Asian Journal of Endoscopic Surgery最新文献

{"title":"Thoracoscopic Plication for Neonatal Diaphragmatic Eventration With Intrathoracic Ectopic Kidney: A Rare Case Report","authors":"Eunyoung Jung","doi":"10.1111/ases.70157","DOIUrl":"10.1111/ases.70157","url":null,"abstract":"<div>\u0000 \u0000 <p>Coexistence of congenital diaphragmatic eventration (CDE) and an intrathoracic ectopic kidney (ITEK) is extremely rare and may lead to substantial respiratory distress in neonates. This study reports the case of a small-for-gestational-age male neonate presenting with respiratory distress and requiring nasal continuous positive airway pressure. Computed tomography revealed right-sided CDE accompanied by an ITEK. At 44 days old, the infant underwent thoracoscopic diaphragmatic plication. CO₂ insufflation during surgery led to spontaneous reduction of the ectopic kidney into the abdominal cavity, eliminating the need for direct manipulation. The postoperative course was uneventful, and at 14 months, the child remains healthy with no signs of recurrence. This case demonstrates that thoracoscopic plication is a safe and effective option for managing this rare condition, even in low-birth-weight infants. It also suggests that the ectopic position of the kidney is a secondary consequence of diaphragmatic laxity.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201175","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":"Mid to Long-Term Endoscopic Findings Following Conversion From Sleeve Gastrectomy to One-Anastomosis Gastric Bypass","authors":"Hussein Allam Aldin,&nbsp;Abdolreza Pazouki,&nbsp;Fahime Yarigholi,&nbsp;Sepideh Hosseini,&nbsp;Tofigh Mobaderi,&nbsp;Farid Ahmad Qaderi,&nbsp;Seyed Nooredin Daryabari","doi":"10.1111/ases.70154","DOIUrl":"10.1111/ases.70154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>One anastomosis gastric bypass (OAGB) is an option to address recurrent weight gain (RWG) or suboptimal clinical response (SoCR) after sleeve gastrectomy (SG). The need for endoscopic follow-ups in the mid- and long-term after conversional OAGB is less discussed. This study aims to assess the mid- and long-term endoscopic findings in patients undergoing conversional OAGB following SG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospectively collected dataset from a retrospective study was analyzed in an academic fellowship-training hospital for patients who underwent conversion from SG to OAGB. Patients with pre- and post-operative esophagogastroduodenoscopy (EGD) results and at least 1 year of follow-up were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 108 patients underwent conversional OAGB following SG to treat RWG or SoCR. The patients were invited for follow-up EGD. A total of 40 of 108 patients accepted to undergo EGD. Of 40 patients (mean age: 42.45 ± 9.93 years), 32 (80%) were female. The mean follow-up period was 4.3 years. Significant BMI reduction was observed (mean BMI decreased from 46.58 to 34.04 kg/m², <i>p</i> &lt; 0.001). Endoscopic findings: 10% developed de novo non-erosive reflux disease (NERD), 2.6% developed de novo esophagitis B, and one patient had bile reflux post-operatively. No esophagitis C, D, or Barrett's esophagus was observed. Marginal ulcers were seen in 10% post-conversion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Conversion of SG to OAGB effectively achieves significant weight loss. However, a mild risk remains for developing marginal ulcers and de novo esophagitis. OAGB is a promising conversional option to address RWG without any significant EGD pathological consequences in the mid to long term.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187308","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":"Suprapubic Open and Single-Port Laparoscopic Surgery for Urachal Remnant in Children: A Case Series","authors":"Kazuaki Takiguchi,&nbsp;Yosuke Minami,&nbsp;Seiya Ogata,&nbsp;Kotaro Minori,&nbsp;Kakeru Machino,&nbsp;Toru Futami,&nbsp;Hirofumi Shimizu,&nbsp;Hideaki Tanaka","doi":"10.1111/ases.70152","DOIUrl":"https://doi.org/10.1111/ases.70152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>A narrow operative field, difficult dissection of an inflamed urachal remnant (UR) and possible incomplete resection of UR at the bladder dome may be serious problems in laparoscopic surgery with umbilical and extraperitoneal approaches. To overcome these problems, we recently introduced suprapubic open and single-port laparoscopic surgery (SOSLS) for UR in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Surgical Technique</h3>\u0000 \u0000 <p>The root of UR was resected and the bladder wall was closed under direct vision through a 3 cm suprapubic transverse incision. A multichannel port with three trocars was applied to the suprapubic incision, and the laparoscopic dissection proceeded until reaching the cephalic end of UR below