Journal of Minimal Access Surgery最新文献

{"title":"Bariatric surgery on an outpatient basis: Our experience in a regional hospital centre and key pitfalls to avoid for enhanced success.","authors":"Maroon Tohmeh, Marc Haber, Michael S Nasr, Amelie Toussaint","doi":"10.4103/jmas.jmas_340_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_340_24","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates the feasibility and safety of outpatient management for bariatric surgery, specifically sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), within a regional hospital centre in France. It compares outcomes with existing literature and aims to identify factors affecting the success of the outpatient approach.</p><p><strong>Patients and methods: </strong>An observational, retrospective study was conducted from January 2019 to May 2024, analysing 69 outpatient bariatric surgery patients. The inclusion criteria followed the HAS guidelines. The study assessed demographic data, post-operative conversion to inpatient hospitalisation and its determinants.</p><p><strong>Results: </strong>The average patient age was 36.4 years, with a predominance of females (88.4%) and an average body mass index of 40.7 kg/m 2 . Outpatient procedures included 52 SGs and 17 RYGBs. Conversion to inpatient hospitalisation occurred in 29% of the patients due to issues of unrelieved pain and food intolerance. Eight patients visited the emergency department postoperatively and seven patients required readmissions for complications. No mortality was reported. Mild obstructive sleep apnoea was independently associated with increased odds of conversion to inpatient hospitalisation (adjusted odds ratio [OR]: 3.91, 95% confidence interval [CI]: 1.02-15.00), while increasing age was associated with decreased odds (adjusted OR: 0.93 per year, 95% CI: 0.87-0.99).</p><p><strong>Discussion: </strong>Outpatient bariatric surgery, particularly for selected patients, is generally feasible and safe. However, the study observed a higher conversion rate compared to other centers, attributed to patient selection, pain management and post-operative complications. Effective pre-operative evaluation, refined patient selection, improved post-operative care, patient education on pain and expectations are crucial for optimising outcomes.</p><p><strong>Conclusion: </strong>Outpatient bariatric surgery can be successful with expert surgical and anaesthetic management, proper patient selection and rigorous post-operative protocols.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel technical modification for surgical treatment of achalasia: Submucosal injection to facilitate safe oesophagomyotomy.","authors":"Francisco Javier Pérez Lara, Tatiana Prieto-Puga Arjona, Daniel Gonzalez Plo, Maria Pitarch Martinez, Patricia Maldonado Validivieso, Carmen Rueda Cruces","doi":"10.4103/jmas.jmas_363_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_363_24","url":null,"abstract":"<p><strong>Abstract: </strong>Achalasia is a primary ES motility disorder in which the lower oesophageal sphincter does not relax properly, and there is no peristalsis. Surgical management of this condition is most often performed using the procedure known as oesophagomyotomy; however, this procedure carries a risk of mucosal perforation, which is dangerous to the patient. We propose a technical modification consisting of submucosal hydrodissection so as to perform oesophagomyotomy more safely. The new technique of injecting saline into the submucosal space enables us to part the mucosa and submucosa from the muscularis, making the dissection easier and minimising the risk of damaging the mucosa. In this article, we have described about this technique, basic advantages and limited outcomes of the patients who have underwent into this kind of modification.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148800284","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":"Study on endoscopic management of foreign bodies in the upper gastrointestinal tract and practice recommendations for rural surgeons.","authors":"Easwaramoorthy Sundaram, Sonal Kapoor, Emaya Anand, Reshma Leandra Sivaprakasam, Nikita Agrawal, Haridra Sundararajan, Aishwarya Sunil Dutt","doi":"10.4103/jmas.jmas_432_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_432_25","url":null,"abstract":"<p><strong>Introduction: </strong>Foreign bodies (FBs) in the upper gastrointestinal (GI) tract often present as a surgical emergency. Swift diagnosis and an expert endoscopic management are paramount for a good outcome. In this study, we reviewed the endoscopic management of 60 cases of FB in the upper GI tract and outlined the recommendations for such an emergency in a rural setting.