Asian Journal of Endoscopic Surgery最新文献

{"title":"Impact of Operative Time on Postoperative Severe Complications in Elderly Patients With Colorectal Cancer: A Multicenter Retrospective Study","authors":"Mariko Yamashita,&nbsp;Shintaro Hashimoto,&nbsp;Tetsuro Tominaga,&nbsp;Yuma Takamura,&nbsp;Hiroki Katayama,&nbsp;Keisuke Noda,&nbsp;Shoko Tei,&nbsp;Rika Ono,&nbsp;Makoto Hisanaga,&nbsp;Kaido Oishi,&nbsp;Hidetoshi Fukuoka,&nbsp;Fumitake Uchida,&nbsp;Toshio Shiraishi,&nbsp;Masaki Kunizaki,&nbsp;Takashi Nonaka,&nbsp;Keitaro Matsumoto","doi":"10.1111/ases.70341","DOIUrl":"10.1111/ases.70341","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>A high proportion of elderly patients have multiple comorbidities, and postoperative complications may contribute to poor outcomes. The purpose of this study is to investigate whether operation time could affect the occurrence of postoperative complications in elderly patients who have undergone colorectal surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study included 1316 colorectal cancer patients aged ≥ 80 years who underwent colorectal cancer surgery between 2016 and 2024. We classified patients into two groups based on operative time (≥ 250 min [<i>n</i> = 418] and &lt; 250 min [<i>n</i> = 898]). Clinical and perioperative features were compared between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Blood loss was higher (39 mL vs. 16 mL; <i>p</i> &lt; 0.001), postoperative complications were higher (30.4% vs. 19.8%; <i>p</i> &lt; 0.001), and hospital stay was longer (16 days vs. 14 days; <i>p</i> &lt; 0.001) in the ≥ 250 group. Multivariate analysis revealed that open surgery (<i>p</i> = 0.003; odds ratio 2.438; 95% confidence interval 1.350–4.402) and operative time ≥ 250 min (<i>p</i> = 0.004; odds ratio 1.966; 95% confidence interval 1.233–3.135) were independent predictors for postoperative severe complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In elderly patients undergoing colorectal cancer surgery, high-risk cases should be managed by expert surgeons using minimally invasive techniques and with efforts to minimize operative time.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148382946","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":"Endoscopic-Assisted Division of Septal Formation After Duhamel Procedure for Hirschsprung Disease: Two Case Reports","authors":"Shohei Takami,&nbsp;Shunji Nonaka,&nbsp;Hideyuki Yokokawa,&nbsp;Ayumi Kitahara,&nbsp;Shinzo Yamamoto,&nbsp;Kazuko Obana,&nbsp;Yoshiakira Kanai,&nbsp;Jun Fujishiro","doi":"10.1111/ases.70334","DOIUrl":"10.1111/ases.70334","url":null,"abstract":"<p>The management of septal formation after the Duhamel procedure in Hirschsprung disease remains unclear. We report two cases treated with an endoscopic-assisted approach. Case 1 is a 5-year-old girl with Hirschsprung disease who underwent the Duhamel procedure. Persistent constipation led to a contrast enema, confirming septal formation. Transanal endoscopic-assisted division with an endoscopic linear stapler improved symptoms initially. However, constipation and enterocolitis with bleeding recurred 5 months later, requiring redo surgery. Case 2 is a 21-year-old female with a history of Hirschsprung disease, treated with the Duhamel procedure. She had three episodes of severe abdominal pain and enterocolitis in the past month. Colonoscopy revealed a septal formation with proximal intestinal dilatation. Endoscopic-assisted division resulted in complete resolution of symptoms. No complications occurred. Septal formation may cause an obstruction contributing to constipation and enterocolitis. Early recognition and division of the septum are recommended in patients with severe constipation or enterocolitis after the Duhamel procedure.