Journal of Minimal Access Surgery最新文献

{"title":"Self-gripping mesh in laparoscopic inguinal hernia repair: A comparative study about surgical time, post-operative pain and recurrence.","authors":"Lucía Aragone, Mariana Toffolo Pasquini, Raul Croceri, Pablo Medina, Daniel Pirchi","doi":"10.4103/jmas.jmas_62_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_62_24","url":null,"abstract":"<p><strong>Introduction: </strong>In laparoscopic inguinal hernia repair (LIHR), fixation means for meshes (FMMs) are commonly used to reduce hernia recurrence risk. Their use may result in post-operative pain (PP) and may even increase surgical time (ST). Recently, self-gripping meshes (SGMs) have been developed, which leave aside fixation devices; they could potentially reduce PP and even decrease ST. Our primary outcome was to compare ST, PP and recurrence rates in LIHR using SGM versus FMM.</p><p><strong>Patients and methods: </strong>A comparative retrospective study with prospective case registry was conducted. All patients who underwent LIHR with transabdominal pre-peritoneal approach from January to December 2022 in a high-volume centre were analysed. Patients were divided into two groups according to the type of mesh used in surgery (SGM vs. FMM). Demographic variables, hernia type and size, mesh type and size, ST, PP, recurrence and other morbidities were compared between the groups.</p><p><strong>Results: </strong>A total of 411 LIHRs were performed during the period, of which 283 were included in the study. Of these, 234 patients were repaired with FMM and 49 with SGM. ST had a statistically significant reduction in the SGM group (P = 0.0004) with a mean time of 58.9 min (±13.6), compared to 68.1 min (±18.9) for the FMM group. A trend towards lower PP in the SGM group was noted (P = 0.08). No recurrences were found in the SGM group with a median follow-up of 18 months (interquartile range: 3).</p><p><strong>Conclusions: </strong>SGMs have proven to be a safe, efficient and fast for LIHR in our series. They are a feasible alternative for LIHR, reducing ST and potentially reducing PP. Prospective randomised trials are needed to confirm this trend, along with a longer follow-up period to determine potential advantages in terms of recurrences.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transvaginal natural orifice specimen extraction surgery for left-sided colorectal resection: A single-centre cohort study.","authors":"Ruben Gregory Xavier, Tao-Wei Ke, William Tzu-Liang Chen","doi":"10.4103/jmas.jmas_108_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_108_24","url":null,"abstract":"<p><strong>Introduction: </strong>Transvaginal natural orifice specimen extraction surgery (NOSES) is an innovative and feasible approach for left-sided colorectal resections in females. This study aimed to report our experience with transvaginal NOSES for left-sided laparoscopic colorectal resections.</p><p><strong>Patients and methods: </strong>We analysed data for all patients with transvaginal extraction performed for left-sided laparoscopic colorectal resections between 2011 and 2021 at a tertiary teaching hospital in Taiwan.</p><p><strong>Results: </strong>The 18 post-menopausal patients were of a mean age of 69.2 ± 10.14 years. The lesions were located at the descending (n = 5), sigmoid colon (n = 12) and rectum (n = 1). The operative time was 262.5 ± 83.91 min, and the blood loss was 34 ± 35.98 mL. All patients had an end-to-end anastomosis, and the anastomotic height was 15.06 ± 8.57 cm. Two patients received diversion stoma. The mean length of hospital stay was 5.1 days (standard deviation ± 2.42; range: 3-12 days). There were no cases of clinical infection. The pathology was malignancy (n = 14, 77.8%), diverticulitis (n = 2, 11.2%) and benign (n = 2, 11.2%). In cancers, they were Stage I (n = 1, 7.1%), IIa (n = 1, 7.1%), IIIb (n = 15, 78.7%) and IV (n = 1, 7.1%). Malignant specimens (n = 14) were mostly moderately differentiated (n = 11, 78.6%), with two poorly differentiated (14.3%) and one well-differentiated (7.1%). The lymph nodes harvested were 16.1 ± 8.11. The widest dimension of the lesion was 3.43 cm ± 1.28 (range: 1.5-6) and the length of the specimen was 14.69 cm ± 5.01 (range: 8-27).</p><p><strong>Conclusion: </strong>Transvaginal NOSES is safe and feasible for left-sided colorectal resection. Factors to consider are the characteristics of the specimen, anal canal and vagina.