Asian Journal of Endoscopic Surgery最新文献

{"title":"Feasibility and Safety of Laparoscopic Partial Splenectomy: A Case Series","authors":"Takako Yamada Fujii,&nbsp;Masumi Kawashima,&nbsp;Masafumi Inoue,&nbsp;Takuya Kimura","doi":"10.1111/ases.70363","DOIUrl":"10.1111/ases.70363","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Total splenectomy is associated with infectious and thrombotic complications; thus, partial splenectomy has emerged as a spleen-preserving alternative. However, despite reports of advantageous perioperative outcomes with total splenectomy, the feasibility and safety of laparoscopic partial splenectomy (LPS) in adults remain insufficiently established.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed six consecutive adult patients undergoing LPS for splenic neoplasms and a cyst. Preoperative 3D-CT was used to evaluate hilar vascular anatomy and plan resection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No cases required conversion to open surgery or total splenectomy, and no blood transfusions were needed. The mean postoperative hospital stay was 6.2 days; no postoperative infectious complications, splenic or portal vein thrombosis, or splenosis were observed. The preoperative splenic volume ranged from 59–1204 mL, with 2–4 arterial branches, and the median tumor size was 35.5 mm. The remnant splenic volume ranged from 18–524 mL. In all evaluable cases, tumors were included within the ischemic demarcation area after division of feeding arteries, and postoperative imaging correlated well with the predicted remnant arterial supply.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>LPS is a safe and feasible procedure that preserves splenic function and allows for preoperative planning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680462","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":"Transoral Endoscopic Thyroidectomy for Bilateral Papillary Thyroid Carcinoma: Early Outcomes From a Vietnamese Center","authors":"Hau Xuan Nguyen,&nbsp;Hien Xuan Nguyen,&nbsp;Duong Thai Pham,&nbsp;Tri Minh Ngo,&nbsp;Nhat Tan Nguyen,&nbsp;Linh Dieu Nguyen,&nbsp;Quang Van Le","doi":"10.1111/ases.70362","DOIUrl":"10.1111/ases.70362","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Transoral endoscopic thyroidectomy via the vestibular approach (TOETVA) has emerged as a scarless, remote-access surgical technique for thyroid cancer. However, evidence regarding its feasibility and oncologic safety in bilateral papillary thyroid carcinoma (PTC) remains limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>We conducted a prospective study at a single high-volume endocrine surgery center in Vietnam from January 2020 to July 2024. Patients with clinically and cytologically confirmed bilateral PTC (tumor size &lt; 20 mm) underwent TOETVA with total thyroidectomy and bilateral central lymph node (CLN) dissection. Outcomes assessed included operative time, complications, lymph node yield, and early oncologic outcomes. Risk stratification and radioactive iodine (RAI) therapy were applied per 2015 American Thyroid Association guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 30 patients (96.7% female, mean age 33.1 years) were included. The average operative time was 104.0 min, and mean blood loss was 16.3 mL. Transient complications included hypoparathyroidism (10.0%) and recurrent laryngeal nerve injury (13.3%); no permanent complications were observed. CLN metastasis was found in 46.7% of cases. Among 10 patients who received RAI therapy, all had favorable responses. At a median follow-up of 35 months, no structural recurrence or distant metastasis has been detected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TOETVA may represent a feasible surgical option for selected patients with bilateral PTC ≤ 20 mm, yielding acceptable surgical morbidity and encouraging early oncologic outcomes without visible scarring. The technique is particularly suitable for experienced endocrine surgeons. Further multicenter studies are warranted to confirm these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670857","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":"Single-Port Versus Multiport Robotic Right Colectomy: Short-Term Outcomes and Impact of Extraction-Site Location on Postoperative Pain","authors":"Yuta Nishikawa,&nbsp;Tomohiko Mori,&nbsp;Midori Hara,&nbsp;Yu Kageyama,&nbsp;Yuki Bando,&nbsp;Shunpei Jikihara,&nbsp;Tatsuto Nishigori,&nbsp;Koichiro Hata","doi":"10.1111/ases.70364","DOIUrl":"10.1111/ases.70364","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Robotic right hemicolectomy has been widely adopted, but the impact of extraction-site location on postoperative pain in single-port (SP) surgery remains unclear. We aimed to compare short-term outcomes between SP and multiport robotic surgery and to evaluate postoperative wound pain according to extraction-site location.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective single-center study included 49 consecutive patients who underwent robotic right hemicolectomy (January 2024–December 2025): 25 in the SP group and 24 in the Xi group. Postoperative pain was assessed using the cumulative pain score (sum of daily maximum NRS values, POD1–POD7). Pain outcomes were compared among SP_P (Pfannenstiel, <i>n</i> = 13), SP_Umb (umbilical, <i>n</i> = 12), and Xi_P (Pfannenstiel, <i>n</i> = 22).