Asian Journal of Endoscopic Surgery最新文献

{"title":"A Case of Laparoscopic Distal Gastrectomy for Early Gastric Cancer Associated With an Upside-Down Stomach: Sac-First Dissection Before Lymphadenectomy","authors":"Hideyuki Masui,&nbsp;Keiko Kubota,&nbsp;Yusuke Kimura,&nbsp;Motoko Mizumoto,&nbsp;Masahiro Yamada,&nbsp;Osamu Takeyama,&nbsp;Shigeru Tsunoda,&nbsp;Kazutaka Obama","doi":"10.1111/ases.70322","DOIUrl":"10.1111/ases.70322","url":null,"abstract":"<div>\u0000 \u0000 <p>Gastric cancer associated with an upside-down stomach, an advanced form of paraesophageal hiatal hernia, is rare, and laparoscopic surgery is technically demanding because of marked anatomical distortion. We report an 88-year-old woman with marked kyphosis who presented with vomiting and was diagnosed with early gastric cancer on the lesser curvature of the gastric angle. Computed tomography revealed a giant hiatal hernia with an upside-down stomach. Laparoscopic distal gastrectomy with D1 plus lymphadenectomy and concomitant hiatal hernia repair were performed. The herniated stomach was first reduced into the abdominal cavity, followed by circumferential dissection of the hernia sac at the hiatus and mobilization of the lower esophagus. Lymphadenectomy was then performed with improved orientation. After gastric transection, the redundant hernia sac was excised before Roux-en-Y reconstruction and hiatal closure. The postoperative course was uneventful. This case suggests sac-first dissection may be feasible for laparoscopic gastrectomy in patients with an upside-down stomach.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206631","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 Footprint in Hepatectomy Increases as the Approach Shifts From Open to Laparoscopic and Robot-Assisted Surgery","authors":"Takuma Okada,&nbsp;Shogo Tanaka,&nbsp;Ryoji Sada,&nbsp;Hiroji Shinkawa,&nbsp;Kenjiro Kimura,&nbsp;Takeaki Ishizawa","doi":"10.1111/ases.70319","DOIUrl":"10.1111/ases.70319","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study evaluated the environmental impact of hepatectomy approaches—open, laparoscopic, and robot-assisted—in terms of carbon footprint (CFP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty patients undergoing partial hepatectomy were divided equally into open (<i>n</i> = 10), laparoscopic (<i>n</i> = 10), and robot-assisted (<i>n</i> = 10) groups. CFP was calculated by considering disposable device production, operating room energy consumption, and disposal stages based on device characteristics, energy measurements, and surgical video analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The robot-assisted group (median [range], 59.7 [41.8–100.4] kg-CO₂) demonstrated a significantly higher total CFP than the laparoscopic group (46.1 [31.6–58.3] kg-CO₂, <i>p</i> = 0.041) and the open group (32.3 [20.2–45.8] kg-CO₂, <i>p</i> &lt; 0.001). The service stage contributed the largest share of total emissions across all groups. However, the proportion of CFP attributable to procurement and decommissioning of disposable devices tended to increase as the approach shifted from open to laparoscopic and then robot-assisted surgery. CFP increased with prolonged operative time, particularly in robot-assisted hepatectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Minimally invasive hepatectomy approaches increase CFP, with robot-assisted procedures producing approximately 1.5 times more emissions than open surgery. For surgical sustainability, unnecessary prolonged laparoscopic and robotic surgeries should be avoided, along with efforts to reduce the use of disposable devices.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70319","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148158527","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":"Stepwise Colpotomy With Selective Vaginal Septum Trimming During Total Laparoscopic Hysterectomy for High-Reaching Longitudinal Vaginal Septum","authors":"Momoka Ito,&nbsp;Norihito Kamo,&nbsp;Akari Inatsuki,&nbsp;Keisuke Yoshida,&nbsp;Hideki Miura,&nbsp;Chihiro Okoshi,&nbsp;Shu Soeda,&nbsp;Keiya Fujimori","doi":"10.1111/ases.70320","DOIUrl":"10.1111/ases.70320","url":null,"abstract":"<div>\u0000 \u0000 <p>A high-reaching longitudinal vaginal septum presents specific technical challenges during total laparoscopic hysterectomy, particularly in achieving controlled colpotomy and tension-free vaginal cuff closure. In asymptomatic patients, the optimal timing and extent of septal resection remain undefined, and routine complete excision may represent overtreatment. We report a case of total laparoscopic hysterectomy performed using a stepwise colpotomy guided by independent vaginal landmarks in a patient with a complete uterine septum and complete longitudinal vaginal septum extending to the cervix. Colpotomy was completed with partial septal transection, and septal management was intentionally deferred until vaginal cuff closure. Selective trimming was limited to the septal segment mechanically interfering with suturing, enabling tension-free closure while preserving vaginal anatomy. This case suggests that stepwise colpotomy with deferred selective septal trimming may facilitate total laparoscopic hysterectomy in selected patients with a high-reaching longitudinal vaginal septum and offers an anatomically conservative alternative to routine complete septal excision.