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report on the loss of an Iglesias resectoscope beak during hysteroscopic myomectomy.","authors":"Ugo Indraccolo","doi":"10.4103/jmas.jmas_376_23","DOIUrl":"https://doi.org/10.4103/jmas.jmas_376_23","url":null,"abstract":"<p><strong>Abstract: </strong>This case report describes the dynamics of the detachment of the ceramic beak of an Iglesias resectoscope that was lost in the uterine cavity during 'cold loop' hysteroscopic myomectomy. Our aim is to increase awareness of this issue and caution our colleagues against using Iglesias resectoscopes for hysteroscopies. The ceramic beak of an Iglesias resectoscope can detach itself if hard tissue is encountered during operative hysteroscopy.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conversion of 2-dimensional to 3-dimensional mesh for resource-limited centres in developing countries.","authors":"Shaikh Nazrah, Shrivastava Rajesh","doi":"10.4103/jmas.jmas_52_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_52_24","url":null,"abstract":"<p><strong>Background: </strong>In recent years, laparoscopic hernia repair, i.e. transabdominal pre-peritoneal and totally extraperitoneal repairs have been considered the method of choice, especially for recurrent hernias after open repair or bilateral inguinal hernias. However, they pose numerous challenges such as increased post-operative pain due to tacking or fixation of mesh, chronic pain syndrome due to entrapment of nerves and mesh migration or invagination. A 3-dimensional (3D) mesh was introduced to overcome the shortcomings of a 2-dimensional (2D) mesh which does not conform to inguinal anatomy. However, in a resource-limited country like India, the widespread use of a 3D mesh may not be possible owing to its high cost.</p><p><strong>Patients and methods: </strong>We included a total of 55 patients in our study who underwent laparoscopic extended totally extraperitoneal repair hernia repair for 1 year beginning from December 2021 to November 2022 with a follow-up of a minimum of 1 year till November 2023. In our study group (n = 27), we used a novel technique of converting a 2D mesh to a 3D mesh, which was subsequently placed without fixation. In our control group (n = 28), we used a standard polypropylene mesh with one-point suture fixation.</p><p><strong>Results and conclusions: </strong>All patients in our study showed satisfactory post-operative recovery. There was no significant difference in the post-operative pain (assessed by mean Visual Analogue Scores 1.24 ± 0.44 vs. 1.87 ± 0.56; P > 0.1) and the mean length of hospital stay in days (1.12 ± 0.33 vs. 1.16 ± 0.38; P > 0.1), respectively, in the study and control groups. None of our patients showed signs or symptoms of chronic pain or recurrence in our period of follow-up. Our technique of converting 2D to 3D mesh is a safe and feasible approach and maybe a potential alternative to a traditional 3D mesh in resource-limited settings.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic versus laparoscopic intersphincteric resection for patients with low rectal cancer: Short-term outcomes.","authors":"Wei Ge, Li-Hua Shao, Yu-Dong Qiu, Gang Chen","doi":"10.4103/jmas.jmas_320_23","DOIUrl":"https://doi.org/10.4103/jmas.jmas_320_23","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the short-term outcomes between laparoscopic intersphincteric resection (L-ISR) and robotic intersphincteric resection (R-ISR) for low rectal cancer.</p><p><strong>Patients and methods: </strong>We performed a retrospective clinical analysis between August 2018 and August 2021 at the Department Of General Surgery, the Affiliated Hospital of Nanjing University Medical School.</p><p><strong>Results: </strong>A total of 28 patients were recruited in this research. Among these patients, there were 12 patients who underwent L-ISR and assigned to L-ISR group, and the remaining 16 patients underwent R-ISR and assigned to R-ISR group. The time to start oral fluids, time to start soft diet and time to first motion in R-ISR group were earlier than those in L-ISR group (P < 0.05). The hospital stay in R-ISR group was shorter than that in L-ISR group (P < 0.05). However, the operation time of R-ISR was longer compared to L-ISR group (P < 0.05). Most important of all, the Kelly score in R-ISR group was 5.1 ± 0.9, which was higher than that in L-ISR group (P = 0.004).</p><p><strong>Conclusion: </strong>R-ISR is safe and feasible for patients with low rectal cancer. R-ISR is superior to L-ISR despite the operation time of R-ISR is longer. A randomised controlled trial will be performed to confirm the conclusion further.