Asian Journal of Endoscopic Surgery最新文献

{"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}

{"title":"Two Cases of Interrupted Pulmonary Artery Dissection Using the SureForm SmartFire Stapling System due to Activation of the Safety Mechanism “Tissue Too Thick to Continue”","authors":"Yusuke Muranishi,&nbsp;Suiha Takeuchi,&nbsp;Tomoya Kono,&nbsp;Ryo Miyahara","doi":"10.1111/ases.70144","DOIUrl":"https://doi.org/10.1111/ases.70144","url":null,"abstract":"<div>\u0000 \u0000 <p>Robot-assisted thoracoscopic surgery (RATS) is now widely performed worldwide, and the use of robotic staplers is increasingly common. In this report, we present two cases in which pulmonary artery transection was interrupted due to activation of the robotic stapler's safety mechanism, labeled “Tissue Too Thick to Continue.” Although no superfluous tissue was apparent upon inspection, the transaction was halted mid-procedure in both cases. Potential causes for this interruption include inappropriate cartridge selection for the tissue thickness, a dropped staple, or insufficient detachment of tissue in a visually inaccessible area. Malfunction or interruption of an automatic stapling device during vascular transection can lead to serious complications. Therefore, we believe this safety system should assess tissue suitability before initiating transection. Here, we describe how we managed these intraoperative events and discuss possible factors contributing to robotic stapler malfunction.</p>\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":"144929687","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 Comparative Study of Clinical Outcomes in Full-Endoscopic Interlaminar Discectomy for Patients With Congenital and Non-Congenital Lumbar Spinal Canal Stenosis: A Midterm Results","authors":"Suttinont Surapuchong,&nbsp;Tinnakorn Pluemvitayaporn,&nbsp;Pritsanai Pruttikul,&nbsp;Pheeraphon Yiamphiphatthana,&nbsp;Piyabuth Kittithamvongs,&nbsp;Warot Ratanakoosakul,&nbsp;Kitjapat Tiracharnvut,&nbsp;Chaiwat Piyasakulkaew,&nbsp;Sombat Kunakornsawat","doi":"10.1111/ases.70143","DOIUrl":"https://doi.org/10.1111/ases.70143","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>A comparative study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Congenital lumbar spinal canal stenosis (CLSS) is characterized by maldevelopment of the dorsal spinal elements, which results in a constricted spinal canal. Endoscopic discectomy procedures in patients with CLSS present more significant challenges in achieving sufficient decompression than those in patients with noncongenital spinal stenosis. To our knowledge, no studies disaggregate the outcomes of endoscopic discectomy between CLSS and non-CLSS patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the clinical outcomes of full endoscopic interlaminar discectomy (FEID) in patients diagnosed with congenital lumbar spinal canal stenosis (CLSS) against those with non-congenital lumbar spinal canal stenosis (non-CLSS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between 2016 and 2020, patients who underwent full-endoscopic discectomy at our institution were enrolled in this study. Inclusion criteria included individuals under 50 years of age, presenting symptoms of lumbar disc herniation with a positive straight leg raise test, failed conservative treatment, and no prior lumbar spine surgeries. Outcomes measured included operative times, visual analog scale (VAS) scores, Oswestry Disability Index (ODI), and modified Macnab criteria at 1 day, 2 weeks, 6 weeks, 3 months, 6 months, 1 year, and 2 years postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-six patients participated in the study, with 22 in the CLSS group and 34 in the non-CLSS group. Visual Analog Scale (VAS) scores for back and leg pain, along with the Oswestry Disability Index (ODI) scores, were measured at various time points postoperatively. No significant differences were found between the groups (<i>p</i> &gt; 0.05). According to the modified Macnab criteria, 100% of the CLSS group reported good to excellent results, compared to 91% of the non-CLSS group (<i>p</i> = 0.6690). Both groups showed improvements in VAS and ODI scores at immediate, short-term, and long-term follow-ups (<i>p</i> &lt; 0.05). Mean operative times were 53.09 min for CLSS and 43.26 min for non-CLSS, with a <i>p</i>-value of 0.053.