Journal of Minimal Access Surgery最新文献

{"title":"Effect of scrotal support application on seroma formation following minimal access surgery for inguinal hernia: A randomised controlled trial.","authors":"Satya Prakash Meena, Mayank Badkur, Mahendra Lodha, Mahaveer Singh Rodha, Ramkaran Chaudhary, Naveen Sharma, Niladri Banerjee, Spoorthi D Shetty","doi":"10.4103/jmas.jmas_85_24","DOIUrl":"10.4103/jmas.jmas_85_24","url":null,"abstract":"<p><strong>Background: </strong>The incidence of seroma formation is high following laparoscopic surgery for an inguinal hernia. Literature has shown many intraoperative techniques to reduce post-operative seroma formation. The hypothesis was made that scrotal support may reduce seroma formation following laparoscopic or robotic hernia surgery. This study aimed to compare the post-operative outcome of uncomplicated inguinal hernia patients with or without scrotal support application.</p><p><strong>Patients and methods: </strong>A randomised controlled trial was conducted on 266 male patients with inguinal hernias. A block randomisation was done, and accordingly, a scrotal support was applied after mobilisation of study patients following laparoscopic or robotic surgery. After discharge, all patients were followed up for 30 days and their outcomes were compared.</p><p><strong>Results: </strong>Post-operative numbness after hernia surgery was significantly reduced with the application of scrotal support ( P = 0.03). However, there were no significant differences in the early post-operative period for seroma formation, scrotal oedema, scrotal haematoma, surgical site infections, epididymo-orchitis or groin pain between the groups.</p><p><strong>Conclusion: </strong>A scrotal support application is not effective at reducing the formation of seroma after laparoscopic or robotic inguinal hernia repairs. Early post-operative groin numbness may be reduced by including scrotal support in post-operative care protocols.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"169-174"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced view totally extraperitoneal approach: The best available option for recurrent incisional hernias following previous laparoscopic intraperitoneal onlay mesh plus repairs.","authors":"K Ganesh Shenoy","doi":"10.4103/jmas.jmas_152_24","DOIUrl":"10.4103/jmas.jmas_152_24","url":null,"abstract":"<p><strong>Abstract: </strong>The available options for recurrent incisional hernias (RIH) following previous laparoscopic intraperitoneal onlay mesh (IPOM) plus were open onlay repair, open Rives-Stoppa (RS), laparoscopic enhanced view totally extraperitoneal-RS (ETEP-RS) and laparoscopic subcutaneous onlay mesh repair. Majority of these RIH were managed by open onlay mesh repairs or laparoscopic Redo IPOM plus. There are not much data available in the literature on the ETEP approach for RIH following previous IPOM plus with the placement of mesh in the retrorectus space. In this article, I would like to share technical aspects, challenges faced and tips to overcome these challenges of performing ETEP for RIH following previous IPOM plus repairs.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"217-222"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478507","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of low-pressure pneumoperitoneum and deep neuromuscular blockade on surgeon satisfaction and patient outcomes in laparoscopic cholecystectomy patients: A prospective randomised controlled study.","authors":"Alparslan Koç, Ufuk Memiş, Didem Onk, Talha Karataş, Mustafa Gazi, Ali Caner Sayar, Muhammet Ali Arı","doi":"10.4103/jmas.jmas_78_24","DOIUrl":"10.4103/jmas.jmas_78_24","url":null,"abstract":"<p><strong>Introduction: </strong>The impact of laparoscopic surgery on homeostatic systems necessitates careful consideration of intra-abdominal pressure (IAP) management. This study investigated the effects of low-pressure pneumoperitoneum with deep neuromuscular blockade (NMB) on surgeon satisfaction, haemodynamics and post-operative outcomes in laparoscopic cholecystectomy patients.