Asian Journal of Endoscopic Surgery最新文献

{"title":"New strategy using laparoscopic hepatectomy for an intrahepatic portal-hepatic venous shunt with hyperammonemia (with video)","authors":"Jungo Yasuda,&nbsp;Hironori Shiozaki,&nbsp;Yasuro Futagawa,&nbsp;Tomoyoshi Okamoto,&nbsp;Toru Ikegami","doi":"10.1111/ases.13408","DOIUrl":"10.1111/ases.13408","url":null,"abstract":"<p>Intrahepatic portal and hepatic venous shunts have been reported in children (Takama et al. Surg Case Rep 2020;6(1):73) but are very rare in adults (Papamichail et al. Hepatobiliary Pancreat Dis Int 2016;15(3):329–333). Treatment is indicated in cases of portal hypertension or hyperammonemia. We evaluated and reported the usefulness, safety, and effectiveness of laparoscopic liver resection for this case. After performing intraoperative ultrasonography, the hilar plate was manipulated to identify the target Glissonean branch of segment 5 (G5). Bulldog forceps were then used for test clamping, which was identified by negative staining, Segment 5 was dissected and hepatic parenchymal resection was performed. The hepatic veins running within the ischemic area were dissected, and hepatic parenchymal resection, including intrahepatic portal and hepatic venous shunts, was performed. The operation time was 257 min, and she was discharged on the 8th postoperative day, with no complications. Serum ammonia levels decreased rapidly postoperatively. Laparoscopic liver resection may be effective for intrahepatic portal and hepatic venous shunts.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814563","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":"Specific Findings of Blood Perfusion on Anastomosed Esophagus of Neonatal Esophageal Atresia and Tracheoesophageal Fistula Using Indocyanine Green Fluorescence During Thoracoscopic Surgery","authors":"Yudai Tsuruno,&nbsp;Toshio Harumatsu,&nbsp;Yumiko Tabata,&nbsp;Chihiro Kedoin,&nbsp;Masakazu Murakami,&nbsp;Koshiro Sugita,&nbsp;Keisuke Yano,&nbsp;Shun Onishi,&nbsp;Takafumi Kawano,&nbsp;Satoshi Ieiri","doi":"10.1111/ases.13422","DOIUrl":"10.1111/ases.13422","url":null,"abstract":"<p>We herein report a neonatal case showing specific findings of blood perfusion in the anastomosed esophagus of esophageal atresia (EA) and tracheoesophageal fistula (TEF) using indocyanine green (ICG) fluorescence during thoracoscopic surgery. The patient was a 3054 g, 0-day neonatal boy diagnosed with EA-TEF based on a coil-up sign of the nasogastric tube. Thoracoscopic surgery was performed on Day 4 after birth. After TEF transection, esophageal anastomosis was performed using interrupted sutures. ICG was administered intravenously to confirm blood perfusion at the anastomotic site. Initially, the upper esophagus was visualized, and 5 s later, the lower esophagus was visualized. However, no fluorescence signal was detected at the anastomotic site. The postoperative course was uneventful without anastomotic leakage. After discharge, mild anastomotic stenosis was observed, which required balloon dilatation. The time lag of fluorescent findings was considered to reflect differences in the feeding artery.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.13422","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830261","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":"Sleeve gastrectomy plus single anastomosis sleeve ileal bipartition versus sleeve gastrectomy alone: The role of bipartition","authors":"Xiaoguang Qin,&nbsp;Zhongqi Mao,&nbsp;Wei-Jei Lee,&nbsp;Min Zhang,&nbsp;Guoqiang Wu,&nbsp;Xiaoqing Zhou","doi":"10.1111/ases.13398","DOIUrl":"10.1111/ases.13398","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sleeve gastrectomy (SG) with single anastomosis sleeve ileal bipartition (SASI) is a novel procedure for increasing the anti-metabolic efficacy of SG in severely people with obesity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to compare 1-year results between SASI and SG, thereby assessing the role of bipartition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The study was conducted at the Medical University hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between November 2021 and December 2022, 39 patients received an SG + SASI surgery, a total of 35 patients completed 1-year follow-up after the surgery. They were matched with a group of 70 patients with SG that were equal in age, sex, and body mass index (BMI). Operative risk, weight loss, and remission of comorbidities were evaluated after 12 months.