{"title":"Robotic-assisted sacrocolpopexy with hinotori, a brand-new surgical robot system produced in Japan; report of initial clinical case series","authors":"Manabu Ichino, Hitomi Sasaki, Masashi Takenaka, Kenji Zennami, Kiyoshi Takahara, Ryoichi Shiroki","doi":"10.1111/ases.13380","DOIUrl":"10.1111/ases.13380","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction and Hypothesis</h3>\u0000 \u0000 <p>Robot-assisted sacrocolpopexy (RASC) is increasingly common due to the increased uptake of surgical robot systems. The aim of this retrospective study was to assess the perioperative outcomes of the first patient cohort to undergo RASC using a brand-new surgical robot system, the hinotori surgical system (robot-assisted sacrocolpopexy with hinotori surgical system [h-RASC]). This study also aimed to compare the outcomes of this group with those of the group of patients who had undergone RASC with the da Vinci surgical system (d-RASC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 15 patients per group. Operative times, blood loss, complications, overactive bladder symptom score (OABSS; subjective measure), and urodynamic outcomes (objective measure) were compared between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All cases were completed without serious problems during RASC procedure. Perioperative outcomes were similar between the groups except for longer operation time (min) (h-RASC 266 vs. d-RASC 229; <i>p</i> < .01) and console time (min) (178 vs. 159; <i>p</i> = .02) in the h-RASC group than in the d-RASC. De novo stress urinary incontinence (SUI) and pelvic organ prolapse (POP) recurrence were comparable. LUTS improved in the postoperative OABSS total score (preoperative 6 vs. postoperative 3; <i>p</i> < .01) in the h-RASC group. However, OABSS assessment (h-RASC −3 vs. d-RASC −4; <i>p</i> = .38) was similar between the two groups. Urodynamic studies showed similar outcomes in the median Qmax (maximum flow rate) values in both groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first report focusing on RASC using the hinotori surgical system. RASC using the hinotori surgical system could provide favorable perioperative outcomes as comparable with those of the existing da Vinci system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.13380","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074156","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":"Low incidence of postoperative infectious complications following laparoscopic distal gastrectomy for locally advanced gastric cancer in older adult patients above 75 years: Propensity score-matched comparison with open distal gastrectomy","authors":"Yosuke Morimoto, Shinichi Sakuramoto, Hirofumi Sugita, Keiji Nishibeppu, Gen Ebara, Shohei Fujita, Shiro Fujihata, Shuichiro Oya, Yutaka Miyawaki, Hiroshi Sato, Keishi Yamashita","doi":"10.1111/ases.13371","DOIUrl":"10.1111/ases.13371","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study compared the short-term outcomes of older adult patients with locally advanced gastric cancer who underwent open distal gastrectomy (ODG) with those who underwent laparoscopic distal gastrectomy (LDG) using propensity score matching analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Overall, 341 consecutive older adult patients aged 75 years with gastric cancer who underwent ODG or LDG between January 2013 and December 2020 were retrospectively assessed. Among them, 121 patients with locally advanced gastric cancer were included. To compare short-term outcomes, a 1:1 propensity score matching analysis was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After matching, 29 patients were included in both groups. Compared with the ODG group, the LDG group had a longer operative time (mean, 290 vs. 190 min; <i>p</i> < .0001) and lower estimated blood loss (mean, 39 vs. 223 mL; <i>p</i> < .0001). Overall postoperative complications of grade 2 and higher were observed in 2 (6.9%) and 12 (41%) patients in the LDG and ODG groups, respectively (<i>p</i> = .0046). Of these, the LDG group had a significantly lower incidence rate of infectious complications than the ODG group (3.4% vs. 27.6%; <i>p</i> = .025). Furthermore, in multivariate analysis, the laparoscopic approach was an independent protective factor against postoperative complications (<i>p</i> = .029).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>LDG is safe and feasible for locally advanced gastric cancer in patients aged ≥75 years. Moreover, it may be a promising alternative to ODG with better short-term outcomes, including significantly lower incidence rates of postoperative complications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"First pediatric pelvic surgery with the Senhance® robotic surgical system: A case series","authors":"Daiki Kato, Hiroo Uchida, Chiyoe Shirota, Takahisa Tainaka, Satoshi Makita, Hizuru Amano, Miwa Satomi, Akihiro Yasui, Yoichi Nakagawa, Takuya Maeda, Hiroki Ishii, Kazuki Ota, Naoki Nagata, Akinari Hinoki","doi":"10.1111/ases.13379","DOIUrl":"10.1111/ases.13379","url":null,"abstract":"<p>The Senhance® robotic system (Senhance [Asensus Surgical Inc., Naderhan, NC, USA]) is a new surgical assistive robot following the da Vinci Surgical System that has been demonstrated to be safe and efficacious. Herein, we report the first case series of pediatric pelvic surgery using Senhance. Two anorectoplasties and one rectal pull-through coloanal anastomosis for rectal stenosis were performed in three children (5–9 months, 7–9 kg) using a 10-mm three-dimensional (3D) 4K camera and 3 and 5 mm forceps operated with Senhance. None of the patients had intraoperative complications or a good postoperative course. Pediatric pelvic surgery with Senhance could be performed precisely and safely with a small body cavity. With its beautiful 3D images, motion of forceps with reduced tremor, and availability of 3-mm forceps, Senhance may be better suited for children compared with other models.