Journal of Minimal Access Surgery最新文献

{"title":"Robotic retroperitoneal lymph node dissection for post-chemotherapy nodal mass in testicular non-seminomatous germ cell tumours: Initial experience, insights into patient selection and point of technique.","authors":"Kevin Arulraj, Sridhar Panaiyadiyan, Brusabhanu Nayak","doi":"10.4103/jmas.jmas_317_26","DOIUrl":"https://doi.org/10.4103/jmas.jmas_317_26","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the outcomes of robotic retroperitoneal lymph node dissection (R-RPLND) for post-chemotherapy residual retroperitoneal masses in patients with testicular non-seminomatous germ cell tumours. Open retroperitoneal lymph node dissection (O-RPLND) is associated with long skin incisions, increased post-operative pain and prolonged recovery. R-RPLND is a minimally invasive alternative, offering improved visualisation and precision, particularly in proximity to major vessels.</p><p><strong>Patients and methods: </strong>A retrospective analysis of patients who underwent R-RPLND at our centre between January 2023 and January 2026 was conducted. Patient selection was based on imaging and technical feasibility following informed consent. Procedures were performed by a high-volume robotic surgeon using the da Vinci Xi system. Demographic, perioperative and pathological outcomes were evaluated.</p><p><strong>Results: </strong>Ten patients underwent R-RPLND during the study period. The median age was 27 years. Embryonal carcinoma was the predominant histology on orchiectomy (70%). Sixty percent of patients had clinical N3 disease. Post-chemotherapy serum tumour markers normalised in all but two patients who required second-line chemotherapy. The mean residual nodal mass size was 4 ± 1.58 cm. The median console time and estimated blood loss were 240 min (interquartile range [IQR]: 240-310) and 220 ml (IQR: 90-300), respectively. Three patients required open conversion. Histopathology revealed necrosis in 40%, teratoma in 40% and viable tumour in 20% of the cases. There were no recurrences at a median follow-up of 20 months.</p><p><strong>Conclusion: </strong>R-RPLND is a safe and feasible alternative to O-RPLND in carefully selected patients. Optimal outcomes depend on meticulous pre-operative planning, patient selection and surgical expertise.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207454","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":"Completion cholecystectomy for remnant gall bladder stones: A tertiary centre experience.","authors":"Mohammed Motiwala, Devender Singh, Aryan Gupta, Niharika Grover, Piyush Ranjan, Sunil Chumber","doi":"10.4103/jmas.jmas_234_26","DOIUrl":"https://doi.org/10.4103/jmas.jmas_234_26","url":null,"abstract":"<p><strong>Introduction: </strong>Remnant gall bladder and cystic duct stump calculi are uncommon but significant causes of post-cholecystectomy syndrome, often presenting after a prolonged interval and posing diagnostic and technical challenges. Evidence from contemporary Indian cohorts remains limited and heterogeneous.</p><p><strong>Patients and methods: </strong>This retrospective observational study analysed 22 consecutive patients who underwent completion cholecystectomy for symptomatic remnant gall bladder or cystic duct stump calculi between January 2015 and December 2024 at a tertiary referral centre. Patients with radiologically confirmed remnant pathology and prior sub-total or difficult cholecystectomy were included. Clinical, imaging, operative, perioperative and follow-up outcomes were analysed.</p><p><strong>Results: </strong>The mean age was 47.8 years with female predominance (77.2%). The median interval between index surgery and symptom onset was 4 years. Biliary colic was the most common presentation (86.4%), with complications in 18.2% of patients. Ultrasonography detected pathology in 76%, whereas magnetic resonance cholangiopancreatography (MRCP) demonstrated 100% diagnostic accuracy. Laparoscopic completion cholecystectomy was successfully performed in 86.4% of patients, with a conversion rate of 9%. The mean operative duration was 118 min, and the mean blood loss was 87 ml. Critical view of safety was achieved in 50% of cases. Post-operative complications (Clavien-Dindo >II) occurred in 13.6% of patients, with no mortality. The median hospital stay was 2 days. At a median follow-up of 26 months, all patients achieved complete relief of biliary pain, although 35% of patients reported mild dyspeptic symptoms.</p><p><strong>Conclusions: </strong>Completion cholecystectomy is a safe and effective definitive treatment for remnant gall bladder and cystic duct stump calculi, with high laparoscopic feasibility and favourable outcomes in experienced hands. MRCP plays a crucial role in diagnosis and operative planning, while redo surgery remains technically demanding due to altered anatomy.