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The operation time of the SASI group was significantly longer than the SG group (140.3 ± 22.8 vs. 114.9 ± 21.6 min; <i>p</i> &lt; .001). At 12 months after surgery, the SASI group had better weight loss (total weight loss: 37.0% vs. 29.7%; <i>p</i> = .001) and achieved a lower BMI than SG (23.4 ± 2.6 kg/m² vs. 24.6 ± 2.9 kg/m²; <i>p</i> = .046). Reduction of A1C and remission of T2D was greater in the SASI group. The SASI group had a higher reduction in uric acid, low-density lipoprotein, total cholesterol, and triglyceride levels after operation than the SG group. However, the SG group is superior to the SASI group in mean corpuscular volume, calcium, and iron levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this study, adding an ileum bipartition to SG increases the weight loss, glycemic, and blood lipid control of SG only.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787414","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":"Operator Experience With Robot-Assisted Laparoscopic Rectal Resection and the Impact of Using an Extra Arm on Surgical Outcomes","authors":"Tetsuro Tominaga,&nbsp;Takashi Nonaka,&nbsp;Yuma Takamura,&nbsp;Kaido Oishi,&nbsp;Toshio Shiraishi,&nbsp;Shintaro Hashimoto,&nbsp;Keisuke Noda,&nbsp;Rika Ono,&nbsp;Makoto Hisanaga,&nbsp;Terumitsu Sawai,&nbsp;Keitaro Matsumoto","doi":"10.1111/ases.13420","DOIUrl":"https://doi.org/10.1111/ases.13420","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although robot-assisted surgery has been rapidly gaining popularity in recent years, few reports have examined the impact of individual robotic arm movements on surgical outcomes. This study investigated the relationship between extra arm (EA) usage and experience of surgeons in robot-assisted surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 176 robot-assisted rectal resections were performed by three surgeons from 2018 to 2022. Each surgeon's first 20 cases categorized in the Early group and the 21st–40th cases in the Late group. Sixty cases in the Early group and 60 cases in the Late group were included to compare patient background, EA motion, and surgical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>More anastomoses were performed closer to the anus in the Late group (<i>p</i> = 0.001). Console time was significantly shorter in the Late group (196 min vs. 153 min, <i>p</i> = 0.020). EA injuries, improper grasping, and intraoperative problems (intraoperative bleeding, misidentification of layers) were significantly less frequent in the Late group (<i>p</i> = 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>As experience with robot-assisted surgery increases, appropriate and safe use of an EA was achieved, and operative time and intraoperative problems were reduced.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142763989","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":"Effects of the Scopist's Skills on the Perioperative Outcomes of Laparoscopic Liver Resection","authors":"Taku Kimura,&nbsp;Hiroyuki Nitta,&nbsp;Hirokatsu Katagiri,&nbsp;Shoji Kanno,&nbsp;Akira Umemura,&nbsp;Daiki Takeda,&nbsp;Taro Ando,&nbsp;Satoshi Amano,&nbsp;Toma Kawashima,&nbsp;Koji Kikuchi,&nbsp;Shuta Kuchida,&nbsp;Akira Sasaki","doi":"10.1111/ases.13413","DOIUrl":"https://doi.org/10.1111/ases.13413","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Laparoscopic liver resection (LLR) is a difficult procedure that requires the scopist to have a high skill level. Scopists play an important role in ensuring an appropriate surgical field. This is the first study that focuses on the scopist's skills in perioperative outcomes of LLR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Patients who underwent LLR from April 2018 to March 2023 were included in this study. The scopists were separated into expert (≥ 10 LLR procedures as a scopist) and beginner (&lt; 10 LLR procedures as a scopist) groups. The effects of the scopists' skills on the perioperative outcomes of LLR between the two groups were examined retrospectively. In addition to listing baseline characteristics and perioperative outcomes, this study viewed video recordings to list intraoperative surgical manipulation factors as new attempts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant differences were observed in the baseline characteristics or perioperative outcomes between the two groups. The duration of the time during which the surgical procedure was interrupted due to scope operation errors during the Pringle maneuver was significantly longer in the beginner group (71 vs. 198 s, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The scope manipulation by the less experienced LLR scopists sometimes hindered the progress of the surgery. The scopist's skills may lead to an increased psychological burden on the surgeon and prolonged operative times.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749204","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 “Practice Guidelines on Endoscopic Surgery for Qualified Surgeons by the Endoscopic Surgical Skill Qualification System: Breast”","authors":"","doi":"10.1111/ases.13417","DOIUrl":"https://doi.org/10.1111/ases.13417","url":null,"abstract":"<p>Y. Tamaki, K. Yamashita, and A. Tangoku. “Practice Guidelines on Endoscopic Surgery for Qualified Surgeons by the Endoscopic Surgical Skill Qualification System: Breast.” <i>Asian Journal of Endoscopic Surgery</i> 17, no. 4 (2024): E13376.