Journal of Minimal Access Surgery最新文献

{"title":"Stitch-induced caecal fecolith: An unusual long-term complication following laparoscopic appendicectomy.","authors":"S Sree Subramaniyan, Sri Vengadesh Gopal","doi":"10.4103/jmas.jmas_14_23","DOIUrl":"10.4103/jmas.jmas_14_23","url":null,"abstract":"<p><strong>Abstract: </strong>A fecolith is a mass of accumulated hardened faecal matter usually seen in patients with Chagas disease, Hirschsprung's disease and inflammatory bowel disease. We report a 21-year-old female with chronic right lower abdominal pain post-appendicectomy. An abdominal computed tomography revealed a fecolith near the caecum and a right simple ovarian cyst. On diagnostic laparoscopy, a Prolene stitch in the previous appendicectomy site acting as a nidus and forming a fecolith was noted. It was excised by a small enterotomy and primary closure of the same. She had an uneventful post-operative course. This case highlights the danger of using a non-absorbable suture for appendicectomy and the rare phenomenon of fecolith formation post-appendicectomy after 4 years presenting with features of chronic recurrent abdominal pain.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"71-73"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10598256","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 versus laparoscopic intersphincteric resection for patients with low rectal cancer: Short-term outcomes.","authors":"Wei Ge, Li-Hua Shao, Yu-Dong Qiu, Gang Chen","doi":"10.4103/jmas.jmas_320_23","DOIUrl":"10.4103/jmas.jmas_320_23","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the short-term outcomes between laparoscopic intersphincteric resection (L-ISR) and robotic intersphincteric resection (R-ISR) for low rectal cancer.</p><p><strong>Patients and methods: </strong>We performed a retrospective clinical analysis between August 2018 and August 2021 at the Department Of General Surgery, the Affiliated Hospital of Nanjing University Medical School.</p><p><strong>Results: </strong>A total of 28 patients were recruited in this research. Among these patients, there were 12 patients who underwent L-ISR and assigned to L-ISR group, and the remaining 16 patients underwent R-ISR and assigned to R-ISR group. The time to start oral fluids, time to start soft diet and time to first motion in R-ISR group were earlier than those in L-ISR group ( P < 0.05). The hospital stay in R-ISR group was shorter than that in L-ISR group ( P < 0.05). However, the operation time of R-ISR was longer compared to L-ISR group ( P < 0.05). Most important of all, the Kelly score in R-ISR group was 5.1 ± 0.9, which was higher than that in L-ISR group ( P = 0.004).</p><p><strong>Conclusion: </strong>R-ISR is safe and feasible for patients with low rectal cancer. R-ISR is superior to L-ISR despite the operation time of R-ISR is longer. A randomised controlled trial will be performed to confirm the conclusion further.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"60-65"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886276","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":"Conversion of 2-dimensional to 3-dimensional mesh for resource-limited centres in developing countries.","authors":"Shaikh Nazrah, Shrivastava Rajesh","doi":"10.4103/jmas.jmas_52_24","DOIUrl":"10.4103/jmas.jmas_52_24","url":null,"abstract":"<p><strong>Background: </strong>In recent years, laparoscopic hernia repair, i.e. transabdominal pre-peritoneal and totally extraperitoneal repairs have been considered the method of choice, especially for recurrent hernias after open repair or bilateral inguinal hernias. However, they pose numerous challenges such as increased post-operative pain due to tacking or fixation of mesh, chronic pain syndrome due to entrapment of nerves and mesh migration or invagination. A 3-dimensional (3D) mesh was introduced to overcome the shortcomings of a 2-dimensional (2D) mesh which does not conform to inguinal anatomy. However, in a resource-limited country like India, the widespread use of a 3D mesh may not be possible owing to its high cost.</p><p><strong>Patients and methods: </strong>We included a total of 55 patients in our study who underwent laparoscopic extended totally extraperitoneal repair hernia repair for 1 year beginning from December 2021 to November 2022 with a follow-up of a minimum of 1 year till November 2023. In our study group ( n = 27), we used a novel technique of converting a 2D mesh to a 3D mesh, which was subsequently placed without fixation. In our control group ( n = 28), we used a standard polypropylene mesh with one-point suture fixation.