Journal of Minimal Access Surgery最新文献

{"title":"Robotic reconstruction in genitourinary tuberculosis: Surmounting technical challenges.","authors":"R Bharath, Sidhartha Kalra, Rudra Prasad Ghorai, Sreerag Kodakkattil Sreenivasan, L N Dorairajan, Sidhant Bolar, Rajat Mudhol, Guka Priyan, Pulkit Gupta, N L Bharath","doi":"10.4103/jmas.jmas_585_25","DOIUrl":"10.4103/jmas.jmas_585_25","url":null,"abstract":"<p><strong>Introduction: </strong>Genitourinary tuberculosis (GUTB) causes long ureteric strictures, bladder contracture and renal function impairment. While open reconstruction has been traditional, it entails considerable morbidity. Robotic-assisted reconstructive surgery provides three-dimensional visualisation, greater precision and expedited recovery. This study evaluates the complexities of reconstructive robotic surgery and explores strategies to mitigate them, aiming for optimal outcomes. The primary objective was to discern the surgical and technical challenges, intraoperative difficulties and perioperative complications associated with robotic intracorporeal reconstructive surgeries for GUTB.</p><p><strong>Patients and methods: </strong>This retrospective study was conducted at a single tertiary centre. Thirteen patients were diagnosed with GUTB who underwent robotic urological procedures from January 2018 to May 2025. All patients received antitubercular treatment.</p><p><strong>Results: </strong>Thirteen patients (11 males and 2 females) with GUTB underwent robotic surgery during the study period. The mean age of the study population was 42.3 ± 13.2 years. The mean robotic console time was 236.5 ± 40.07 min, and the intra-operative mean blood loss was 122.3 ± 14.23 ml. The average follow-up period was 13.3 ± 10.01 months. This study encompassed robotic procedures, such as ileal ureter substitution, augmentation cystoplasty, Boari flap reconstruction, combined ileal ureter and augmentation cystoplasty and Studer neobladder reconstruction.</p><p><strong>Conclusions: </strong>Robotic reconstruction in GUTB is a feasible and safe procedure, even in the presence of anatomical distortion and fibrosis. Robotic platforms facilitate meticulous dissection and boost anastomosis accuracy, resulting in better outcomes and decreased morbidity.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354502","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":"Pyloric botulinum toxin injection and single-port laparoscopic intragastric surgery for bulbus hamartoma.","authors":"Deniz Tikici, Salim Ilksen Basceken","doi":"10.4103/jmas.jmas_352_24","DOIUrl":"10.4103/jmas.jmas_352_24","url":null,"abstract":"<p><strong>Abstract: </strong>Gastrointestinal polyps are associated with risks such as bleeding, intussusception, obstruction and malignancy, necessitating removal. Technological advancements in endoscopic and laparoscopic surgery have introduced minimally invasive options like laparoscopic intragastric surgery (LIGS), especially beneficial for polyps that cannot be resected endoscopically. This report presents a 37-year-old male patient with Peutz-Jeghers Syndrome who exhibited symptoms of nausea, vomiting and weight loss. Endoscopy and computed tomography imaging revealed obstructive polyps in the bulbus and gastric cardia. The patient underwent single-port LIGS with preoperative botulinum toxin injection to facilitate pyloric opening. This combined approach allowed effective lesion resection without requiring extensive gastric resection. Pathology confirmed a hamartomatous polyp in the bulbus and high-grade dysplasia with negative margin in the gastric cardia. LIGS, particularly with botulinum toxin assistance, appears to be a safe and effective method for excising intraluminal lesions in complex anatomical areas, such as the duodenal bulbus and cardia.