Journal of Minimal Access Surgery最新文献

{"title":"Demographic and clinical predictors of bariatric surgery patients: A retrospective cohort study.","authors":"Raghad Abdulmohsen Aljuhani, Fatma Elsayed Hassan, Zainab Jasim AlQurain, Tanveer Nidal Khan, Doaa A Turkistani, Mohammed Ahmed Alabbadi","doi":"10.4103/jmas.jmas_377_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_377_24","url":null,"abstract":"<p><strong>Introduction: </strong>The significant rise in bariatric procedures (BPs) reflects the global increase in obesity. In Saudi Arabia, obesity prevalence is notably high at 35.6%, surpassing the global average. This retrospective cohort study primarily aims to identify demographic and clinical predictors influencing BP uptake among individuals at a single healthcare centre in Jeddah, Saudi Arabia. Secondarily, it evaluates the effectiveness of BPs, particularly laparoscopic sleeve gastrectomy (LSG), in reducing body mass index (BMI) and obesity-related comorbidities.</p><p><strong>Patients and methods: </strong>Data were extracted from the hospital's registry between October 2023 and June 2024. The study population included obese adults of varying ages, genders and comorbidities who underwent bariatric surgery. However, the single-centre design limited generalisability, long-term outcome data were unavailable and contextual factors, such as socioeconomic status and health literacy, were not captured.</p><p><strong>Results: </strong>A cohort of 208 patients was analysed, 64.9% females and 34.2% males, with a mean age of 36 ± 11.2 years. The pre-operative BMI was 44.10 ± 6.2 kg/m² (P = 0.462), which decreased to 35.1 ± 6.5 kg/m² (P = 0.577) postoperatively, reflecting a mean reduction of 9.03 ± 4.9 kg/m² (20.5%) (P = 0.255). LSG was the most performed BP at 93.3%. The most prevalent obesity-related comorbidities identified were hypertension, diabetes and GIT disease including gall bladder disorders (15.9%, 13.9% and 13.5%, respectively).</p><p><strong>Conclusions: </strong>This study highlights the increasing prevalence of BP, particularly among young, predominantly female patients. LSG demonstrated substantial effectiveness, achieving a 20.5% reduction in BMI and improvement in obesity-related comorbidities. Future research could explore more patient demographics that could not be analysed in this study.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694216","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":"Robot-assisted lateral pancreaticojejunostomy in a patient with chronic pancreatitis and history of liver transplantation.","authors":"Boštjan Plešnik, Jan Grosek, Blaž Trotovšek, Aleš Tomažic, Miha Petric","doi":"10.4103/jmas.jmas_347_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_347_24","url":null,"abstract":"<p><strong>Abstract: </strong>A 52-year-old female patient with a history of liver transplantation due to alcoholic liver cirrhosis presented with persistent post-prandial pain, leading to substantial weight loss of 16 kg. The findings of contrast-enhanced computed tomography were consistent with the diagnosis of chronic pancreatitis, and endoscopic treatment provided no functional improvement. The patient was scheduled for a robot-assisted lateral pancreaticojejunostomy which was performed after initial lysis of adhesions from her prior liver transplantation. The procedure was completed safely using the robotic da Vinci Xi platform in 180 min, with an estimated blood loss of 300 mL. During the post-operative course, anaemia was noted and treated with a blood transfusion, and the patient was discharged on the post-operative day 4. The patient fully recovered without post-prandial pain and began regaining weight 1 month after the procedure. To the best of our knowledge, this is the first report of a successful robot-assisted lateral pancreaticojejunostomy following prior liver transplantation.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694143","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 evaluation of enhanced total extraperitoneal repair and intraperitoneal onlay mesh repair-plus for ventral hernias: A randomised controlled study.","authors":"Shikha Singh, Himanshu Agrawal, Aditya Kumar, Nitin Agarwal, Nikhil Gupta","doi":"10.4103/jmas.jmas_379_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_379_24","url":null,"abstract":"<p><strong>Introduction: </strong>Ventral hernia repair techniques have evolved, with enhanced total extraperitoneal repair (eTEP) and intraperitoneal onlay mesh repair-plus (IPOM+) emerging as alternatives. While eTEP avoids complications such as adhesions and infections associated with intraperitoneal mesh placement, its effectiveness compared to IPOM+ remains debated. To compare the outcomes of eTEP and IPOM+ in primary midline ventral hernia repair, focusing on post-operative pain, complications and early recurrence rates.