</p>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70334","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377511","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 Common Bile Duct Exploration for Choledocholithiasis-Induced Cholangitis in a 2-Month-Old Infant: A Case Report","authors":"Hajime Asai,&nbsp;Takahisa Tainaka,&nbsp;Chiyoe Shirota,&nbsp;Satoshi Makita,&nbsp;Katsuhiro Ogawa,&nbsp;Akihiro Yasui,&nbsp;Shunya Takada,&nbsp;Kaito Hayashi,&nbsp;Hiroki Ishii,&nbsp;Kazuki Ota,&nbsp;Hiroo Uchida","doi":"10.1111/ases.70339","DOIUrl":"10.1111/ases.70339","url":null,"abstract":"<div>\u0000 \u0000 <p>A 2-month-old, 2.9-kg infant, who had previously undergone neonatal surgery for coarctation of the aorta and ventricular septal defect, developed acholic stools and jaundice on day of life (DOL) 55. Fasting and ursodeoxycholic acid therapy were initiated, but on DOL 61, she became febrile with elevated inflammatory markers and cholestatic enzymes. Ultrasound and computed tomography (CT) imaging showed marked dilatation of the gallbladder and common bile duct, with sludge/stones present. Given the severe cholangitis and poor cardiopulmonary reserve, urgent percutaneous transhepatic gallbladder drainage (PTGBD) was performed, resulting in rapid clinical stabilization. Tube cholangiography later confirmed a persistent distal stone and ongoing cholestasis. After recovery, a laparoscopic cholecystectomy with common bile duct exploration and saline irrigation was performed on DOL 81 to achieve complete stone clearance. The postoperative course was uncomplicated, with resolution of jaundice and normalization of liver function tests. In very small infants, endoscopic retrograde cholangiopancreatography (ERCP) may not be feasible; therefore, staged PTGBD followed by laparoscopic exploration offers a definitive, minimally invasive alternative approach.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148377531","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":"Intra-Diaphragmatic Extralobar Pulmonary Sequestration in an Adult With Laparoscopic Resection","authors":"Kento Terasaki,&nbsp;Yuto Kitano,&nbsp;Jungo Yoshida,&nbsp;Toru Kurata,&nbsp;Kazuhide Watanabe,&nbsp;Akira Takehara,&nbsp;Kazushige Shibahara,&nbsp;Jun Kawamukai,&nbsp;Maki Ohnishi,&nbsp;Yoshinobu Maeda","doi":"10.1111/ases.70342","DOIUrl":"10.1111/ases.70342","url":null,"abstract":"<div>\u0000 \u0000 <p>Intra-diaphragmatic extralobar pulmonary sequestration (IDEPS) is a rare congenital anomaly that is exceedingly uncommon in adults. Herein, we report an adult case of incidentally detected IDEPS. Computed tomography revealed a 49-mm mass beneath the left diaphragm with internal calcifications; however, preoperative diagnosis and precise localization were challenging. The differential diagnoses included extralobar pulmonary sequestration, bronchogenic cyst, and other tumors. Diagnostic surgical resection was planned with a laparoscopic approach based on imaging findings. Intra-operatively, the lesion was identified in the left diaphragmatic muscle, supplied by a branch of the left inferior phrenic artery, and was successfully resected laparoscopically, with an uneventful postoperative course. Histopathological examination confirmed the diagnosis of IDEPS. This case underscores the difficulty in the preoperative localization of IDEPS and demonstrates that appropriate planning and multidisciplinary input are crucial for performing safe and effective surgery.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148370531","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":"Conversion to Resectional Roux-en-Y Gastric Bypass for Refractory GERD With Predominant Non-Acid Reflux After Single-Anastomosis Duodenojejunal Bypass Diagnosed by Multichannel Intraluminal Impedance-pH Monitoring","authors":"Nanami Namba,&nbsp;Kohei Uno,&nbsp;Takashi Oshiro,&nbsp;Mizuki Fukuda,&nbsp;Kazuhide Sato,&nbsp;Keigo Hara,&nbsp;Takahiro Masuda,&nbsp;Masami Yuda,&nbsp;Akira Matsumoto,&nbsp;Yusuke Iteya,&nbsp;Fumiaki Yano,&nbsp;Ken Eto","doi":"10.1111/ases.70340","DOIUrl":"10.1111/ases.70340","url":null,"abstract":"<div>\u0000 \u0000 <p>Metabolic and bariatric surgery has become routine clinical practice for severe obesity in Japan, and sleeve gastrectomy is the most performed procedure. However, bariatric procedures, including a sleeve component, may cause post-operative gastroesophageal reflux disease (GERD) due to disruption of the angle of His and increased intra-gastric pressure. Sleeve-plus procedures such as single-anastomosis duodenojejunal bypass with sleeve gastrectomy (SADJB-SG) can also cause non-acid reflux related to bile and pancreatic juices. Consequently, acid-suppressive therapy is often ineffective. We report a case of refractory GERD after SADJB-SG, in which multichannel intra-luminal impedance (MII)–pH monitoring revealed predominant non-acid reflux. The patient was successfully treated with conversion to resectional Roux-en-Y gastric bypass, which resulted in marked resolution of symptoms. This case highlights the importance of objective functional evaluation, including high-resolution manometry and MII-pH monitoring, to characterize reflux patterns, and to guide appropriate conversion surgery after sleeve-plus procedures.