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Perioperative and oncological outcomes were comparable between the groups. The SP group had significantly shorter operative time (244 vs. 309 min, <i>p</i> = 0.0013) and console time (167 vs. 239 min, <i>p</i> = 0.0014). Postoperative pain differed significantly among the three subgroups (<i>p</i> = 0.0049). Pairwise comparisons showed significantly lower pain in SP_P than in SP_Umb (<i>p</i> = 0.0062), with no significant difference for the other two comparisons. The difference between SP_P and SP_Umb remained significant after adjusting for anastomotic technique and surgical procedure in multiple regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SP-assisted right hemicolectomy was safe, with short-term outcomes comparable to the Xi platform. These findings suggest that postoperative pain following robotic right hemicolectomy may be influenced not only by the number of abdominal ports but also by the location of the extraction incision.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664507","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":"Sex-Related Quality of Life After Totally Extraperitoneal Versus Lichtenstein Inguinal Hernia Repair: A Randomized Controlled Trial","authors":"Saurabh Maurya,&nbsp;Ashutosh Silodia,&nbsp;Pradeep Kothiya,&nbsp;Sanjay Kumar Yadav,&nbsp;Dhananjaya Sharma","doi":"10.1111/ases.70365","DOIUrl":"10.1111/ases.70365","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Comparative randomized evidence specifically evaluating totally extraperitoneal (TEP) and Lichtenstein repair is limited. This study compared sex-related and general health-related quality of life following these two techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this prospective randomized controlled trial, sexually active adult men with primary uncomplicated inguinal hernias were randomized to TEP or open Lichtenstein repair. The primary endpoint was pain during sexual activity at 1 year, measured using the Sexual Inguinal Hernia Questionnaire (SexIHQ). Secondary outcomes included additional SexIHQ domains and health-related quality of life measured by the 36-Item Short Form Health Survey (SF-36).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 105 patients were analyzed, including 50 undergoing TEP and 55 undergoing open repair. Baseline demographic, clinical, SF-36, and SexIHQ measures were comparable between groups. At 1 year, pain during sexual activity was reported less frequently after TEP than after open repair (16.0% vs. 43.6%; risk ratio 0.37, 95% CI 0.18–0.74; <i>p</i> = 0.003). Among patients reporting pain during sexual activity, the degree of impairment in sexual activity did not differ significantly between groups. SF-36 scores at 1 year were significantly higher after TEP across all measured domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TEP repair was associated with a lower rate of pain during sexual activity at 1 year compared with Lichtenstein repair. However, other SexIHQ domains were not significantly different. These findings suggest a possible benefit of avoiding anterior inguinal canal dissection, but do not establish broad superiority of TEP for overall sexual function.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664459","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-Term Outcomes Including Cost of Distal Pancreatectomy Using the Hinotori Surgical Robot System","authors":"Keishi Kawasaki,&nbsp;Teppei Tatsuoka,&nbsp;Musashi Takada,&nbsp;Soya Meguro,&nbsp;Hirotaka Ishido,&nbsp;Hidehiro Tajima,&nbsp;Takashi Okuyama,&nbsp;Hideyuki Yoshitomi","doi":"10.1111/ases.70357","DOIUrl":"https://doi.org/10.1111/ases.70357","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The first domestically developed Japanese surgical robot, the hinotori Surgical Robot System, was approved in August 2020, and its adoption has gradually increased in Japan. However, reports on its use in pancreatic surgery remain limited. This study evaluated the short-term perioperative outcomes of robot-assisted distal pancreatectomy (RDP) using the hinotori system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>RDP using the da Vinci Surgical System Xi was introduced in our department in July 2020, and RDP using hinotori was initiated in October 2023. A total of 73 patients underwent RDP by June 2025. Perioperative outcomes of RDP performed using hinotori were retrospectively analyzed and compared with those performed using the da Vinci system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The hinotori and da Vinci groups included 22 and 51 patients, respectively. The median age was 71.0 years in both groups (<i>p</i> = 0.782), with no significant difference in sex distribution (<i>p</i> &gt; 0.999). The median operative time was 381.0 and 428.0 min (<i>p</i> = 0.108), and median blood loss was 100.0 and 62.5 mL (<i>p</i> = 0.272), respectively. The length of hospital stay was significantly shorter (9.0 vs. 13.5 days, <i>p</i> = 0.003), and hospitalization costs were also significantly lower (1 499 810 vs. 1 735 355 yen, <i>p</i> = 0.005) in the hinotori group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Initial results suggest that RDP using the hinotori system is safe and feasible, with perioperative outcomes generally comparable to those achieved using the da Vinci system.