Journal of Minimal Access Surgery最新文献

{"title":"Single-incision versus multi-port robotic cholecystectomy: A retrospective comparison in 188 patients.","authors":"Moaz Abulfaraj","doi":"10.4103/jmas.jmas_123_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_123_25","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic-assisted cholecystectomy enhances precision and visualisation compared to traditional laparoscopy. This study compares single-incision robotic cholecystectomy (SIRC) with multi-port robotic cholecystectomy (MPRC) in elective settings.</p><p><strong>Materials and methods: </strong>A retrospective cohort study analysed 188 patients (63 SIRC, 125 MPRC) at a tertiary centre from 2018 to 2023, assessing operative time, length of stay (LOS) and complications.</p><p><strong>Results: </strong>SIRC had longer mean operative time (66 vs. 55 min, P < 0.001) and LOS (1.4 vs. 1.2 days, P = 0.02) than MPRC, with comparable wound infection (3.2% vs. 0.8%, P = 0.25) and hernia rates (1.6% vs. 0%, P = 0.33).</p><p><strong>Conclusion: </strong>SIRC is a safe, cosmetically appealing alternative to MPRC despite longer operative times, suitable for lower-body mass index patients prioritising aesthetics.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082233","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":"Application of an improved continuous single-layer pancreaticojejunostomy technique in laparoscopic pancreaticoduodenectomy.","authors":"Xiaodong Zhou, Xuefeng Bu, Feng Yu, Yongjun Zhang, Leizhou Xia","doi":"10.4103/jmas.jmas_236_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_236_24","url":null,"abstract":"<p><strong>Abstract: </strong>Laparoscopic pancreaticoduodenectomy (LPD) is a minimally invasive approach for pancreatic head and ampullary tumours, with pancreaticojejunostomy (PJ) critically influencing post-operative outcomes. This study aimed to compare a modified continuous single-layer PJ technique with the conventional two-layer method in LPD. A retrospective cohort study of 22 patients undergoing LPD compared the surgical outcomes between the modified group (n = 12) and the conventional group (n = 10). Baseline characteristics were well-matched between the two groups. The modified group demonstrated significantly shorter anastomosis time (19.08 vs. 23.1 min, P < 0.001) and lower abdominal infection rates (0 vs. 3 cases, P = 0.041). No significant differences were observed in clinically relevant post-operative pancreatic fistula or bleeding. Conclusively, the modified continuous single-layer PJ technique appears safe and feasible, offering efficiency advantages without compromising short-term outcomes. However, large-scale randomised controlled trials are warranted to validate safety, efficacy and long-term prognostic implications.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692156","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 oesophagectomy for corrosive oesophageal strictures - A single-centre experience from central India.","authors":"Gayatri Amit Deshpande, Bhupesh Tirpude, Hemant Bhanarkar, Girish Kodape, Mahima Advaitha, Raj Gajbhiye","doi":"10.4103/jmas.jmas_140_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_140_24","url":null,"abstract":"<p><strong>Introduction: </strong>Corrosive ingestion is a common cause for benign oesophageal stricture in the developing countries. There is limited literature available on the minimally invasive surgical approach for the management of this condition. This study analyses our experience of managing corrosive oesophageal strictures by combined thoraco-laparoscopic approach.</p><p><strong>Patients and methods: </strong>A retrospective analysis of 24 patients (22 - gastric conduit and 2 - colonic conduit) who underwent minimally invasive oesophagectomy for corrosive oesophageal strictures from January 2019 to December 2023 was done.</p><p><strong>Results: </strong>The median age of the patients in the study group was 30.5 years (range 18-60 years). Eighteen patients had a history of accidental corrosive ingestion, and 6 patients with suicidal intent. Post-operative complications included chest infections in 6, recurrent laryngeal nerve paresis in 2, anastomotic leak in 2 and anastomotic stricture in 4 patients. There was one mortality.</p><p><strong>Conclusion: </strong>Minimal invasive oesophagectomy for corrosive stricture is technically challenging and needs expertise. It not only permits the native and physiological route for conduit placement but also avoids complications related to retained diseased oesophagus.