Asian Journal of Endoscopic Surgery最新文献

{"title":"Robotic Posterior Retroperitoneoscopic Adrenalectomy: 1-Year Experience at a High-Volume Endocrine Referral Center","authors":"Francesco Pennestrì,&nbsp;Priscilla Francesca Procopio,&nbsp;Antonio Laurino,&nbsp;Pierpaolo Gallucci,&nbsp;Carmela De Crea,&nbsp;Marco Raffaelli","doi":"10.1111/ases.70393","DOIUrl":"10.1111/ases.70393","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Evidence on multiplatform implementation of robotic posterior retroperitoneoscopic adrenalectomy remains limited. We assessed first-year operative performance in a high-volume endocrine referral center experienced in laparoscopic posterior retroperitoneoscopic and robotic adrenal surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All consecutive adults undergoing unilateral total robotic posterior retroperitoneoscopic adrenalectomy between July 2025 and July 2026 were retrospectively analyzed. Operative times, perioperative outcomes, chronological trends, cumulative sum curves, and multivariable Gamma generalized linear models were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-four procedures were performed: 7 with Toumai, 25 with da Vinci Xi, and 2 with da Vinci SP. Median total operative, docking, console, and procedure times were 59.0, 6.0, 19.0, and 54.0 min, respectively. One conversion to laparoscopic posterior retroperitoneoscopic adrenalectomy occurred (2.9%). Two intraoperative complications (5.9%) and two 30-day postoperative complications (5.9%) were recorded, including one death after postdischarge acute myocardial infarction. Across the cohort, docking time decreased with consecutive case number (Spearman <i>ρ</i> = −0.623; <i>p</i> &lt; 0.001), whereas total operative and console times did not. After adjustment for platform, body mass index, and lesion size in 32 multiport procedures, only docking time remained associated with case number (time ratio 0.980, 95% confidence interval 0.963–0.997; <i>p</i> = 0.021). Cumulative sum inflections occurred around Cases 7–8 but coincided with platform transition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this limited first-year experience in an expert adrenal surgery program, robotic posterior retroperitoneoscopic adrenalectomy implementation was feasible across three platforms, with adaptation reflected mainly by docking optimization. Platform-specific time differences were descriptive and cannot establish comparative efficiency because platform use was sequential and instrumentation differed across systems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197121","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":"Feasibility of Laparoscopic Partial Cystectomy for Bladder Paraganglioma: A Four-Case Series","authors":"Taito Sato,&nbsp;Naoki Hayata,&nbsp;Takayoshi Miura,&nbsp;Mutsuki Mishina,&nbsp;Takuya Kitamura,&nbsp;Mika Tsuiki,&nbsp;Yoichiro Hijikata,&nbsp;Ryo Kuwahara,&nbsp;Seiko Kasahara,&nbsp;Koki Moriyoshi,&nbsp;Toru Kanno","doi":"10.1111/ases.70394","DOIUrl":"10.1111/ases.70394","url":null,"abstract":"<div>\u0000 \u0000 <p>Urinary bladder paraganglioma is a rare tumor associated with a risk of catecholamine-induced hypertensive crisis during tumor manipulation. The optimal surgical approach remains uncertain, particularly for larger tumors or those with suspected local invasion. We report four cases managed at our institution. All tumors were diagnosed preoperatively by magnetic resonance imaging and ¹²³I-metaiodobenzylguanidine scintigraphy, and all patients received preoperative α-blockade. Three tumors (1.0–1.5 cm) without extravesical extension were treated with laparoscopic partial cystectomy without conversion. One larger tumor (4.3 cm) with suspected local invasion was managed using a planned open procedure and was associated with marked intraoperative hypertension and technical difficulty. These findings suggest that laparoscopic partial cystectomy is technically feasible in selected patients with small, localized bladder paragangliomas, whereas tumor size and suspected local invasion may influence surgical planning. The technical requirements for complete resection and catecholamine-related hemodynamic risk should be assessed separately.