</p><p>In the part of affiliations of authors</p><p>Incorrect</p><p>⁴Department of Thoracic Endocrine Surgery and Oncology, Institute of Health Bioscience, The University of Tokushima Graduate School of Medicine, Tokushima, Japan</p><p>⁵Department of Breast Surgery, Nippon Medical School, Bunkyo-ku, Japan</p><p>Correct</p><p>⁴Department of Breast Surgery, Nippon Medical School, Bunkyo-ku, Tokyo, Japan</p><p>⁵Department of Thoracic Endocrine Surgery and Oncology, Institute of Health Bioscience, The University of Tokushima Graduate School of Medicine, Tokushima, Japan</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":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.13417","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749203","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 Retroperitoneal Lymph Node Dissection After Chemotherapy for Nonseminomatous Testicular Germ-Cell Tumor at a Single Center","authors":"Masaki Shiota,&nbsp;Tokiyoshi Tanegashima,&nbsp;Shigehiro Tsukahara,&nbsp;Jun Mutaguchi,&nbsp;Shunsuke Goto,&nbsp;Satoshi Kobayashi,&nbsp;Takashi Matsumoto,&nbsp;Masatoshi Eto","doi":"10.1111/ases.13416","DOIUrl":"10.1111/ases.13416","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigated the perioperative and oncological outcomes of laparoscopic retroperitoneal lymph node dissection (RPLND) procedures for post-chemotherapy patients with nonseminomatous testicular germ-cell tumor at a single center.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included patients with nonseminomatous testicular cancer who underwent RPLND after chemotherapy at the Kyushu University Hospital between 2016 and 2024. The preoperative clinicopathological characteristics, perioperative outcomes, and oncological outcomes were investigated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 13 patients underwent laparoscopic RPLND. Median maximum retroperitoneal tumor size at post-chemotherapy before RPLND was 11 mm (range, 2–30 mm). RPLND template was one side and both sides in nine and four patients. Median operative time was 272 min (range, 129–490 min), and median estimated blood loss was 27 mL (range, 0–100 mL). Median time from operation to discharge was 8 days (range, 5–15 days). There was no severe perioperative and postoperative complication. Residual cancer and teratoma were detected in one and seven patients. During median follow-up of 18.6 months (range, 1.0–95.7 months), no case presented recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Laparoscopic RPLND presented safety in perioperative outcomes and favorable oncological outcomes. Thus, it was confirmed that laparoscopic RPLND is a feasible minimally invasive procedure for selected cases.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733316","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 Outcomes and Feasibility of Single-Stage Laparoscopic Common Bile Duct Exploration (LCBDE) and Cholecystectomy With Internal Endo-Biliary Drainage for Management of Concomitant Cholelithiasis With Choledocholithiasis: A Report From a Tertiary Care Hospital","authors":"Ankita Bajpai,&nbsp;Akshay Anand,&nbsp;Awanish Kumar,&nbsp;Manish Agrawal,&nbsp;Ajay Kumar Pal,&nbsp;Pankaj Kumar,&nbsp;Amit Karnik,&nbsp;Sumit Rungta,&nbsp;Harvinder Singh Pahwa,&nbsp;Abhinav Arun Sonkar","doi":"10.1111/ases.13418","DOIUrl":"10.1111/ases.13418","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Managing choledocholithiasis alongside cholelithiasis has seen significant evolution, presenting options such as single-stage cholecystectomy with common bile duct (CBD) exploration, or a two-stage procedure involving endoscopic retrograde cholangiopancreatography (ERCP) performed before or after cholecystectomy. Evidence from Western settings may not fully capture the unique disease burden and demographic characteristics prevalent in developing countries. Laparoscopic common bile duct exploration (LCBDE) is more commonly performed in the Indian subcontinent compared to Western centers due to limited access to advanced procedures and specialized instrumentation for complex ERCP cases. The high cost and the need for extensive armamentarium in managing failed ERCPs make LCBDE a more feasible option in many Indian centers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective study, conducted from August 2019 to July 2020 at King George's Medical University, UP, India, included <i>n</i> = 24 patients diagnosed with choledocholithiasis. The operative procedures performed included laparoscopic CBD exploration and cholecystectomy, along with internal endo-biliary drainage. Perioperative outcomes were assessed, and follow-up data were included to monitor any recurrence until 36 months post-surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study