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692168","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":"Quality-based assessment of laparoscopic camera navigation for resident surgeons - A randomised control study.","authors":"Ramesh Bhargav Kavuluri, Jayanta Kumar Biswal, Sujit Kumar Mohanty, Deepak Ranjan Nayak","doi":"10.4103/jmas.jmas_38_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_38_25","url":null,"abstract":"<p><strong>Introduction: </strong>The introduction of laparoscopy has revolutionised the field of surgery. Camera navigation is a pivotal factor for a successful laparoscopic surgery. Good camera assistance guides the operating surgeon towards a safe and successful surgery. Laparoscopic camera navigation is a complicated task, requiring specific psychomotor and visuospatial skills. This study aimed to find out whether the objective structured assessment of camera navigation skills (OSA-CNS) is an effective tool for assessment and feedback to the residents.</p><p><strong>Patients and methods: </strong>This was a single-centre randomised study with a test group and a control group having surgical residents as participants. The sample size is 24, with 12 in each group. Residents were assessed based on the five key parameters of camera navigation skills by an expert surgeon and the operating surgeon. The test and control group scores were analysed along with the progress of the groups after each assessment. Each participant assisted in five laparoscopic cholecystectomies. Statistical tests were conducted using SSPN and R-code.</p><p><strong>Results: </strong>After the assessment, the test group had improved scores compared to the control group, which was statistically significant (P < 0.001). The analysis of variance test of the groups revealed that the test group participant scores improved after each assessment (F = 23.45, P < 0.001). The residents opined that the objective assessment helped improve their navigation skills.</p><p><strong>Conclusion: </strong>The data from our study showed that the OSA-CNS is a viable and reliable tool. This structured assessment helps to improve camera navigation and has great scope in the future with regard to surgical training.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692170","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 simplified technique for laparoscopic feeding jejunostomy and its outcomes.","authors":"Manav Manohar, Manjunath Maruti Pol, Mohammed Fawaz, Ravi Ranjan Kumar, Venu Madhav Jarapala, Mohammed Saheer","doi":"10.4103/jmas.jmas_232_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_232_24","url":null,"abstract":"<p><strong>Abstract: </strong>Feeding jejunostomy (FJ) is essential for patients with absolute dysphagia, providing a critical means of nutrition. Despite various techniques being described in the literature, there is no standardized, cost-effective approach for laparoscopic FJ. This study aims to describe a modified, simplified laparoscopic FJ technique and assess its safety, feasibility, and cost-effectiveness. A case series of 30 patients who underwent laparoscopic FJ between June and December 2022 was evaluated. The mean age of the patients was 29 ± 1.2 years, with an average operating time of 46.5 ± 9 minutes. Intraoperative blood loss was minimal, and there were no major complications during the hospital stay. Only one minor complication, catheter displacement, occurred during the 1-month follow-up. The average hospital stay was 2 ± 0.66 days. The cost of the procedure was compared to existing commercial kits in India, demonstrating significant savings. The findings suggest that the modified laparoscopic FJ technique is a safe, feasible, and cost-effective alternative, offering a simplified approach with minimal complications and a short hospital stay. Further studies with larger sample sizes and longer follow-up are needed to validate these results.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of post-operative pain in laparoscopic extended-view total extraperitoneal inguinal hernioplasty using self-gripping mesh versus polypropylene mesh fixed with absorbable tackers - A parallel-arm, double-blinded randomised control trial.","authors":"S Vidhul Kada, Uday Shamrao Kumbhar, Chellappa Vijayakumar, Abhinaya A Reddy","doi":"10.4103/jmas.jmas_153_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_153_25","url":null,"abstract":"<p><strong>Introduction: </strong>To compare short- and mid-term outcomes in patients undergoing laparoscopic extended-view totally extraperitoneal (eTEP) inguinal hernia repair using either self-gripping mesh or polypropylene mesh with absorbable tackers.