Journal of Minimal Access Surgery最新文献

{"title":"Robotic transabdominal preperitoneal repair of the left-sided secondary lumbar hernia.","authors":"Krishna Venkata Rajesh Varma Chundru, P Reddy Abhinaya, Kumbhar Uday Shamrao","doi":"10.4103/jmas.jmas_354_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_354_24","url":null,"abstract":"<p><strong>Abstract: </strong>Lumbar hernias (LHs) are exceedingly rare, with definite management being surgery immediately upon diagnosis when the patient is medically fit. Herein, we report the case of a male patient in his mid-40s who presented with acquired left LH secondary to transabdominal percutaneous drainage of necrotic collection in a case of necrotising pancreatitis as a part of a step-up approach. He underwent robotic transabdominal preperitoneal repair using 15 cm × 12 cm polypropylene mesh. He was discharged on the second post-operative day. The patient returned to regular activity within 10 days, and at 2-month follow-up, he continued with routine daily activities. Robotic repair of the LH is feasible and safe with the advantage of having a three-dimensional high-definition vision, better ergonomics, intuitive motion, higher precision, tremor filtration and self-camera control.</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":"144692171","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":"Safety and feasibility of concomitant ventral hernia repair and total laparoscopic hysterectomy: A single-centre experience of over 1000 cases.","authors":"Pradeep Joshua Christopher, Rajapandian Subbiah, Parthasarathi Ramakrishnan, Anand Vijai Natesan, Kavitha Yogini Duraisamy, Praveen Raj Palanivelu, Palanivelu Chinnusamy","doi":"10.4103/jmas.jmas_2_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_2_25","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic ventral hernia surgery has become the standard of care for most surgeons, offering improved patient outcomes, shorter hospital stays, and fewer complications compared to open surgeries. However, the benefits of combining Intraperitoneal Onlay Meshplasty (IPOM) with other surgeries are rarely discussed and not commonly practiced. This study examines the safety of placing mesh after Total Laparoscopic Hysterectomy (TLH) based on a single center's retrospective experience of over 1,000 cases spanning 15 years.</p><p><strong>Materials and methods: </strong>Data of all the patients who underwent concomitant TLH with IPOM were collected retrospectively. Details of the surgery, immediate post-op outcomes, long term follow ups with complications and recurrences were analysed.</p><p><strong>Results: </strong>Between January 2006 and January 2021, we reviewed 1,273 cases, of which 1,058 met our inclusion and exclusion criteria. There were no open conversions. The mean patient age was 48.23 years with a standard deviation (SD) of 2.19. The mean BMI was 33.21 kg/m² with an SD of 1.83. The average defect size was 5.8 cm with an SD of 1.65. The mean operating time was 231 minutes with an SD of 10.15. The average hospital stay was 3.2 days with an SD of 0.84. There were no 30 day readmissions or mortality. Out of 1,058 cases, 782 patients had a minimum follow-up period of 2 years, conducted through telephone conversations or in-person hospital visits. An additional 155 patients had at least 1 year of follow-up, while 121 patients were lost to follow-up within the first year. The median follow-up duration for all patients was 2.8 years. 52 cases (4.9%) experienced postoperative seroma. We had only one case (0.094%) of mesh infection, which required mesh explantation. There were two instances of recurrence (0.189%): one patient underwent open repair after 24 months, and another underwent eTEP repair 32 months after the initial surgery. Both patients completed 1 year of follow-up post-second procedure and were doing well.</p><p><strong>Conclusion: </strong>Meshes can be safely placed in a clean, contaminated environment alongside total laparoscopic hysterectomy, with the discretion of the operating surgeon considering his expertise and judgment. We can conclude that combining ventral hernia repairs with TLH is safe and feasible with acceptable morbidity.</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":"144692172","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":"Demographics, complications and outcomes of laparoscopic appendectomy in paediatric patients: A 15-year study from western India.","authors":"Prativa Choudhury, Amar Shah, Ria Sharma, Anirudh Shah","doi":"10.4103/jmas.jmas_348_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_348_24","url":null,"abstract":"<p><strong>Introduction: </strong>Acute appendicitis is one of the most common causes of abdominal pain in children and is considered the most frequent paediatric surgical emergency. The incidence progresses from extremely low in the neonatal period to a peak incidence between ages 12 and 18 years. Prompt diagnosis and management are imperative to prevent serious complications such as perforation, peritonitis, intra-abdominal abscess formation and bowel obstruction. Laparoscopy has improved intra- and post-operative outcomes for children with appendicitis. This study was conducted to evaluate demographics and complications of laparoscopic appendicectomy in Indian children.