Journal of Minimal Access Surgery最新文献

{"title":"Robotic totally extraperitoneal inguinal hernia repair.","authors":"Uday Shamrao Kumbhar, Bhagyasri Pourouchottamane, Abhinaya P Reddy","doi":"10.4103/jmas.jmas_369_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_369_24","url":null,"abstract":"<p><strong>Abstract: </strong>Inguinal hernia is one of the most common surgeries performed worldwide. The operative technique of inguinal hernia has evolved drastically to provide a better quality of life with minimal complications. One of the recent advances is robot-assisted inguinal hernia repair. Owing to its ease of surgery and better operative visualisation, it will soon become one of the most fruitful inventions. Many studies and reports are regarding robotic transabdominal preperitoneal repair. However, very few reports describe robotic totally extraperitoneal (rTEP) repair. This report mainly describes the surgical procedure of rTEP inguinal hernia repair and its challenges to aid fellow colleagues in performing and improvising the technique.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295173","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":"Outcome after flexible endoscopy structured training of surgeons in a novel hybrid format.","authors":"Sundaram Easwaramoorthy, Sakthivel Chandrasekar, Satyapriya DeSarkar, Kanagavel Manickavasakam, Vijay Borgoankar, Senthil Manickavasakam","doi":"10.4103/jmas.jmas_15_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_15_25","url":null,"abstract":"","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267687","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":"Intrapancreatic accessory spleen mimicking a pancreatic neuroendocrine tumour - An important but almost forgotten differential diagnosis.","authors":"Kaique Flavio Xavier Cardoso Filardi, José Donizeti de Meira Júnior, Thiago Nogueira Costa, André Montagnini, Ismael Dominguez-Rosado, Carlos Chan, José Jukemura, Paulo Herman","doi":"10.4103/jmas.jmas_245_24","DOIUrl":"10.4103/jmas.jmas_245_24","url":null,"abstract":"<p><strong>Abstract: </strong>Intrapancreatic accessory spleen (IPAS) is a rare condition resulting from the failure of embryological splenic buds to fuse. Found in approximately 1.1% to 3.4% of the population, IPAS can present significant diagnostic challenges, often mimicking pancreatic tumours such as pancreatic neuroendocrine tumours. We report two cases of IPAS, each illustrating different diagnostic approaches and outcomes. These cases highlight the importance of considering IPAS in differential diagnoses for hypervascular pancreatic tail lesions. Advanced imaging techniques such as magnetic resonance imaging, computerised tomography, technetium-99m scintigraphy and endoscopic ultrasound-guided fine-needle aspiration are critical in distinguishing IPAS from malignant conditions, potentially preventing unwarranted surgical interventions. Comprehensive diagnostic protocols combining multiple modalities are recommended to enhance diagnostic accuracy and optimise patient outcomes.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250498","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":"Learning curve in robotic rectal cancer surgery: A national two-centre study.","authors":"Anislav Ventsislavov Gabarski, Paulina T Vladova, Martin P Karamanliev, Nikolai Ramadanov, Aleksandar K Zlatarov, Turgay T Kalinov","doi":"10.4103/jmas.jmas_179_23","DOIUrl":"10.4103/jmas.jmas_179_23","url":null,"abstract":"<p><strong>Introduction: </strong>Colon and rectal surgery was amongst the earliest specialities to adopt robotic surgery, with Weber and Hashizume reporting the first operations for benign and malignant colorectal disease, respectively, in 2002. Although robotic-assisted surgery benefits from technical advantages that shorten the learning curve, it nonetheless presents a steep and extended learning curve.</p><p><strong>Patients and methods: </strong>A prospective study was performed by a surgical team formed from two different departments in Bulgaria, using the da Vinci Si HD robotic system. The patients were divided into two groups: group I - the first 28 patients without indocyanine green (ICG) use and group II - the next 17 patients with ICG fluorescence imaging to assess bowel perfusion. Correlations between patient characteristics, operation duration, conversions, hospitalisation duration, complications, bleeding, reoperation, type of operation and ICG usage were assessed using multivariate analysis. This research aims to evaluate our learning curve, oncological safety and technical proficiency using the cumulative summation (CUSUM) method. To determine the CUSUM scores for each procedure index, the average console and docking time were taken into account. Subsequently, CUSUM plots were generated for the initial 45 cases.