</p><p><strong>Patients and methods: </strong>This was a retrospective study on 60 consecutive patients with FB ingestion who underwent endoscopic removal of FB over 12 months. The present study aimed to assess the effectiveness of various endoscopic tools and techniques for retrieving different foreign objects, along with their associated success rates.</p><p><strong>Results: </strong>Amongst the 60 patients, 38 were male and the remaining 22 were female. The mean age of the patients was 36.4 years. Most cases presented with ingestion of blunt objects (36.7%), followed by food bolus (30%), sharps (18.3%) and finally long objects (15%). Most FBs were seen lodged in the lower oesophagus. Rat-toothed forceps and Roth Net ® were the common endoscopic tools used for FB retrieval.</p><p><strong>Discussion: </strong>The FB oesophagus needs immediate attention and removal within 24 h to avoid the risk of perforation and aspiration. Button battery, denture with sharp wire and impacted fish or chicken bones are problem cases and need immediate attention by experts. If the FB is already in the stomach and beyond, one may choose to observe for spontaneous expulsion in the next 2-5 days. In adults, removal can be accomplished under xylocaine spray or conscious sedation, but in children, it invariably requires the presence of an anaesthetist and general anaesthesia, as airway control is vital.</p><p><strong>Conclusion: </strong>Endoscopic removal of FB from the upper GI tract is safe and effective, provided the right tools, team and technical expertise are available. An endoscopic skillset is essential for future surgeons.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148799865","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":"Conventional versus laparoscopic ventriculoperitoneal shunt placement: A retrospective study with prospectively collected data.","authors":"Anshul Gupta, Ashish Dey, Anurag Jain, Tamajit Chakraborty, Sneyhil Tyagi, Samir Kumar Kalra, Rajesh Acharya, Satnam Singh Chhabra, Shresth Manglik, Anmol Ahuja, Tarun Mittal","doi":"10.4103/jmas.jmas_431_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_431_25","url":null,"abstract":"<p><strong>Introduction: </strong>Ventriculoperitoneal (VP) shunt placement is among the most common neurosurgical procedures. Distal shunt failure remains a significant complication, often necessitating revision surgery. Laparoscopic placement offers direct visualisation of catheter positioning and cerebrospinal fluid flow confirmation. This study compares outcomes of open mini-laparotomy versus laparoscopic distal catheter placement.</p><p><strong>Patients and methods: </strong>A retrospective observational study of 150 patients (75 per group) undergoing VP shunt placement at Sir Ganga Ram Hospital, New Delhi, from May 2017 to April 2020. Group A underwent open mini-laparotomy; Group B underwent laparoscopic distal catheter placement. The primary outcome was distal shunt failure requiring revision surgery. Secondary outcomes included operative duration, post-operative pain (Visual Analogue Scale [VAS]), analgesic requirements, bowel recovery, and hospital stay.</p><p><strong>Results: </strong>Groups were comparable in demographics. Mean total operative time was similar (86.7 ± 16.7 vs. 87.7 ± 17.0 min; P = 0.699). Abdominal operative time was significantly shorter in Group B (28.5 ± 5.3 vs. 37.7 ± 7.2 min; P < 0.001). Mean VAS score was significantly lower in Group B (2.45 ± 1.09 vs. 4.19 ± 1.15; P < 0.001). Post-operative nausea/vomiting (10.7% vs. 26.7%; P = 0.012), analgesic requirement on post-operative day (POD) 2 (26.7% vs. 58.7%; P < 0.001), and bowel recovery time (2.61 ± 1.10 vs. 6.04 ± 1.86 h; P < 0.001) all favoured Group B. Shunt revision rate was significantly lower in Group B (4% vs. 17.3%; P = 0.015).</p><p><strong>Conclusions: </strong>Laparoscopic distal VP shunt placement is safe, feasible, and associated with significantly lower shunt revision rates and superior perioperative recovery compared to open mini-laparotomy.