the umbilicus, when adhesion to the omentum or intestines, if present, could be dissected. Then an open procedure through a circumumbilical incision completed the resection of the UR, including the bottom of the umbilical skin and part of the linea alba, and the specimen was extracted through the umbilical incision. The two incisions were closed using antiadhesion sheets in the abdominal cavity. Four patients with a UR (median age, 12.5 [range: 9–16] years) received SOSLS in 2021–2024. The median operative time was 193.5 (180–217) minutes and the median blood loss was 5 (1–20) ml. The postoperative course was uneventful, with a median postoperative hospital stay of 3.5 (3–5) days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>SOSLS appears to be an easy and effective procedure for treating UR in elder children with a longer umbilicus–bladder distance. It shows satisfactory cosmetic results, taking advantage of both open and laparoscopic procedures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145110781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Three-Point Gastric Retraction Technique (3P-GRT) for Enhanced Surgical Field Exposure in Robotic Distal Pancreatectomy","authors":"Shingo Kozono,&nbsp;Takaaki Tatsuguchi,&nbsp;Atsushi Fujii,&nbsp;Norimasa Abe,&nbsp;Hirotaka Kuga,&nbsp;Toru Nakano","doi":"10.1111/ases.70153","DOIUrl":"10.1111/ases.70153","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Robotic distal pancreatectomy (RDP) is increasingly performed for tumors of the pancreatic body and tail, offering reduced blood loss and faster recovery. However, prolonged operative time and higher costs remain challenges. Effective gastric retraction is critical for smooth surgical manipulation during RDP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Surgical Technique</h3>\u0000 \u0000 <p>We developed the Three-Point Gastric Retraction Technique (3P-GRT). The greater omentum is incised to release the omental bursa, and the gastro-splenic ligament is divided to mobilize the stomach. The first fixation sutures the gastric antrum to the abdominal wall, exposing the pancreatic body. The second fixation secures the posterior gastric fundus, enhancing access to the gastro-pancreatic mesentery. The third fixation uses robotic-assisted traction on the left gastric artery pedicle, providing adjustable retraction. This approach achieves stable, wide exposure from the pancreatic body to the tail, enabling smooth and efficient surgical maneuvers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Operative Results</h3>\u0000 \u0000 <p>Eight consecutive patients underwent RDP with 3P-GRT. Median operative time was 282 min and median blood loss was 25 mL. All procedures were completed safely without complications attributable to the technique.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The 3P-GRT provides simple, reproducible gastric retraction, facilitating stable pancreatic exposure and efficient operative workflow in RDP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082049","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 Robot-Assisted Laparoscopic Pyeloplasty Technique to Ensure Secure Anastomosis for Lower Pole Ureteropelvic Junction Obstruction in a Patient With an Incomplete Duplicated Collecting System","authors":"Tomoaki Terakawa,&nbsp;Takuto Hara,&nbsp;Hideto Ueki,&nbsp;Kotaro Suzuki,&nbsp;Jun Teishima,&nbsp;Koji Chiba,&nbsp;Hideaki Miyake","doi":"10.1111/ases.70151","DOIUrl":"10.1111/ases.70151","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Ureteropelvic junction obstruction (UPJO) in patients with a duplicated collecting system is rare, and evidence on robot-assisted laparoscopic pyeloplasty (RALP) and technical strategies for end-to-side pyeloureterostomy in such cases remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Surgical Technique</h3>\u0000 \u0000 <p>We present technical refinements used during RALP in a patient with an incomplete duplicated collecting system. First, an open-ended ureteral catheter was used to guide accurate ureteral incision and secure anastomosis. Second, the dorsal pelvis of the lower pole was anastomosed to the larger-caliber common ureter rather than the narrow upper pole ureter. To ensure a tension-free anastomosis, the kidney and pelvis were mobilized as needed. Third, an M-shaped traction technique was applied during posterior wall suturing: the lateral stay suture was tied, while the medial one was left untied and retracted with a bulldog clamp to create a groove, enhancing lumen visibility and enabling continuous posterior suturing under direct vision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This case demonstrates the feasibility of end-to-side pyeloureterostomy for UPJO with incomplete duplication using robotic techniques. Key modifications—catheter-assisted incision, anatomical mobilization, and