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197174","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":"Low Anterior Access Approach for Single-Port Retroperitoneal Robot-Assisted Adrenalectomy: Surgical Technique and Early Outcomes","authors":"Shinnosuke Fujiwara,&nbsp;Masaru Ishida,&nbsp;Yuichiro Konnai,&nbsp;Tansei Sanjo,&nbsp;Tadatsugu Anno","doi":"10.1111/ases.70391","DOIUrl":"10.1111/ases.70391","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The da Vinci single-port (SP) system has been utilized across various surgical procedures. However, a standardized technique for SP robot-assisted adrenalectomy (SP-RAA) remains unestablished. Herein, we report our technique for retroperitoneal SP-RAA via the low anterior access (LAA) approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Surgical Technique</h3>\u0000 \u0000 <p>Nine patients underwent SP-RAA using our standardized procedure. Patients were placed in a modified supine position. The primary incision was typically located two fingerbreadths cranial to a point two-thirds laterally along the spino-umbilical line. The operation was performed via a retroperitoneal approach. For right-sided tumors, dissection proceeded cranially along the psoas muscle and the inferior vena cava. For left-sided tumors, a gonadal vein-guided ascending approach was utilized to clear the surgical plane. After identifying and transecting the adrenal vein, periadrenal dissection was performed, and the adrenal gland was dissected free from its retroperitoneal attachments. Median operative and console times were 128 and 91 min, respectively, with no perioperative or postoperative complications or readmissions occurring within 30 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Although surgeons require familiarization with this unique approach and the corresponding orientation of anatomical structures, the LAA approach can be successfully utilized for SP-RAA. It may enhance safety over traditional methods, including prone or transperitoneal approaches, by avoiding forced positioning and mitigating the risks associated with intraperitoneal manipulation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185039","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":"Item-Level Scoring Profiles and Technical Domains in the Colorectal Endoscopic Surgical Skill Qualification Examination","authors":"Suguru Hasegawa,&nbsp;Hiroya Kuroyanagi,&nbsp;Junichiro Kawamura,&nbsp;Yusuke Kinugasa,&nbsp;Kazutaka Obama,&nbsp;Yuko Kitagawa","doi":"10.1111/ases.70389","DOIUrl":"https://doi.org/10.1111/ases.70389","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>\u0000 <span>Video-based assessment is increasingly used to evaluate operative performance, but pass–fail outcomes alone provide limited information on the technical components associated with the decision. This study aimed to clarify item-level scoring patterns and latent technical domains underlying pass–fail decisions in the colorectal Endoscopic Surgical Skill Qualification examination.</span>\u0000 </p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p><span>This secondary item-level analysis used the colorectal ESSQS examination dataset of the Japan Society for Endoscopic Surgery from 2020 to 2024. The final application-level pass–fail decision was the primary outcome, and each primary reviewer evaluation was the unit of analysis. Item scores were standardized as proportions of the version-specific maximum. Univariable logistic regression, multivariable generalized linear mixed-effects models, and exploratory factor analysis were performed</span>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>\u0000 <span>A total of 1945 applications yielded 3890 reviewer-level observations, with a final pass rate of 33.2%. Items related to operative field exposure, cooperation with assistants, dissection-plane recognition, workflow planning, vascular control, and transection/anastomosis were most strongly associated with the outcome. Exploratory factor analysis identified seven clinically interpretable domains; operative field exposure and team coordination, dissection-plane recognition, vessel management and lymphadenectomy, and transection/anastomosis were most strongly associated with the final decision.</span>\u0000 </p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p><span>Pass–fail decisions in the colorectal ESSQS examination were characterized by both general endoscopic competencies and colorectal procedure-specific technical components. Item- and domain-level</span> <span>analyses describe the internal structure of the rubric; application to individualized feedback would require improved inter-reviewer reliability and further validation, and the findings may inform reviewer calibration and refinement of video-based skill assessment.