</p><p><strong>Patients and methods: </strong>This is a retrospective cohort study encompassing 714 consecutive patients of appendicitis operated over 15 years (2006-2021) by a single surgeon at a high-volume private paediatric surgical centre in Western India. Data collected included age and gender, duration of surgery and post-operative variables such as length of stay and early or delayed interventions, if any. The patients were categorised into two groups: complicated appendicitis and non-complicated appendicitis, depending on the operative findings. Patients with acutely inflamed appendix without perforation, peritonitis or collection and patients with chronically inflamed appendix were categorised as non-complicated appendicitis. Patients with perforated or gangrenous appendicitis, appendicular lump and appendicitis with intraperitoneal collection were categorised as complicated appendicitis. Additional pathologies found and treated during the surgery were also documented. The statistical analysis was performed using IBM SPSS Statistics 28.0.0.0.</p><p><strong>Results: </strong>The total cohort of patients who underwent laparoscopic appendectomy in the study was 714. The number of male patients was significantly greater than the female population (P < 0.001). The total number of cases of non-complicated appendicitis was 580 (81.23%). Patients with uncomplicated appendicitis had a mean age of 9.12 ± 3.65 years, while those with complicated appendicitis had a mean age of 7.49 ± 3.58 years. Additional pathologies such as simple ovarian cyst, Meckel's diverticulum and Enterobius vermicularis were found in 11.55% of uncomplicated cases. Post-operative complications were observed to be higher in the complicated group (27.6%) compared to the uncomplicated group (1.72%).</p><p><strong>Conclusion: </strong>This study shows that acute appendicitis affects our study population at a mean age of 8.84 years, with a majority of males (64.14%). It also shows that complicated appendicitis has a higher incidence of post-operative complications of 27.6% and prolonged hospital stay. A multicentre research across various states in India can help establish a clear outlook regarding the demographics of complicated and uncomplicated paediatric appendicitis in the country.</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":"144692162","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 experimental investigation of the split-attention effect on endoscopic surgical performance.","authors":"Erol Ozcelik, Damla Topalli, Nergiz Ercil Cagiltay","doi":"10.4103/jmas.jmas_5_25","DOIUrl":"10.4103/jmas.jmas_5_25","url":null,"abstract":"<p><strong>Introduction: </strong>Surgeons in the operating theatre frequently need to split their attention, such as when switching between the monitor and radiological images during endoscopic surgery. This split attention can lead to cognitive overload, potentially impacting performance. Despite this, limited research has been conducted on how split attention affects surgical outcomes.</p><p><strong>Patients and methods: </strong>This study examines the impact of split attention on surgical performance in a simulation-based training environment with two conditions: A far-condition (where information sources were spaced farther apart) and a near-condition (where sources were positioned closer together). A total of 53 participants (13 experienced surgical residents and 40 beginners) completed ten trials in each condition.</p><p><strong>Results: </strong>The results indicated that split attention led to diminished performance in beginners but not in residents. These findings suggest that expertise plays a crucial role in managing cognitive load for surgeons.</p><p><strong>Conclusion: </strong>The study highlights the need to develop training curricula that promote the automation of surgical skills through practice, allowing surgeons to allocate more cognitive resources effectively.