</p><p><strong>Patients and methods: </strong>The study design involves prospective randomised control. Ninety patients were assigned to low (7-10 mmHg, n = 45) or normal (12-16 mmHg, n = 45) IAP groups. Deep NMB, guided by train-of-four monitoring, was administered. This study evaluated surgical rating scale scores, haemodynamics and post-operative outcomes through a literature review. A computer programme (IBM, SPSS) was used for statistical analysis. Chi-square and Mann-Whitney U tests were used to analyse patients' IAP levels, additional NMB requirements, surgical rating scale scores and numerical rating scales. Patient demographics and other intraoperative and post-operative variables were analysed with Student's t -test and the Mann-Whitney U test. Values of P < 0.05 were considered to indicate statistical significance.</p><p><strong>Results: </strong>No significant demographic differences were observed. The low-pressure group exhibited lower post-operative pain ( P < 0.01) and reduced analgesia requirements ( P = 0.00). On analysis of the surgeon rating scale, no disparities were evident between the groups. NMB usage correlated with height and weight ( P < 0.01). Heart rate showed no intergroup differences. The MAP measured after 15 min was lower in Group L, and the difference was significant ( P = 0.023). The SAP measured after 30 min was lower in Group L, and the difference was significant ( P = 0.017). Blood gas values and surgical field visibility were unaffected by the IAP. The positive correlations between NMB, height and weight aligned with previous research.</p><p><strong>Conclusion: </strong>This study highlights successful laparoscopic cholecystectomy under low IAP, deep NMB and favourable post-operative outcomes. Despite these limitations, the findings contribute to optimising laparoscopic surgical approaches.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"183-188"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the educational value of laparoscopic radical nephrectomy videos on YouTube®: A comparative analysis of short versus long videos.","authors":"Muharrem Baturu, Mehmet Öztürk, Ömer Bayrak, Sakıp Erturhan, Ilker Seckiner","doi":"10.4103/jmas.jmas_355_23","DOIUrl":"10.4103/jmas.jmas_355_23","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the quality of laparoscopic radical nephrectomy videos and determine the extent to which they are informative and educational for healthcare professionals.</p><p><strong>Patients and methods: </strong>We used the YouTube ® search engine to search for the term 'laparoscopic radical nephrectomy' with time filters of 4-20 min (Group 1) and >20 min (Group 2) and then sorted the results uploaded chronologically before January 2023. One hundred videos were analysed for each group. The reliability of the videos was assessed using the Journal of American Medical Association (JAMA) Benchmark Criteria and DISCERN questionnaire scores (DISCERN). Educational quality was assessed using the Global Quality Score (GQS) and a 20-item objective scoring system (OSS) for laparoscopic nephrectomy. The popularity of the videos was evaluated using the video power index (VPI).</p><p><strong>Results: </strong>The mean video duration was 8.9 ± 4.3 min in Group 1 and 52.02 ± 31.09 min in Group 2 ( P < 0.001). The mean JAMA (2.49 ± 0.61) and OSS scores (60 ± 12.3) were higher in Group 2 than in Group 1, while no significant difference was observed in the mean GQS (2.53 ± 0.7, 2.39 ± 0.88, respectively) between the groups ( P < 0.001, P = 0.039, P = 0.131, respectively).</p><p><strong>Conclusion: </strong>While the standardisation of surgical videos published on YouTube ® and the establishment of auditing mechanisms do not seem plausible, high total OSS, periprocedural OSS, and VPI scores, and high OSS, JAMAS, GQS and DISCERN scores in long videos indicate that such videos offer a greater contribution to education.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"119-125"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adrenal pheochromocytoma masquerading as a hydatid cyst: A case report and review of literature.","authors":"Mehul Saxena, Shubhajeet Roy, Kushagra Gaurav, Akshay Anand, Chanchal Rana, Abhinav Arun Sonkar","doi":"10.4103/jmas.jmas_329_23","DOIUrl":"10.4103/jmas.jmas_329_23","url":null,"abstract":"<p><strong>Abstract: </strong>Hydatid cysts, caused by Echinococcus larval infections, are common in certain regions. In an unusual medical case, a 26-year-old female with a hydatid cyst was unexpectedly found to have an adrenal pheochromocytoma, a rare tumour producing catecholamines. She initially complained of persistent, non-specific right