Journal of Minimal Access Surgery最新文献

Hiatal sling liver retraction technique in bariatric and upper gastrointestinal surgeries - Our 15 year experience with 1874 surgeries.

IF 1 4区医学

Journal of Minimal Access Surgery Pub Date : 2025-02-04 DOI: 10.4103/jmas.jmas_97_24

Muvva Sri Harsha, Raj Palaniappan, Nikhilesh Krishna

{"title":"Hiatal sling liver retraction technique in bariatric and upper gastrointestinal surgeries - Our 15 year experience with 1874 surgeries.","authors":"Muvva Sri Harsha, Raj Palaniappan, Nikhilesh Krishna","doi":"10.4103/jmas.jmas_97_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_97_24","url":null,"abstract":"Introduction: Liver retraction is an important aspect when performing minimal access surgeries, especially bariatric and upper gastrointestinal (GI) surgeries. Various liver retraction methods are available and have been tried. Here, we present our experience with our indigenous hiatal sling technique for liver retraction and compare it with Nathanson liver retractor which is a popular and commonly used liver retraction method.Patients and methods: This is a retrospective observational study of 1874 patients who underwent bariatric and upper GI surgeries over the last 15 years since September 2009. A secondary study was conducted amongst the two groups of patients who underwent upper GI and bariatric surgeries using hiatal sling technique and Nathanson retractor system for liver retraction between January 2023 and October 2023. End points measured were time taken, conversions and complication along with liver function tests (LFTs) such as aspartate aminotransferase (AST) and alanine transaminase measured between the two groups pre- and postoperatively day 0, day 1, day 3 and day 7.Results: In our series of 1874 patients, hiatal sling liver traction was possible without any difficulties in all except 2 patients with no associated liver injury and with adequate exposure. In the comparative study, patients in the hiatal sling group (Group B) had significantly lesser elevation in LFTs as compared to the patients in the Nathanson liver retraction group (Group A), with no adverse events in both the groups.Conclusion: Hiatal sling technique for liver retraction is an effective technique which provides adequate exposure of the hiatus and causes lesser liver insult compared to rigid liver retraction system like Nathanson liver retraction system. Hiatal sling does not interfere with surgeons' field causing less errors during surgery and thus making it more ergonomic friendly.","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123026","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}

引用次数: 0

Laparoscopic resection of a duplicated gall bladder: A case report and literature review.

IF 1 4区医学

Journal of Minimal Access Surgery Pub Date : 2025-02-04 DOI: 10.4103/jmas.jmas_185_24

Hai-Tao Zhou, Jian-Feng Chu, Jian-Chun Zhou

{"title":"Laparoscopic resection of a duplicated gall bladder: A case report and literature review.","authors":"Hai-Tao Zhou, Jian-Feng Chu, Jian-Chun Zhou","doi":"10.4103/jmas.jmas_185_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_185_24","url":null,"abstract":"Abstract: A duplicated gall bladder is a rare congenital biliary anomaly, with an incidence rate estimated between 1 in 4000-1 in 5000. It may present with no apparent symptoms or can manifest as biliary colic or symptoms related to pancreatitis. The Harlaftis classification system is widely used for categorising duplicated gall bladders: type I is the split primordial gallbladder, which includes the septated, V-shaped and Y-shaped varieties; type II is the accessory gall bladder type, encompassing the H-shaped or tubular and trabecular types and type III is the triplicated gall bladder type. Prophylactic surgical treatment is not recommended for asymptomatic duplicated gall bladders. However, for symptomatic cases, surgical resection remains the treatment of choice, and intraoperative cholangiography can help reduce the risk of bile duct injury. This article reports a case of a 59-year-old female patient in whom a duplicated gall bladder anomaly was not detected preoperatively but was found intraoperatively. The patient successfully underwent laparoscopic cholecystectomy, and the post-operative pathological examination confirmed the diagnosis of duplicated gall bladder anomaly.","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123131","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}

引用次数: 0

Prospective analysis of 246 fires of da Vinci SureForm SmartFire stapler in colorectal cancer: First Indian study.

IF 1 4区医学

Journal of Minimal Access Surgery Pub Date : 2025-02-04 DOI: 10.4103/jmas.jmas_151_24

S P Somashekhar, Elroy Saldanha, Rohit Kumar, Kush Shah, Akhil Dahiya, K R Ashwin