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708184","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":"GelPOINT single-incision access with yellow enhancement imaging for endoscopic gynecomastia surgery.","authors":"Subhash Khanna, Areendam Barua, Swagata Khanna","doi":"10.4103/jmas.jmas_560_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_560_25","url":null,"abstract":"<p><strong>Introduction: </strong>Standard endoscopic gynecomastia surgery, while offering better cosmetic outcomes than open procedures, is often hindered by suboptimal visualization of the glandular-adipose interface, instrument clashing due to multiple concealed ports, and the risk of nipple-areolar complex (NAC) ischemia. This paper describes a technical modification using a single-incision platform and advanced imaging to overcome these limitations.</p><p><strong>Methods: </strong>The authors utilize the GelPOINT Mini platform for single-site access through a concealed 3-cm incision behind the anterior axillary fold. To enhance visualization, the VISERA ELITE III Yellow Enhancement (YE) imaging system is employed. This technology brightens fat-rich yellow tissues, allowing for a clearer distinction between the glandular tissue and overlying fat. This technique is specifically indicated for Simon Grade IIa-IIb patients with firm glandular tissue and minimal skin excess.</p><p><strong>Results: </strong>The single-incision approach eliminates instrument clashing and poor triangulation associated with multi-port techniques. The use of YE imaging facilitates a more precise dissection in the plane beneath the NAC, reducing the risk of vascular compromise, residual pathology, and contour irregularities.</p><p><strong>Conclusion: </strong>The integration of a single-port platform with Yellow Enhancement imaging offers a refined approach to endoscopic gynecomastia surgery. By improving visualization and ergonomics, this modification enhances surgical precision and aesthetic outcomes while minimizing visible scarring.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of the improved SELECT concept in the diagnosis and treatment of hepatic echinococcosis.","authors":"Jianguo Feng, Fucai Ma, Xiaosong Wang, Yan Wang, Changzhen Shang, Haihong Zhu","doi":"10.4103/jmas.jmas_552_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_552_25","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Hepatic echinococcosis is a zoonotic parasitic disease caused by the larvae of the tapeworm Echinococcus granulosus . It is prevalent in high-altitude pastoral regions such as Qinghai, China, posing a serious threat to the health of local residents. Due to its insidious early symptoms, many patients present at an advanced stage, with lesions often invading critical vascular structures. This results in significant treatment challenges and a high incidence of post-operative complications. The traditional single-modality diagnostic and therapeutic approach faces challenges, necessitating an integrated strategy to optimise the clinical pathway.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This article aims to systematically elaborate on the enhanced SELECT concept based on multi-endoscopic technology. By comparing it with conventional approaches, this study evaluates its clinical value in the one-stop precision diagnosis and treatment of hepatic echinococcosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This study is a comprehensive literature review and conceptual exposition. Systematic searches were conducted in databases, including PubMed, Web of Science, China National Knowledge Infrastructure and Wanfang Data Knowledge Service Platform. Search terms encompassed 'hepatic echinococcosis', 'combined endoscopic techniques', 'SELECT concept', 'Spyglass (digital single-operator cholangioscopy system)', 'endoscopic retrograde cholangiopancreatography, ERCP,' 'laparoscopic hepatectomy', 'endoscopic ultrasound, EUS,' 'choledochoscopy' and 'autologous liver transplantation'. The time span covered the period from database inception to June 2025. In addition, drawing on the extensive surgical experience documented in the literature, this review summarises and analyses the technical essentials, indications and unique advantages of each component of the SELECT approach in the diagnosis and treatment of hepatic echinococcosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The improved SELECT concept integrates multiple endoscopic and surgical techniques to achieve precise pre-operative assessment, intra-operative manipulation