</p><p><strong>Patients and methods: </strong>A prospective, parallel-arm, double-blinded randomised controlled trial was conducted at a tertiary care centre between April 2023 and July 2024. Adults with primary unilateral uncomplicated inguinal hernias were randomly assigned to receive self-gripping or polypropylene mesh with tackers. Pain was assessed using the Visual Analogue Scale (VAS) at 12 h and on post-operative days 1, 2, 7, 30 and at 3 months. The secondary outcomes included short-term complications, chronic pain, recurrence and quality of life (QoL) using the HerQLes questionnaire. Data were analysed using t-tests or Mann-Whitney U-test for the continuous variables and Chi-square or Fisher's exact tests for the categorical variables. P < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Sixty-two patients were randomised equally. The mean VAS score at 12 h was 4.68 ± 0.94 in the polypropylene mesh group versus 4.58 ± 0.92 in the self-gripping mesh group (P = 0.657). No statistically significant difference in pain was observed at any assessed time point. Chronic pain at 3 months was negligible (mean VAS <1), and no recurrences were detected. Short-term complications and quality-of-life scores (HerQLes) were comparable between the two groups.</p><p><strong>Conclusions: </strong>Laparoscopic eTEP hernia repair with either self-gripping mesh or polypropylene mesh fixed with absorbable tackers yields similar short- and mid-term outcomes regarding post-operative pain, complications, recurrence and QoL. Both techniques are safe and effective for primary unilateral inguinal hernia repair.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective analysis of post-operative mesh infection after laparoscopic inguinal hernia repair and preventive measures.","authors":"Pankaj Kataria, Shardool Vikram Gupta, Lalit Kumar Bansal, Atul Jain, Srishti Bishnoi, Neeti Kapur","doi":"10.4103/jmas.jmas_290_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_290_24","url":null,"abstract":"<p><strong>Introduction: </strong>Post-operative mesh infection is a rare but serious complication of laparoscopic hernia surgery. In this study, we share our experience of post-laparoscopic hernia repair mesh infections, with a review of the literature and possible preventive steps that can be taken to for such a dreaded complication.</p><p><strong>Patients and methods: </strong>This retrospective observational study was done from January 2014 to 30 June 2024. We reviewed the prospectively maintained data of all the patients who underwent laparoscopic inguinal hernia surgery. Thousand eight hundred and twenty patients underwent laparoscopic hernia repair, and we found case records of six patients who experienced surgical site infections (SSIs) following laparoscopic inguinal mesh hernioplasty.</p><p><strong>Results: </strong>The rate of SSI or the mesh infection was 0.34% (6 cases). All were male with 4 of them in the age group between 51 and 60 years. One patient (16.66%) had undergone totally extraperitoneal repair, whereas 5 patients (83.33%) had undergone transabdominal preperitoneal repair. All the patients presented with mesh infection within the first 4 weeks of surgery. Three (50%) of patients presenting with post-mesh infection had different comorbidities. Four (66.6%) patients of post-laparoscopic inguinal hernia repair mesh infection underwent mesh explantation and the remaining 2 (33.33%) were treated conservatively.</p><p><strong>Conclusion: </strong>Intra-abdominal abscess and mesh infection, though rare, are serious complications of laparoscopic hernia repair. Prevention remains the best approach, and the surgical team must ensure adherence to key preventive measures at each stage.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692153","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":"Stapler-assisted endoscopic mini- or less-open sublay technique: How do I do it?","authors":"Alaa Zahalka, Fahim Kanani, Wasim Shaqqur, Asad Asem, Ronit Bar-Haim, Arkadiy Iskhakov, Katia Dayan","doi":"10.4103/jmas.jmas_137_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_137_25","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the clinical efficacy of the endoscopic mini- or less-open sublay (EMILOS) technique with stapler-assisted fascial closure for ventral hernia repair.</p><p><strong>Materials and methods: </strong>Twelve patients underwent EMILOS with stapler-assisted fascial closure between July 2022 and August 2024 with a mean follow-up of 12.4 months.</p><p><strong>Results: </strong>The cohort (7 females and 5 males; mean age: 58.9 ± 16.3 years and body mass index: 27.8 ± 3.5 kg/m²) underwent repair for various ventral hernias (mean defect: 4.9 cm × 5.2 cm). The mean operative time was 95 min. Complications included seroma (17%), surgical site infection (8%) and small bowel obstruction requiring reoperation (8%). The hernia recurrence rate was 8%. Patients reporting excellent quality of life increased from 17% preoperatively to 50% postoperatively.</p><p><strong>Conclusions: </strong>EMILOS with stapler-assisted closure offers a safe, efficient approach with favourable short-term outcomes, particularly for obese patients and medium-sized hernias. The technique combines enhanced visualisation with efficient fascial closure, yielding an 8% recurrence rate that compares favourably with alternatives. Larger studies with extended follow-up are needed to establish long-term efficacy.