedures for the treatment of gastric cancer. Among the reconstruction methods used following distal gastrectomy, the Billroth-I technique is often preferred owing to its low complication rates. Delta-shaped anastomosis, a method that eliminates the need for a mini-laparotomy, represents a significant advancement in minimally invasive surgeries. In this report, we aim to present a novel technique using bidirectional barbed sutures for temporary closure of the entry hole during delta-shaped anastomosis in laparoscopic and robotic gastrectomies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Surgical Technique</h3>\u0000 \u0000 <p>The entry hole was closed using a bidirectional barbed suture, starting centrally to prevent overlapping of the gastric and duodenal staple lines. The suture length was meticulously adjusted to align with the stapler dimensions. All the procedures were successfully completed without any complications in both laparoscopic and robotic gastrectomies. Bidirectional barbed sutures enabled precise tissue alignment and prevented slippage, thereby facilitating secure, full-thickness closure of the entry hole while minimizing the risk of incomplete stapler firing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Bidirectional barbed sutures offer a safe and feasible alternative option for the temporary closure of the entry hole during a stapled anastomotic technique in robotic and laparoscopic gastrectomies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595208","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 Donor Left Lateral Sectionectomy Using the Glissonean Pedicle Approach: Technical Details With Video","authors":"Yasushi Hasegawa,&nbsp;Yuta Abe,&nbsp;Hideaki Obara,&nbsp;Yohei Yamada,&nbsp;Minoru Kitago,&nbsp;Akihiro Fujino,&nbsp;Yuko Kitagawa","doi":"10.1111/ases.70043","DOIUrl":"https://doi.org/10.1111/ases.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Pure laparoscopy for living donor hepatectomy is gaining popularity due to its advantages. However, despite the long-standing application of laparoscopic donor left lateral sectionectomy, the dissection of the Glisson branch, portal vein, and biliary ducts, particularly those of the caudate lobe, remains insufficiently described. Although the Glissonean approach offers easy standardization for hilar dissection, clear landmarks for parenchymal transection, and reduces postoperative bile leakage, it has not been widely adopted in laparoscopic donor hepatectomy. Here, we introduce a modified Glissonean pedicle approach to address the movement restrictions in laparoscopic surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Surgical Technique</h3>\u0000 \u0000 <p>After liver mobilization, the Glisson of Spiegel lobe (G1L) was divided, followed by encircling the left Glissonean pedicle. A tape for the liver hanging maneuver was placed from the right edge of the left Glissonean pedicle, along the Arantius plate, to the left edge of the left hepatic vein. When the parenchymal transection was completed, the left hepatic vein was automatically taped. The left hepatic artery and left portal vein were exposed, and some branches of P1 were divided to lengthen for anastomosis. The left hepatic duct was taped by removing the left hepatic artery and left hepatic vein from the left Glissonean pedicle. The left hepatic duct was divided under intraoperative cholangiography. Next, the left hepatic artery, left portal vein, and left hepatic vein were sequentially divided, and the graft liver was retrieved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our Glissonean approach can help standardize donor left lateral sectionectomy, minimize the exposure of the left hepatic duct, and clarify B1 branch dissection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595246","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":"Utility of Laparoscopic Distal Pancreatectomy Following Esophagectomy With Gastric Roll Reconstruction Through the Retrosternal Route","authors":"Yusuke Yamamoto,&nbsp;Ryo Morimura,&nbsp;Taisuke Imamura,&nbsp;Hisashi Ikoma,&nbsp;Hitoshi Fujiwara,&nbsp;Atsushi Shiozaki,&nbsp;Hirotaka Konishi,&nbsp;Kenji Nanishi,&nbsp;Jun Kiuchi,&nbsp;Hiroki Shimizu,&nbsp;Tomohiro Arita,&nbsp;Yoshiaki Kuriu,&nbsp;Takeshi Kubota,&nbsp;Eigo Otsuji","doi":"10.1111/ases.70039","DOIUrl":"https://doi.org/10.1111/ases.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Esophagectomy with gastric roll reconstruction through the retrosternal route can result in significant anatomical shifts in the pancreatic head and neck. These shifts must be carefully considered when planning distal pancreatectomy (DP) after esophagectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed 15 patients who underwent CT scans after discharge following esophagectomy with gastric roll reconstruction via the retrosternal route. Using CT images, we examined the anatomical features necessary to safely perform DP after esophagectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The horizontal distances from the vertebral body to the superior mesenteric vein (SMV), superior mesenteric artery (SMA), and gastroduodenal artery (GDA) post-esophagectomy were 12.0, 21.7, and − 4.0 mm, respectively, indicating significant leftward shifts compared with preoperative measurements (SMV: 2.7 mm, <i>p</i> = 0.023; SMA: 9.2 mm, <i>p</i> = 0.046; GDA: −17.5 mm, <i>p</i> &lt; 0.001). The angles between the horizontal line through the center of the SMA and the line connecting the SMA to the SMV (34.5°) and GDA (34.7°) were wider compared with the preoperative SMV (18.4°, <i>p</i> = 0.050) and GDA (17.9°, <i>p</i> = 0.018). Based on sagittal CT sections, the distance between the caudal edge of the gastric roll and the xiphoid process was 100.7 mm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Video Presentation</h3>\u0000 \u0000 <p>We present a case of laparoscopic DP for pancreatic tail cancer after esophagectomy with gastric roll reconstruction via the retrosternal route.