and minimally invasive management of post-operative complications for hepatic echinococcosis, particularly in complex cases. This model optimises the diagnostic and therapeutic process through a one-stop service, potentially reducing post-operative recurrence rates and complications while conserving medical resources. Recent basic research (such as the effects of Thymbra spicata L. essential oil) has also provided new perspectives for adjunctive therapies in echinococcosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The improved SELECT diagnostic and treatment model utilising multiple imaging modalities represents an effective strategy for managing complex hepatic echinococcosis, particularly in the high-burden regions with relatively scarce medical resources. Future research should further validate its long-term efficacy through prospective clinical","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708221","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 subtotal cholecystectomy for difficult gall bladder disease: Outcomes of a reconstituting technique at a tertiary care centre.","authors":"Mahesh Kumar Sethi, Washim Firoz Khan, Aditya Baksi, Aditya Kumar, Yashvant Singh Rathode, Sandeep Aggarwal, Puneet Khanna, Hemanga K Bhattacharjee","doi":"10.4103/jmas.jmas_79_26","DOIUrl":"https://doi.org/10.4103/jmas.jmas_79_26","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic subtotal cholecystectomy (LSC) serves as a \"bailout\" technique in difficult intraoperative scenarios, which preserves the advantages of laparoscopy while ensuring patient safety. This study analyses the indications, intraoperative challenges and outcomes of LSC in a tertiary care teaching hospital.</p><p><strong>Patients and methods: </strong>A retrospective review was conducted of patients who underwent cholecystectomy between June 2021 and November 2024. Patients were categorised into laparoscopic total cholecystectomy (LTC), LSC and laparoscopic converted to open cholecystectomy (LCOC). The primary endpoint was to compare the post-operative morbidity between the three groups using Clavien-Dindo grading system, while secondary outcomes included early and late post-operative outcomes.</p><p><strong>Results: </strong>Of the 872 patients, 805 (92.3%) underwent LTC, 64 (7.3%) LSC and 3 (0.4%) LCOC. Among LSC cases, 81.3% were Nassar Grade III-IV, reflecting its need in higher intraoperative difficulty. Bile leak occurred in 3 (4.7%) patients of LSC group. LSC showed 52 patients (81.3%) had no complication, 5 (7.8%) had Grade I, 6 (9.3%) Grade II and 1 (1.6%) Grade III complications. The median post-operative hospital stay was longer in LSC (2 days) compared with LCOC (5 days). Two (3.9%) patients in LSC group had stump cholelithiasis with cholecystitis and had to undergo of redo completion cholecystectomy.</p><p><strong>Conclusion: </strong>LSC should be used cautiously as a bailout procedure reserved for difficult gall bladders when safe dissection is not possible, rather than as a risk-free substitute for standard cholecystectomy, because it was associated with lower risk of bile duct injury but carries its own long-term morbidity.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708245","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":"Incidence and factors associated with de novo cholelithiasis formation following bariatric surgery: A multicentre, retrospective cohort study.","authors":"Bahador Oshidari, Mohadeseh Pishgahroudsari, Fahimeh Yarigholi, Foolad Eghbali","doi":"10.4103/jmas.jmas_344_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_344_25","url":null,"abstract":"<p><strong>Introduction: </strong>Bariatric surgery is an approved method of weight loss, while the post-operative complications are still under the question. This study aimed to estimate the incidence of de novo cholelithiasis (CL) and factors associated with it.</p><p><strong>Patients and methods: </strong>In this study, 4618 patients who underwent one-anastomosis gastric bypass (OAGB), laparoscopic sleeve gastrectomy (LSG) or Roux-en-Y gastric bypass (RYGB) completed 12 months' follow-up. Ultrasound examination was performed at 12 months after surgery to detect CL formation. Multivariable analyses were performed to identify CL predictors using the SPSS software version 11.5.