</p><p><strong>Patients and methods: </strong>A randomised controlled study was conducted in a tertiary hospital in Delhi from August 2022 to February 2024. Forty-eight patients with primary midline ventral hernias (defect size: 2-6 cm) were randomised into eTEP (n = 24) and IPOM+ (n = 24) groups. Outcomes included operative time, pain scores (evaluated at 6 h, 24 h, 7 days, 1 month and 3 months), analgesic use, complications (seroma and surgical site infections) and recurrence rates.</p><p><strong>Results: </strong>eTEP had significantly longer operative time (115.83 ± 36.30 min vs. 63.94 ± 10.94 min; P < 0.001) but significantly lower pain scores at 6 and 24 h (P < 0.001). Analgesic requirements were reduced in the eTEP group, with only two patients requiring rescue analgesia compared to 20 in the IPOM+ group (P < 0.001). No significant differences were observed in seroma rates, surgical site infections or recurrence at 3 months.</p><p><strong>Conclusions: </strong>eTEP offers reduced early post-operative pain and lower analgesic use compared to IPOM+, with similar complication and recurrence rates. Despite longer operative times, eTEP provides a viable alternative for ventral hernia repair with potential quality-of-life benefits.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694213","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":"Osteitis pubis after laparoscopic totally extraperitoneal inguinal hernia repair: An uncommon complication - Report of two cases.","authors":"Sanjay Marwah, Mahavir Singh, Deepanshu Lather, Ritesh Kumar","doi":"10.4103/jmas.jmas_259_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_259_24","url":null,"abstract":"<p><strong>Abstract: </strong>Osteitis pubis is a well-known complication of urologic and gynecologic procedures but its association with hernioplasty is poorly documented in the literature. We are reporting two cases of osteitis pubis following laparoscopic hernia repair. In first case, a 52-year-old man underwent bilateral totally extra-peritoneal repair (TEP) for bilateral inguinal hernia. Mesh fixation was done with metallic (titanium) tackers at iliopubic tract. Two weeks later he complained of sharp stabbing pain in the pubic area and dull aching pain on inner aspect of right thigh more during abduction and extension of hip joint. There was no associated fever or local signs of acute inflammation. Roentgenogram and MRI showed changes typical of osteitis pubis. There was no evidence of infection in the urinary tract or elsewhere. The patient was managed conservatively with analgesics and physiotherapy. Patient recovered well. In second case, a 40-years-old male underwent bilateral totally extra-peritoneal repair (TEP) for bilateral inguinal hernia with mesh fixation with metallic tackers at iliopubic tract. After 20 days of surgery patient developed pain on medial aspect of thigh which was exaggerated on extension and abduction at hip joint. Again, Roentgenogram and MRI showed changes typical of osteitis pubis. This patient was also managed conservatively on same line as previous case.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694140","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":"Laparoscopic treatment of a Nuck cyst with an inguinal hernia.","authors":"Carlos Alfredo Mares, Salvador Cristobal De Las Casas, Maria Valeria Vega, Wilfredo Bozzo","doi":"10.4103/jmas.jmas_389_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_389_24","url":null,"abstract":"<p><strong>Abstract: </strong>Nuck's canal cysts are rare surgical embryological anomalies primarily observed in females under 5 years of age. They occur due to a failure of the processus vaginalis to completely obliterate, a process that should be complete within the first year of life. Clinically, these cysts manifest as a mass in the inguinal region or labia majora, which may or may not be associated with pain. This report presents the case of a 29-year-old female patient who presented with a painful mass in the right inguinal region. An abdominal wall ultrasound and magnetic resonance imaging revealed a right inguinal cystic lesion. A diagnostic and therapeutic laparoscopy was performed and revealed a cystic tumour adjacent to the round ligament. The tumour was treated through a transabdominal preperitoneal approach. The patient was discharged without complications and experienced no complications during subsequent follow-ups.