upper abdominal pain. Imaging revealed a cystic lesion resembling a hydatid cyst. During surgery, unexpected arrhythmia and electrocardiographic changes led to the suspicion of acute coronary syndrome, halting the procedure. Further investigation revealed elevated urinary metanephrine levels and a suspicious soft-tissue mass, resulting in laparoscopic right adrenalectomy with hypertensive spikes. The patient was successfully managed, and post-operative examination confirmed the adrenal pheochromocytoma. Hydatid cysts usually present with non-specific symptoms and are diagnosed through imaging. Similarly, diagnosing cystic pheochromocytomas is challenging without typical symptoms, potentially leading to intraoperative complications. Misdiagnosed cases can result in hypertensive crises and hypotension, requiring specific management. Due to their variable presentation and rarity, pheochromocytomas are often misdiagnosed.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":"21 2","pages":"209-213"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic hernia repair with the novel HUGO robot system - An initial experience from a tertiary centre.","authors":"S Gilbert Samuel Jebakumar, Sudeepta Kumar Swain, Venkatesh Munikrishnan, Loganathan Jayapal, R Santhosh Kumar, Aravind Baskaran, Siddhesh Tasgaonkar, Sumanth Srivatsan","doi":"10.4103/jmas.jmas_193_23","DOIUrl":"10.4103/jmas.jmas_193_23","url":null,"abstract":"<p><strong>Background: </strong>Hernia repair using robotic platforms has been on the rise in the last decade. The HUGO robotic-assisted surgery (RAS) system, introduced in 2021, is a new addition to the field. In this study, we share our experience with this innovative system for the management of ventral and groin hernias.</p><p><strong>Patients and methods: </strong>The aim of our study was to evaluate the feasibility and safety of using the HUGO robotic platform for hernia surgeries. We conducted a retrospective analysis of all hernia surgeries performed with the HUGO system over a 1-year study period. The study assessed various aspects, including the technical manoeuvres of the robotic system, duration of surgery, length of hospital stay, post-operative pain levels and 30-day morbidity rates.</p><p><strong>Results and conclusions: </strong>A total of seven hernia surgeries were performed using the HUGO system, including five ventral hernias and two groin hernias. The average duration of surgery was 128 min, with a docking duration of 22.8 min. Notably, there were no intraoperative or post-operative adverse events reported during these procedures. The HUGO system features an open console that provides a panoramic view of the operating room. In addition, the individual arm carts can be easily manoeuvred around the operating table, facilitating improved access to multiple quadrants during surgery. In our case series, Robotic hernia repair using the HUGO system has demonstrated feasibility, with post-operative outcomes comparable to traditional approaches. This innovative system serves as an additional tool in the armamentarium of hernia surgery and shows potential for improving surgical outcomes. However, further investigation through large-scale prospective studies is necessary to comprehensively evaluate its efficacy and benefits.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"195-199"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awake thoracoscopic non-anatomic pulmonary resections under thoracic paravertebral block: Results of a tertiary referral centre.","authors":"Onur Derdiyok, Uğur Temel","doi":"10.4103/jmas.jmas_124_24","DOIUrl":"10.4103/jmas.jmas_124_24","url":null,"abstract":"<p><strong>Introduction: </strong>Awake video-assisted thoracoscopic surgery (VATS) helps to avoid the adverse effects of general anaesthesia (GA) with single-lung ventilation. Its usage in anatomic and non-anatomic pulmonary resections has spread worldwide, and it is mostly performed under thoracic epidural analgesia (TEA). We herein report our surgical experience with awake VATS non-anatomical resections under the thoracic paravertebral block (TPB).</p><p><strong>Patients and methods: </strong>This retrospective, single-centred study reviewed patients undergoing awake VATS non-anatomical pulmonary resection under TPB, who voluntarily accepted awake VATS despite being suitable for GA and were found unsuitable for GA based on pre-operative assessment results. Demographic, pre-, per- and post-operative data were collected, analysed and compared with the literature data.