</p><p><strong>Results: </strong>The incidence rate of gallstone formation was 9.42% (435 events; 95% confidence interval: 8.61%-10.30%). This rate differed among the surgical groups: 5.02% for RYGB, 16.0% for LSG and 6.55% for OAGB ( P < 0.001 for inter-group comparison). The frequency of dyslipidaemia ( P = 0.015) and total weight loss (TWL) ( P = 0.008) was different between patients with and without CL. In logistic regression, 12-month TWL (odds ratio [OR] =1.028, P = 0.004) and having dyslipidaemia before surgery (OR = 1.424, P = 0.011) were the significant factors.</p><p><strong>Conclusions: </strong>The significance of careful selection of the appropriate bariatric surgery for each patient, in addition to close monitoring and applying preventive measures in individuals with a high risk of CL formation. Further prospective research is required to confirm these findings while clarifying the underlying mechanisms linking bariatric surgery to CL formation.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708234","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":"Revision after gastric sleeve and gastric bypass for weight re-gain: Emphasis on biliopancreatic limb length across procedures.","authors":"Jacob C Benna, Cameron Shonnard, Felipe D Diaz-Valadez, Kent C Sasse","doi":"10.4103/jmas.jmas_254_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_254_25","url":null,"abstract":"<p><strong>Introduction: </strong>This report describes a series of gastric sleeve revision procedures stemming from the common indications of weight re-gain, diabetes mellitus (T2) and gastro-oesophageal reflux disease. The aim is to report the outcomes of a revisional strategy emphasising the lengthening of the biliopancreatic (BP) limb as a central principle and assessing its efficacy in achieving weight loss and remission of obesity-related conditions.</p><p><strong>Patients and methods: </strong>Revisional procedures were conducted from 2019 to 2022, encompassing 19 laparoscopic Roux-en-Y gastric bypass (LRYGB), 40 limb distalisation with lengthening of the BP limb and 95 Single Anastomosis Duodenal Switch (SADI) cases. A standardised approach maintained a 300 cm common channel and a minimum 375 cm alimentary length while adding 100 cm or more of BP limb length. Monitoring included weight loss, comorbidity resolution and complications. Data were collected from the patient charts.</p><p><strong>Results: </strong>Reduction in body mass index (BMI) at 6-month follow-up was 18.7% for LRYGB, 21.8% for SADI and 11.1% for BP patients. Single-factor ANOVA showed statistical significance for BMI change in all three groups (LRYGB P = 0.01; SADI P = 0.006 and BP P = 0.02). Three SADI patients required reoperation; meanwhile, 2 LRYGB, 2 BP and 5 SADI patients experienced post-operative vitamin deficiencies.</p><p><strong>Conclusion: </strong>Revisional bariatric surgery demonstrates substantial weight and BMI reduction with relatively few complications. SADI procedures exhibited the greatest BMI reduction at 6 months. The emphasis on lengthening the BP limb may provide a structured framework for successful revision surgery decisions, potentially contributing to the standardisation of care across procedures in this context.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708278","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":"Management of an unsuspected double gall bladder.","authors":"Suvir Kumar Gupta, Rajal Jani","doi":"10.4103/jmas.jmas_292_26","DOIUrl":"https://doi.org/10.4103/jmas.jmas_292_26","url":null,"abstract":"<p><strong>Abstract: </strong>Gall bladder duplication is a rare congenital anomaly that is often asymptomatic and frequently goes undiagnosed until surgery. We present the case of a 47-year-old female who reported abdominal pain, vomiting, loss of appetite and generalised weakness. Initial imaging, including ultrasound and magnetic resonance cholangiopancreatography, identified cholelithiasis but did not reveal the presence of a duplicated gall bladder. During a laparoscopic cholecystectomy, a double gall bladder with two separate cystic ducts was unexpectedly discovered. Both gall bladders were successfully removed using standard laparoscopic techniques. Histopathological examination confirmed chronic cholecystitis in both specimens. This case highlights the challenges in pre-operative diagnosis of biliary anomalies and underscores the importance of intraoperative vigilance.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708243","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}