M-shaped traction—allowed for precise anastomosis. Further case accumulation is needed to validate these strategies for similar anatomical variations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082015","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 Wound Protector With Honeycomb Meshing for Thoracoscopic Surgery","authors":"Kaoruko Koga,&nbsp;Shinya Tane,&nbsp;Yugo Tanaka,&nbsp;Midori Takanashi,&nbsp;Ryosuke Izawa,&nbsp;Hiroyuki Ogawa,&nbsp;Daisuke Hokka,&nbsp;Yoshitaka Kitamura,&nbsp;Yoshimasa Maniwa","doi":"10.1111/ases.70150","DOIUrl":"10.1111/ases.70150","url":null,"abstract":"<div>\u0000 \u0000 <p>Blood oozing from the access port due to breakage of the wound protector may obscure the surgical view during thoracoscopic surgery. Therefore, we developed a novel wound protector with honeycomb meshing that prevents its breakage by dispersing the force acting on the edge of the access port in six directions. This novel wound protector could reduce the likelihood of interruption during surgery due to blood oozing from the surface of the access port, contributing to surgical efficacy and safety.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070850","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":"Nerve Sparing Is Beneficial for Recovery From Urinary Incontinence in Patients With Shorter Membranous Urethral Length After Robot-Assisted Laparoscopic Radical Prostatectomy","authors":"Kazuki Kokura,&nbsp;Akihiro Kanematsu,&nbsp;Shingo Yamamoto,&nbsp;Jun Watanabe","doi":"10.1111/ases.70147","DOIUrl":"10.1111/ases.70147","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>We analyze determinants of postoperative recovery from urinary incontinence following robot-assisted laparoscopic radical prostatectomy, with a focus on membranous urethral length and inclusion of nerve sparing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective study included patients who underwent robot-assisted laparoscopic radical prostatectomy from 2017 to 2022 performed at a single institution. Cox proportional hazards analysis was conducted for postoperative recovery from urinary incontinence, defined as use of zero or one pad/day. Examined patient factors were age, body mass index, prostate volume, and membranous urethral length, while surgical factors were nerve-sparing status, operative time, and console time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 197 patients were included in the analysis. Median membranous urethral length was 11.6 mm. Nerve sparing was performed in 92 (46.7%), with unilateral preservation in 68 and bilateral preservation in 24. In total, patients both univariate and multivariate Cox hazard analyses showed that the only significant factor for recovery from urinary incontinence was membranous urethral length (hazard ratio 1.059, <i>p</i> = 0.01), while nerve sparing was not significant (hazard ratio 1.132, <i>p</i> = 0.43). However, when patients were subdivided into two groups based on the median value for membranous urethral length (11.6 mm), nerve sparing was not a significant factor for recovery in the longer group (≥ 11.6 mm, <i>n</i> = 99, hazard ratio 0.898, <i>p</i> = 0.64), while that was significant in the shorter group (&lt; 11.6 mm, <i>n</i> = 98, hazard ratio 1.55, <i>p</i> = 0.049).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present results may indicate that nerve sparing is more recommended for patients with a shorter membranous urethral length.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034555","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":"Clinical Impacts of Minimally Invasive Transperineal Abdominoperineal Resection in Crohn's Disease: A Retrospective Analysis","authors":"Yoshitaka Kondo,&nbsp;Nobuhiko Kanaya,&nbsp;Ryohei Shoji,&nbsp;Toshihiro Inokuchi,&nbsp;Sakiko Hiraoka,&nbsp;Yusuke Yoshida,&nbsp;Yuki Matsumi,&nbsp;Kunitoshi Shigeyasu,&nbsp;Fuminori Teraishi,&nbsp;Shinji Kuroda,&nbsp;Toshiyoshi Fujiwara","doi":"10.1111/ases.70149","DOIUrl":"10.1111/ases.70149","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Crohn's disease (CD) often leads to complex anorectal complications, posing significant challenges in surgical management. Transperineal abdominoperineal resection (TpAPR) has emerged as a minimally invasive alternative to APR. This study aims to evaluate the safety and efficacy of TpAPR compared to APR in patients with CD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on 19 CD patients who underwent either minimally invasive TpAPR (<i>n</i> = 11) or APR (<i>n</i> = 8) between 2008 and 2023 from a single institution. The primary outcomes were assessed: intraoperative blood loss, operative time, and surgical site infection (SSI) rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The minimally invasive TpAPR group exhibited significantly reduced intraoperative blood loss (223 mL vs. 