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148616803","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":"On-Demand Suction to Maintain a Dry Operative Field During Robotic Esophagectomy With Video","authors":"Shinsuke Sato,&nbsp;Mao Tsuru,&nbsp;Erina Nagai,&nbsp;Yusuke Taki,&nbsp;Masato Nishida,&nbsp;Masaya Watanabe,&nbsp;Hideyuki Kanemoto","doi":"10.1111/ases.70358","DOIUrl":"10.1111/ases.70358","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Lymphadenectomy around the left recurrent laryngeal nerve is one of the most technically demanding steps in esophagectomy. Even in robot-assisted esophagectomy, the operative field easily becomes wet and achieving on-demand suction remains challenging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Surgical Technique</h3>\u0000 \u0000 <p>Between July 2024 and November 2025, 11 patients underwent robot-assisted esophagectomy in the prone position. We developed a simple on-demand suction technique by suturing gauze to a commercially available suction tube, allowing both the surgeon and the assistant to perform suction as needed. The modified tube can be manipulated using either robotic instruments or assistant forceps and can also be used for gentle tracheal rolling during lymphadenectomy. Furthermore, to evaluate the feasibility and safety of this technique, we conducted a retrospective comparison with 11 cases performed using the conventional method (tracheal traction with a robotic Cadiere forceps) between March 2023 and May 2024. All procedures were performed by a single surgeon.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This simple and low-cost technique facilitates maintenance of a dry operative field during robot-assisted esophagectomy. Furthermore, in comparison with the conventional method, no significant differences were observed in operative time, blood loss, or the incidence of recurrent laryngeal nerve palsy; however, there was a trend toward reduced intraoperative manipulation time. These findings suggest that this technique offers comparable safety to the conventional approach while potentially contributing to improved operative field management.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608356","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":"Exploratory Analysis of Intraoperative Time Structure During the Initial Clinical Experience With Minimally Invasive Laparoscopic and Robotic Surgery (MILAR) Using the da Vinci SP System","authors":"Yuki Takenaka,&nbsp;Tsutomu Hayashi,&nbsp;Maho Takuwa,&nbsp;Yurina Fujisaki,&nbsp;Rei Ogawa,&nbsp;Ayako Kamiya,&nbsp;Takeyuki Wada,&nbsp;Yukinori Yamagata,&nbsp;Yusuke Kinugasa,&nbsp;Masanori Tokunaga,&nbsp;Takaki Yoshikawa,&nbsp;Yasuyuki Seto","doi":"10.1111/ases.70356","DOIUrl":"10.1111/ases.70356","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic gastrectomy has been adopted for gastric cancer. However, operative time remains longer than that of laparoscopic surgery. Junk time has been proposed as a major contributor to prolonged operative duration. This study evaluated intraoperative time structure during the initial clinical experience with the minimally invasive laparoscopic and robotic (MILAR) approach using the da Vinci SP system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective exploratory workflow analysis included consecutive patients who underwent robot-assisted distal gastrectomy with D1+/D2 lymphadenectomy between May 2024 and June 2025. Patients were divided into the SP (MILAR) group and the conventional multi-port robotic (Xi) group. Operative videos from skin incision to gastric transection were reviewed to quantify effective time and junk time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 40 patients were analyzed (SP, <i>n</i> = 11; Xi, <i>n</i> = 29). Total operative time was significantly shorter in the SP group than in the Xi group (148.0 vs. 204.0 min, <i>p</i> = 0.001). Junk time was significantly reduced (30.4 vs. 36.6 min, <i>p</i> = 0.034), accompanied by fewer robotic instrument exchanges (4 vs. 46, <i>p</i> &lt; 0.001). Effective time was shorter in the SP group; although this finding may have been influenced by surgeon expertise and case complexity. No increase in procedure-related complications was observed in the SP group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The present exploratory study describes differences in intraoperative time structure observed during the initial clinical experience with the MILAR approach using SP system. These findings provide insight into workflow characteristics of a hybrid team-based approach and warrant further evaluation in prospective studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608361","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":"Predictive