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692173","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":"Comparative outcome of metal versus plastic stents for the management of walled-off pancreatic necrosis - An updated meta-analysis of randomised studies.","authors":"Suprabhat Giri, Prasanna Gore, Gaurav Khatana, Chandramauli Mishra, Sridhar Sundaram, Vaishali Bhardwaj","doi":"10.4103/jmas.jmas_147_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_147_25","url":null,"abstract":"<p><strong>Objective: </strong>The choice of the stent for managing walled-off pancreatic necrosis (WOPN) is a topic of debate with varying reported outcomes between metal and plastic stents. The present meta-analysis aimed to compare the efficacy and safety of metal and plastic stents for the drainage of WOPN.</p><p><strong>Patients and methods: </strong>A comprehensive search of literature from inception to December 2024 was done on three databases for randomised controlled trials comparing metal and plastic stents for drainage of WOPN. Risk ratios with 95% confidence intervals (CIs) were calculated for all the dichotomous outcomes. Continuous variables were analysed using mean difference (MD).</p><p><strong>Results: </strong>A total of 821 records were identified, of which seven studies were included in the final analysis. The procedural duration was significantly lower with metal stents with an MD of-11.32 min (95% CI: -17.75--4.88). However, there was no difference between the two groups in terms of stent-related periprocedural adverse events, bleeding, serious bleeding, treatment success, need for necrosectomy, number of necrosectomies, number of reinterventions, need for percutaneous drainage, need for surgery, duration of hospitalisation, mortality, stent dysfunction, recurrence of WOPN, endocrine and exocrine insufficiency. The procedural costs were significantly higher for metal compared with plastic stents (MD 2.4 × 103 $, 95% CI: 1.2-3.7), with no significant difference in the overall cost.</p><p><strong>Conclusion: </strong>Except for a significantly shorter procedural duration, metal stents do not offer any significant advantage over plastic stents for WOPN drainage. Further studies are required before routinely recommending metal stents for WOPN drainage.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692157","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":"Feasibility and outcomes of laparoscopic management in perforation peritonitis: A prospective cohort study with propensity score matching.","authors":"Shruti Soni, Yash Kumar Parihar, Ramkaran Chaudhary, Naveen Sharma, Mahaveer Singh Rodha, Mahendra Lodha, Manoj Kumar Gupta, Nikhil Kothari, Aditya Baksi, Ashok Kumar Puranik","doi":"10.4103/jmas.jmas_135_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_135_25","url":null,"abstract":"<p><strong>Background: </strong>Perforation peritonitis remains a significant cause of morbidity and mortality in emergency surgical patients. Conventionally, open laparotomy has been the preferred approach. However, with advancements in minimally invasive techniques, laparoscopic management has emerged as a potential alternative. The study aims to assess the feasibility and effectiveness of laparoscopic surgery compared to open laparotomy in managing perforation peritonitis.</p><p><strong>Patients and methods: </strong>A prospective observational study was conducted from January 2022 to May 2023 for patients diagnosed with perforation peritonitis. A total of 140 patients were recruited, 110 patients underwent laparotomy while 30 patients underwent laparoscopic management. Propensity score matching (PSM) in 1:1 ratio was applied to balance confounding variables, resulting in two matched groups of 28 patients each. Operative time, length of post-operative stay, post-operative Visual Analogue Scale score, morbidity and mortality rates were compared.</p><p><strong>Results: </strong>The mean operative time was significantly longer in the laparoscopic group (217.43 ± 86.10 min) compared to the laparotomy group (182.46 ± 31.63 min; P = 0.049). However, patients in the laparoscopic group experienced a significantly shorter hospital stay (4.39 ± 2.04 days vs. 8.68 ± 3.45 days; P < 0.001) and lower post-operative pain scores at all time points (P < 0.012). The 30-day morbidity rate was lower in the laparoscopic group (10% vs. 32%), with fewer surgical site infections and reoperations.</p><p><strong>Conclusion: </strong>Laparoscopy is a feasible and effective alternative to laparotomy in selected cases of perforation peritonitis, offering benefits such as reduced post-operative pain and shorter hospital stay. Despite technical challenges, improved surgical expertise and patient selection can enhance its role in emergency surgical settings.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692165","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}