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208112","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":"Laparoendoscopic rendezvous for paediatric cholecysto-choledocholithiasis: A safe and effective single-stage approach with technical insights.","authors":"Levan Koiava, Oleg Koiava, Leeroy Musiyarira, Salome Gavasheli, Malkhaz Kartozia, Levan Kharashvili, Vakhtang Kerkadze, Ivane Abiatari","doi":"10.4103/jmas.jmas_193_26","DOIUrl":"https://doi.org/10.4103/jmas.jmas_193_26","url":null,"abstract":"<p><strong>Introduction: </strong>Paediatric choledocholithiasis is increasingly encountered in clinical practice. The conventional two-stage strategy of endoscopic retrograde cholangiopancreatography followed by laparoscopic cholecystectomy is effective but technically demanding and associated with procedure-related complications. Laparoendoscopic rendezvous (LERV) offers a single-stage minimally invasive alternative; however, paediatric evidence remains limited.</p><p><strong>Patients and methods: </strong>This retrospective single-centre study included seven consecutive paediatric patients (4 males, 3 females; median age: 14 years; range: 9-17 years) with cholecysto-choledocholithiasis who underwent LERV between March 2021 and September 2025. The primary endpoint was complete common bile duct (CBD) stone clearance. Secondary endpoints included operative time, complications and length of hospital stay.</p><p><strong>Results: </strong>LERV was successfully completed in all patients, achieving complete CBD stone clearance without conversion to open surgery or the need for additional interventions. Median operative time was 110 min (range: 80-140), and median hospital stay was 2 days (range: 2-4). No intraoperative or post-operative complications occurred. Mean follow-up was 38.6 months, with no late biliary complications or recurrent stones.</p><p><strong>Conclusion: </strong>LERV appears to be a feasible and promising single-stage technique for selected paediatric patients with cholecysto-choledocholithiasis, providing high ductal clearance while avoiding additional procedures. The standardised step-by-step technique presented may facilitate reproducibility and broader adoption in paediatric surgical practice.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229114","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":"Non-intubated video-assisted thoracoscopic McKeown oesophagectomy using i-gel™ and continuous pressure support ventilation: A case report.","authors":"Megha Ranjan, Prashant Sirohiya, Prateek Maurya, Naveen Kumar","doi":"10.4103/jmas.jmas_302_26","DOIUrl":"https://doi.org/10.4103/jmas.jmas_302_26","url":null,"abstract":"<p><strong>Abstract: </strong>Non-intubated video-assisted thoracoscopic surgery (NIVATS) minimises airway trauma and ventilator-induced lung injury, yet its application in complex, multi-phase McKeown oesophagectomy is seldom reported. A 32-year-old female (40 kg, 140 cm and body mass index: 20.4 kg/m 2 ) presented for McKeown minimally invasive oesophagectomy following neoadjuvant chemoradiotherapy. We employed a 'less invasive anaesthesia' strategy combining T9-T10 thoracic epidural analgesia with Bispectral Index-guided target-controlled propofol infusion. Continuous pressure support ventilation (16 cmH 2 O above a positive end-expiratory pressure of 5 cmH 2 O) with preserved spontaneous breathing was maintained via a size 3 i-gel™ throughout surgery; neuromuscular blockade and controlled mechanical ventilation were not used at any stage. Surgical exposure was optimised via right-sided capnothorax. The resulting permissive hypercapnia was haemodynamically well-tolerated. Recovery was uneventful, and the airway device was removed after protective airway reflexes had returned. She was discharged from the hospital on post-operative day 6 without any complications. NIVATS for McKeown oesophagectomy may be feasible in carefully selected patients.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207337","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":"Role of indocyanine green fluorescence cholangiography in laparoscopic cholecystectomy for complicated gall bladder disease: A prospective comparative study.","authors":"M Praveen Kumar, P Niranjan, H R Ravishankar, K Lakshman, Nishanth Lakshmikantha, Aeiman Saniya, Nithya Ravichandran","doi":"10.4103/jmas.jmas_233_26","DOIUrl":"https://doi.org/10.4103/jmas.jmas_233_26","url":null,"abstract":"<p><strong>Background: </strong>Bile duct injury during laparoscopic cholecystectomy (LC) remains an uncommon but serious complication, especially in the presence of inflammation and distorted biliary anatomy. Reported injury rates range from 0.26% to 0.7%, with conversion-to-open rates of 2.6%-10% when the critical view of safety (CVS) cannot be achieved. Indocyanine green fluorescence (ICG-F) imaging has been introduced to improve real-time biliary visualization. This study evaluates its role in complicated gallbladder disease.</p><p><strong>Methods: </strong>This prospective comparative study included 80 patients undergoing LC between May 2024 and October 2025. Patients were divided into ICG-assisted LC ( n = 40) and conventional LC ( n = 40). Difficulty was assessed using Nassar and Sugrue grading systems. Primary outcomes were time to biliary identification and total operative duration. Secondary outcomes included conversion rate, complications, hospital stay, and surgeon satisfaction.