</p><p><strong>Results: </strong>Twenty-four patients (16 patients with normal pre-operative assessment results and 8 patients having high risk for GA) were selected. Fourteen bullectomies for recurrent spontaneous pneumothorax and 10 wedge resections (nine for metastasectomy and one for lung biopsy) were performed. Global in-operating room time was 77 ± 31 min. The morbidity rate was 20.8% ( n = 5), including prolonged air leak in three and pneumonia in two patients. The mean duration of the chest tube was 1.9 ± 1.5 days and mean duration of hospital stay was 3.5 ± 2.1 days. There was no in-hospital mortality. Our results were mostly similar to the literature data.</p><p><strong>Conclusion: </strong>Non-anatomical lung resections by VATS can be performed easily and safely under TPB in awake patients. Although the perioperative and post-operative outcomes are not superior to other anaesthesia approaches, preferring TPB may help to avoid the serious potential complications of TEA.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"189-194"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of surgically performed continuous superficial serratus anterior plane block in uniportal video-assisted thoracic surgery.","authors":"Giovanni Punzo, Dania Nachira, Giuseppe Calabrese, Chiara Cambise, Maria Teresa Congedo, Maria Letizia Vita, Elisa Meacci, Stefano Margaritora","doi":"10.4103/jmas.jmas_345_23","DOIUrl":"10.4103/jmas.jmas_345_23","url":null,"abstract":"<p><strong>Introduction: </strong>The 'surgically performed' continuous superficial serratus anterior plane block (continuous s-SAPB) was never described before in uniportal video-assisted thoracic surgery (uniportal VATS) surgery. The aim of the study was to evaluate the safety and efficacy of the technique.</p><p><strong>Patients and methods: </strong>Between March 2022 and April 2023, 50 patients, undergone uniportal VATS surgery at our thoracic surgery department, were scheduled for a surgically performed continuous s-SAPB as post-operative analgesia protocol.</p><p><strong>Results: </strong>The mean execution time for the block was 3.92 ± 2.56 min. Ten patients (20%) required morphine for a visual analogue scale (VAS) score >4 immediately after surgery. The recorded VAS score at chest tube removal was 1.87 ± 1.41, whereas 2 h after the manoeuvre was 0.42 ± 0.72. No complication related to block insertion was recorded. The onset of chronic pain was observed in a total of 2 patients (4%).</p><p><strong>Conclusions: </strong>The surgically performed continuous s-SAPB in uniportal VATS seems to be safe and easy to perform, and it provides a satisfactory analgesic effect.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"162-168"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-pressure pneumoperitoneum with intraoperative dexmedetomidine infusion in laparoscopic cholecystectomy for enhanced recovery after surgery: A prospective randomised controlled clinical trial.","authors":"Sucheta Gaiwal, J H Palep, Rohini Mirkute, Nimitha Prasad, Mehta Kush","doi":"10.4103/jmas.jmas_69_24","DOIUrl":"10.4103/jmas.jmas_69_24","url":null,"abstract":"<p><strong>Background: </strong>Enhanced Recovery After Surgery (ERAS) programs represent a shift in perioperative care, combining evidence-based interventions to reduce surgical stress to expedite recovery. ERAS requires cohesive team efforts to facilitate early discharge and reduce hospital stays. Anaesthesia and pneumoperitoneum management within ERAS play crucial roles in influencing postoperative outcomes. Laparoscopic cholecystectomy is widely acknowledged as the foremost approach for managing symptomatic gallstone disease due to its minimally invasive nature and favourable recovery. It has been demonstrated that increased abdominal pressures with prolonged CO2 exposure produce changes in cardio-vascular and pulmonary dynamics, which can be minimized by insufflating at minimum pressure required for adequate exposure, as advocated by European endoscopic guidelines. Dexmedetomidine, a highly selective alpha-2 adrenoreceptor agonist, has gained attention in anaesthesia armamentarium due to its sedative, analgesic, sympatholytic, and opioid-sparing properties. For multimodal opioid sparing postoperative pain management it's advantageous.