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148362935","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":"Feasibility and Early Outcomes of Single-Port Robot-Assisted Partial Nephrectomy via Supine Low Anterior Access","authors":"Masashi Takenaka,&nbsp;Ryoichi Shiroki,&nbsp;Akihito Takeuchi,&nbsp;Masanobu Saruta,&nbsp;Atsuhiko Yoshizawa,&nbsp;Takuhisa Nukaya,&nbsp;Kenji Zennami,&nbsp;Manabu Ichino,&nbsp;Hitomi Sasaki,&nbsp;Kiyoshi Takahara","doi":"10.1111/ases.70335","DOIUrl":"https://doi.org/10.1111/ases.70335","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We aimed to evaluate the feasibility, safety, and perioperative outcomes of single-port (SP) robot-assisted partial nephrectomy (RAPN) via the supine low anterior access (LAA) compared with conventional multi-port (MP) RAPN.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed 65 patients with cT1a renal tumors who underwent retroperitoneal RAPN between October 2023 and September 2025. Fifteen patients underwent SP-RAPN via the supine LAA, and 50 patients underwent MP-RAPN via the lateral flank access (LFA). Perioperative outcomes and postoperative outcomes, including warm ischemia time (WIT), estimated blood loss (EBL), complications, trifecta achievement, renal function, and length of hospital stay, were compared between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After adjusting patient variables by 1:2 propensity score matching (PSM), 13 and 26 patients were in the respective groups, and there were no significant differences in baseline characteristics between groups. SP-RAPN demonstrated longer WIT (17.4 ± 3.2 vs. 13.7 ± 3.7 min, <i>p</i> = 0.004). EBL (95 ± 86.1 vs. 63.1 ± 89.3 mL, <i>p</i> = 0.295) and complication rates were similar, with no conversions or positive surgical margins in either group. Length of hospital stay was shorter in the SP group (7.3 ± 0.9 vs. 8.5 ± 0.9 days, <i>p</i> = 0.001). Trifecta achievement was 100% in SP-RAPN vs. 96.2% in MP-RAPN (<i>p</i> = 1). Postoperative renal function was comparable between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SP-RAPN via the supine LAA is a safe alternative to MP-RAPN, offering comparable oncologic outcomes with reduced hospitalization. Despite longer WIT during the learning phase, the supine LAA and single-port access may provide ergonomic and recovery benefits. However, further studies are warranted to assess its clinical benefits, cost-effectiveness, and long-term oncologic outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70335","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324489","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":"Rectal Transection by Pushing Method Using the Rectum Holding Forceps During Laparoscopic Anterior Resection","authors":"Shozo Yokoyama,&nbsp;Takeshi Joo,&nbsp;Toru Sato,&nbsp;Shuichi Matsumura,&nbsp;Kazuki Shimomura,&nbsp;Yu Ito,&nbsp;Ryogo Takenaka,&nbsp;Ryo Hariki,&nbsp;Yonehiro Kanemura","doi":"10.1111/ases.70336","DOIUrl":"https://doi.org/10.1111/ases.70336","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Anastomosis leakage is a serious complication in patients with rectal cancer. Reducing anastomosis leakage in the double-stapling technique is always challenging. Recently, we developed a novel laparoscopic surgical technique and device for use during rectum transection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Surgical Technique</h3>\u0000 \u0000 <p>In anterior resection, the rectum is sutured and cut using a linear stapler. An operator inserts a stapler through a port in the lower right abdomen, and an assistant inserts the rectum holding forceps through a port in the lower left abdomen. A silicone rubber band positioned at the tip of the rectum holding forceps (Hariki Seiko Co. Ltd) is hooked to the tip of the stapler, with force applied from the elastic band extending from the tip toward the handle on both the oral and anal sides of the stapler, preventing the elastic band from sliding out toward the tip of the stapler. The rectum is pushed into the stapler to the appropriate position and then clamped, sutured, and cut. Ten patients prospectively underwent rectal transection using the rectum holding forceps during rectal transection. Performing this technique was possible in all cases using a single linear stapler.