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The altered vascular positioning and the presence of the gastric roll make minimally invasive approaches, particularly laparoscopic DP, advantageous, as they reduce the risk of damaging the gastric roll and the right gastroepiploic artery (RGEA).</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Port and Arm Placement Strategy for the Hugo Robotic-Assisted Surgery (RAS) System in Gynecologic Oncology: Initial Experience and Technical Considerations","authors":"Hiroaki Komatsu,&nbsp;Koji Yamamoto,&nbsp;Kohei Hikino,&nbsp;Masayo Okawa,&nbsp;Yuki Iida,&nbsp;Ikumi Wada,&nbsp;Mayumi Sawada,&nbsp;Shinya Sato,&nbsp;Fuminori Taniguchi","doi":"10.1111/ases.70045","DOIUrl":"https://doi.org/10.1111/ases.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The Hugo robotic-assisted surgery (RAS) system is a novel surgical platform that expands the potential for minimally invasive procedures in gynecologic oncology. Early studies have shown promise, but the optimal configuration of ports and robotic arms requires further clarification. This study aimed to introduce a refined strategy for optimizing port placement and robotic arm arrangement with the Hugo RAS system and compare its performance to previously employed configurations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Surgical Technique</h3>\u0000 \u0000 <p>Initial experiences in two cases of early-stage endometrial cancer are presented. A new configuration was developed through iterative discussions and a review of emerging Hugo RAS literature. Port placement and arm arrangement with three arms on the patient's right side and one on the left—were designed to expand the assistant's working space. Two patients with stage IA endometrial cancer underwent surgery with this approach. Operative times, blood loss, and procedural details were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Both procedures were completed successfully with improved instrument articulation, reduced arm collisions, and enhanced workflow. Compared with previous strategies, this new configuration provided better ergonomics, minimized interference between robotic and assistant instruments, and expanded the operative field for both the first and second assistants, enabling smoother transvaginal specimen retrieval. Initial findings suggest that optimizing both port placement and arm settings enhances the surgical environment for the Hugo RAS system and may improve procedural efficiency and patient outcomes. Further studies with larger cohorts are warranted to validate these findings and potentially establish standardized guidelines.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143554481","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":"Correction to “Advantages of Robotic Total Mesorectal Excision With Partial Prostatectomy Compared With Open Surgery for Rectal Cancer: A Single-Center Retrospective Cohort Study”","authors":"","doi":"10.1111/ases.70042","DOIUrl":"https://doi.org/10.1111/ases.70042","url":null,"abstract":"<p>R. Shimano, S. Kasai, H. Kagawa, et al., “Advantages of Robotic Total Mesorectal Excision With Partial Prostatectomy Compared With Open Surgery for Rectal Cancer: A Single-Center Retrospective Cohort Study,” <i>Asian Journal of Endoscopic Surgery</i> 18, no. 1 (2025): e70003.</p><p>In Table 4, the number of patients written in the Recurrence site Lung area for Robotic surgery, “1(7.1),” and its <i>p</i> value, “0.056,” were incorrect. These should have changed to “2(14.2)” and “0.177” for each.</p><p>We apologize for this error.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535802","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":"Dorsal Stable Surgical Procedure for the Glissonean Approach in Robot Anatomic Liver Resections of the Left Lateral Segment","authors":"Yusuke Uemoto,&nbsp;Takahisa Fujikawa","doi":"10.1111/ases.70038","DOIUrl":"https://doi.org/10.1111/ases.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Laparoscopic left lateral sectionectomy (LLLS) is often performed as an introduction to laparoscopic liver resection (LLR). However, laparoscopic anatomical liver resection (LALR) of the left lateral segment is a challenging procedure. There are few reports on LALR of the left lateral segment. Robot liver resection (RLR) has the benefits of a stable blur-free visual field and mobility with multi-joint forceps, so robot anatomical liver resection (RALR) of the left lateral segment can be carried out safely.