{"title":"Prospective analysis of 246 fires of da Vinci SureForm SmartFire stapler in colorectal cancer: First Indian study.","authors":"S P Somashekhar, Elroy Saldanha, Rohit Kumar, Kush Shah, Akhil Dahiya, K R Ashwin","doi":"10.4103/jmas.jmas_151_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_151_24","url":null,"abstract":"Introduction: One of the critical steps involved is the distal transection of the rectum in rectal cancer surgeries. Multiple staple firings have been proven to increase the rate of anastomotic leakage. In this study, we intended to learn the effectiveness of the robotic SureForm SmartFire (SS) stapling system and its application in robotic sigmoid colon and rectal procedures performed at our institution.Patients and methods: Prospective study of patients who underwent surgeries for sigmoid/rectal cancer at our centre was considered. During the surgery, SS staplers were used, and its internal data log with regard to reload selection by the colour, reloads, clamp attempts and staple fires was considered along with intra- and post-operative outcomes.Results: 246 firings were done in 147 cases with mean body mass index of 26.3 ± 4.3 kg/m2; mean blood loss was 53.6 ± 21.8 ml. None of our patients had stapler-related complications, and the mean length of stay was 7.18 ± 1.5 days. Average reloads used in robotic-low anterior resection (LAR) were 1.73 with the fire attempts beyond lap angle occurring only in robotic-assisted LAR (RA-LAR)/abdominoperineal resection in 87 fires (41%) with 120 instances of controlled and sequential pauses occurred in 246 fires once fire pedal was activated.Conclusion: Apart from oncological nodal and margin clearance in the carcinoma rectum surgery, obtaining adequate distal margin, sphincter preserving approach and distal transection of the rectum forms one of the key steps in the low anterior resection. Robotic SS staplers have 120° angulation in both axes with EndoWrist technology that has better manoeuvrability within the confines of the pelvis.","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123598","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}

引用次数: 0

Impact of thoracoscopic segmental lung resection versus wedge on early post-operative recovery and short-term prognosis in elderly patients with early non-small cell lung cancer: A retrospective non-randomised controlled cohort study.

IF 1 4区医学

Journal of Minimal Access Surgery Pub Date : 2025-02-04 DOI: 10.4103/jmas.jmas_249_24

Xiaoyun Song, Hongwei Li, Haibo Zhou, Wei Zeng, Weijing Feng, Chen Chen, Xue Ban, Xianglong Kong, Zhidong Liu

{"title":"Impact of thoracoscopic segmental lung resection versus wedge on early post-operative recovery and short-term prognosis in elderly patients with early non-small cell lung cancer: A retrospective non-randomised controlled cohort study.","authors":"Xiaoyun Song, Hongwei Li, Haibo Zhou, Wei Zeng, Weijing Feng, Chen Chen, Xue Ban, Xianglong Kong, Zhidong Liu","doi":"10.4103/jmas.jmas_249_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_249_24","url":null,"abstract":"Introduction: The post-operative rehabilitation and prognostic indexes of thoracoscopic segmental resection and wedge resection in the treatment of early-stage non-small cell lung cancer (NSCLC) were retrospectively analysed. The objective of this study was to provide a theoretical basis for the treatment of early-stage NSCLC in the elderly.Patients and methods: One hundred and twenty elderly patients diagnosed with early-stage NSCLC in our hospital from January 2018 to December 2021 were selected as study subjects. The patients were divided into the thoracoscopic segmental lung resection group and the thoracoscopic wedge resection group. Various clinical data were compared between the two groups of patients.Results: In the thoracoscopic wedge resection group, operation time, anaesthesia time, intraoperative blood loss, post-operative chest tube volume, chest tube indwelling time and hospital stay were significantly higher compared to the thoracoscopic segmental lung resection group. Patients undergoing segmental resection also had higher Visual Analogue Scale scores and serum indices. In addition, the mini-mental state examination scores were lower in the segmental resection group compared to the wedge resection group.Conclusions: Thoracoscopic segmental resection and thoracoscopic wedge resection were both safe and feasible for the treatment of NSCLC. However, thoracoscopic segmental resection had the advantage of effectively reducing the amount of intraoperative bleeding, shortening the operation time and having less impact on lung function and physical function. This was conducive to the patient's faster recovery after surgery.","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123130","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}

引用次数: 0

Single-docking robot-assisted radical antegrade modular pancreatosplenectomy with partial left nephrectomy in a patient with synchronous pancreatic neuroendocrine neoplasm and clear cell renal cell carcinoma.

IF 1 4区医学

Journal of Minimal Access Surgery Pub Date : 2025-01-14 DOI: 10.4103/jmas.jmas_169_24

Miha Petric, Manca Bregar, Jan Grosek, Aleš Tomažic, Simon Hawlina

引用次数: 0

Innovative technique of corking the lumen of an intraoperatively decompressed turgid gall bladder with surgical gauze to prevent gall bladder stone/bile spillage during a laparoscopic cholecystectomy.