</p><p><strong>Results: </strong>Baseline characteristics were comparable ( P > 0.05). The ICG group had significantly shorter time to CVS identification (19.6 ± 5.36 vs. 35.5 ± 5.10 minutes) and total operative time (49.1 ± 11.20 vs. 80.2 ± 9.79 minutes; P < 0.05). Conversion occurred in four conventional cases and none in the ICG group ( P = 0.220). Surgeon satisfaction was higher with ICG ( P < 0.001). Hospital stay was shorter but not significant.</p><p><strong>Conclusion: </strong>ICG-F cholangiography facilitates earlier biliary identification and reduces operative time in difficult LC. Larger multicentre randomized studies are required to confirm its impact on conversion rates and clinical outcomes.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207956","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 surgery for locally advanced rectal cancer: A decade of outcomes from a tertiary referral centre.","authors":"Prateek Arora, Aseem Jindal, Lucy Larby, Lorena Martin-Roman, Lucy Buckley, Hemy Imogen, Hamish Clouston, Paul Sutton, Jonathan R L Wild, Rebecca Fish, Chelliah Selvasekar","doi":"10.4103/jmas.jmas_450_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_450_25","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic surgery offers potential advantages for the surgical management of rectal cancer; however, robust data on its use in locally advanced rectal cancer (LARC) populations are limited. We aimed to evaluate the long-term oncological and perioperative outcomes of robotic surgery in a cohort of patients treated at a single tertiary referral cancer centre.</p><p><strong>Patients and methods: </strong>In this retrospective study, 105 consecutive patients who underwent robotic surgery for rectal adenocarcinoma between July 2012 and May 2024 at a specialist UK centre were analysed. Patient demographics, tumour characteristics, perioperative outcomes (margin status, complications and conversion rate) and survival (disease-free survival [DFS] and overall survival [OS]) were assessed.</p><p><strong>Results: </strong>The cohort was predominantly male (68.6%) with a median age of 63 (interquartile range 56-70) years. 89.5% of patients had LARC with 53.3% low rectal tumours and 13.3% requiring pelvic exenteration. Neoadjuvant therapy was used in 88.6%. An R0 resection was achieved in 86.7%. The conversion rate to open surgery was low at 0.9%. Clavien-Dindo Grade ≥ III complications occurred in 13.3%, with no 90-day mortality. After a mean follow-up of 53.7 months, the 5-year OS and DFS were 76% and 65%, respectively.</p><p><strong>Conclusion: </strong>Robotic surgery for LARC in a specialised referral setting is safe and feasible, achieving very low conversion rates and zero perioperative mortality. While the R1 and complication rate reflects the cohort's complexity, it is comparable to benchmarks for advanced pelvic malignancies. These findings endorse the robotic platform for treating challenging rectal cancers within a dedicated multidisciplinary framework.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149208001","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":"Wernicke's encephalopathy after laparoscopic sleeve gastrectomy.","authors":"Mikel Rojo Abecia, María Marqueta de Salas, Ana Álvarez Cuiñas, María Dolores Cancelas Felgueras, Ricardo Jesús Castro Lara, Asier Mañaricua Arnaiz, Sara Neira Melús, Miriam Pérez Pelayo, Raquel Blanco Corral, Javier Martín Ramiro","doi":"10.4103/jmas.jmas_231_25","DOIUrl":"10.4103/jmas.jmas_231_25","url":null,"abstract":"<p><strong>Abstract: </strong>Bariatric surgery is one of the causes of Wernicke's encephalopathy. It is more frequent in techniques with malabsorption and less common in surgeries such as sleeve gastrectomy. We present the case of a 48-year-old patient with a body mass index of 55 who, after a sleeve gastrectomy with cholecystectomy, suffered an episode of prolonged vomiting and was hospitalised with confusion, amnesia and limb weakness associated with low thiamine levels. After a diagnosis based on clinical manifestations and low blood thiamine levels, treatment with intravenous thiamine was started with an adequate evolution. Clinical suspicion is essential for prompt treatment to reduce the risk of serious sequelae or death.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"438-440"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291588","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":"Next-generation mesh materials, beyond polypropylene and biologics: A scoping review.","authors":"Karamveer Singh, V Arunkumar, Parth Maheshwari, Adarsh Jha, Aayush Karn, Aditya Mishra, Satish Ammapalem, Amit Gupta","doi":"10.4103/jmas.jmas_423_25","DOIUrl":"10.4103/jmas.jmas_423_25","url":null,"abstract":"<p><strong>Abstract: </strong>Hernia repair remains one of the most frequent surgical procedures worldwide, with more than 20 million cases performed annually. Although polypropylene has served as the clinical workhorse since the mid-20 th century due to its mechanical strength and accessibility, it is often limited by complications such as infection, fibrosis, and chronic pain. This scoping review synthesizes the evolution of mesh technology, evaluating the transition from traditional synthetics and biologics toward next-generation biomaterials. While biologic and biosynthetic meshes were developed to offer improved biocompatibility, they are frequently hindered by high