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.13379","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019143","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":"The urinary tract reconstruction in a robot-assisted surgery for rectal malignancy with combined prostate and seminal vesicle resection","authors":"Ryo Iguchi, Mitsuru Yokota, Kenji Kawada, Tomoki Ohnishi, Naoya Kani, Yuta Mine, Iori Matsuda, Yusuke Hama, Kyohei Sugiyama, Akito Terai, Koji Inoue","doi":"10.1111/ases.13375","DOIUrl":"10.1111/ases.13375","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In certain cases of rectal malignancy in which invasion is confined to the prostate and/or seminal vesicles, bladder-sparing surgery may be chosen instead of total pelvic exenteration. However, even if the bladder is preserved, postoperative urinary dysfunction and vesicourethral anastomotic leakage are concern.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Surgical Technique</h3>\u0000 \u0000 <p>We employ various techniques based on robot-assisted radical prostatectomy for reconstructing the urinary tract. These techniques include advanced reconstruction of vesicourethral support, total anatomical reconstruction, and a method called anterior reconstruction. In addition, suture fixation of bladder to the anterior abdominal wall, and re-approximation of bladder by peritoneal suture were done.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Reliable robot-assisted vesicourethral anastomosis and reinforcement of the anastomotic wall could potentially enhance the self-voiding rate and decrease the risk of anastomotic failure.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001014","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":"Validity of laparoscopic surgery for lower gastrointestinal perforations","authors":"Kensuke Kudou, Ryoko Aoyama, Kento Ishihara, Tomohide Kawashita, Shuhei Kajiwara, Takashi Motomura, Takafumi Yukaya, Tomonori Nakanoko, Yosuke Kuroda, Masahiro Okamoto, Tadashi Koga, Yo-Ichi Yamashita, Eiji Oki, Tomoharu Yoshizumi","doi":"10.1111/ases.13373","DOIUrl":"10.1111/ases.13373","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study aimed to clarify the validity of laparoscopic surgery for lower gastrointestinal perforation by comparing the clinical outcomes of laparoscopic and open emergency surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We reviewed the data of patients who underwent surgery for lower gastrointestinal perforation. Patients were categorized into two groups: the laparoscopic group who underwent laparoscopic surgery, and the open group who underwent laparotomy. Clinical and operative outcomes between the two groups were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 219 patients were included in the study. There were 66 and 153 patients with small bowel and colorectal perforations, respectively. The median operative time in the laparoscopic group was shorter than that in the open group (126 min vs. 146 min, <i>p</i> = .049). The mean amount of intraoperative blood loss was significantly lower in the laparoscopic group (50.4 mL vs. 400.1 mL, <i>p</i> < .001). The incidence of postoperative complication was higher in the open group (20.0% vs. 66.5%, <i>p</i> < .001), especially wound infection (0% vs. 26.3%, <i>p</i> = .002). Median hospital stays were 14 days and 24 days in the laparoscopic and open groups, respectively (<i>p</i> < .001). In the laparoscopic group, hospital mortality was 0%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The laparoscopic approach for small bowel and colorectal perforation in an emergency setting is a safe procedure in carefully selected patients and may contribute to decreased intraoperative blood loss, shortened hospital stay, and decreased incidence of postoperative complications, especially wound infection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.13373","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001015","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":"Laparoscopically assisted diaphragmatic hernia repair with mesh and a myocutaneous flap after left ventricular assist device explantation: A case report","authors":"Kota Kawabata, Tsuyoshi Takahashi, Soichiro Funaki, Daisuke Maeda, Kiyokazu Nakajima, Yukinori Kurokawa, Kazuyoshi Yamamoto, Takuro Saito, Kota Momose, Kotaro Yamashita, Koji Tanaka, Tomoki Makino, Tateki Kubo, Yasushi Shintani, Hidetoshi Eguchi, Yuichiro Doki","doi":"10.1111/ases.13372","DOIUrl":"10.1111/ases.13372","url":null,"abstract":"<p>We report the case of a 32-year-old man who developed a giant diaphragmatic hernia following the removal of a left ventricular assist device 4 years prior due to improved cardiac function. Chest radiography revealed an intrathoracic prolapse of the gastrointestinal tract. The patient was diagnosed with a diaphragmatic hernia and a laparoscopy-assisted repair was performed. A 12 × 8 cm hernia was found intraoperatively on the left diaphragm, and a large portion of the gastrointestinal tract had prolapsed into the thoracic cavity. We attempted to repair the ventromedial defect using mesh; however, it was found to be insufficient. Therefore, we used a left rectus abdominis myocutaneous flap to fill the defect and sutured it to the mesh. A myocutaneous flap could be a useful strategy in cases where complete closure with mesh is difficult.