</p><p><strong>Results: </strong>Forty-five patients were included: 32 men (71.1%) and 13 women (28.9%). The procedures performed included 37 anterior resections (82.2%) and 8 (17.8%) abdominoperineal excisions. The operative time was shorter in group II for both the docking and console times. The docking time in group I was 10 min (range, 4-30 min) compared with 9 min (ranging 5-20 min) in group II ( P = 0.691). The console time was 166 min in group I (ranging 45-300 min) and 147 min in group II (ranging 60-235 min) ( P = 0.020).</p><p><strong>Conclusion: </strong>A significant reduction in console time was observed after the 28 th case. Anastomotic leaks were not observed in the ICG group. Despite our small patient cohort, we believe our institution contributes to the literature by describing our experience and the learning curve associated with robotic rectal resections.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250499","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 bariatric surgery with BORNS Simphoni: First experience.","authors":"Vivek Bindal, Dhananjay Pandey, Shailesh Gupta, Rajesh Saxena, Alexander Tobias Teichmann","doi":"10.4103/jmas.jmas_237_24","DOIUrl":"10.4103/jmas.jmas_237_24","url":null,"abstract":"<p><strong>Introduction: </strong>To overcome the challenges in laparoscopic bariatric surgery, robotic platforms are an attractive option. One such robotic platform is the BORNS Simphoni Robotic System, which has been evaluated for clinical use in this study.</p><p><strong>Patients and methods: </strong>This study includes seven severely obese patients undergoing robot-assisted sleeve gastrectomy at our centre on 10 March-9 May 2023, all performed by BORNS Simphoni Robotic System. This was a pilot study after all relevant approvals and the Clinical Trials Registry-India registration. Demographic data including body mass index (BMI), comorbidities, operative time, blood loss as well as postoperative hospital stay and results were recorded and analysed.</p><p><strong>Results: </strong>All 7 patients completed robot-assisted laparoscopic sleeve gastrectomy without laparotomy or conversion to other surgical methods. The total mean operation time was 100.6 ± 5.99 min (mean docking and console time of 12.1 ± 1.74 min and 76.7 ± 5.69 min, respectively), the mean intraoperative blood loss was 11.57 ± 1.78 ml and the mean post-operative hospital stay was 2.18 ± 0.37 days. The mean weight and BMI at the time of surgery were 118.13 ± 17.7 kg and 42.4 ± 4.9 kg/m 2 , respectively. During follow-up at 3, 6 and 12 months, the percentage of excess weight loss was 45.2% ±11.91%, 64.5% ±13.5% and 84.9% ±15.21%, respectively. The percentage of total weight loss at 3, 6 and 12 months was 17.9% ±3.87%, 25.9% ±5.75% and 34.01% ±5.36%, respectively. Significant resolution of comorbidities was noted in our series.</p><p><strong>Conclusion: </strong>We found BORNS Simphoni Robotic System to be safe and feasible to use for bariatric procedures in the pilot study. The clinical outcomes are similar when compared to published data on sleeve gastrectomy.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250500","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":"Ventral transabdominal preperitoneal plus repair for primary ventral hernia: How do I do it?","authors":"Jyoti Sharma, Devender Singh, Niharika Grover, Ankita Singh, Yashwant Singh Rathore, Piyush Ranjan, Sunil Chumber","doi":"10.4103/jmas.jmas_341_24","DOIUrl":"10.4103/jmas.jmas_341_24","url":null,"abstract":"<p><strong>Abstract: </strong>The optimal technique of ventral hernia repair is still debatable. While intraperitoneal onlay mesh repair is the most widely used method, extraperitoneal repair of ventral hernia is gaining popularity, mainly due to its proposed lesser pain and complication profile. This article describes one such method, ventral transabdominal preperitoneal plus repair and also discusses its benefits and post-operative outcomes.