{"title":"Laparoscopic Anatomical Liver Resection for the Patients With Constitutional Indocyanine Green Excretory Defect: A Case Report","authors":"Takanori Morikawa, Yuta Wakui, Yasuhiro Hasegawa, Norihiko Sugisawa, Shunichi Kimura, Tomoaki Hirashima, Makoto Kinouchi, Hajime Iwasashi","doi":"10.1111/ases.13415","DOIUrl":"10.1111/ases.13415","url":null,"abstract":"<div>\u0000 \u0000 <p>Constitutional indocyanine green (ICG) excretion defect (CIED) is a rare clinical condition characterized by markedly delayed ICG disappearance with other normal liver function tests. Here, we report a case of CIED in which laparoscopic anatomical liver resection was successfully performed using ICG fluorescence staining. A 64-year-old man with a 4-cm tumor located in the liver segment 5 was referred to our hospital. His ICG retention rate at 15 min was 70%, but other liver function tests including <sup>99m</sup>Tc-galactosyl human serum albumin scintigraphy were normal. We then planned laparoscopic segmentectomy under the diagnosis of hepatocellular carcinoma and suspected CIED. Laparoscopic hepatectomy was started after confirming a histologically normal liver. After clamping the Glissonean pedicle of segment 5, ICG was injected and the demarcation line was identified. Liver dissection was performed along the demarcation line and the operation was completed. The patient was discharged on postoperative day 10 without any complications.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923587","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":"Sciatic Nerve Preservation in Robot-Assisted Surgery for Initially Unresectable Primary Rectal Cancer: A Case Report","authors":"Ryosuke Mizuno, Ryosuke Okamura, Yoshiro Itatani, Hiromitsu Kinoshita, Yuki Aisu, Hisatsugu Maekawa, Nobuaki Hoshino, Koya Hida, Kazutaka Obama","doi":"10.1111/ases.70013","DOIUrl":"10.1111/ases.70013","url":null,"abstract":"<div>\u0000 \u0000 <p>Radical surgery for rectal cancer with bulky lateral pelvic lymph node (LPLN) metastasis involving the sciatic nerve presents both technical and oncological challenges. Preoperative multidisciplinary treatments have recently been anticipated to control the disease as well as to preserve organ function. A 51-year-old man, presenting with right buttock pain and impairment of walking, was diagnosed with sciatic nerve impairment due to right LPLN metastasis from rectal cancer. He was initially treated with palliative radiotherapy followed by FOLFOX plus bevacizumab. After 13 cycles of the chemotherapy, his symptoms disappeared and the LPLN shrank. Then, conversion surgery via robot-assisted low anterior resection with right LPLN dissection was performed. Although he had moderate right leg pain postoperatively, there were no motor deficits or other complications. Pathological examination of the specimen revealed microscopic residual disease at the resection margin, but he is currently surviving recurrence-free for 1.5 years. Preoperative multidisciplinary treatment enabled the preservation of the sciatic nerve in the robot-assisted conversion surgery.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923592","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":"Comparison of Short-Term Outcomes of Colorectal Cancer Surgery Performed by Male and Female Surgeons: A Japanese Multicenter Study","authors":"Rika Ono, Tetsuro Tominaga, Takashi Nonaka, Toshio Shiraishi, Shintaro Hashimoto, Keisuke Noda, Masato Araki, Yorihisa Sumida, Hiroaki Takeshita, Hidetoshi Fukuoka, Shosaburo Oyama, Kazuhide Ishimaru, Keitaro Matsumoto","doi":"10.1111/ases.70017","DOIUrl":"10.1111/ases.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The number of female doctors is increasing worldwide, but the percentage of female general surgeons and gastrointestinal surgeons remains low, at only 6% in Japan. Furthermore, in rural areas, the number of doctors is small and training opportunities are limited, and training in surgical techniques is reportedly inadequate compared with urban areas. This study examined the current status and surgical outcomes of colorectal cancer surgery by surgeon sex using a multicenter database in a Japanese rural area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed 3440 consecutive patients who underwent laparoscopic colorectal surgery in six participating hospitals between April 2016 and March 2023. Clinical and perioperative outcomes were compared between patients who underwent surgery by a male surgeon (M group; <i>n</i> = 3142) or by a female surgeon (F group; <i>n</i> = 298).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Years of experience as a doctor was significantly shorter (M group vs. F group: 12 years vs. 9 years, <i>p</i> < 0.001), frequency of participation of an expert surgeon was higher (79.9% vs. 89.9%, <i>p</i> = 0.038), frequency of preoperative treatment was lower (8.2% vs. 2.3%, <i>p</i> < 0.001), clinical <i>T</i> status was lower (<i>p</i> = 0.011), and re-operation rate was lower (3.1% vs. 1.0%, <i>p</i> = 0.045) in the F group. Multivariate analysis of clinical factors predicting postoperative severe complications revealed comorbidities (odds ratio 1.442, 95% confidence interval 1.045–1.990, <i>p</i> = 0.025) as an independent predictor of severe postoperative complications but not the presence of a female surgeon.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Female surgeons in our study achieved comparable short-term outcomes to male surgeons, including for laparoscopic procedures. Establishing an educational system in rural areas could provide improved surgical techniques.