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes following laparoscopic adrenalectomy: Experience of more than two decades at a tertiary care centre.","authors":"Virinder Kumar Bansal, Krishna Asuri, Deepti Singh, Keshav Agarwal, Raghunandan Dixit, Om Prakash, Subodh Kumar, Rajeshwari Subramaniam, Rashmi Ramachandran, Nikhil Tandon, M C Misra","doi":"10.4103/jmas.jmas_8_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_8_24","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic transperitoneal adrenalectomy was first described by Gagner M et al. Here, we present our experience of more than two decades of laparoscopic adrenalectomy performed in a single surgical unit at a tertiary care centre.</p><p><strong>Patients and methods: </strong>A prospectively collected database of patients undergoing laparoscopic adrenalectomy from December 1994 to May 2020 was analysed retrospectively. The demographic profile, details of clinical workup and laboratory parameters were recorded in a pre-structured pro forma. Functional workup and anatomical imaging were performed for all the patients. Patients were taken up for surgery after adequate pre-operative optimisation using a multidisciplinary approach. All the patients were operated by a single surgical team of experienced laparoscopic surgeons.</p><p><strong>Results: </strong>A total of 158 patients underwent laparoscopic transperitoneal adrenalectomy. The majority patients were females (64.5%). The median tumour size was 5 cm (range, 1-18 cm). The diagnosis in the majority of the patients was pheochromocytoma (56.3%). The mean operative time was 80 min (range: 45-210 min). The most common complication was bleeding in 6 (3.7%) patients, which required laparotomy. The median duration of post-operative hospital stay was 3 days (range: 1-13). There was no 30-day mortality. The mean follow-up period was 15 months (range: 6-72 months), during which two patients developed local recurrence.</p><p><strong>Conclusion: </strong>The advantages of laparoscopic surgery are well established and have been extensively explored for the management of adrenal lesions. A multidisciplinary approach to management, consisting of endocrinologists, surgeons and anaesthesiologists is preferred. Pre-operative evaluation, optimisation and accurate selection of patients are crucial for successful laparoscopic adrenalectomy.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report and review of literature on idiopathic ascites after laparoscopic appendectomy - A surgeon's dilemma.","authors":"Nithin Bangaradka, S Saravana Kumar, Pradeep Joshua Christopher, Bharath Cumar, Ramesh Natarajan, Parthasarathi Ramakrishnan, Palanivelu Chinnusamy","doi":"10.4103/jmas.jmas_228_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_228_24","url":null,"abstract":"<p><strong>Abstract: </strong>Acute appendicitis is one of the most common emergency surgical conditions, typically treated by laparoscopic appendectomy in most centres. Post-operative ascites is a rare complication after laparoscopic surgery, especially in the absence of a bowel, urinary tract or lymphatic injury. This condition creates a diagnostic challenge for surgeons, even after thorough investigation. While the typical post-operative course following laparoscopic appendectomy is well documented, our case offers a unique perspective to this sequela. We present a case of idiopathic ascites following laparoscopic appendectomy for acute appendicitis, with literature review.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic common bile duct exploration and retrieval of endoscopic lithotripsy basket after mechanical failure.","authors":"Lawrence Nip, Mark Lynch, Zinu Philipose, Serena Ceraldi","doi":"10.4103/jmas.jmas_177_24","DOIUrl":"10.4103/jmas.jmas_177_24","url":null,"abstract":"<p><strong>Abstract: </strong>Impaction of a mechanical lithotripsy basket during endoscopic retrograde cholangiopancreatography is a rare but serious complication resulting from technical failure. We describe a novel case of lithotripsy basket retrieval aided by laser fragmentation. This 87-year-old male underwent an emergency laparoscopic subtotal cholecystectomy, common bile duct (CBD) exploration and laser lithotripsy after attempts at endoscopic mechanical lithotripsy caused a stone-basket complex to become impacted within the CBD. In the absence of endoscopic salvage techniques, laparoscopic CBD exploration is a valid and safe option where surgical expertise permits.