Journal of Minimal Access Surgery最新文献

{"title":"Laparoscopic repair of iatrogenic splenic artery injury during total gastrectomy: Tips for troubleshooting.","authors":"K Ganesh Shenoy, Marina Thomas, Amol S Jeur","doi":"10.4103/jmas.jmas_473_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_473_25","url":null,"abstract":"<p><strong>Abstract: </strong>Iatrogenic splenic artery (SA) injury during laparoscopic total gastrectomy (LTG) is rare but a potentially catastrophic event and remains one of the major causes of conversion to open procedure. Prompt recognition and control are vital to avoid splenectomy. A 70-year-old man underwent LTG with D2 lymphadenectomy for proximal gastric adenocarcinoma. During dissection along the superior border of the pancreas, a 4-mm rent in the SA occurred near the distal pancreas, 3 cm from the hilum. Bleeding was controlled laparoscopically by intracorporeal interrupted 4-0 polypropylene suturing of the rent. After release of graspers, haemostasis and preserved splenic perfusion were confirmed. Post-operative computed tomography angiography on day 10 showed normal splenic flow. This case demonstrates the feasibility and safety of primary laparoscopic repair of iatrogenic SA injury during total gastrectomy, avoiding conversion or splenectomy. To the best of our knowledge, such cases are exceedingly rare, with no prior detailed technical descriptions available.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786498","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":"Prospective comparative analysis of operative variables after transabdominal pre-peritoneal and eTEP techniques for unilateral inguinal hernia with respect to hernia sac volume based on computer tomography in male patients.","authors":"Ajinkya Harish Akre, Santosh Thorat, Akshay Mhase Changdeo","doi":"10.4103/jmas.jmas_19_26","DOIUrl":"https://doi.org/10.4103/jmas.jmas_19_26","url":null,"abstract":"<p><strong>Background: </strong>The impact of hernia sac volume on post-operative pain and operative time in laparoscopic transabdominal pre-peritoneal (TAPP) and enhanced-view totally extraperitoneal (eTEP) repair of unilateral inguinal hernia remains unexplored. This study aimed to evaluate differences in post-operative pain between TAPP and eTEP techniques based on hernia sac volume quantified by computed tomography (CT), with operative time as a secondary outcome.</p><p><strong>Patients and methods: </strong>This prospective randomised study was conducted at a single centre in Pune, Maharashtra, India, from September 2022 to August 2023. Seventy-two male patients with unilateral inguinal hernia were randomised equally into TAPP (n = 36) and eTEP (n = 36) groups. Hernia sac volume was calculated preoperatively using an ellipsoidal formula applied to diameters derived from Computed Tomography scan and expressed as a volume ratio (volume of hernia sac to volume of abdominal cavity). Post-operative pain was assessed using the Visual Analogue Scale (VAS) at 24 hrs and 36 hrs. Operative time was recorded for all procedures. Statistical analysis employed the Mann-Whitney U-test for pain scores and independent samples t-test for operative time.</p><p><strong>Results: </strong>At 24 hrs, the mean VAS score was significantly lower in the eTEP group (3.06 ± 1.09) than in the TAPP group (3.97 ± 1.18; P = 0.0011). Both groups exhibited a non-linear pain response relative to sac volume, with higher pain in smaller sacs, a decrease in mid-sized sacs and a drop in larger sacs. At 36 hrs, VAS scores converged between TAPP (2.51 ± 0.74) and eTEP (2.45 ± 0.71; P = 0.73). The mean operative time was significantly shorter for eTEP (41.61 ± 5.43 min) compared to TAPP (54.83 ± 5.93 min; P = 7.19 × 10-15).</p><p><strong>Conclusions: </strong>The eTEP technique demonstrated significantly lower post-operative pain at 24 hrs and shorter operative time compared to TAPP for unilateral inguinal hernia repair. Hernia sac volume influenced pain patterns in both groups, with smaller sacs associated with higher pain scores. These findings support the consideration of hernia sac volume as a clinical parameter for planning surgical technique.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786529","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":"Unusual case of an ectopic pre-uterine spleen.","authors":"Guido Schumacher, Uwe Gebert, Simona Costa, Sonia Prader","doi":"10.4103/jmas.jmas_531_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_531_25","url":null,"abstract":"<p><strong>Abstract: </strong>Ectopic spleens are rare and most commonly occur congenitally, but also after trauma or pregnancy. They may be asymptomatic or cause pain due to pressure or torsion of the vascular pedicle. They may even extend into the small pelvis. We report on a 30-year-old patient with lower abdominal pain and the desire to have children. The spleen was located in front of the uterus in the lower abdomen. In case of pregnancy, the growing uterus could cause vascular torsion with recurrent pain, or complications could occur during a caesarean section. Thus, the indication for surgery was made in cooperation between surgeons, gynecologists and the patient. We preferred the laparoscopic splenectomy as the simplest operation rather than the splenopexy. The operation and post-operative course were uneventful, so she was able to be discharged on the 4th post-operative day. Ultimately, the decision of treatment modality remains individually.