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694223","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":"Single-stage robot-assisted repair of symptomatic inguinal and Morgagni hernias in an adult male.","authors":"Sydney C Bertram, Savannah H Skidmore, Daniel Akyeampong, Mike M Mallah, Stephen A Fann","doi":"10.4103/jmas.jmas_281_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_281_24","url":null,"abstract":"<p><strong>Abstract: </strong>While laparoscopic and robotic repair of diaphragmatic hernias has recently become commonplace, minimally invasive single-stage procedures combining diaphragmatic hernia repair with another procedure remain rare. Our patient is a 61-year-old male presenting with a left-sided inguinal bulge and later dyspnoea, found to have concomitant left inguinal hernia and Morgagni-type diaphragmatic hernia. The patient was taken to the operating room for simultaneous robotic repair of both hernias. The procedure was completed robotically using two different docking orientations with the same three 8-mm port sites. The inguinal hernia was repaired using a standard transabdominal preperitoneal approach, and the Morgagni hernia was repaired primarily and reinforced with porcine biologic mesh. The procedure was without complication and the patient's symptoms resolved. We infer from our experience that simultaneous robotic repair of multiple hernia types is feasible and may decrease patient anaesthesia episodes as well as surgeon fatigue associated with laparoscopic and open approaches.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694242","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":"From flab to fab: A cross-sectional study for cultural adaptation and validation of the Fat Phobia Scale-Short Form in India.","authors":"Kumari Rina, Rosali Bhoi, Anubhav Vindal, Pawanindra Lal","doi":"10.4103/jmas.jmas_271_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_271_24","url":null,"abstract":"<p><strong>Background: </strong>Due to the lack of a validated instrument to measure fatphobia, its epidemiology in India remains unknown. This study aimed to culturally adapt and validate the Fat Phobia Scale-Short Form (FPS-SF) in Hindi.</p><p><strong>Patients and methods: </strong>A cross-sectional study using a purposive sampling technique was conducted in the metabolic surgery clinic of a tertiary care teaching institution. We followed the World Health Organization's procedure for cultural adaptation and validation of an instrument. The study was biphasic. The phase-1 entailed forward translation, formation of an expert panel, backward translation and cognitive interviewing with the two groups of seven individuals, each with severe obesity. During phase-2, 175 participants (students [n = 120], patients [n = 55]) were recruited after written informed consent. Hindi-FPS-SF was administered to students twice, 1 week apart. All participants completed Hindi-FPS-SF, Modified Weight Bias Internalization Scale (Hindi-WBIS-M), Patient Health Questionnaire (Hindi-PHQ-9) and Generalised Anxiety Disorder Questionnaire (Hindi-GAD-7). Statistical analysis was done.</p><p><strong>Results: </strong>Several items of forward-translated Hindi-FPS-SF underwent culture-specific modifications in Phase-1. Content or curricular validity and face validity were assessed. In Phase-2, the reliability and validity of Hindi-FPS-SF were evaluated. The internal consistency (Cronbach's alpha), intra-class correlation type-A coefficient (ICC) and cross-cultural reliability were α =0.902 (P < 0.001), 0.799 (95% CI = 0.753-0.840) (P < 0.001) and (ICC: 0.865-0.992) (P < 0.001), respectively. The convergent-construct validity assessed by correlations between total scores of Hindi-WBIS-M and Hindi-FPS-SF was significant. Criterion validity measured through correlations with original FPS-SF, Hindi-WBIS-M, PHQ-9 and GAD-7 was significant.</p><p><strong>Conclusions: </strong>The Hindi-FPS-SF demonstrated good psychometric properties and may be used to measure fat phobia and its correlates in India for epidemiological purposes.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694220","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":"Closure of contralateral patent processus vaginalis in laparoscopic unilateral inguinal hernia repair: Is it necessary?","authors":"Amar Shah, Ria Sharma, Anirudh Shah","doi":"10.4103/jmas.jmas_329_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_329_24","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopy has increasingly become a preferred method for repairing inguinal hernias in children. However, there is ongoing debate about the necessity of closing the contralateral open internal ring during laparoscopic repair of symptomatic unilateral hernias. This study aimed to determine the incidence of contralateral patent processus vaginalis (PPV) in children undergoing laparoscopic inguinal hernia repair and to evaluate whether closure of the contralateral ring is warranted in asymptomatic patients.</p><p><strong>Patients and methods: </strong>This study included all children who presented to us with unilateral inguinal hernia. The parameters examined comprised age, gender, side of hernia, the incidence of contralateral PPV and complications. The study was conducted in two phases, each lasting 5 years. In the first phase, if the contralateral processus vaginalis was patent, it was closed following the repair of the symptomatic side. In the second phase, only the symptomatic side was repaired, and the contralateral processus vaginalis was left untreated if patent. All repairs were performed laparoscopically by a single surgeon. The results were analysed to assess the rationale for laparoscopic closure of asymptomatic contralateral PPV.