</span></p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149146346","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":"Incidental Gallbladder Cancer After Laparoscopic Cholecystectomy: A Comparison Between Patients With and Without Acute Cholecystitis at a High-Volume Center","authors":"Ryutaro Watanabe,&nbsp;Koji Asai,&nbsp;Manabu Watanabe,&nbsp;Yu Shibahara,&nbsp;Shintaro Teraoka,&nbsp;Jiro Sato,&nbsp;Osahiko Hagiwara,&nbsp;Toshiyuki Enomoto,&nbsp;Takuya Nagata,&nbsp;Yoshihisa Saida","doi":"10.1111/ases.70388","DOIUrl":"10.1111/ases.70388","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Incidental gallbladder cancer (iGBC) after laparoscopic cholecystectomy (LC) remains clinically relevant, and preoperative recognition may be especially difficult in acute cholecystitis (AC). We reviewed iGBC cases diagnosed after LC and descriptively compared cases with and without AC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed 2572 consecutive LCs performed between January 2013 and November 2025. After excluding patients with preoperatively detected gallbladder polyps or suspected malignancy, 2224 patients were analyzed (AC, <i>n</i> = 663; non-AC, <i>n</i> = 1561). The denominator cohort was used to estimate iGBC incidence, and clinicopathologic details were reviewed for the 12 iGBC cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twelve patients (0.54%) had iGBC. The incidence was numerically higher in the AC group than in the non-AC group (0.90% vs. 0.38%; <i>p</i> = 0.201), but the difference was not statistically significant. Among 11 patients with evaluable T stage, nine had T2 or deeper disease, and flat-type morphology predominated. Bile leakage occurred in two AC cases, subtotal cholecystectomy was required in one AC case and peritoneal dissemination developed in one AC case. Because only 12 iGBC cases were identified, causal interpretation was not possible.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>iGBC was uncommon after LC and was numerically, but not significantly, more frequent in patients with AC. These findings should be regarded as hypothesis-generating. Surgeons should maintain awareness of occult malignancy during LC for AC and should minimize uncontrolled bile contamination when bailout procedures are unavoidable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149128691","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":"Laparoscopic Spleen-Preserving Distal Pancreatectomy for Mucinous Cystic Neoplasm With Unexpected Immunoglobulin G4-Related Periarteritis of the Splenic Artery: A Case Report","authors":"Dongha Lee,&nbsp;Yoshihide Nanno,&nbsp;Jun Ishida,&nbsp;Takuya Mizumoto,&nbsp;Yuki Ueda,&nbsp;Hiroyuki Nakamura,&nbsp;Taisuke Okawa,&nbsp;Kouki Hamano,&nbsp;Masaharu Yokota,&nbsp;Masayuki Akita,&nbsp;Keisuke Arai,&nbsp;Toshihiko Yoshida,&nbsp;Takeshi Urade,&nbsp;Kenji Fukushima,&nbsp;Sadaki Asari,&nbsp;Masahiro Kido,&nbsp;Atsuhiro Masuda,&nbsp;Takayuki Kodama,&nbsp;Shohei Komatsu","doi":"10.1111/ases.70387","DOIUrl":"10.1111/ases.70387","url":null,"abstract":"<div>\u0000 \u0000 <p>Unexpected vascular lesions may complicate standard laparoscopic pancreatic procedures. We report a case of mucinous cystic neoplasm (MCN) treated with laparoscopic spleen-preserving distal pancreatectomy (LSPDP) in which unrecognized immunoglobulin G4 (IgG4)-related periarteritis of the splenic artery caused difficulty during vascular division. A 76-year-old woman underwent LSPDP for MCN. Preoperative computed tomography demonstrated circumferential soft-tissue thickening along the splenic artery. Intraoperatively, the splenic artery was deeply embedded within the pancreatic parenchyma, making the Kimura technique impractical; therefore, the Warshaw technique was selected. However, the splenic artery demonstrated marked circumferential wall thickening, precluding safe division with ligation or clipping alone. The artery was ultimately divided using a vascular stapler. Histopathological examination revealed low-grade MCN and IgG4-related periarteritis involving the splenic artery. This case highlights that IgG4-related periarteritis should be considered when unexplained perivascular soft-tissue thickening is identified preoperatively, as it may significantly alter intraoperative strategy during LSPDP.