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Using this technique and device, the rectum could be cut in the appropriate position using a reduced number of staples.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148324329","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":"Impact of Changes in the Profiles of Patients' Backgrounds on the Indications of Thoracoscopic Lobectomy for Congenital Lung Malformations: A Multicenter Retrospective Study in Southern Japan","authors":"Masaaki Kuda,&nbsp;Koshiro Sugita,&nbsp;Kazuhiko Nakame,&nbsp;Tokuro Baba,&nbsp;Yudai Tsuruno,&nbsp;Yumiko Tabata,&nbsp;Nanako Nishida,&nbsp;Chihiro Kedoin,&nbsp;Ayaka Nagano,&nbsp;Masakazu Murakami,&nbsp;Keisuke Yano,&nbsp;Shun Onishi,&nbsp;Toshio Harumatsu,&nbsp;Koji Yamada,&nbsp;Ryuta Masuya,&nbsp;Makoto Matsukubo,&nbsp;Takafumi Kawano,&nbsp;Shin Shinyama,&nbsp;Motofumi Torikai,&nbsp;Mitsuhisa Takatsuki,&nbsp;Satoshi Ieiri","doi":"10.1111/ases.70338","DOIUrl":"10.1111/ases.70338","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The number of patients with congenital lung malformations (CLM) is increasing because of prenatal diagnosis. We investigated the changes in the patient backgrounds and the surgical approach for lobectomy, evaluating the surgical outcomes of thoracoscopic surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We enrolled 50 CLM patients who underwent lobectomy between 1995 and 2024. Patients were divided into three 10-year groups to evaluate the trends in patient backgrounds. We also divided them into the thoracotomy and thoracoscopy groups to compare the patient backgrounds and surgical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>An increase in the prenatal diagnosis rate (<i>p</i> &lt; 0.01) resulted in a decreased preoperative infection rate (<i>p</i> = 0.04), a younger age at surgery (<i>p</i> = 0.03), and an extended preoperative interval (<i>p</i> = 0.03). The cutoff value for predicting the presence of preoperative complications based on surgical age was 1.26 years (area under the curve [AUC]: 0.72, 95% confidence interval [CI]: 0.57–0.86, sensitivity: 0.73, specificity: 0.70). Thoracoscopic surgery was introduced stepwise from 2016, ultimately accounting for 30.0% of all cases. The thoracoscopy group showed significantly less blood loss (thoracotomy: 4.5 [2.0–11.5] mL/kg, thoracoscopy: 1.0 [0.0–2.8] mL/kg, <i>p</i> &lt; 0.01) and a shorter length of hospital stay (thoracotomy: 11.0 [8.8–20.3] days, thoracoscopy: 6.0 [5.0–8.0] days, <i>p</i> &lt; 0.01) compared to the thoracotomy group. Thoracoscopy tended to have a shorter time to chest drain removal than thoracotomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The present study demonstrates a recent trend toward an earlier diagnosis and the indications for thoracoscopic surgery for CLM. Thoracoscopic surgery is performed safely, improving surgical outcomes compared to thoracotomy even in regional, non-high-volume centers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70338","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309915","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":"Initial Clinical Experience With Robotic Liver Resection Using the Saroa Surgical System: Practical Feasibility and Technical Challenges","authors":"Nobuhisa Tanioka,&nbsp;Satoru Seo,&nbsp;Kento Shinno,&nbsp;Kazune Fujisawa,&nbsp;Masaya Munekage,&nbsp;Hiromichi Maeda,&nbsp;Hiroyuki Kitagawa","doi":"10.1111/ases.70337","DOIUrl":"10.1111/ases.70337","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The Saroa Surgical System is a newly developed robotic platform with force-feedback capability and a compact, relatively low-cost design. This study aimed to report our initial clinical experience with robotic liver resection using the Saroa Surgical System, with particular emphasis on its feasibility, safety, practical advantages, and the technical challenges encountered during the early implementation phase.