Journal of Minimal Access Surgery最新文献

{"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}

{"title":"The effects of sympathectomy ganglion levels on late complications in the treatment of hyperhidrosis.","authors":"Osman Emre Ersin, Fazli Yanik, Yekta Altemur Karamustafaoglu, Yener Yoruk","doi":"10.4103/jmas.jmas_75_24","DOIUrl":"10.4103/jmas.jmas_75_24","url":null,"abstract":"<p><strong>Introduction: </strong>Pathologically excessive sweating in areas such as the palmar, axillary and/or plantar together with sympathetic hyperactivity that occurs independently of systemic causes is called primary hyperhidrosis. Although primary idiopathic hyperhidrosis can be seen at any age, the disease is most commonly seen in adolescents and young adults. The frequency of male and female genders is usually equal. Some medical and minimally invasive methods can be used in the treatment of primary hyperhidrosis. However, the known curative gold standard treatment method for the disease is thoracoscopic thoracic sympathectomy operation.</p><p><strong>Patients and methods: </strong>In this study, a total of 150 patients who applied to Trakya University Health Practice and Research Center, Department of Thoracic Surgery, between 15 October 2008 and 15 June 2021 and underwent thoracoscopic thoracic sympathectomy due to the diagnosis of hyperhidrosis were evaluated retrospectively. The patients were separated into two groups. Thoracoscopic thoracic sympathectomy was performed on the T2-T4 in the first group (Group I - n : 88) and on the T3-T5 sympathetic ganglions in the second group (Group II - n : 62).</p><p><strong>Results: </strong>The median age of patients included in the study was found to be 24 (20.75-28) years. Group I and Group II were similar in terms of gender characteristics, but Group II was older. Our success rate was found to be 92% ( n = 138). There was no mortality, major complication such as bleeding requiring open thoracotomy, chylothorax or Horner's syndrome in any of the patients. Minor complications were seen in the early and late period of the operation at a low rate. Our overall compensatory hyperhidrosis rate was 52% ( n = 78). Compensatory hyperhidrosis was detected more in Group I, although this was not statistically significant. We determined the overall satisfaction rate of our patients as 87.3% ( n = 133). The satisfaction rates of the patients in Group I and Group II were found to be similar.</p><p><strong>Conclusions: </strong>Thoracoscopic thoracic sympathectomy is a fast, safe and minimally invasive treatment method with a low complication rate. More than 90% success and a significant increase in psychosocial condition and professional quality of life can be achieved with this procedure. Future studies are needed to reveal the relationship between operated ganglion levels and the development of compensatory hyperhidrosis.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"175-182"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752180","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":"First ever reported case of right-sided rupture of eventration of the diaphragm: Thoraco-laparoscopic approach.","authors":"Priya Gupta, Sachin Wani, Vishakha Kalikar, Roy Patankar","doi":"10.4103/jmas.jmas_333_23","DOIUrl":"10.4103/jmas.jmas_333_23","url":null,"abstract":"<p><strong>Abstract: </strong>Diaphragmatic eventration (DE) is an abnormal condition where a portion or the entire hemidiaphragm elevates due to insufficient muscle or nerve function while maintaining its anatomical attachments. On the other hand, congenital diaphragmatic hernias occur due to the abnormal development of muscular entities of the diaphragm, resulting in the displacement of abdominal contents into the thorax. The difference between diaphragmatic hernia and eventration is important as there is no true defect in DE. Ruptured eventration of the diaphragm is a rare entity, with only three cases reported in adults in literature till date, all on the left side. We report the first case of ruptured eventration of the diaphragm on the right side, which was repaired by a combination of laparoscopy and thoracoscopy and with double-mesh placement.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"205-208"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492618","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":"Analysis of risk factors for major post-operative complications following intraperitoneal hyperthermic perfusion for pseudomyxoma peritonei: A retrospective cohort study.","authors":"Xiang Zhang, Shun-Cai Gao","doi":"10.4103/jmas.jmas_299_23","DOIUrl":"10.4103/jmas.jmas_299_23","url":null,"abstract":"<p><strong>Introduction: </strong>Pseudomyxoma peritonei (PMP) is a condition characterised by the presence of gelatinous tumour-like growth within the peritoneal cavity. Combined cytoreductive surgery and intraperitoneal chemotherapy have shown to improve the survival rate in PMP patients. However, post-operative complications such as cognitive dysfunction, respiratory insufficiency and acute renal failure are still observed. This retrospective study aims to explore the risk factors associated with major post-operative complications and specifically investigate the correlation with intraoperative hypotension.</p><p><strong>Patients and methods: </strong>This retrospective cohort study included PMP patients treated at Beijing Aerospace Center Hospital from 1 June, 2014 to 30 December, 2020. The primary outcome measures were major post-operative complications, including neurological, pulmonary, cardiovascular, surgical complications, acute hepatic injury and acute kidney injuries. The secondary outcome measures included infection, fever and deep venous thrombosis. Statistical analysis was conducted using EmpowerStats and R software.</p><p><strong>Results: </strong>A total of 782 patients were screened, and 668 patients were included in the statistical analysis. Amongst them, 234 (35.03%) individuals experienced major post-operative complications. Factors such as pre-operative American Society of Anaesthesiologists grading, age, haemoglobin and albumin levels, intraoperative mean arterial pressure, blood loss, fluid replacement volume, method of intraperitoneal hyperthermic perfusion and post-operative requirement for intensive care unit mechanical ventilation were found to be correlated with major complications.</p><p><strong>Conclusion: </strong>The identified risk factors provide valuable insights for improving clinical pathways in the management of PMP. Further prospective studies are warranted to establish the association between these factors and patient outcomes.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"112-118"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140337270","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 novel technique to identify midline during endoscopic thyroidectomy.","authors":"Kamal Kataria, Richa Garg, Vikram Saini, Pritam Yadav, Sehaj Preet, Yashwant Virwadia, T Nelson","doi":"10.4103/jmas.jmas_341_23","DOIUrl":"10.4103/jmas.jmas_341_23","url":null,"abstract":"<p><strong>Abstract: </strong>Endoscopic thyroidectomy is a minimally invasive surgical approach that has become popular due to its cosmetic advantages and reduced post-operative discomfort. Central to the success of this procedure is the accurate identification of the midline, which becomes a challenge in endoscopic surgeries. We propose a novel method of using methylene blue, a Food and Drug Administration-approved dye, which offers the ability to clearly mark the midline, enhancing orientation and reducing the potential for injury to critical anatomical structures. Although using methylene blue has many benefits, there are drawbacks, including the requirement for intraoperative ultrasonography. Continued research and clinical experience will be critical in improving and extending its use in the field of thyroid surgery.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"214-216"},"PeriodicalIF":1.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425731","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}