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354523","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":"Minimally invasive adrenalectomy for the treatment of large pheochromocytoma: A single-centre experience.","authors":"Marium Iqbal, Fnu Tooba, Muhammad Hassan Saeed","doi":"10.4103/jmas.jmas_249_26","DOIUrl":"https://doi.org/10.4103/jmas.jmas_249_26","url":null,"abstract":"","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354566","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":"Enhanced view totally extraperitoneal (eTEP) repair for ventral hernia: A prospective analysis of peri-operative outcomes, functional recovery, and cost effectiveness.","authors":"Jyoti Singh, Akshay Anand, Ved Prakash Singh, Awanish Kumar, Pankaj Kumar, Amit Karnik, Harvinder S Pahwa, Abhinav Arun Sonkar","doi":"10.4103/jmas.jmas_577_25","DOIUrl":"10.4103/jmas.jmas_577_25","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive ventral hernia repair has traditionally been performed using intraperitoneal onlay mesh (IPOM). Although effective, IPOM places mesh within the peritoneal cavity, with potential risks related to adhesions and mesh-bowel interaction. Enhanced-view totally extraperitoneal (eTEP) repair recreates the retromuscular (Rives-Stoppa) plane using a laparoscopic approach and may reduce these concerns.</p><p><strong>Patients and methods: </strong>A prospective, observational study was conducted on n = 24 adult patients undergoing eTEP retrorectus ventral hernia repair. Perioperative outcomes, post-operative pain (Visual Analogue Scale), complications, quality of life (Carolinas Comfort Scale; HerQLes) and abdominal wall function (double-leg lowering and trunk-raising tests) were assessed at 7 days, 1 month and 3 months.</p><p><strong>Results: </strong>The mean age was 45.6 ± 13.7 years; 54.2% were women. Mean operative time was 167.0 ± 28.7 min; no intraoperative visceral or vascular injury occurred. Surgical-site infection and seroma occurred in one patient each (4.2%) at 7 days and resolved by 1 month. Pain peaked in the early post-operative period and declined significantly over the follow-up (repeated-measures analysis of variance P < 0.001). Both CCS and HerQLes scores improved significantly at 1 and 3 months ( P < 0.001), with parallel improvement in abdominal wall function tests ( P < 0.001).</p><p><strong>Conclusion: </strong>In this early experience, eTEP retrorectus repair was feasible and safe with low early morbidity, significant improvement in patient-reported outcomes and improved abdominal wall function over 3 months. Larger comparative studies with longer follow-up are warranted.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354497","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 cholecystectomy in the paediatric population: A quality-of-life study.","authors":"Palak Singhai, Muneer Abas Malik, Nitin James Peters, Jai Kumar Mahajan","doi":"10.4103/jmas.jmas_583_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_583_25","url":null,"abstract":"<p><strong>Introduction: </strong>Cholelithiasis is uncommon in childhood but is more likely to present with symptoms that adversely affect the quality of life (QoL). This study assessed patient-reported outcomes after laparoscopic cholecystectomy (LC) using a paediatric-specific gastrointestinal (GI) health-related quality-of-life tool at a tertiary care centre in northern India.</p><p><strong>Patients and methods: </strong>A retrospective study of a cohort of children aged <12 years who underwent LC between 2016 and 2022 was performed. The PedsQL™ GI module questionnaire was administered to the patients or their parents, and the change in the QoL after surgery was evaluated across 14 GI symptom-related domains.</p><p><strong>Results: </strong>Thirty-five children (23 males: 12 females) with a mean age of 7.24 years (standard deviation [SD]: 3.27) were recruited. The most common indication for surgery was biliary colic (70.3%). The mean post-operative hospital stay was 1.7 days. At a mean follow-up of 52.6 months (SD: 29.7), there was a significant improvement in the mean PedsQL™ GI score after surgery (93.37 [±5.2] vs. 99.65 [±1.35], P < 0.0001). The domains of stomach pain, stomach discomfort, nausea and vomiting and worry about stomach aches showed significant improvement after LC.</p><p><strong>Conclusions: </strong>LC for paediatric cholelithiasis results in a significant improvement in QoL following surgery.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206665","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":"Perioperative complications of laparoscopic mesh repair for inguinal hernia: A prospective observational study from a tertiary centre in Kashmir.","authors":"Mohd Nasir, G M Naikoo, Heena Nazir Wani, Irfan Nazir, M R Attri","doi":"10.4103/jmas.jmas_15_26","DOIUrl":"https://doi.org/10.4103/jmas.jmas_15_26","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic mesh repair for inguinal hernia offers faster recovery and less post-operative pain than open repair, though concerns persist regarding perioperative and mesh-related complications. This prospective observational study evaluated the incidence and pattern of complications following laparoscopic inguinal hernia repair in a high-volume tertiary care centre in Kashmir.