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective case series included the first eight consecutive patients who underwent Saroa-assisted robotic liver resection at our institution between November 2024 and August 2025. The selected patients had superficial liver lesions that did not require anatomical resection. Clinical characteristics and short-term perioperative outcomes were descriptively analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eight patients underwent partial hepatectomy: five had hepatocellular carcinoma, two had metastatic liver tumors, and one had intrahepatic cholangiocarcinoma. The median operative time, console time, hepatic inflow occlusion time, and blood loss were 267 min, 136 min, 41 min, and 17.5 mL, respectively. Three patients required unplanned conversion to laparoscopy, which was performed smoothly using a port configuration compatible with laparoscopic surgery. One patient who underwent a third hepatectomy developed postoperative bile leakage (Clavien–Dindo grade IIIa). The median length of postoperative hospital stay was 10 days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Robotic liver resection using the Saroa Surgical System was feasible in selected patients during the introductory phase. Its compatibility with the laparoscopic workflow, compact design, and force-feedback capability may offer practical advantages. However, the restricted working range, limited instrument availability, and relatively low grasping force remain as limitations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70337","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148309862","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":"Retzius-Sparing Laparoscopic Radical Prostatectomy in A Nonrobotic Setting: A 30-Case Implementation Series With Minimum 18-Month Follow-Up","authors":"Joaquin Fernandez-Alberti,&nbsp;Glenda Ernst,&nbsp;Guillermo Scolari,&nbsp;Alex Villaalta Lopez,&nbsp;Nicolas Panzardi,&nbsp;Marcelo Featherston,&nbsp;Pablo Miguel Martinez","doi":"10.1111/ases.70332","DOIUrl":"10.1111/ases.70332","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Published experience with Retzius-sparing laparoscopic radical prostatectomy remains limited, particularly in nonrobotic settings. We aimed to describe procedural completion, perioperative safety, and descriptive functional and early oncologic outcomes in an initial 30-case implementation series with minimum 18-month follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective single-center study of 30 consecutive men with localized prostate cancer who underwent Retzius-sparing laparoscopic radical prostatectomy between October 2022 and November 2023. All procedures were performed by a single experienced laparoscopic surgeon. The co-primary endpoints were procedural completion pattern and perioperative safety within 30 days. Secondary endpoints included positive surgical margins, social urinary continence, erectile function, and early oncologic outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-six of 30 procedures (86.7%) were completed entirely through the posterior Retzius-sparing approach, whereas four cases (13.3%) required limited prevesical release for hybrid anterior completion; no open conversions occurred. Three of these four hybrid completions occurred within the first tertile of the series. Mean operative time was 224.6 min and mean estimated blood loss was 307.7 mL. Major complications occurred in four patients (13.3%), including one distal ureteral injury requiring laparoscopic reoperation and ureteral reimplantation. Positive surgical margins were found in seven patients (23.3%). Social continence rates using a 0–1 safety pad/day definition were 23.3% at catheter removal, 36.7% at 1 month, 60.0% at 3 months, 83.3% at 6 months, and 93.3% at both 12 and 18 months. Strict 0-pad continence was not systematically recorded. Persistent PSA and biochemical recurrence were observed in 6.7% and 20.0% of patients, respectively, during available follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Retzius-sparing laparoscopic radical prostatectomy was technically feasible in selected patients in a nonrobotic setting, with full posterior completion achieved in most cases and hybrid anterior completion required in a minority during early adoption. Functional and oncologic outcomes should be interpreted cautiously given the retrospective single-arm design, small cohort, complication profile, heterogeneous mpMRI use, and limited follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279192","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}