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148151450","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 Reported Case Using ANSUR for Local Resection of the Stomach","authors":"Reo Sato,&nbsp;Hiroyuki Sagawa,&nbsp;Shohei Hayashi,&nbsp;Eri Tsuji,&nbsp;Kohei Fujita,&nbsp;Sunao Ito,&nbsp;Shunsuke Hayakawa,&nbsp;Takuya Suzuki,&nbsp;Kenta Saito,&nbsp;Yushi Yamakawa,&nbsp;Takafumi Sato,&nbsp;Ryo Ogawa,&nbsp;Shuji Takiguchi","doi":"10.1111/ases.70315","DOIUrl":"10.1111/ases.70315","url":null,"abstract":"<div>\u0000 \u0000 <p>To the best of our knowledge, this study reports the first case of laparoscopic local resection of the stomach performed using an ANSUR surgeon-controlled robotic assistant for a gastric gastrointestinal stromal tumor. A 63-year-old man with a gastric submucosal tumor underwent local resection of the stomach using ANSUR, which provided camera guidance and traction, allowing the completion of the procedure with limited assistance. The operating room configuration and port placement were optimized for the surgeon's ergonomics and procedural efficiency. The operation was completed safely, with minimal blood loss. The patient recovered uneventfully and was discharged. Pathological examination confirmed the presence of a high-risk gastrointestinal stromal tumor with clear margins. This case demonstrates the feasibility and safety of surgeon-led laparoscopic gastric surgery with ANSUR and offers practical guidance for operative setups in future cases.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145007","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":"Simultaneous Single-Port Robotic Liver Resection and Ileostomy Closure Using the da Vinci SP System: First Case Report","authors":"Toru Kato,&nbsp;Masafumi Imamura,&nbsp;Takeshi Murakami,&nbsp;Yamato Sahashi,&nbsp;Maho Toyota,&nbsp;Eiji Yoshida,&nbsp;Kazuharu Kukita,&nbsp;Koichi Okuya,&nbsp;Toru Mizuguchi,&nbsp;Takayuki Anazawa","doi":"10.1111/ases.70317","DOIUrl":"https://doi.org/10.1111/ases.70317","url":null,"abstract":"<div>\u0000 \u0000 <p>Simultaneous minimally invasive liver resection and stoma closure is frequently avoided due to concerns of intra-abdominal contamination and increased infectious risk. The da Vinci SP system enables complex resections through a single port. We report a strategy in which the ileostomy closure site was repurposed as the primary access port for single-port robotic liver resection. A 66-year-old man previously underwent low anterior resection with diverting double-barrel ileostomy for rectal cancer followed by adjuvant chemotherapy. Surveillance imaging revealed a solitary 2.6-cm lesion in segment 8, preoperatively considered a metastasis. Simultaneous ileostomy closure and robotic liver resection using the da Vinci SP system were performed, with one additional port for assistance and postoperative drain placement. The operation was completed without complications, and the postoperative course was uneventful. Pathology revealed mass-forming intrahepatic cholangiocarcinoma with negative margins. This strategy may be safely implemented in selected patients.</p>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148174713","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":"Retroperitoneal Robot-Assisted Nephroureterectomy: Technical Description and Single Center Experience","authors":"Atsunari Kawashima,&nbsp;Yu Ishizuya,&nbsp;Yoshiyuki Yamamoto,&nbsp;Takuji Hayashi,&nbsp;Masataka Kawamura,&nbsp;Norichika Ueda,&nbsp;Shigeaki Nakazawa,&nbsp;Kentaro Takezawa,&nbsp;Taigo Kato,&nbsp;Koji Hatano,&nbsp;Yoichi Kakuta,&nbsp;Norio Nonomura","doi":"10.1111/ases.70316","DOIUrl":"10.1111/ases.70316","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Robot-assisted radical nephroureterectomy (RANU) is increasingly used for upper tract urothelial carcinoma (UTUC). The retroperitoneal approach avoids bowel mobilization, but its adoption in robotic surgery remains limited because of the confined working space and technical complexity. We described our step by step retroperitoneal technique and evaluated perioperative outcomes in an initial single center series.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed consecutive patients who underwent intended fully robot assisted retroperitoneal RANU at our institution between July 2022 and September 2025. Patients requiring planned laparoscopic assistance, concomitant radical cystectomy, or upfront transperitoneal surgery were excluded. Patient characteristics, operative variables, unplanned intraoperative deviations from the intended approach, and perioperative complications were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty six patients were included. The median total operative time, insufflation time, and console time were 372, 328, and 268 min, respectively. Median estimated blood loss was 20 mL, and median postoperative hospital stay was 11 days. Unplanned deviation from the intended retroperitoneal robotic approach occurred in four patients (8.8%), with observed contributing factors including massive hydronephrosis, prior urinary tract surgery, recent urinary extravasation, and suspected adjacent organ invasion. Clavien-Dindo grade ≥ 3 complications occurred in four patients (8.8%), including one intraoperative duodenal serosal injury that was repaired immediately. Limitations include the retrospective design, single center setting, small sample size, learning curve effect, and lack of a transperitoneal comparator.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this initial single center series, retroperitoneal RANU was feasible in selected patients. Our experience suggests that careful preoperative assessment of anatomic complexity and prior surgical history may help identify cases in which completion of the retroperitoneal approach is difficult.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ases.70316","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057507","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148094369","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148092001","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148092002","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":"","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":47019,"journal":{"name":"Asian Journal of Endoscopic Surgery","volume":"19 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148086583","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}