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250501","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":"Did scarless thyroidectomy meet expectations? An evaluation in the aspect of cosmesis: A single-centre prospective study.","authors":"Mehmet Taner Unlu, Ozan Caliskan, Isik Cetinoglu, Yasin Cakir, Nurcihan Aygun, Mehmet Uludag","doi":"10.4103/jmas.jmas_27_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_27_25","url":null,"abstract":"<p><strong>Objective: </strong>Thyroidectomy is among the most commonly performed endocrine surgeries. Concerns regarding cosmetic outcomes and pain management have led to various surgical innovations. This study compares post-operative patient satisfaction based on cosmesis and expectations between open thyroidectomy (conventional open thyroidectomy [COT]) and transoral endoscopic thyroidectomy vestibular approach (TOETVA).</p><p><strong>Patients and methods: </strong>Female patients aged 18-65 years who underwent thyroidectomy for benign conditions were included. Patients were divided into two groups: COT and TOETVA, with 20 patients in each. Post-operative evaluations were conducted on days 15 and 30 using the Vancouver Scar Scale, the modified Stony Brook Scar Evaluation Scale and general/visual satisfaction questionnaires.</p><p><strong>Results: </strong>Participants rated their surgeries on a scale of 1 (poor) to 4 (excellent) on days 15 and 30. No significant difference in visual scores was observed between groups. However, overall satisfaction scores were higher in the COT group on day 15 (3.5 ± 0.5 vs. 2.7 ± 0.9, P = 0.004) and day 30 (3.7 ± 0.5 vs. 3.1 ± 0.8, P = 0.021). Satisfaction scores and incision site oedema showed no significant differences between groups, but hyperaemia was significantly lower in the TOETVA group on day 30. Scar length was also significantly shorter in the TOETVA group.</p><p><strong>Conclusion: </strong>Higher satisfaction in the COT group may result from post-operative pain and transient chin numbness in the TOETVA group, alongside short follow-up period. Longer-term studies could better evaluate these differences. The lack of a significant difference in satisfaction suggests that patients' expectations-shaped by the surgical approach they independently choose-may significantly influence their overall satisfaction. While satisfaction scores were similar, TOETVA provides a notable cosmetic advantage due to hidden incisions, making it particularly appealing for patients with aesthetic concerns. This technique represents a significant advancement in achieving patient-centred outcomes.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053555","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":"Is the Mayo adhesive probability score predictive of post-operative Clavien-Dindo complication grade in laparoscopic adrenalectomy?","authors":"Burhan Baylan, Yasin Sarıkaya","doi":"10.4103/jmas.jmas_257_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_257_24","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic adrenalectomy (LA) continues to be considered the optimum approach to the surgical treatment of small benign adrenal tumours. The present study explores the correlation between the Mayo adhesive probability (MAP) score, derived from computed tomography images and delineating such perinephric fat characteristics as thickness and adhesiveness, and post-operative complications in patients undergoing LA.</p><p><strong>Patients and methods: </strong>Data of patients who underwent LA between 2013 and 2023 were subjected to a retrospective analysis, and MAP scores were calculated for all patients. Intraoperative and post-operative surgical outcomes, as well as any complications, were categorised using Modified Clavien-Dindo grading, and the relationship between their MAP scores and outcomes was analysed.</p><p><strong>Results: </strong>The mean body mass index, rate of overweight patients, Clavien-Dindo scores of II, III or IV, surgical time, hospitalisation duration, transfusion requirement and post-operative blood loss of the group of patients with MAP scores of 2-3 were significantly higher than those in the group with MAP scores in the 0-1 range (P < 0.05). Each one-point increase in MAP score led to a 2.559-times greater probability of a Clavien-Dindo Grade > I (95% confidence interval: 1.391-4.708, P < 0.05).</p><p><strong>Conclusion: </strong>A high MAP score is associated with Grade II and higher Clavien-Dindo complications in LA.