</p><p><strong>Results: </strong>A total of 1300 patients with unilateral inguinal hernia without any associated pathologies were included in this 10-year study. Six hundred and fifty cases were analysed in each of the two 5-year phases. The mean age of the patients was 34 months (1 month-13 years). Of the participants, 73% were male and 27% were female. The surgical procedure involved ligating the hernia sac (PPV) at the internal ring without division. Follow-up durations varied from 6 months to 5 years, with a mean of 4.2 years. In phase 1, 247 children (38%) had a contralateral PPV (asymptomatic side), which was subsequently closed. In phase 2, 260 children (40%) had a contralateral PPV (asymptomatic side) which was left untreated. Development of a metachronous hernia was seen in only 10% of these cases where the PPV was not closed.</p><p><strong>Conclusion: </strong>Our results show that upfront closure of the contralateral open ring in children with unilateral inguinal hernia is unnecessary. These patients can be monitored, and the contralateral side should only be repaired if a clinically significant hernia develops.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568628","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":"When 'winner winner chicken dinner' turned into a catastrophe: Intestinal perforation, a case of acute abdomen, a clinical case study.","authors":"Queena Sheryl Dsouza, Hansa Dhar, Atif Naeem Raja, Qamariya Ambusaidi, Teena Sheethal Dsouza, Abhishek Singh Nayyar","doi":"10.4103/jmas.jmas_203_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_203_24","url":null,"abstract":"<p><strong>Abstract: </strong>Intestinal perforation due to an ingested foreign body is a serious complication; although it is often misdiagnosed, while treatment gets delayed due to non-specific symptoms. The present case report describes the case of small bowel perforation due to an ingested chicken bone wherein a 35-year-old female patient presented to the emergency department with a complaint of lower abdominal pain for 2 days. Based on history and symptom review, initially, a working diagnosis of a case of the ruptured haemorrhagic cyst was given, while the ultrasonography findings of the abdomen and pelvis, also, pointed towards a similar diagnosis. As the symptoms worsened, a computed tomography (CT) scan of the abdomen was advised to rule-out acute appendicitis, although, the CT findings revealed a foreign body perforating the small bowel. The patient was subsequently advised laparoscopy-assisted foreign body removal with segmental jejunal resection and an end-to-end anastomosis. The patient had an uneventful post-operative recovery, and was eventually, discharged on the 2nd post-operative day.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568636","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":"Randomised comparison between navigation and non-navigation-assisted camera control performance in a surgical simulation task using a haptic device interface.","authors":"Nergiz Ercil Cagiltay, Damla Topalli, Emre Tuner, Mustafa Berker","doi":"10.4103/jmas.jmas_335_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_335_24","url":null,"abstract":"<p><strong>Introduction: </strong>Navigation skills for controlling the camera in the surgical field are critical for many minimally invasive surgery (MIS) procedures. Currently, endoscopes lack integrated navigation aids, making camera control a challenging task. This experimental study aims to investigate the effect of navigation guidance on the performance of beginners.</p><p><strong>Patients and methods: </strong>A custom computer-based simulation environment was developed for this study, featuring two conditions - one with navigation guidance and one without - focussed on a camera-cleaning task. Participants (64 beginners) were randomly assigned to one of these groups and used two haptic devices to simulate the endoscope and surgical tools.</p><p><strong>Results: </strong>Participants in the guided condition performed significantly better than those in the unguided condition. Notably, female participants completed the task in significantly less time under the guided condition compared to the unguided one.</p><p><strong>Conclusion: </strong>These findings suggest that incorporating navigation aids into endoscope interfaces could improve user performance, especially for beginners. Medical device manufacturers should consider adding navigation features to enhance usability. In addition, simulation-based instructional systems should integrate navigation aids to better support surgical training.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568631","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}