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116389","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":"Perioperative Changes in Intra-Abdominal and Airway Pressure After Endoscopic Anterior Component Separation With Intraperitoneal Onlay Mesh Repair for Large Midline Incisional Hernia: A Prospective Observational Study","authors":"Meghna Purohit,&nbsp;Romesh Lal,&nbsp;Saurabh Borgharia","doi":"10.1111/ases.70386","DOIUrl":"10.1111/ases.70386","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Purpose&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Reduction of chronically herniated viscera and restoration of midline continuity in a large incisional hernia can raise intra-abdominal pressure (IAP), occasionally to the point of intra-abdominal hypertension. Component separation is intended to mitigate this by increasing the capacity and compliance of the abdominal wall, yet the perioperative pressure profile of endoscopic anterior component separation combined with intraperitoneal onlay mesh repair with fascial closure (IPOM-plus) has not been well characterized. We measured IAP and airway pressure across the perioperative period in patients undergoing this reconstruction.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Thirty consecutive adults with a midline incisional hernia of at least 6 cm width underwent bilateral endoscopic anterior component separation with primary fascial closure and IPOM-plus repair at a tertiary center. IAP was measured indirectly as intravesical pressure (IVP) at four predefined time points: preoperatively, immediately after induction of anesthesia, after completion of the reconstruction before anesthetic reversal, and 24 h postoperatively. Peak airway pressure (Paw) was recorded after induction and before reversal. Loss of domain was quantified on preoperative computed tomography using the Tanaka method. The primary outcome was the change in IVP from the preoperative measurement to 24 h. Repeated measures were compared using the Friedman test with post hoc Wilcoxon signed-rank tests and Bonferroni correction.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Mean IVP was 9.43 ± 1.01 mmHg preoperatively, 8.67 ± 0.84 mmHg after induction, 8.87 ± 0.82 mmHg before reversal and 9.93 ± 1.05 mmHg at 24 h, differing significantly overall (Friedman &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;(3) = 46.06, &lt;i&gt;p&lt;/i&gt; &lt; 0.001; Kendall &lt;i&gt;W&lt;/i&gt; = 0.51). The primary outcome, the preoperative to 24-h change, was an increase of 0.50 ± 0.68 mmHg, which was statistically significant (adjusted &lt;i&gt;p&lt;/i&gt; = 0.006) but clinically negligible. Two patients (6.7%) reached 12 mmHg and so met the threshold for Grade I intra-abdominal hypertension, and none developed organ dysfunction. IVP did not change significantly during the surgery itself (8.67–8.87 mmHg, adjusted &lt;i&gt;p&lt;/i&gt; = 0.347). Paw was unchanged (19.60 ± 1.22 to 19.53 ± 1.11 cmH&lt;sub&gt;2&lt;/sub&gt;O, &lt;i&gt;p&lt;/i&gt; = 0.564), as were FVC, FEV&lt;sub&gt;1&lt;/sub&gt; and FEV&lt;sub&gt;1&lt;/sub&gt;/FVC. The Tanaka score (mean 25.7 ± 1.1%) was not associated with IVP at any time point or with the change in IVP. Fascial closure was achieved in all 30 patients, and 30-day morbidity comprised one seroma and one abdominal wall ecchymosis, both Clavien–Dindo Grade I.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 ","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116493","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":"Delayed Thoracoscopic Repair Following Abdominal Esophageal Banding in a 539-g Infant With Triple Atresia: A Case Report","authors":"Kaito Hayashi,&nbsp;Chiyoe Shirota,&nbsp;Takahisa Tainaka,&nbsp;Satoshi Makita,&nbsp;Katsuhiro Ogawa,&nbsp;Masamune Okamoto,&nbsp;Akihiro Yasui,&nbsp;Aitaro Takimoto,&nbsp;Shunya Takada,&nbsp;Daiki Kato,&nbsp;Hiroki Ishii,&nbsp;Hajime Asai,&nbsp;Kazuki Ota,&nbsp;Hiroo Uchida","doi":"10.1111/ases.70373","DOIUrl":"10.1111/ases.70373","url":null,"abstract":"<div>\u0000 \u0000 <p>Triple atresia, comprising esophageal atresia, duodenal atresia, and anorectal malformation, has no established management strategy in extremely low-birth-weight (ELBW) infants. We report successful staged treatment in a 539-g infant with severe respiratory failure. Transabdominal esophageal banding and gastrostomy on Day 0 controlled airflow through the tracheoesophageal fistula without thoracic intervention. Duodeno-duodenostomy and transverse colostomy were performed on Day 18 (680 g), permitting enteral feeding. After growth to 1924 g, thoracoscopic repair of Gross type C esophageal atresia was completed on Day 127. The temporary band was removed without esophageal injury. The patient was discharged on Day 219 at 2793 g with partial oral intake and no anastomotic stricture. This abdominal-first strategy served as a bridge from cardiorespiratory stabilization and enteral nutrition to delayed thoracoscopic repair while preserving an unoperated thoracic cavity.