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Endoscopic discectomy has demonstrated an enhancement in clinical outcomes for patients with lumbar disc herniation when comparing preoperative and postoperative results in both CLSS and non-CLSS groups. No significan","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144923375","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 of Solitary Small Intestinal Metastasis of Malignant Melanoma Presenting With Bowel Obstruction: A Case Report","authors":"Yusuke Ogi,&nbsp;Taro Oshikiri,&nbsp;Satoshi Akita,&nbsp;Kei Ishimaru,&nbsp;Shigehiro Koga,&nbsp;Motohira Yoshida,&nbsp;Satoshi Kikuchi,&nbsp;Jun Kuwabara,&nbsp;Hironori Matsumoto,&nbsp;Kai Goyo,&nbsp;Noriaki Kashu,&nbsp;Katsuya Watanabe,&nbsp;Kyousuke Habu,&nbsp;Kenji Takagi,&nbsp;Hiroki Sugishita","doi":"10.1111/ases.70141","DOIUrl":"https://doi.org/10.1111/ases.70141","url":null,"abstract":"<div>\u0000 \u0000 <p>Solitary small-intestinal metastasis of malignant melanoma is rare. If curative intent resection surgery for small intestinal metastasis can be performed, then a good prognosis can be expected. A 49-year-old woman underwent resection for malignant melanoma of the upper extremity 17 months previously and was admitted to our hospital with vomiting as the main complaint. A tumor causing bowel obstruction of the small intestine was detected, and we diagnosed a solitary small intestinal tumor using positron emission tomography computed tomography (PET-CT). Suspecting a high possibility of solitary malignant melanoma metastasis, we performed a laparoscopic resection for the small intestine and confirmed the absence of abdominal dissemination. The pathological diagnosis was small intestinal metastasis of malignant melanoma. The combination of PET-CT and laparoscopic surgery is useful for the preoperative identification of solitary small intestinal metastasis, and complete resection is possible, with a good prognosis achievable.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144897357","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":"Multi-Vector Retraction Using Extracorporeally Suspended Retractor in Single Port Total Gastrectomy","authors":"Kengo Hayashi,&nbsp;Noriyuki Inaki,&nbsp;Jun Kinoshita,&nbsp;Hideki Moriyama,&nbsp;Toshikatsu Tsuji,&nbsp;Ryota Matsui,&nbsp;Saki Hayashi,&nbsp;Kenta Doden,&nbsp;Kenichi Ishibayashi","doi":"10.1111/ases.70139","DOIUrl":"https://doi.org/10.1111/ases.70139","url":null,"abstract":"<div>\u0000 \u0000 <p>Single-incision laparoscopic surgery (SILS) and needle forceps have been introduced to enhance cosmetic outcomes and reduce postoperative pain. However, in demanding procedures like total gastrectomy, these approaches can be technically challenging due to limited triangulation and lack of assistant support. We report the case of a 31-year-old woman with gastric cancer who requested a cosmetically favorable procedure. A total gastrectomy with D2 lymphadenectomy was performed using a SILS approach with one 3-mm needle forceps. To maintain adequate exposure without an assistant port, we utilized an adjustable organ retractor that allows multidirectional traction by repositioning external sutures. This technique provided stable visualization and facilitated a safe, oncologically appropriate dissection. The patient was discharged uneventfully without major complications and remains recurrence-free at 3 years. We report a technical modification that enabled the safe performance of SILS total gastrectomy using a needle forceps in combination with an adjustable organ retractor.