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>LLR and RLR were retrospectively investigated from January 2017 to August 2024. The procedure of RALR of the left lateral segment was demonstrated, and the safety of RALR of the left lateral segment was evaluated by comparing the perioperative outcomes to LLR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study comprised 13 LLLS cases, 5 LALR cases, and 10 RALR cases. In LLR, it was more likely that LLLS was performed for the lesion of Segment 2 (11 cases) and LALR was performed for the lesion of Segment 3 (4 cases). LALR had a significantly longer operation time than LLLS. On the other hand, the difference in operation time between RALR and LLLS was not statistically significant. The amount of blood loss was not significantly different between LLLS and RALR. Other perioperative outcomes, such as length of stay or postoperative complications, did not show any differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RALR of the left lateral segment is regarded as a safe approach in the treatment of liver tumors.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Series of Six Patients With Renal Cell Carcinoma With Inferior Vena Cava Tumor Thrombus Who Underwent Robotic-Assisted Radical Nephrectomy","authors":"Takuto Hara,&nbsp;Kotaro Suzuki,&nbsp;Hiromitsu Watanabe,&nbsp;Daisuke Motoyama,&nbsp;Atsushi Otsuka,&nbsp;Hideaki Miyake","doi":"10.1111/ases.70041","DOIUrl":"https://doi.org/10.1111/ases.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Inferior vena cava (IVC) tumor thrombus occurs in 4%–10% of renal cell carcinoma (RCC) cases. Robotic-assisted radical nephrectomy (RARN) with IVC tumor thrombectomy offers a minimally invasive alternative to open surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed six cases of RARN for RCC with IVC thrombus at two institutions between April 2022 and August 2024. For left-sided RCC, the left renal vein was transected using a vascular stapler before IVC thrombectomy, ensuring adequate access for thrombus removal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four patients had right-sided RCC, and two had left-sided RCC. The median operative time was 256 min, with a median blood loss of 175 mL. No conversions to open surgery, positive surgical margins, or major complications (Clavien-Dindo grade ≥ 3) were reported. No blood transfusions were required.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>RARN with IVC thrombectomy resulted in minimal blood loss and no serious complications. Our findings suggest that it is a feasible and safe procedure, even when performed with technical modifications for left-sided RCC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497314","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":"First Report of Robotic-Assisted Liver Resection With Pre-Coagulation Technique by Microwave (With Video)","authors":"Akihiko Takagi,&nbsp;Daisuke Yamamoto,&nbsp;Akitsugu Fujita,&nbsp;Satoshi Tokuda,&nbsp;Takeo Toda,&nbsp;Shinsuke Sato,&nbsp;Hideyuki Kanemoto","doi":"10.1111/ases.70040","DOIUrl":"https://doi.org/10.1111/ases.70040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The high spatial cognition and freedom of forceps manipulation provided by robotic assistance enable three-dimensional liver resection. This is highly beneficial and innovative in laparoscopic hepatectomy. One of the remaining issues is bleeding control in cases of easily hemorrhagic cirrhotic liver. We reported a pre-coagulation technique by microwave. To our knowledge, this is the first report of robotic-assisted liver resection with a pre-coagulation technique by microwave.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Surgical Technique</h3>\u0000 \u0000 <p>The patient was a 71-year-old male with a history of alcoholic hepatitis and was diagnosed with a 2-cm HCC in segment 3. The preoperative indocyanine green retention test at 15 min (ICG-R15) was 18.9%; imaging studies showed findings suggestive of chronic hepatitis or cirrhosis. We decided to perform microwave pre-coagulation because of fears of difficulty in controlling bleeding. After taping the hepatoduodenal ligament, the location of the tumor was confirmed using ultrasound. The resection line with margin was marked on liver, and microwave pre-coagulation was performed, avoiding major Glisson branch and veins. The location of the pre-coagulated area and the tumor was determined by ultrasound. After pre-coagulation, the liver parenchyma was dissected under Pringle's maneuver by double bipolar technique. The operation time was 248 min; blood loss was 100 mL. The patient was discharged on the sixth postoperative day without intraoperative or postoperative complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Microwave pre-coagulation may be a useful approach to bleeding control in robotic hepatectomy. This technique would not necessarily be needed in all cases. However, it is important to have this knowledge to ensure safety in cases where hemostasis is expected to be difficult or when robotic hepatectomy is being introduced.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143481578","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}