</p><p><strong>Aim: </strong>To evaluate combined effect of low-pressure pneumoperitoneum and intra-operative dexmedetomidine infusion in laparoscopic cholecystectomy for ERAS.</p><p><strong>Patients and methods: </strong>160 patients of American Society of Anaesthesiologists (ASA) score 1 and 2, undergoing elective laparoscopic cholecystectomy were randomized into low pressure pneumoperitoneum (10-12 mmHg) and standard pressure pneumoperitoneum (13-15 mmHg) groups. Each group is subdivided into, no Dexmedetomidine (ND) and with Dexmedetomidine (WD) infusion (0.7 mcg/kg/hr) intra-operatively. Thus, 40 patients in each of the 4 study arms. Perioperative variables were collected and analysed.</p><p><strong>Results and conclusions: </strong>Low pressure pneumoperitoneum with intra-operative Dexmedetomidine infusion (0.7 mcg/kg/hr) resulted in stable hemodynamics, reduced post-operative pain, no requirement of additional analgesics and early discharge. Thus, synergistic impact of these interventions significantly improved postoperative outcomes when used as part of ERAS protocols.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"147-152"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography roadmap for post-operative fundoplication imaging with a novel structured reporting checklist.","authors":"Ritesh Kamat, Roy Patankar, Avinash Supe, Pallavi Dubey, Ravi Thapar, Vishakha Kalikar","doi":"10.4103/jmas.jmas_325_23","DOIUrl":"10.4103/jmas.jmas_325_23","url":null,"abstract":"<p><strong>Introduction: </strong>With increasing numbers and acceptability of laparoscopic anti-reflux surgery (LARS) procedures over long-term medical treatment in the past decade, it follows that the complications of fundoplication wrap are seen intermittently with recurrent symptoms of heartburn and dysphagia. Endoscopy and barium swallow are the initial investigations performed for suspected fundoplication wrap failures. However, with easy availability of multislice computed tomography (CT) and the multiplanar reconstructions along with reduction in familiarity with barium examinations, it would be prudent for the surgeons to familiarise themselves with various appearances of wrap failure. Currently, there is no accepted standard to report a fundoplication wrap failure. We did a thorough literature review on the use of CT scans for fundoplication wrap failure, created a multidisciplinary hernia team with prominent radiologists and surgeons and discussed the role of CT scans in the management of suspected wrap failure. After completing a pilot study with around 43 patients of wrap failure, we created a standard CT reporting format which helped us in the management of even the most complex cases. This standard reporting format can be used by trainees and surgeons worldwide. This would lead to uniformity in reporting, would help in decision-making and would also help create national and international primary wrap failure and redo fundoplication registry.</p><p><strong>Patients and methods: </strong>A total of 43 patients of wrap failure of multislice CT evaluation were analysed for type of failure along with factors responsible for the maintenance of integrity of the wrap. A novel checklist with structured reporting was used for the description of the post-operative imaging findings.</p><p><strong>Results: </strong>The demographic characteristics, post-operative imaging and intraoperative findings were described. The different types of wrap failure - Hinder types and associated pathologies were analysed for relative frequency in wrap failures. The novel structured reporting included wrap integrity and failure complications in post-operative patients of LARS.</p><p><strong>Conclusion: </strong>Fundoplication wrap failure is not an uncommon complication seen after LARS. A novel structured report with checklist will help the surgeons to evaluate the post-operative patient with recurrent symptoms. Multislice CT is the ideal modality for imaging suspected wrap failures after primary endoscopic evaluation. Multiplanar imaging with coronal and sagittal reconstructions is useful for understanding the integrity of the wrap and its ability to detect failure/migration.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"153-161"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}