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915936","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 of a Novel Hybrid Technique, Minimally Invasive Laparoscopic and Robotic Surgery (MILAR) Using the da Vinci SP System for Gastric Cancer","authors":"Takaki Yoshikawa, Tsutomu Hayashi, Masashi Nishino, Rei Ogawa, Yurina Fujisaki, Takeyuki Wada, Yukinori Yamagata, Yasuyuki Seto","doi":"10.1111/ases.70012","DOIUrl":"10.1111/ases.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Robotic surgery may have shown advantages over conventional laparoscopic surgery, but the da Vinci SP system, which utilizes a single incision, has had limited use in gastric cancer surgery. This study aims to evaluate the short-term outcomes of a novel hybrid technique, minimally invasive laparoscopic and robotic surgery (MILAR), with the da Vinci SP system for gastric cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective study reviewed 23 consecutive patients who underwent gastrectomy for gastric cancer using the MILAR technique with the da Vinci SP system between May and October 2024. Operative time, blood loss, and morbidity were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median operation time was 192 min (191 min for distal gastrectomy, 174 min for proximal gastrectomy, and 308 min for total gastrectomy). Blood loss was minimal, with a median of 13 mL and no patient exceeding 250 mL. Postoperative complications were also minimal; one patient developed a grade II intra-abdominal fluid infection and another had grade II enteritis. There were no anastomotic leakages or pancreatic fistulas, and no grade III or higher complications were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MILAR using the da Vinci SP system is feasible and safe for gastric cancer surgery, with minimal blood loss and acceptable operative times. This is the first report from Japan showing the successful application of this system in gastric cancer, offering new prospects in minimally invasive surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910855","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 Novel Surgical Solution for Sciatic Hernia: Exploring the Totally Extraperitoneal Approach","authors":"Reimi Kawagoe, Yuji Konishi, Yosuke Wakui, Kazuhiro Mino, Hideki Kawamura, Akinobu Taketomi","doi":"10.1111/ases.70009","DOIUrl":"10.1111/ases.70009","url":null,"abstract":"<div>\u0000 \u0000 <p>Sciatic hernia, a rare type of pelvic floor hernia, presents significant diagnostic and therapeutic challenges. We report the first totally extraperitoneal (TEP) repair of a sciatic hernia, which was performed in a 63-year-old woman who presented with vomiting and poor dietary intake. Computed tomography revealed a strangulated femoral hernia and an incidental herniation of the sigmoid colon through the right sciatic foramen. Simultaneous TEP repair of both hernias was successfully performed. The TEP approach offered a wide field of view without disturbing the abdominal organs and facilitated the management of concurrent hernias, making it particularly beneficial when the diagnosis of sciatic hernia is certain.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910834","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":"Comparison of Clinical Outcomes Between Delta-Shaped and Circular Anastomoses After Laparoscopic Distal Gastrectomy","authors":"Takanobu Yamada, Shinsuke Nagasawa, Kyohei Kanematsu, Junya Morita, Shizune Onuma, Mie Tanabe, Yuta Nakayama, Manabu Shiozawa, Naoto Yamamoto, Takashi Ogata, Takashi Oshima","doi":"10.1111/ases.70014","DOIUrl":"10.1111/ases.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Laparoscopic distal gastrectomy (LDG) is the standard treatment for gastric cancer, during which the laparoscopic Billroth I anastomosis technique, also known as the delta-shaped anastomosis (DA), is widely performed. This study aimed to evaluate the differences in short- and long-term symptoms between DA and traditional circular anastomosis (CA) techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively compared DA and CA procedures in patients undergoing LDG and subsequent reconstruction using the Billroth I method at the Kanagawa Cancer Center from 2017 to 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Other than blood loss, no significant differences were observed in the short-term outcomes between the two groups. However, 1-year post-surgery, the DA group had a higher incidence of diarrhea, lower incidence of remnant gastritis, and higher weight loss than the CA group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Both DA and CA techniques were similar in terms of safety. However, the DA group had a higher incidence of diarrhea and a lower incidence of remnant gastritis than the CA group 1-year after surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910845","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 Repair of Internal Hernia at the Pelvic Floor After Low Anterior Resection: A Case Report","authors":"Takuki Yagyu, Manabu Yamamoto, Chiharu Yasui, Ryo Ishiguro, Yusuke Kono, Kyoichi Kihara, Tomoyuki Matsunaga, Naruo Tokuyasu, Teruhisa Sakamoto, Yoshiyuki Fujiwara","doi":"10.1111/ases.70016","DOIUrl":"10.1111/ases.70016","url":null,"abstract":"<div>\u0000 \u0000 <p>Internal hernia following colorectal surgery is an uncommon but serious complication. Most reported cases have involved hernias resulting from mesenteric defects after left-sided colon resection. We herein report a case of laparoscopic repair of an internal hernia at the pelvic floor following low anterior resection. A 78-year-old woman with a history of robotic low anterior resection for rectal cancer presented to our hospital with severe abdominal pain and vomiting. Computed tomography revealed a strangulated bowel passing dorsally behind the reconstructed colon in the pelvis, prompting emergency surgery. The hernia orifice was formed by the levator ani and the reconstructed colon. We successfully reduced the hernia, laparoscopically sutured the orifice, and resected the strangulated bowel segment. The patient was discharged without complications and has experienced no hernia recurrence to date. Although internal hernia at the pelvic floor is very rare, this case demonstrates that safe laparoscopic reduction and repair are possible.