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel technique of robotic excision of caesarean scar ectopic pregnancy with near-infrared guidance using the da Vinci Xi system.","authors":"Rakshita Kattimani, Rooma Sinha, Bana Rupa, Srivastava Sakshi, K Ramya Anusha","doi":"10.4103/jmas.jmas_63_26","DOIUrl":"https://doi.org/10.4103/jmas.jmas_63_26","url":null,"abstract":"<p><strong>Abstract: </strong>Surgical management of caesarean scar ectopic pregnancy (CSEP) can cause severe bleeding and bladder injury, especially when the vesicouterine plane is scarred with minimal residual myometrium. A 36-year-old multigravida presented at 5 weeks 3 days period of gestation with vaginal bleeding. Beta-human chorionic gonadotropin (β-hCG) level was 23,190 mIU/mL. Imaging confirmed CSEP in the lower uterine segment with residual myometrial thickness of 1 mm. We performed a robotic-assisted excision of CSEP with Firefly technology for delineation of bladder margins, hence improving procedure safety and outcome. Following bladder mobilisation and hysterotomy, products of conception were excised and the uterine defect repaired. Estimated blood loss was 75 mL with no intraoperative complications and preserved bladder integrity. Post-operative recovery was uneventful, and β-hCG was negative by 3 months. Robotic excision with firefly guidance can enhance the identification of vesicouterine interface and facilitate safe bladder dissection.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678023","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":"Clinical outcomes of video-assisted thoracoscopic surgery, talc pleurodesis and indwelling catheterisation for malignant pleural effusion: A retrospective comparative study.","authors":"Turkan Dubus, Erman Bagatur Ozturk, Gokce Cangel, Ozlem Ceyran","doi":"10.4103/jmas.jmas_487_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_487_25","url":null,"abstract":"<p><strong>Introduction: </strong>Malignant pleural effusion (MPE) is a common complication of advanced cancer that impairs quality of life. The present study compared the outcomes of three procedures: tube thoracostomy with talc pleurodesis, video-assisted thoracoscopic surgery (VATS) with talc and indwelling pleural catheter (IPC).</p><p><strong>Patients and methods: </strong>In this retrospective study, 76 MPE patients were assigned to tube + talc ( n = 29), VATS + talc ( n = 27) or IPC ( n = 20). Outcomes included pleurodesis success, complications, hospitalisation, 30-day reintervention, mortality and overall survival. Eastern Cooperative Oncology Group (ECOG) performance score and serum albumin were analysed as prognostic factors using Cox regression.</p><p><strong>Results: </strong>IPC had the shortest hospital stay (3 days) and the highest 30-day reintervention rate (20%, P = 0.030). Pleurodesis success was 84.6% in both the tube and VATS groups. Median survival differed among groups (66 days for IPC, 95 days for tube and 118 days for VATS; P = 0.041); however, procedure type was not an independent predictor of survival, and these differences should be interpreted cautiously. ECOG ≥2 (hazard ratio [HR]: 1.74, P = 0.020) and albumin <3.0 g/dL (HR: 1.60, P = 0.040) were identified as independent predictors of poorer survival.</p><p><strong>Conclusion: </strong>Treatment selection should primarily be based on functional and nutritional status rather than expected survival benefit. ECOG performance status and serum albumin levels should play a central role in guiding individualised management strategies.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678058","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":"The role of percutaneous transhepatic cholangioscopy lithotripsy in the treatment of hepatolithiasis.","authors":"Lin Hu, Gang Lu, Yao Cheng, Mingliang Lai","doi":"10.4103/jmas.jmas_435_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_435_25","url":null,"abstract":"<p><strong>Introduction: </strong>The objective of this meta-analysis was to analyse the role of percutaneous transhepatic cholangioscopy lithotripsy in the treatment of hepatolithiasis.</p><p><strong>Patients and methods: </strong>We searched for relevant studies in PubMed, EMBASE and Cochrane Library databases and analysed the complete stone clearance rate, complication rate, minor complication rate, severe complication rate, biliary haemorrhage rate and stone recurrence rate of the included literature. Finally, a meta-analysis was conducted on them using Stata software.</p><p><strong>Results: </strong>Eventually, 17 studies were included, involving a total of 1962 patients with hepatolithiasis. The complete stone clearance rate, complication rate, minor complication rate, severe complication rate, biliary haemorrhage rate and recurrence rate of stones and/or cholangitis in the treatment of hepatolithiasis with percutaneous transhepatic cholangioscopy lithotripsy (PTCSL) were 85.4% (95% confidence interval [CI]: 78.5%-91.3%), 12.5% (95% CI: 7.8%-18.0%), 10.2% (95% CI: 4.2%-18.1%), 2.6% (95% CI: 0.8%-5.1%), 3% (95% CI: 1.7%-4.5%) and 31.4% (95% CI: 21.8%-41.8%), respectively. The results of the meta-analysis showed that PTCSL had a considerable complete stone clearance rate and a relatively low complication rate in the treatment of hepatolithiasis, but the recurrence rate of hepatolithiasis still needed attention.