</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":"144692155","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":"Cholecystectomy clip-induced biliary stone: Case report and literature review.","authors":"Sabo Tanimu, Reilly A Coombs, Yusuf Tanimu, Adedayo A Onitilo","doi":"10.4103/jmas.jmas_323_23","DOIUrl":"10.4103/jmas.jmas_323_23","url":null,"abstract":"<p><strong>Abstract: </strong>Migration of cholecystectomy surgical clip into the common bile duct with subsequent stone formation is a rare phenomenon, one which may lead to complications including obstruction, pain, nausea, vomiting and fever. The mechanism of migration is largely unknown but may result from a combination of factors including necrosis, intra-abdominal pressure or poor surgical technique with migrated clip serving as a nidus for stone formation. We present a 55-year-old woman with clip-induced stone impacted at the distal common bile duct 12 years post-cholecystectomy and a review of the literature related to cholecystectomy clip stone formation. In addition, we reviewed relevant English language case reports and literature reviews by searching PubMed using search terms 'stone', 'clip', 'cholecystectomy' and 'biliary'. There was no limit to the date of publication. Our study found 68 unduplicated cases of clip-induced stones which had a wide range of onset and presenting systems. Further research is needed to identify risk factors, methods of prevention and benefits of early detection screening.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"306-311"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716546","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":"Subcutaneous endoscopic surgery for plicating divarication of recti and epigastric hernia repair in a child.","authors":"Suresh Kumar Thanneeru, Reyaz Ahmad, Chandrakala Singh Rajput, Amit Gupta","doi":"10.4103/jmas.jmas_76_24","DOIUrl":"10.4103/jmas.jmas_76_24","url":null,"abstract":"<p><strong>Abstract: </strong>Epigastric hernia with divarication of recti is uncommon in children, and the aetiology remains incompletely understood - as does the optimal management strategy - whether to repair epigastric hernia alone or both defects. We present an innovative technique utilising subcutaneous endoscopic surgery to address both epigastric hernia and divarication in children. Our approach yields excellent cosmetic outcomes, avoids the need for a larger laparotomy scar and mitigates the risks associated with the transperitoneal laparoscopic approach. It is a viable option with all the advantages of minimally invasive surgery for repairing epigastric hernia and divarication of recti in symptomatic cases, particularly when the aetiology is uncertain and multiple defects are anticipated. Its use may be extrapolated to isolated diastasis recti as working in subcutaneous space involves lesser risk with excellent cosmesis.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"326-328"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879714","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":"A rare case of transverse testicular ectopia associated with polyorchidism addressed by minimally invasive surgery: A case report.","authors":"Mario Alberto Riquelme, Ana Cantu-Zendejas, Carlos Rodriguez","doi":"10.4103/jmas.jmas_30_24","DOIUrl":"10.4103/jmas.jmas_30_24","url":null,"abstract":"<p><strong>Abstract: </strong>This report describes the rare case of transverse testicular ectopia (TTE) associated with polyorchidism in a 16-month-old male, successfully managed through laparoscopic surgery. The patient presented with bilateral cryptorchidism, a palpable mass in the right inguinal canal and an absent left-side gonad. Ultrasound revealed three gonad-like structures. Laparoscopy identified duplicated and fused testes at the right deep inguinal ring, and a third testis in the right inguinal canal. Minimally invasive techniques positioned the duplicated testes in the right hemiscrotum and the single testis in the left hemiscrotum. Post-operative follow-up confirmed optimal scrotal positioning, with normal growth. This rare case underscores the efficacy of laparoscopy in diagnosing and managing rare paediatric conditions, providing valuable insights for surgeons facing cryptorchidism or scrotal masses.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"312-314"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576684","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":"Self-gripping mesh in laparoscopic inguinal hernia repair: A comparative study about surgical time, post-operative pain and recurrence.","authors":"Lucía Aragone, Mariana Toffolo Pasquini, Raul Croceri, Pablo Medina, Daniel Pirchi","doi":"10.4103/jmas.jmas_62_24","DOIUrl":"10.4103/jmas.jmas_62_24","url":null,"abstract":"<p><strong>Introduction: </strong>In laparoscopic inguinal hernia repair (LIHR), fixation means for meshes (FMMs) are commonly used to reduce hernia recurrence risk. Their use may result in post-operative pain (PP) and may even increase surgical time (ST). Recently, self-gripping meshes (SGMs) have been developed, which leave aside fixation devices; they could potentially reduce PP and even decrease ST. Our primary outcome was to compare ST, PP and recurrence rates in LIHR using SGM versus FMM.