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910851","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":"Concomitant Robot-Assisted Partial Nephrectomy and Pyelolithotomy for Small Renal Cell Carcinoma and Partial Staghorn Calculus in the Same Kidney: A Case Report and Literature Review","authors":"Harutake Sawazaki, Yosuke Kitamura, Yoshiyuki Furukawa, Atsushi Asano, Ichiro Yoshimura","doi":"10.1111/ases.70011","DOIUrl":"10.1111/ases.70011","url":null,"abstract":"<div>\u0000 \u0000 <p>Management of a small renal mass and a renal stone in the same kidney presents several dilemmas. Simultaneous robot-assisted partial nephrectomy and pyelolithotomy via the same surgical access site is a reasonable approach in a patient with both entities. An 80-year-old woman was diagnosed with a 2.3-cm enhancing mass in the lower pole of the right kidney (cT1aN0M0, RENAL score 4a) and a 1.5-cm ipsilateral partial staghorn calculus. Concurrent robot-assisted partial nephrectomy and pyelolithotomy was planned. Partial nephrectomy was performed first, followed by pyelolithotomy performed through the same surgical access. Both operations were completed successfully. The total operation time was 319 min and the estimated blood loss was 30 mL. Warm ischemia time was 22 min. There were no intraoperative or postoperative complications. Simultaneous robot-assisted partial nephrectomy and pyelolithotomy was technically feasible and safe. This minimally invasive approach should be considered when managing a kidney that contains both entities.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899197","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}
Yung-Chia Kuo, Ching-Yang Wu, Ming- Ju Hsieh, Diego Gonzalez-Rivas, Tzu -Yi Yang, Ching-Feng Wu
{"title":"Early Experience of Uniportal Robotic-Assisted Anatomic Resection in Lung Cancer Patients: Is it Safe and Feasible for Direct Transition From Uniportal Video Thoracoscopic–Assisted Surgery to Uniportal Robotic-Assisted Surgery?","authors":"Yung-Chia Kuo, Ching-Yang Wu, Ming- Ju Hsieh, Diego Gonzalez-Rivas, Tzu -Yi Yang, Ching-Feng Wu","doi":"10.1111/ases.70006","DOIUrl":"10.1111/ases.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Lung cancer remains a leading cause of mortality worldwide, with surgery being a primary treatment option for early-stage cases. Minimally invasive surgery has gained attention due to its potential benefits. Uniportal robotic-assisted thoracic surgery (RATS) is emerging as a viable option for treating lung cancer patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective study, conducted from August 2023 to December 2023, we assessed the feasibility of Uniportal robotic-assisted thoracic surgery (URATS) in 15 patients with 16 lung cancers. The perioperative and 30-day short-term outcome results were collected.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Perioperative outcomes, including length of hospital stay and postoperative complications, were evaluated. No perioperative or 30-day mortality was observed, and there were no cases requiring conversion to multiport RATS or thoracotomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest that URATS can be successfully performed in lung cancer patients, provided the surgical team possesses excellent communication skills and extensive training in Uniport video-assisted thoracoscopic surgery and comprehensive RATS techniques.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899198","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":"Safe Laparoscopic Treatment of a Giant Hepatic Cyst That Compressed the Inferior Vena Cava With Severe Kyphosis","authors":"Tatsuhiro Araki, Yasunori Tsuchiya, Tetsuya Omura, Nagayoshi Ota, Katsuo Shimada, Tsutomu Fujii","doi":"10.1111/ases.70008","DOIUrl":"10.1111/ases.70008","url":null,"abstract":"<div>\u0000 \u0000 <p>We report a case in which a giant hepatic cyst located at the hepatic hilum and compressing the inferior vena cava was safely treated laparoscopically with careful attention to hemodynamics in a difficult fenestrated resection in a patient with severe kyphosis. The anatomic location of the cyst was evaluated preoperatively via 3D reconstruction of computed tomography images to identify a site where safe fenestrated resection could be performed. This was challenging because the surgical field was narrow due to the presence of severe kyphosis, and there was a risk of damage to surrounding organs during fenestrated resection. The cyst was filled with a greater omentum because the opening site was covered due to compression of the liver by the costal arch, and there was a risk of recurrence. Even when severe kyphosis makes fenestration of the cyst difficult, laparoscopic surgery may be a useful option given the appropriate preoperative preparation.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"18 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899199","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}