Factors for Conversion From Single Incision Appendectomy to Multiport Appendectomy for Pediatric Acute Appendicitis: A Single-Center, Retrospective Cohort Study","authors":"Ko Miyazaki,&nbsp;Makoto Hayashida,&nbsp;Shoma Koga,&nbsp;Akihiko Tamaki","doi":"10.1111/ases.70359","DOIUrl":"10.1111/ases.70359","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Single-incision appendectomy (SIA), including laparoscopic and laparoscopic-assisted techniques, offers superior cosmetic outcomes and is increasingly applied to both uncomplicated and complicated cases of acute appendicitis. In our practice, transumbilical laparoscopic-assisted appendectomy is the initial approach for all patients with acute appendicitis. This retrospective cohort study aimed to identify risk factors associated with conversion from SIA to multiport appendectomy (MPA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed medical records of patients aged &lt; 15 years who underwent appendectomy for acute appendicitis at our hospital between April 2018 and June 2025. Patients were categorized into two groups: the SIA group and the MPA group, based on whether the procedure was completed as SIA or required conversion to MPA. Perioperative variables were compared between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 129 patients were included in this study. Of these, 79 (61.2%) were in the SIA group and 50 (38.8%) were in the MPA group. Univariate analysis revealed significant intergroup differences in preoperative C-reactive protein (CRP) levels, maximal appendiceal diameter on preoperative imaging, time from symptom onset to hospital visit (&gt; 24 h), and sex. Multivariate exploratory stepwise logistic regression analysis identified elevated preoperative CRP levels (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.03–1.21; <i>p</i> = 0.009) and female sex (OR, 2.72; 95% CI, 1.23–6.04; <i>p</i> = 0.014) as independent risk factors for conversion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Elevated preoperative CRP levels and female sex were significantly associated with difficulty in completing SIA; larger prospective studies are warranted to validate these findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608451","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":"Carbon Dioxide Embolism During Transoral Endoscopic Thyroidectomy Vestibular Approach: A Case Report","authors":"Jaruthep Preechadechcharern,&nbsp;Angkoon Anuwong,&nbsp;Theethawat Thanawiboonchai","doi":"10.1111/ases.70354","DOIUrl":"10.1111/ases.70354","url":null,"abstract":"<div>\u0000 \u0000 <p>Carbon dioxide (CO₂) embolism is a rare but serious complication during transoral endoscopic thyroidectomy vestibular approach (TOETVA). We report the case of a 58-years-old Thai woman with hypertension and hyperthyroidism who underwent TOETVA for completion thyroidectomy. Intraoperatively, injury to the anterior jugular vein likely caused CO₂ embolism, indicated by a sudden rise in end-tidal CO₂. The procedure was converted to open surgery. Postoperatively, she developed seizures, left-sided weakness, and confusion. Imaging confirmed cerebral gas embolism, and echocardiography revealed a patent foramen ovale. She was treated with antiepileptic medications and hyperbaric oxygen therapy, resulting in full neurological recovery. This case shows that CO₂ embolism can still occur during TOETVA at low insufflation pressure, following anterior jugular vein injury. A sudden end-tidal CO₂ change may be an early clue, and early recognition with prompt hyperbaric oxygen therapy (HBOT) can help prevent lasting neurologic deficits.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608397","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":"Technical Feasibility and Setup Optimization of the HUGO RAS System for Robotic-Assisted Transaxillary Thyroidectomy: A Preclinical Study in a Porcine Model","authors":"Byung-Chang Kim,&nbsp;Young-min Lee,&nbsp;Sookyung Kim,&nbsp;Won Woong Kim,&nbsp;Yu-mi Lee,&nbsp;Ki-Wook Chung,&nbsp;Tae-Yon Sung","doi":"10.1111/ases.70355","DOIUrl":"10.1111/ases.70355","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic thyroidectomy has been increasingly adopted as a minimally invasive approach, with feasibility and safety established using existing robotic platforms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We report the first experimental application of the HUGO Robotic-Assisted Surgery (RAS) system for thyroidectomy via a transaxillary approach in a porcine model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All procedural steps, from flap creation to thyroid gland dissection, were completed successfully without technical difficulties. The presumed recurrent laryngeal nerve was identified and preserved throughout the procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This preclinical study demonstrates the technical feasibility of thyroidectomy using the HUGO RAS system. These findings support its applicability in human thyroid surgery and future clinical translation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594076","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}