</p><p><strong>Conclusions: </strong>As a minimally invasive technique for the treatment of hepatolithiasis, PTCSL has been widely used in clinical practice and is one of the effective methods for the treatment of hepatolithiasis.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677354","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":"Long-term nutritional outcomes after bariatric surgery: A multicentre study by the Obesity and Metabolic Surgery Society of India.","authors":"Vivek Bindal, P Praveen Raj, Manish Khaitan, Priyanka Agarwal, Arun Prasad, Atul N C Peters, Mahendra Narwaria, Sandeep Aggarwal, K S Kular, Randeep Wadhawan, Sarfaraz Baig, Aparna Govil Bhaskar, Abhishek Katakwar, Deep Goel, Mehul Vikani, Dhananjay Pandey, Shailesh Gupta, Dipali Dhagat, Harsha Jaithlia, Deeba Siddiqui, Beena Arora, Arya Singh","doi":"10.4103/jmas.jmas_462_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_462_25","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to examine the impact of metabolic and bariatric surgery (MBS) on key micronutrients in patients with obesity over 10 years.</p><p><strong>Patients and methods: </strong>A retrospective chart review was carried out for individuals who had MBS from February 2013 to May 2022 at 11 centres. The micronutrient (iron, Vitamin B12, Vitamin D3 and calcium) levels were collected before surgery and up to 10 years afterwards.</p><p><strong>Results: </strong>The data from 1675 individuals with a mean age of 43.09 ± 11.93 years were analysed. The study population comprised 34.81% of males and 65.19% of females. There was an increase in the serum iron levels over 1 year (P < 0.01), 3 years (P < 0.01), 5 years (P = 0.2175), 7 years (P < 0.01) and 10 years (P = 0.0998) after surgery. Similar results were observed for Vitamin B12 levels at 1 year (P < 0.01), 3 years (P < 0.01), 5 years (P = 0.3083), 7 years (P = 0.2817) and 10 years (P = 0.2645). Vitamin D3 levels increased at 1 year (P < 0.01), 3 years (P < 0.01), 5 years (P < 0.01), 7 years (P = 0.0069) and 10 years (P = 0.8179). However, calcium levels exhibited a downwards trend at 5 years (P = 0.0008) post-surgery.</p><p><strong>Conclusions: </strong>A high prevalence of micronutrient deficiency was observed amongst patients preoperatively, which improved following MBS.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678033","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":"Self-adhesive mesh versus tacker-fixed polypropylene in transabdominal preperitoneal inguinal hernia repair: An observational cohort analysis of recurrence rates.","authors":"Nathalí Bencosme, Andres Trujillo, Cindy Franco, Daniel Mera, Frederico Santiago, Gabrielle David, Guilherme Cotta","doi":"10.4103/jmas.jmas_433_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_433_25","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic repair has become the preferred approach for inguinal hernia due to its lower post-operative morbidity and faster recovery. However, the choice of mesh fixation remains a topic of debate. Self-adhesive meshes were developed to eliminate the need for mechanical fixation, aiming to reduce post-operative pain, though their long-term outcomes compared to traditional tacker fixation are still under investigation. This study aimed to compare recurrence rates and post-operative outcomes between self-adhesive and tacker-fixed polypropylene meshes in transabdominal preperitoneal (TAPP) inguinal hernia repair.</p><p><strong>Patients and methods: </strong>An observational cohort study including 400 patients who underwent TAPP laparoscopic repair between 2018 and 2023 in hospitals across Rio de Janeiro, Brazil. Demographic variables, hernia laterality, mesh type, complications and recurrence were recorded. Fisher's exact test and linear regression were used. P ≤ 0.05 was considered significant. Follow-up was 3 months.</p><p><strong>Results: </strong>The sample consisted predominantly of males (89.5%), with bilateral hernias being the most common presentation (51.25%). Self-adhesive mesh was used in 72.5% of cases, and polypropylene mesh with tacker fixation in 27.5%. The overall recurrence rate was 6%, with no significant difference between mesh types (P = 0.249). The global complication rate was 4.25%, mainly post-operative pain (3.0%) and seroma (0.75%), with no significant differences between groups.</p><p><strong>Conclusions: </strong>Self-adhesive and tacker-fixed polypropylene meshes demonstrated comparable recurrence and complication rates in TAPP repair. Self-adhesive meshes remain a safe alternative that eliminates the need for mechanical fixation, although longer follow-up studies are required to assess late recurrence and long-term outcomes.