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983607","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 right gastroepiploic artery-sparing distal gastric tube resection with lymph node dissection for gastric tube cancer after esophagectomy: A novel surgical approach (with video)","authors":"Hikaru Aoki, Hironori Kawada, Yusuke Hanabata, Akina Shinkura, Kaichiro Harada, Keigo Tachibana, Kento Awane, Keisuke Tanino, Ryuta Nishitai","doi":"10.1111/ases.13359","DOIUrl":"10.1111/ases.13359","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Total resection of the gastric tube with lymphadenectomy for advanced gastric tube cancer is highly invasive and associated with severe complications. Other surgical option, partial gastrectomy or wedge resection, is insufficient if lymph node metastasis is suspected. Therefore, a technique balancing invasiveness and curability is required.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Surgical Technique</h3>\u0000 \u0000 <p>First, we laparoscopically peeled off adhesions of the gastric tube, gastric mesentery (including the right gastroepiploic artery/vein), pericardial membrane, and aorta, up to the planned resection line. Subsequently, we cut the infrapyloric and right gastric arteries at their roots and dissected No. 5 and No. 6 lymph nodes. We taped and spared the right gastroepiploic artery and vein and dissected the tissues including No. 4d lymph nodes. Finally, the gastric tube was cut using a linear stapler, and the remaining gastric tube was anastomosed to the jejunum with a circular stapler. The mean operative time for the three cases treated using this intervention was 729 min. The patients were discharged on postoperative day 8 or 9 without any complications. They all remained alive and recurrence-free.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This novel approach balances invasiveness and curability by leveraging the advantages of laparoscopy. The procedure was performed safely and reproducibly in three consecutive cases, providing another viable option for the treatment of gastric tube cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907978","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-grade appendiceal mucinous neoplasm penetrating sigmoid colon: A case report","authors":"Michio Okamoto, Ryosuke Okamura, Yoshiro Itatani, Yuki Aisu, Hiromitsu Kinoshita, Nobuaki Hoshino, Hisatsugu Maekawa, Takashi Sakamoto, Keiko Kasahara, Shintaro Okumura, Tatsuto Nishigori, Shigeo Hisamori, Shigeru Tsunoda, Koya Hida, Mitsuhiro Nikaido, Yukiko Hiramatsu, Yuki Teramoto, Satoshi Nagayama, Kazutaka Obama","doi":"10.1111/ases.13368","DOIUrl":"10.1111/ases.13368","url":null,"abstract":"<p>Low-grade appendiceal mucinous neoplasm (LAMN) is principally characterized by low-grade cytology without evidence of invasion to other organs. We report a LAMN surgical case whose appendiceal tumor penetrated the sigmoid colon wall. An 87-year-old man was referred for endoscopic resection (ER) of a colon polyp. Despite four ERs over 5 years, the polyp recurred at the same site. Laparoscopic surgery revealed a dilated appendix firmly attached to the sigmoid colon. We performed en bloc resection of both the sigmoid colon and appendix without tumor exposure. The histopathological evaluation showed that the LAMN had penetrated the sigmoid colon wall, forming two polyps on the colonic mucosa. In cases where the appendiceal-colonic fistula is suspected, en bloc resection of the appendix and colon wall should be considered.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890452","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}
Gaku Inaguma, Junichiro Hiro, Koki Otsuka, Koji Masumori, Yosuke Kobayashi, Yongchol Chong, Yusuke Omura, Yutaka Hattori, Kazuki Tsujimura, Ichiro Uyama, Koichi Suda
{"title":"Usefulness of Deloyers procedure with minimally invasive coloproctectomy in an elderly patient with synchronous colorectal cancer: A case report","authors":"Gaku Inaguma, Junichiro Hiro, Koki Otsuka, Koji Masumori, Yosuke Kobayashi, Yongchol Chong, Yusuke Omura, Yutaka Hattori, Kazuki Tsujimura, Ichiro Uyama, Koichi Suda","doi":"10.1111/ases.13366","DOIUrl":"10.1111/ases.13366","url":null,"abstract":"<p>Subtotal colectomy is often performed on patients with synchronous colorectal cancer. However, compared with colorectal anastomosis, ileorectal anastomosis with subtotal colectomy is more likely to result in bowel dysfunction. The Deloyers procedure is useful in preserving bowel function in a patient with synchronous colorectal cancer. An 87-year-old man presented with bloody stool. Colonoscopy showed masses in the cecum, transverse colon, rectosigmoid, and rectum above the peritoneal reflection. Computed tomography scan revealed no evidence of regional lymph node swelling and distant metastasis. Therefore, robot-assisted low anterior resection, laparoscopic extended left hemicolectomy, laparoscopic cecal resection, and diverting ileostomy were performed. The patient was discharged from the hospital without complications. There was no recurrence, and the patient did not have complaints such as urgency, fecal incontinence, and excretory dysfunction. Hence, minimally invasive coloproctectomy using the Deloyers procedure can be safe and useful in preserving postoperative bowel function in elderly patients.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876350","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}