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082451","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":"Robot-Assisted Ileocecal Resection After Endovascular Aneurysm Repair for Abdominal Aortic Aneurysm: A Case Report Focusing on Technical Strategies to Minimize Graft-Related Stress","authors":"Aina Kunitomo,&nbsp;Tatsuki Matsumura,&nbsp;Konosuke Yogo,&nbsp;Sho Ueda,&nbsp;Kentaro Shinohara,&nbsp;Takaaki Osawa,&nbsp;Masataka Ando,&nbsp;Kenitiro Kaneko,&nbsp;Yasuyuki Fukami","doi":"10.1111/ases.70384","DOIUrl":"10.1111/ases.70384","url":null,"abstract":"<div>\u0000 \u0000 <p>A 79-year-old woman with a history of endovascular aneurysm repair (EVAR) for a large abdominal aortic aneurysm underwent robot-assisted ileocecal resection (R-ICR) for ascending colon cancer. Several technical modifications, including modified port placement, operative sequence adjustment, and strict intraoperative blood pressure control, were implemented to minimize inadvertent stress on the stent graft. The procedure was completed without vascular complications, and the postoperative course was uneventful. Although robot-assisted surgery increases the risk of mechanical aneurysmal compression and lacks tactile feedback, these technical modifications enabled safe procedural completion. R-ICR after EVAR with appropriate technical modifications and perioperative management may be feasible in select patients.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070389","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":"Short- and Long-Term Outcomes of Transanal Total Mesorectal Excision for Rectal Cancer: A Single-Center Retrospective Study of 100 Patients","authors":"Mamoru Miyasaka,&nbsp;Koichi Teramura,&nbsp;Yume Okuda,&nbsp;Yuki Okawa,&nbsp;Sho Sekiya,&nbsp;Toshihiro Kushibiki,&nbsp;Daisuke Saikawa,&nbsp;Yoshinori Suzuki,&nbsp;Yo Kawarada,&nbsp;Yuma Ebihara,&nbsp;Shuji Kitashiro,&nbsp;Shunichi Okushiba,&nbsp;Satoshi Hirano","doi":"10.1111/ases.70385","DOIUrl":"https://doi.org/10.1111/ases.70385","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Transanal total mesorectal excision (TaTME) has been introduced to facilitate distal rectal dissection; however, concerns regarding its oncological safety persist. This study evaluated the outcomes of TaTME in a real-world setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between 2019 and 2025, 123 patients underwent TaTME at our institution. After excluding patients with pathologically confirmed Stage IV disease, combined resection of adjacent organs, and local recurrence, 100 patients were retrospectively analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Median age was 67 years, and 64% were male. Median tumor distance from the anal verge was 6 cm. Procedures included low or ultra-low anterior resection (<i>n</i> = 67), intersphincteric resection (<i>n</i> = 21), abdominoperineal resection (<i>n</i> = 11), and Hartmann's procedure (<i>n</i> = 1). A simultaneous two-team approach, consisting of a surgeon and a camera assistant for each phase, was used in 98 patients. The median operative time and blood loss were 211.5 min and 5 mL, respectively. Median postoperative hospital stay was 15 days. Clavien–Dindo grade≥IIIa complications occurred in 12 patients, and no 90-day mortality was observed. A positive circumferential resection margin was observed in one patient (1%). Median follow-up was 1126 days. Recurrence occurred in 17 patients (17%), including pelvic local recurrence in four patients (4%). The estimated 3-year overall survival (OS) rates for pathological Stages 0, I, II, and III were 100%, 100%, 90.0%, and 92.6%, respectively. The estimated 3-year recurrence-free survival (RFS) rates were 100%, 91.6%, 77.4%, and 66.6%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TaTME was associated with acceptable perioperative and oncological outcomes in a community hospital setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149048460","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}