</p><p><strong>Patients and methods: </strong>Adults ≥18 years with primary, uncomplicated inguinal hernia undergoing elective laparoscopic mesh repair (transabdominal preperitoneal [TAPP], totally extraperitoneal [TEP] or extended TEP [e-TEP]) were included, while obstructed, strangulated, irreducible, recurrent and paediatric hernias were excluded. Demographic, clinical, operative and outcome data were analysed.</p><p><strong>Results: </strong>Fifty-six male patients (mean age 56.25 ± 13.56 years) were studied. Hypertension (32.1%) and hypothyroidism (19.6%) were common comorbidities; smoking (46.4%) was the predominant risk factor. Most hernias were unilateral (75%), right-sided (42.8%) and indirect (71.4%). TAPP was performed in 57.1%, e-TEP in 30.3% and TEP in 12.6% of cases. Mean operative time was 65.7 ± 3.9 min for unilateral and 88 ± 7.4 min for bilateral repairs. No intraoperative complications occurred. Early post-operative complications included pain (7.1%) and urinary retention (1.8%), mainly after TAPP. Intermediate complications comprised port-site infection (1.8%) and seroma (5.4%), more frequent after e-TEP. Mesh infection occurred in 2 patients (3.6%), requiring explantation in one. Mean hospital stay was 1.6 ± 0.62 days (96.4% discharged within 2 days). No mortality or recurrence occurred at 6 months.</p><p><strong>Conclusion: </strong>Laparoscopic mesh repair using TAPP, TEP or e-TEP is safe, with minimal pain, short hospitalisation and low complication rates. Optimisation of comorbidities and mesh selection may further enhance outcomes.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206720","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":"National Aeronautics and Space Administration-Task Load Index for minimally invasive surgeries from multiple departments in a tertiary health care centre - A prospective study.","authors":"Ajay J Sivakumar, Kharishma P Nair, C Vaishnavi","doi":"10.4103/jmas.jmas_49_26","DOIUrl":"https://doi.org/10.4103/jmas.jmas_49_26","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgery (MIS) has become an essential component of modern surgical practice due to improved patient outcomes. However, these procedures impose significant cognitive and physical demands on surgeons, which remain inadequately quantified. The National Aeronautics and Space Administration-Task Load Index (NASA-TLX) is a validated subjective tool used to assess workload during complex tasks, including surgery.</p><p><strong>Aim: </strong>The aim of this study was to evaluate intra-operative surgeon workload during minimally invasive procedures across multiple surgical departments in a tertiary healthcare centre using NASA-TLX.</p><p><strong>Patients and methods: </strong>This prospective observational study included surgeons performing elective minimally invasive procedures over a 3-month period at a tertiary care hospital. A total of 200 procedures performed by 27 surgeons across multiple departments were analysed. Emergency procedures, conversions to open surgery, combined procedures and abandoned surgeries were excluded. Surgeons completed the NASA-TLX questionnaire immediately after each procedure, assessing mental demand, physical demand, temporal demand, performance, effort and frustration. Workload scores were compared across procedure types and surgeon experience levels using appropriate statistical analyses, and effect sizes (η²) were calculated.</p><p><strong>Results: </strong>NASA-TLX scores demonstrated a moderate overall workload, with higher mental and physical demand. Significant differences were observed across procedures in mental demand ( P = 0.013, η² =0.07), physical demand ( P = 0.022, η² =0.06), temporal demand ( P < 0.001, η² =0.11) and frustration ( P < 0.001, η² =0.21). The mean global NASA-TLX score was 5.77 ± 1.3. Laparoscopic gastrointestinal and cholecystectomy procedures demonstrated higher workload scores. Surgeons with < 5 years' experience reported greater temporal demand, while senior surgeons demonstrated higher mental demand, effort and frustration.</p><p><strong>Conclusion: </strong>Surgeon workload during MIS varies with procedure type and experience level. NASA-TLX is a practical and effective tool for assessing intra-operative workload and may help optimise surgical training, ergonomics and operative planning.