population had a mean age of 42.2 years, with 83% (<i>n</i> = of the patients being female). Abdominal pain was the predominant symptom, reported by 91.66% of the patients, followed by nausea/vomiting in 79.20% of cases. The mean CBD diameter observed was consistent with existing literature. The mean operating time was 2.02 h, with primary duct closure taking an average of 13.66 min. Mean blood loss during surgery was 136.25 mL. The average hospital stay was 5.54 days, with the majority of drain removals occurring by the third postoperative day. Complications included fever in 25.0% of the patients and bile leakage in <i>n</i> = 3 out of 24 cases (~12.50%). During the follow-up period, one patient (4.17%) experienced a retained stone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Laparoscopic CBD exploration with primary duct closure and internal biliary drainage appears to be a feasible approach, yielding satisfactory perioperative outcomes. However, further studies are required to firmly establish its superiority over alternative approaches within the Indian context.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733319","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 financial impact of robotic surgery on hospital gross profits in Japan compared to laparoscopic surgery","authors":"Yoshiharu Sakai,&nbsp;Tsutomu Morishita","doi":"10.1111/ases.13410","DOIUrl":"https://doi.org/10.1111/ases.13410","url":null,"abstract":"<p>Robotic surgery is gaining traction in Japan due to its technological advancements, but its financial viability for hospitals remains uncertain. This study investigates the impact of robotic surgery on hospital gross profits, comparing it to laparoscopic surgery using data from surgeries performed at Red Cross Hospital Osaka. The study spans multiple surgical fields, including gastrointestinal, urology, gynecology, and thoracic surgery. While the number of robotic surgeries has increased, they consistently generate lower gross profits for hospitals compared with laparoscopic surgeries, primarily due to the high costs of robotic instruments and maintenance. Certain procedures, such as hernia repair, proximal gastrectomy, and distal pancreatectomy, result in negative profits when performed robotically. This article highlights the financial challenges hospitals face under Japan's current healthcare reimbursement system, where the fees for robotic and laparoscopic surgeries are largely the same. Policy adjustments may be necessary to ensure the financial sustainability of robotic surgery.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142708095","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":"Close Contact Transillumination Light Guides Surgeon to Vaginal Point Aa: Pharus Method for Robot-Assisted Sacrocolpopexy","authors":"Akiko Yoshida Ueno,&nbsp;Takayuki Sato,&nbsp;Michiya Kobayashi,&nbsp;Shinya Wakatsuki,&nbsp;Takaomi Namba,&nbsp;Kazutoshi Hayashi","doi":"10.1111/ases.13412","DOIUrl":"10.1111/ases.13412","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In robot-assisted sacrocolpopexy (RSC) for patients with cystocele, accurate identification of the vaginal point Aa from the serosal side is crucial for surgical mesh placement in the appropriate position. We developed a novel Pharus method for exactly locating the point Aa for RSC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In the Pharus method, the tip of a rigid endoscope was placed directly on the vaginal point Aa. In a preliminary experiment, we observed LED lights with different wavelengths of 450–870 nm using the Firefly imaging system to evaluate which wavelengths of light were captured by the Firefly mode. In a clinical study, the Pharus method was employed in four patients with Stage II or more advanced cystocele undergoing RSC. For comparison, a near-infrared fluorescence method by indocyanine green (ICG) tattooing at the point Aa was also performed. The visibility of each method was evaluated under Firefly-mode imaging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the preliminary experiment, visible LED lights with wavelengths ≤ 720 nm, and near-infrared LED lights with wavelengths ≥ 830 nm were detected by the Firefly mode. In RSC using the Pharus method, the point Aa of each patient was clearly highlighted as a green spot from the serosal side by the endoscopic white light penetrating the vaginal wall with a thickness of 3.3–4.6 mm. Compared with the ICG tattooing method, the Pharus method showed superior visibility in all patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The transillumination light effectively guided the surgeon to the vaginal point Aa, which can be likened to the Latin word “pharus,” meaning lighthouse.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.13412","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693842","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}