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An institutional approach to thick wall gall bladder and our experience of 5450 gallstone disease.","authors":"Bhanu Pratap Singh, Anshuman Pandey, Hitesh Sarda, S N Hareesh, Sudip Regmi","doi":"10.4103/jmas.jmas_209_24","DOIUrl":"10.4103/jmas.jmas_209_24","url":null,"abstract":"<p><strong>Introduction: </strong>Gallstone disease (GSD) has a high prevalence in India. GSD presentation varies from being asymptomatic to severe complications. Laparoscopic cholecystectomy (LC) is the procedure of choice. Histopathological varies from chronic cholecystitis to carcinoma gall bladder (CaGB). Thick wall gall bladder (TWGB) is grey zone. Various parameters of GSD especially TWGB were evaluated to develop an approach to reduce perioperative complications and histopathological surprises.</p><p><strong>Patients and methods: </strong>This study was conducted at the Department of Surgical Gastroenterology, Dr. RMLIMS, Lucknow. Data of all patients undergoing cholecystectomy between January 2015 and March 2023 were analysed retrospectively. Demographic profile, clinical presentation, blood investigations, radiological findings, operative findings and histopathology report were examined. Clinical and radiological features of difficult cholecystectomies, incidence and type of bile duct injury (BDI), presentation and outcomes of TWGB, incidence of incidental CaGB and its outcome, were evaluated and analysed.</p><p><strong>Results: </strong>A total of 5450 patients underwent cholecystectomy during the study period. GSD is common in females and 4 th decade. The laparoscopic to open conversion rate was 1.2%, the most common cause was unclear anatomy. The incidence of BDI in our series was 0.11% ( n = 6). The most common histopathological outcome was chronic cholecystitis followed by xanthogranulomatous cholecystitis. Incidence of incidental carcinoma gall in our series was 0.3% ( n = 16) with an overall survival of 68.75% at a mean follow-up of 19.4 months. TWGB workup includes contrast-enhanced computed tomography, intraoperative most have difficult cholecystectomy and had a higher rate of conversion, injury and incidental CaGB.</p><p><strong>Conclusion: </strong>Thorough pre-operative evaluation and using the suggested algorithm may decrease perioperative complications and histopathological surprises after LC.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of scrotal support application on seroma formation following minimal access surgery for inguinal hernia: A randomised controlled trial.","authors":"Satya Prakash Meena, Mayank Badkur, Mahendra Lodha, Mahaveer Singh Rodha, Ramkaran Chaudhary, Naveen Sharma, Niladri Banerjee, Spoorthi D Shetty","doi":"10.4103/jmas.jmas_85_24","DOIUrl":"10.4103/jmas.jmas_85_24","url":null,"abstract":"<p><strong>Background: </strong>The incidence of seroma formation is high following laparoscopic surgery for an inguinal hernia. Literature has shown many intraoperative techniques to reduce post-operative seroma formation. The hypothesis was made that scrotal support may reduce seroma formation following laparoscopic or robotic hernia surgery. This study aimed to compare the post-operative outcome of uncomplicated inguinal hernia patients with or without scrotal support application.</p><p><strong>Patients and methods: </strong>A randomised controlled trial was conducted on 266 male patients with inguinal hernias. A block randomisation was done, and accordingly, a scrotal support was applied after mobilisation of study patients following laparoscopic or robotic surgery. After discharge, all patients were followed up for 30 days and their outcomes were compared.</p><p><strong>Results: </strong>Post-operative numbness after hernia surgery was significantly reduced with the application of scrotal support ( P = 0.03). However, there were no significant differences in the early post-operative period for seroma formation, scrotal oedema, scrotal haematoma, surgical site infections, epididymo-orchitis or groin pain between the groups.</p><p><strong>Conclusion: </strong>A scrotal support application is not effective at reducing the formation of seroma after laparoscopic or robotic inguinal hernia repairs. Early post-operative groin numbness may be reduced by including scrotal support in post-operative care protocols.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}