IF 1 4区医学

Journal of Minimal Access Surgery Pub Date : 2025-01-14 DOI: 10.4103/jmas.jmas_123_23

A S Ejas Khan, Aashish Shah, J Roopesh Khanna, Tejaswini M Pawar

引用次数: 0

Utilising uniportal video-assisted thoracoscopic surgery for pericardial window: A 12-year single-centre experience in the diagnosis and treatment of pericardial effusion. 利用单门胸腔镜手术治疗心包窗：12年单中心诊断和治疗心包积液的经验。

IF 1 4区医学

Journal of Minimal Access Surgery Pub Date : 2025-01-08 DOI: 10.4103/jmas.jmas_243_24

Mehmet Agar, Ilham Gulcek, Muhammed Kalkan, Hakki Ulutas, Muhammet Reha Celik

{"title":"Utilising uniportal video-assisted thoracoscopic surgery for pericardial window: A 12-year single-centre experience in the diagnosis and treatment of pericardial effusion.","authors":"Mehmet Agar, Ilham Gulcek, Muhammed Kalkan, Hakki Ulutas, Muhammet Reha Celik","doi":"10.4103/jmas.jmas_243_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_243_24","url":null,"abstract":"Introduction: Uniportal video-assisted thoracoscopic surgery (Uni-VATS) is an effective minimally invasive technique for pericardial drainage, biopsy and window creation in cases of pericardial effusion (PE).Patients and methods: This retrospective study evaluated 73 patients with PE who underwent pericardial window procedures between 2012 and 2024. Intraoperative and post-operative data related to Uni-VATS were assessed.Results: The mean age of the patients was 53.79 ± 17.79 years (10-82 years), with 34 (46.6%) females and 39 (53.4%) males. The mean volume of pericardial fluid drained after window creation was 446.23 ± 199.81 cc (75-1100 cc). The mean operation time was 42.87 ± 12.79 min, and chest drain removal occurred after an average of 1.8 ± 1.2 days. The mean duration until discharge or referral to the follow-up clinic was 5.98 ± 2.14 days. In addition to the pericardial window procedure, pleural biopsy was performed in 12 patients, mediastinal mass biopsy in eight patients and wedge resection for parenchymal nodules in six patients. Microbiologic and virologic cultures of the fluids were negative in all cases. Among the 41 patients with benign cytology, pericardial biopsy results indicated tuberculosis in four patients (5.4%), amyloidosis in one patient (1.3%) and chronic or subacute nonspecific pericarditis in the remaining patients.Conclusion: Uni-VATS is a novel and safe technique that may be the preferred choice for pericardial window due to its diagnostic and therapeutic efficacy, ability to perform simultaneous procedures, favourable impact on operation duration/hospital stay, low complication rates and superiority compared to traditional methods.","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957184","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}

引用次数: 0

Effect of intraoperative positive end-expiratory pressure on post-operative pulmonary complications in overweight patients undergoing elective laparoscopic hernia surgery: A prospective randomised controlled trial. 术中呼气末正压对超重患者择期腹腔镜疝手术后肺部并发症的影响：一项前瞻性随机对照试验。

IF 1 4区医学

Journal of Minimal Access Surgery Pub Date : 2025-01-08 DOI: 10.4103/jmas.jmas_321_24

Lokeshwar Vijayakumar, Pavithra L Thirunavukkarasu, Arivarasan Barathi

{"title":"Effect of intraoperative positive end-expiratory pressure on post-operative pulmonary complications in overweight patients undergoing elective laparoscopic hernia surgery: A prospective randomised controlled trial.","authors":"Lokeshwar Vijayakumar, Pavithra L Thirunavukkarasu, Arivarasan Barathi","doi":"10.4103/jmas.jmas_321_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_321_24","url":null,"abstract":"Introduction: Post-operative pulmonary complications (PPCs) are a significant cause of morbidity following surgery. This study evaluated the effect of intraoperative positive end-expiratory pressure (PEEP) on PPCs in overweight patients undergoing elective laparoscopic hernia surgery.Patients and methods: In this randomised controlled trial, 60 patients with a body mass index between 25 and 30 kg/m² were divided equally into a standard PEEP group (5 cm H2O) and a high PEEP group (10 cm H2O). The primary outcome was the incidence of PPCs, with secondary outcomes assessing intraoperative respiratory mechanics, haemodynamics and post-operative oxygenation levels.Results: Both groups demonstrated comparable demographic and baseline characteristics. The results showed a significant reduction in the incidence of PPCs in the high PEEP group, with atelectasis observed in 16% of control patients versus 6% of those receiving higher PEEP. In addition, the high PEEP group exhibited improved dynamic lung compliance and oxygenation but had an increased mean arterial pressure, indicating haemodynamic effects associated with higher PEEP levels. While the Cabrini Respiratory Strain Score and air test scores were comparable, patients in the high PEEP group had shorter durations of supplemental oxygen therapy and improved post-operative oxygenation at 6, 12 and 24 h.Conclusion: These findings suggest that high PEEP may enhance lung mechanics and oxygenation while reducing PPCs in overweight patients, although careful monitoring of haemodynamic stability is recommended.","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957261","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}