533 mL, <i>p</i> = 0.04) and a lower incidence of SSI rates (36.4% vs. 75%, <i>p</i> = 0.07). Operative time and hospital stay were comparable between groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Minimally invasive TpAPR demonstrates potential benefits over APR in reducing blood loss and SSI rates in CD patients. Further large-scale studies are warranted to confirm these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70149","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034547","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 Subtotal Splenectomy in Pediatric Patients With Hematologic Disorders: A Case Series and Operative Technique","authors":"Masaya Yamoto,&nbsp;Yu Sugai,&nbsp;Yuri Nemoto,&nbsp;Yousuke Goda,&nbsp;Yuri Nishiya,&nbsp;Akiyoshi Nomura,&nbsp;Hiromu Miyake,&nbsp;Yutaro Yamashiro,&nbsp;Koji Fukumoto,&nbsp;Kenichiro Watanabe","doi":"10.1111/ases.70146","DOIUrl":"https://doi.org/10.1111/ases.70146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Total splenectomy in children increases the risk of overwhelming post-splenectomy infection (OPSI). Laparoscopic subtotal splenectomy (LSS) is a technique to preserve splenic function while managing disease burden in pediatric hematologic disorders.</p>\u0000 \u0000 <p>Materials and Surgical Technique:</p>\u0000 \u0000 <p>Three children aged 4 to 9 years with juvenile myelomonocytic leukemia (JMML) or hereditary spherocytosis underwent LSS. All received pneumococcal vaccination and preoperative CT imaging. Under general anesthesia, three 5-mm trocars were used. Intraoperative indocyanine green (ICG) fluorescence imaging guided perfusion assessment. In one case, an upper pole was preserved due to anatomical considerations. In two cases, LSS was combined with laparoscopic cholecystectomy. Approximately 90 to 97% of the spleen was resected, leaving a 30 mL remnant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>All patients recovered well without OPSI. One case required transfusion. ICG imaging enabled safe resection with preserved perfusion. No case developed splenosis or required completion splenectomy during follow-up. LSS is a feasible technique for selected pediatric patients to minimize infection risk while maintaining immunologic function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145012090","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":"N-Shaped Port Placement for Simultaneous Robot-Assisted Right and Left-Sided Colectomies","authors":"Ryosuke Okamura,&nbsp;Yoshiro Itatani,&nbsp;Ryuhei Aoyama,&nbsp;Shoichi Kitano,&nbsp;Kohei Ueno,&nbsp;Yu Yoshida,&nbsp;Takashi Sakamoto,&nbsp;Takehito Yamamoto,&nbsp;Shintaro Okumura,&nbsp;Masazumi Sakaguchi,&nbsp;Masahiro Maeda,&nbsp;Keiko Kasahara,&nbsp;Nobuaki Hoshino,&nbsp;Shigeo Hisamori,&nbsp;Shigeru Tsunoda,&nbsp;Koya Hida,&nbsp;Kazutaka Obama","doi":"10.1111/ases.70145","DOIUrl":"https://doi.org/10.1111/ases.70145","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Minimally invasive surgery offers significant advantages, including smaller incisions, reduced postoperative pain, and shorter recovery, especially in surgeries requiring access to multiple abdominal quadrants. However, robot-assisted resection of synchronous colorectal cancer (sCRC) remains technically challenging and unstandardized due to its rarity. Herein, we propose an N-shaped configuration of five-trocar placement for the simultaneous right- and left-sided colectomies with intracorporeal anastomosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Surgical Technique</h3>\u0000 \u0000 <p>An 85-year-old woman with synchronous cecal (T1) and sigmoid colon (T3) cancers underwent simultaneous ileocecal resection and sigmoidectomy. A camera trocar at the umbilical incision and four additional trocars were arranged in an N-shaped configuration. The patient cart was docked from the left caudal side. Right-sided colectomy was performed first with intracorporeal anastomosis using robotic stapling. Following temporary undocking and a 180-degree boom rotation, the robotic sigmoidectomy was completed with a standard double-stapled anastomosis. Total operative time was 311 min with minimal blood loss, and the postoperative course was uneventful.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This N-shaped port configuration facilitated a seamless transition between right- and left-sided colectomies, maximizing the advantages of robotic surgery. Importantly, all tasks can be completed with this port configuration by a single patient-side surgeon. Although further studies are needed to evaluate the adaptability of this approach to other multiport robotic platforms, our experience suggests this technique is practical and effective for multiport robotic sCRC resections.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144929688","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}