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144897359","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":"Sheep Liver as a Model for Advanced Laparoscopic Hepatic Resection Training","authors":"Rawisak Chanwat,&nbsp;Chairat Bunchaliew,&nbsp;Nuengruetai Olarnnapalai,&nbsp;Rapheephat Tanompetsanga,&nbsp;Sarat Sanguanlosit,&nbsp;Kittipong Chaiyabutr,&nbsp;Saard Treepongkaruna","doi":"10.1111/ases.70138","DOIUrl":"https://doi.org/10.1111/ases.70138","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Laparoscopic hepatic resection requires precise surgical skills. The sheep liver, closely resembling the human liver, emerges as a promising alternative for the advanced laparoscopic hepatic resection model. We aim to assess the suitability of the sheep liver as an animal training model for advanced laparoscopic hepatic surgery and identify potential limitations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>This study, conducted at the 20th MESDA Conference in Bangkok on September 23–24, 2022, involved 10 sheep undergoing laparoscopic liver surgery training. Pre-training CT scans identified liver structures after general anesthesia administration. In groups of three, trainees performed live laparoscopic hepatic surgery on anesthetized sheep, with immediate feedback collected through post-training questionnaires assessing the clinical impact on live sheep models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>3D reconstructions revealed that 30% of sheep exhibited human-like ramification in the right portal vein (RPV), while 70% showed independent bifurcation patterns. The left portal vein (LPV) is consistently bifurcated into left medial and lateral sectoral branches, mimicking human anatomy. Hepatic vein drainage showed uniformity, with the right hepatic vein (RHV) forming a common trunk (MHV-like) before draining into the inferior vena cava (IVC). The participant's success rate was high, with 80.0% finding sheep model procedures realistic. Organ and tissue properties received high ratings, with 66.7% very high, 30.0% high, and 3.3% intermediate. Feasibility for advanced laparoscopic liver surgery on sheep models was very high (80.0%) and high (20.0%); overall, 76.7% rated laparoscopic liver surgery training very high in learning success.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study underscores the effectiveness of sheep liver as a suitable model for advanced laparoscopic hepatic resection training. Further research is needed to assess the model's effectiveness and limitations in specific laparoscopic hepatic techniques.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144897327","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":"Outcomes of Laparoscopic Distal Gastrectomy for Gastric Cancer by Female and Male Resident Surgeons","authors":"Hiromi Nagata,&nbsp;Takahiro Kinoshita,&nbsp;Masaru Komatsu,&nbsp;Takumi Habu,&nbsp;Mitsumasa Yoshida,&nbsp;Masahiro Yura","doi":"10.1111/ases.70135","DOIUrl":"https://doi.org/10.1111/ases.70135","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Recently, opportunities for women to assume active roles are expanding, but it is noteworthy that the representation of female surgeons remains still low. As minimally invasive surgery penetrates, physical limitations such as muscle strength are diminishing. This evolution reduces obstacles and enhances the potential to widen opportunities for female surgeons to actively work.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study retrospectively analyzed clinical outcomes of patients who received laparoscopic distal gastrectomy (LDG) (2013–2023) performed by resident surgeons as a primary operator. The patients were divided into two groups according to whether the primary surgeon was female or male. Perioperative outcomes and prognosis were examined after propensity score matching (PSM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 417 patients were eligible, and 24 resident surgeons operated, 7 female (29%) and 17 male (71%). After PSM, 107 patients were extracted for each group. No significant differences were observed in patients' baseline. Operation time (225 vs. 221 min), intraoperative blood loss (10 vs. 14 g), and postoperative hospital stay (8 vs. 8 days) did not differ. The incidence of postoperative complications (all-grade) was 9% vs. 18%. The calculated risk ratio of the female surgeons was 0.53 (95% confidence intervals: 0.26–1.08) (<i>p</i> = 0.08), which upper limit was lower than the prespecified non-inferior margin (1.2), thus the non-inferiority was proved. We found no gender difference in clinical outcomes of LDG performed by resident surgeons. The results of this study help us understand the role of female surgeons and encourage women to apply for surgical positions in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144897328","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}