recurrence rates, prohibitive costs, and uncertain long-term durability under physiological stress. Emerging innovations-including composite designs, antimicrobial coatings (such as benzalkonium chloride), and nanotechnology-enhanced nanofiber scaffolds-aim to bridge these gaps by fostering regenerative healing rather than mere structural reinforcement. Furthermore, the integration of 3D printing and artificial intelligence (AI) heralds a new era of personalized medicine, allowing for bespoke mesh design, predictive outcome modeling, and intraoperative guidance. Ultimately, hernia mesh innovation is shifting from passive, inert barriers toward intelligent, adaptive scaffolds that harmonize with human biology. While regulatory and manufacturing hurdles remain, these advancements signal a transformative shift in the future of abdominal wall reconstruction.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"346-351"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148165154","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":"Comparison of post-operative pain in laparoscopic extended-view total extraperitoneal inguinal hernioplasty using self-gripping mesh versus polypropylene mesh fixed with absorbable tackers - A parallel-arm, double-blinded randomised control trial.","authors":"S Vidhul Kada, Uday Shamrao Kumbhar, Chellappa Vijayakumar, Abhinaya A Reddy","doi":"10.4103/jmas.jmas_153_25","DOIUrl":"10.4103/jmas.jmas_153_25","url":null,"abstract":"<p><strong>Introduction: </strong>To compare short- and mid-term outcomes in patients undergoing laparoscopic extended-view totally extraperitoneal (eTEP) inguinal hernia repair using either self-gripping mesh or polypropylene mesh with absorbable tackers.</p><p><strong>Patients and methods: </strong>A prospective, parallel-arm, double-blinded randomised controlled trial was conducted at a tertiary care centre between April 2023 and July 2024. Adults with primary unilateral uncomplicated inguinal hernias were randomly assigned to receive self-gripping or polypropylene mesh with tackers. Pain was assessed using the Visual Analogue Scale (VAS) at 12 h and on post-operative days 1, 2, 7, 30 and at 3 months. The secondary outcomes included short-term complications, chronic pain, recurrence and quality of life (QoL) using the HerQLes questionnaire. Data were analysed using t -tests or Mann-Whitney U -test for the continuous variables and Chi-square or Fisher's exact tests for the categorical variables. P < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Sixty-two patients were randomised equally. The mean VAS score at 12 h was 4.68 ± 0.94 in the polypropylene mesh group versus 4.58 ± 0.92 in the self-gripping mesh group ( P = 0.657). No statistically significant difference in pain was observed at any assessed time point. Chronic pain at 3 months was negligible (mean VAS <1), and no recurrences were detected. Short-term complications and quality-of-life scores (HerQLes) were comparable between the two groups.</p><p><strong>Conclusions: </strong>Laparoscopic eTEP hernia repair with either self-gripping mesh or polypropylene mesh fixed with absorbable tackers yields similar short- and mid-term outcomes regarding post-operative pain, complications, recurrence and QoL. Both techniques are safe and effective for primary unilateral inguinal hernia repair.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"378-383"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692161","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":"Traumatic diaphragmatic hernia presenting as gastric outlet obstruction: A delayed presentation.","authors":"Katha H Dave, Kalpit R Suthar, Sagar J Vaghela, Archana D Dalal, Nidhi A Saraf, Muhammed A Viajkhora, Chintan N Patel, Kinju A Patel, Dev H Khatri, Sunita N Damor","doi":"10.4103/jmas.jmas_178_25","DOIUrl":"10.4103/jmas.jmas_178_25","url":null,"abstract":"<p><strong>Abstract: </strong>Traumatic diaphragmatic hernia (TDH) is a rare acquired condition usually occurring due to blunt thoracoabdominal trauma, most commonly in road traffic accidents (RTAs). It may also occur due to penetrating trauma. Diagnosis may be delayed due to the masking effect of other severe injuries in a patient with polytrauma. Here, we present the case of a 23-year-old male patient having a history of thoracoabdominal injury due to RTA before 3 months, presenting with severe vomiting, respiratory discomfort and weight loss. He was treated at other places symptomatically for gastritis and flatulence. He was diagnosed with gastric outlet obstruction due to left-sided TDH. He was successfully treated with laparoscopic repair and mesh placement. He needed thoracotomy for left lung decortication in post-operative period owing to persistent pleural effusion and lung collapse. He recovered well and remains asymptomatic on follow-up. Upon asking detailed history, he remembered that he had trauma following being struck by a vehicle. We aim to present this case to highlight the importance of detailed history taking for arriving at a timely diagnosis.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"433-437"},"PeriodicalIF":1.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688465","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}