引用次数: 0

Therapeutic effects of single-port thoracoscopic anatomical segmentectomy on early-stage non-small-cell lung cancer. 单孔胸腔镜解剖分段切除术对早期非小细胞肺癌的治疗效果。

IF 1 4区医学

Journal of Minimal Access Surgery Pub Date : 2025-01-01 Epub Date: 2024-10-09 DOI: 10.4103/jmas.jmas_316_23

Weijie Zhang, Danyang Zhu

{"title":"Therapeutic effects of single-port thoracoscopic anatomical segmentectomy on early-stage non-small-cell lung cancer.","authors":"Weijie Zhang, Danyang Zhu","doi":"10.4103/jmas.jmas_316_23","DOIUrl":"10.4103/jmas.jmas_316_23","url":null,"abstract":"Background: We aimed to assess the therapeutic effects of single-port thoracoscopic anatomical segmentectomy on early-stage non-small-cell lung cancer (NSCLC).Patients and methods: Sixty patients with early-stage NSCLC admitted from December 2022 to July 2023 were selected and divided into a lobectomy group ( n = 30) and a segmentectomy group ( n = 30) according to the different procedures. Their perioperative indicators, pre-operative and post-operative pulmonary function indicators, pain degree 24 h, 48 h, 72 h and 7 day after operation, the incidence of post-operative complications and recurrence, survival and mortality rates 1 year after operation were compared.Results: The segmentectomy group had significantly smaller intraoperative blood loss, shorter length of drainage and length of hospital stay and longer operation time than those of the lobectomy group ( P < 0.05). The pulmonary function decreased significantly in both groups 1 week, 1 month and 3 months after operation. Compared with the lobectomy group, the forced expiratory volume in 1 s per cent, forced-vital capacity per cent and maximal voluntary ventilation of the segmentectomy group significantly increased at each time point after operation ( P < 0.05). The Visual Analogue Scale scores 24 h, 48 h, 72 h and 7 days after operation were significantly lower in the segmentectomy group than those in the lobectomy group ( P < 0.05). There were no significant differences in the incidence of post-operative complications and recurrence, survival and mortality rates 1 year after operation between the two groups ( P > 0.05).Conclusions: Single-port thoracoscopic anatomical segmentectomy has obvious therapeutic effects on early-stage NSCLC, characterised by smaller surgical trauma, milder post-operative pain and less impact on pulmonary function.","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"19-24"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401696","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}

引用次数: 0

Jejunal flap interposition after total gastrectomy in managing patients with familial adenomatous polyposis: A report on the experience of a single centre. 全胃切除术后空肠瓣介入治疗家族性腺瘤性息肉病：单中心经验报告。

IF 1 4区医学

Journal of Minimal Access Surgery Pub Date : 2025-01-01 Epub Date: 2024-11-29 DOI: 10.4103/jmas.jmas_161_23

José Barbosa, Vítor Lopes, Fabiana Sousa, Manuela Baptista, José Pedro Barbosa, Elisabete Barbosa

{"title":"Jejunal flap interposition after total gastrectomy in managing patients with familial adenomatous polyposis: A report on the experience of a single centre.","authors":"José Barbosa, Vítor Lopes, Fabiana Sousa, Manuela Baptista, José Pedro Barbosa, Elisabete Barbosa","doi":"10.4103/jmas.jmas_161_23","DOIUrl":"10.4103/jmas.jmas_161_23","url":null,"abstract":"Introduction: Patients with familial adenomatous polyposis (FAP) are characterised by the appearance of colorectal cancer if the disease is left to follow its natural course, which means they frequently undergo prophylactic colectomy at a young age. In these patients, duodenal cancer becomes the leading cause of death, which deems surveillance necessary. Gastric cancer, although rare, can also occur in these patients, and total gastrectomy is the usual treatment option.Patients and methods: We used a pedicled isoperistaltic jejunal flap interposition technique to reconstruct the digestive tract after a total gastrectomy so that duodenal surveillance could be maintained in patients followed in outpatient consultation for genetic diseases. We also describe how this technique was performed fully through laparoscopy in two of these cases.Results: We identified four patients with FAP who developed malignant or extensive pre-malignant gastric lesions which were not endoscopically resectable. Two patients were submitted to open surgery and the remaining two underwent laparoscopic surgery. There was no perioperative or post-operative morbidity, and all four patients are alive at the time of writing, with a minimum follow-up of 12 months. They were not diagnosed with major nutritional imbalances and were routinely submitted to endoscopic duodenal surveillance, sometimes including polypectomy, with ease.Conclusion: In our experience, this surgical technique has good results, and all surgical steps can be done entirely through laparoscopy, with every advantage this approach entails.","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"7-10"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752159","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}

引用次数: 0