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036051","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 of ventral hernia repair in patients of severe obesity: An experience from a tertiary care centre.","authors":"Sonali Mittal, Arun Kumar, Jagadeep Ajmera, Surabhi Vyas, Sandeep Aggarwal","doi":"10.4103/jmas.jmas_292_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_292_24","url":null,"abstract":"<p><strong>Introduction: </strong>Ventral hernia (VH) in patients with severe obesity poses a surgical challenge during bariatric surgery (BS). There is conflicting evidence regarding the optimal timing to perform a definitive VH repair (VHR). We present our experience in managing severely obese patients with VH.</p><p><strong>Patients and methods: </strong>Sixty-seven severely obese patients with VH underwent a cross-sectional analysis of outcomes after BS and VHR. Outcomes were presented in terms of patients' demographics, BS performed, timing of VHR and recurrence rates.</p><p><strong>Results: </strong>Sixty-seven patients were included in the study. Seven patients who presented with complicated hernia underwent a concomitant BS and VHR (Group 1) and the rest with uncomplicated hernia underwent a staged VHR (Group 2). The mean age of presentation was 45.2 (±11.5) years, with a female preponderance (male:female = 17.9:82.1). The mean defect size was 3.4 (1.6) cm. Majority of Group 1 patients underwent an anatomical repair while Group 2 patients underwent a mesh hernioplasty. The patients in Group 1 had a higher body mass index at the time of VHR (47.4 ± 12.7 vs. 33.7 ± 4.21 kg/m2). The rate of recurrence was also higher in Group 1 compared to Group 2 (42.9% vs. 3.3%) at a mean duration of 10.3 and 12 months, respectively.</p><p><strong>Conclusion: </strong>VHR in patients with severe obesity is challenging. The staged approach appears to be a safer option with acceptable recurrence rates compared to the concomitant approach. However, an individualised approach based on patient presentation should be followed for VHR in such patients.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056518","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":"Early outcomes of robotic transabdominal preperitoneal repair of inguinal hernias: A single surgeon's experience.","authors":"Ramkaran Chaudhary, Akshat Dutt, Indra Singh Choudhary, Anupam Singh Chauhan, Aditya Baksi, Naveen Sharma","doi":"10.4103/jmas.jmas_221_23","DOIUrl":"https://doi.org/10.4103/jmas.jmas_221_23","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive techniques for inguinal hernia repair are becoming more popular due to their advantages over open surgery. These techniques aim to strengthen weakened tissue and result in reduced complications, shorter hospital stays and faster recovery. Robotic surgery provides better visualisation and ergonomics for surgeons and less post-operative pain for patients. This study evaluates the early outcomes of robotic transabdominal preperitoneal repair (rTAPP) for inguinal hernia.</p><p><strong>Patients and methods: </strong>The study included patients who underwent rTAPP for inguinal hernias. Patients with ventral or umbilical hernias were excluded. Data on patient and hernia characteristics, surgical details and outcomes were collected and analysed. The procedure was performed under general anaesthesia, with specific port placements. A mesh was used to cover the hernia defect the patients were followed up after discharge telephonically as well as through scheduled visits to the clinics.</p><p><strong>Results: </strong>Forty-five patients underwent rTAPP for inguinal hernias between November 2019 and March 2023. The majority of patients were males (97.78%). The average age was 48.2 years. Most of the patients (80%) had unilateral defects. Only one patient had a recurrent hernia. The average operative time was 140 min. The complications were minimal. Three patients had post-operative seroma, and one had a repaired vas deferens injury with no adverse symptoms or fertility issues post-surgery.</p><p><strong>Conclusion: </strong>rTAPP is a safe and feasible modality for treating inguinal hernias. It also offers a better three-dimensional visualisation of anatomy, thereby reducing complications due to faulty technique. It may serve as the procedure of choice for young surgeons seeking to learn robotic skills.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047761","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}