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677348","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":"Our short-term results in patients who underwent sphincter-saving trans-sphincteric surgery by excising the invasive proximal sphincteric segment due to advanced lower rectal cancer with external anal sphincteric invasion.","authors":"Ali Naki Yücesoy, Turan Pehlivan, Erkan Yavuz, Hakan Yiğitbaş, Osman Bilgin Gülçiçek, Bilal Öztaş","doi":"10.4103/jmas.jmas_289_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_289_24","url":null,"abstract":"<p><strong>Introduction: </strong>One of the most essential contraindications of the sphincter-saving surgery in lower rectal cancer cases operated with the intersphincteric dissection technique, which is the most commonly used sphincter-saving surgical method, is an external anal sphincteric invasion. This article includes the short-term results of the lower rectal cancer cases with external anal sphincteric invasion who underwent proximal segmental sphincteric excision while performing the sphincter-sparing rectal resection in the trans-sphincteric plane.</p><p><strong>Patients and methods: </strong>Sphincter-sparing surgery by excising the invasive proximal sphincteric segment in the trans-sphincteric plane was performed in 8 male and 3 female patients with advanced lower rectal adenocarcinoma, whose external anal sphincter invasion was seen in the pre-operative magnetic resonance imaging results after neoadjuvant chemoradiotherapy.</p><p><strong>Results: </strong>In the post-operative periods of the patients, perineal fistula developed at the anterior perineal incision line in four patients and anastomotic stenosis developed in three patients. Anastomotic stenosis developed patients were the patients who were already being followed up due to perineal fistula. No evidence of external sphincteric invasion was found in the post-operative histopathological evaluation of two patients. Post-operative anal manometric sphincteric pressure measurements revealed partial decreases in resting and maximal squeeze anal pressures. It was observed that the patients whose ileostomy was closed had adequate continence.</p><p><strong>Conclusion: </strong>Despite high complication rates, it is possible to perform sphincter-preserving surgery with excision of the invasive proximal segment with trans-sphincteric surgery in locally advanced rectal cancer. Trans-sphincteric rectal resection techniques should be considered as alternative sphincter-saving surgical procedures in lower rectal cancer cases with external sphincteric invasion by considering that the invasive proximal segment can be resected.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677993","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":"The evolving landscape of metabolic surgery: An evidence-based review.","authors":"Vidit Dholakia, Subhashish Das, Samiran Nundy","doi":"10.4103/jmas.jmas_551_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_551_25","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity is increasingly recognised as a complex, adiposity-based chronic endocrine disease rather than a simple metric of excess weight. In India, the prevalence of the 'thin-fat' phenotype - characterised by high visceral adiposity and early-onset metabolic syndrome at lower body mass index thresholds - necessitates aggressive, regionally tailored interventions. While novel pharmacotherapies have expanded treatment options, metabolic and bariatric surgery (MBS) remains the most durable intervention for severe obesity.</p><p><strong>Patients and methods: </strong>Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search of PubMed, Scopus and Google Scholar (2000-2025) was conducted. We prioritised Level I and II evidence, including randomised controlled trials with ≥5 years of follow-up, meta-analyses and global registry reports. A total of 81 studies were included to critically evaluate comparative surgical effectiveness, metabolic outcomes and complication profiles.</p><p><strong>Results: </strong>Long-term data (e.g. SLEEVEPASS and STAMPEDE) confirm MBS achieves superior comorbidity remission compared to intensive medical therapy. Laparoscopic Roux-en-Y gastric bypass provides superior long-term remission of dyslipidaemia, hypertension and gastro-oesophageal reflux disease compared to laparoscopic sleeve gastrectomy (SG), though it carries higher mechanical and nutritional risks. To balance profound metabolic correction with the severe nutritional sequelae of classic malabsorptive procedures (biliopancreatic diversion with duodenal switch), emerging single-anastomosis variants (one-anastomosis gastric bypass and single anastomosis duodenal-ileal bypass with SG) demonstrate promising efficacy and improved gastrointestinal profiles.</p><p><strong>Conclusion: </strong>The MBS landscape is undergoing a paradigm shift. Optimal obesity management is evolving beyond rigid anatomical algorithms towards precision medicine, driven by the synergistic integration of dual glucagon-like peptide-1/glucose-dependent insulinotropic polypeptide receptor agonists, procedure personalisation based on metabolic phenotyping and robust lifelong surveillance registries tailored to regional demographics.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677321","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}