</p><p><strong>Patients and methods: </strong>A comparative retrospective study with prospective case registry was conducted. All patients who underwent LIHR with transabdominal pre-peritoneal approach from January to December 2022 in a high-volume centre were analysed. Patients were divided into two groups according to the type of mesh used in surgery (SGM vs. FMM). Demographic variables, hernia type and size, mesh type and size, ST, PP, recurrence and other morbidities were compared between the groups.</p><p><strong>Results: </strong>A total of 411 LIHRs were performed during the period, of which 283 were included in the study. Of these, 234 patients were repaired with FMM and 49 with SGM. ST had a statistically significant reduction in the SGM group ( P = 0.0004) with a mean time of 58.9 min (±13.6), compared to 68.1 min (±18.9) for the FMM group. A trend towards lower PP in the SGM group was noted ( P = 0.08). No recurrences were found in the SGM group with a median follow-up of 18 months (interquartile range: 3).</p><p><strong>Conclusions: </strong>SGMs have proven to be a safe, efficient and fast for LIHR in our series. They are a feasible alternative for LIHR, reducing ST and potentially reducing PP. Prospective randomised trials are needed to confirm this trend, along with a longer follow-up period to determine potential advantages in terms of recurrences.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"292-296"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886278","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":"Intrapancreatic accessory spleen mimicking a pancreatic neuroendocrine tumour - An important but almost forgotten differential diagnosis.","authors":"Kaique Flavio Xavier Cardoso Filardi, José Donizeti de Meira Júnior, Thiago Nogueira Costa, André Montagnini, Ismael Dominguez-Rosado, Carlos Chan, José Jukemura, Paulo Herman","doi":"10.4103/jmas.jmas_245_24","DOIUrl":"10.4103/jmas.jmas_245_24","url":null,"abstract":"<p><strong>Abstract: </strong>Intrapancreatic accessory spleen (IPAS) is a rare condition resulting from the failure of embryological splenic buds to fuse. Found in approximately 1.1% to 3.4% of the population, IPAS can present significant diagnostic challenges, often mimicking pancreatic tumours such as pancreatic neuroendocrine tumours. We report two cases of IPAS, each illustrating different diagnostic approaches and outcomes. These cases highlight the importance of considering IPAS in differential diagnoses for hypervascular pancreatic tail lesions. Advanced imaging techniques such as magnetic resonance imaging, computerised tomography, technetium-99m scintigraphy and endoscopic ultrasound-guided fine-needle aspiration are critical in distinguishing IPAS from malignant conditions, potentially preventing unwarranted surgical interventions. Comprehensive diagnostic protocols combining multiple modalities are recommended to enhance diagnostic accuracy and optimise patient outcomes.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"321-325"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327783/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Roux-en-Y hepaticojejunostomy for post-cholecystectomy type IIIb benign biliary stricture with internal duodenal fistula: A case report with surgical video.","authors":"Lokesh Agarwal, Kaushal Singh Rathore, Vaibhav Kumar Varshney, Subhash Chandra Soni, B Selvakumar, Peeyush Varshney, Ashish Agarwal","doi":"10.4103/jmas.jmas_322_24","DOIUrl":"10.4103/jmas.jmas_322_24","url":null,"abstract":"<p><strong>Abstract: </strong>Laparoscopic cholecystectomy (LC) is a widely performed procedure, but it can be complicated by iatrogenic bile duct injuries, leading to benign biliary strictures (BBS). This report details the case of a 38-year-old man with a Bismuth type IIIb BBS and an internal duodenal fistula following LC. He underwent a totally laparoscopic Roux-en-Y hepaticojejunostomy (RYHJ), a technically demanding procedure, particularly in the presence of complex biliary strictures. The surgery involved meticulous dissection and the creation of a wide hepaticojejunostomy. The patient had an uneventful recovery, with discharge on the post-operative day 4. At 18-month follow-up, he remains asymptomatic with normal liver function. This case demonstrates the feasibility and effectiveness of laparoscopic RYHJ in managing complex BBS, offering the advantages of minimally invasive surgery, including reduced post-operative pain and shorter hospital stay, while ensuring favourable long-term outcomes.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":"21 3","pages":"318-320"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627452","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}