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206672","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":"Critical appraisal of 'skin stapler versus subcuticular suture for port-site skin closure in laparoscopic sleeve gastrectomy'.","authors":"Nikhil Gupta, Himanshu Agrawal","doi":"10.4103/jmas.jmas_225_26","DOIUrl":"https://doi.org/10.4103/jmas.jmas_225_26","url":null,"abstract":"","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206686","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":"Thoracoscopic treatment of recurrent pleural effusions with and without implantation of a small-lumen indwelling pleural catheter - A bicentric retrospective study.","authors":"Bassam Redwan, Eyad Al Masri, Volkan Kösek, Marcus Krüger, Amr Khalil, Thorsten Greve, Christian Biancosino","doi":"10.4103/jmas.jmas_398_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_398_25","url":null,"abstract":"<p><strong>Introduction: </strong>Recurrent pleural effusions (RPEs) significantly impair the quality of life and remain a therapeutic challenge. Video-assisted thoracoscopic surgery (VATS) pleurodesis is an established treatment, while the role of primary indwelling pleural catheter (IPC) implantation during surgery is not yet clearly defined. This study compared the outcomes of thoracoscopic treatment of RPEs with and without primary IPC implantation.</p><p><strong>Patients and methods: </strong>In this retrospective bicentric study, 115 adult patients undergoing VATS for RPEs between January 2022 and December 2023 were analysed. Patients were treated at either Knappschaft Kliniken Lünen (KKL), where VATS pleurodesis without IPC was standard, or Helios University Hospital Wuppertal (WUP), where routine primary IPC implantation was performed. Demographic data, operative characteristics, post-operative chest drainage duration and length of hospital stay (LOS) were evaluated. Statistical analysis was performed using unpaired t -tests.</p><p><strong>Results: </strong>Operative duration did not differ significantly between groups. However, patients in the WUP group demonstrated a significantly shorter duration of post-operative chest drainage (3.4 ± 1.5 vs. 5.2 ± 2.1 days) and reduced LOS (5.8 ± 1.6 vs. 7.4 ± 2.4 days) compared with the KKL group. Post-operative complications were minor and comparable between groups, with no major complications observed.</p><p><strong>Conclusion: </strong>Simultaneous IPC implantation during VATS pleurodesis for RPEs is associated with shorter chest drainage duration and hospital stay without increasing operative time or morbidity. This combined approach represents a safe and effective treatment option for selected patients. Prospective studies are warranted to confirm long-term benefits.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206712","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 unexpected encounter in Calot's triangle: Cystic duct duplication with cholelithiasis in a young male.","authors":"Sarthak Sharma, Krishnanand","doi":"10.4103/jmas.jmas_123_26","DOIUrl":"https://doi.org/10.4103/jmas.jmas_123_26","url":null,"abstract":"<p><strong>Abstract: </strong>A duplicated cystic duct draining a single gall bladder is an exceedingly rare congenital biliary anomaly. Fewer than 25 cases have been described in published literature, and the condition is almost never diagnosed before surgery. We report a 19-year-old male who presented with recurrent right upper quadrant pain. Abdominal ultrasonography confirmed cholelithiasis but revealed no biliary ductal abnormality. During elective laparoscopic cholecystectomy, meticulous dissection of Calot's triangle unexpectedly identified two separate cystic ducts, both draining a single gall bladder. Each duct was individually traced to confirm its distal course, then clipped and divided under direct vision after establishing the critical view of safety. The procedure was completed laparoscopically without complication. The patient was discharged on the post-operative day 2 and remained well at the follow-up. This case underscores that standard pre-operative imaging does not guarantee normal biliary anatomy and that systematic, unhurried dissection with a critical view of safety remains the only reliable safeguard against inadvertent bile duct injury.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148206726","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}