</p><p><strong>Results and conclusions: </strong>All patients in our study showed satisfactory post-operative recovery. There was no significant difference in the post-operative pain (assessed by mean Visual Analogue Scores 1.24 ± 0.44 vs. 1.87 ± 0.56; P > 0.1) and the mean length of hospital stay in days (1.12 ± 0.33 vs. 1.16 ± 0.38; P > 0.1), respectively, in the study and control groups. None of our patients showed signs or symptoms of chronic pain or recurrence in our period of follow-up. Our technique of converting 2D to 3D mesh is a safe and feasible approach and maybe a potential alternative to a traditional 3D mesh in resource-limited settings.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"93-96"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced view totally extraperitoneal approach: A better alternative to transabdominal preperitoneal approach for irreducible inguinoscrotal and giant inguinal hernias!","authors":"K Ganesh Shenoy","doi":"10.4103/jmas.jmas_243_23","DOIUrl":"10.4103/jmas.jmas_243_23","url":null,"abstract":"<p><strong>Abstract: </strong>The advantages of enhanced view totally extraperitoneal (eTEP) over TEP approach are well established in large inguinoscrotal, recurrent inguinal, patients with short pubis to umbilicus distance and in obese patients. Irreducible inguinoscrotal hernias (IISHs) and giant inguinal hernias (GIHs) pose a great challenge. GIHs are hernias which extend below the midpoint of the inner thigh with the patient in the standing position. Majority of these hernias are managed by open, hybrid or by transabdominal pre-peritoneal (TAPP) approach. TAPP was considered the optimal minimally invasive approach for these hernias as it provides a large working space and reduction of contents under vision. My practice of eTEP has been limited to IISH and GIH. I would like to share some technical tips to manage these cases by eTEP approach.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"97-99"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41240099","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":"Incidental detection of rare vascular variation during pyeloplasty and its clinical implication - A case report.","authors":"Deepak Prakash Bhirud, Shashank Shekhar Tripathi, Amit Aggarwal, Mahendra Singh","doi":"10.4103/jmas.jmas_154_23","DOIUrl":"10.4103/jmas.jmas_154_23","url":null,"abstract":"<p><strong>Abstract: </strong>Crossing vessels is one of the important causes of pelviureteric junction obstruction (PUJO). Accessory lower polar vessels are commonly seen with congenital PUJO, but they are not always the cause of obstruction. We incidentally encountered a variation in the lower polar crossing vessel while doing laparoscopic pyeloplasty in a patient with congenital PUJO. We encountered a right accessory lower polar artery and vein along with a right gonadal artery arising from the accessory right renal artery and right gonadal vein draining into the right lower polar crossing accessory renal vein. Knowledge of variations in genitourinary vasculature is important in the current era to prevent inadvertent complications.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"80-82"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716547","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":"Outcomes following laparoscopic adrenalectomy: Experience of more than two decades at a tertiary care centre.","authors":"Virinder Kumar Bansal, Krishna Asuri, Deepti Singh, Keshav Agarwal, Raghunandan Dixit, Om Prakash, Subodh Kumar, Rajeshwari Subramaniam, Rashmi Ramachandran, Nikhil Tandon, M C Misra","doi":"10.4103/jmas.jmas_8_24","DOIUrl":"10.4103/jmas.jmas_8_24","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic transperitoneal adrenalectomy was first described by Gagner M et al . Here, we present our experience of more than two decades of laparoscopic adrenalectomy performed in a single surgical unit at a tertiary care centre.</p><p><strong>Patients and methods: </strong>A prospectively collected database of patients undergoing laparoscopic adrenalectomy from December 1994 to May 2020 was analysed retrospectively. The demographic profile, details of clinical workup and laboratory parameters were recorded in a pre-structured pro forma. Functional workup and anatomical imaging were performed for all the patients. Patients were taken up for surgery after adequate pre-operative optimisation using a multidisciplinary approach. All the patients were operated by a single surgical team of experienced laparoscopic surgeons.</p><p><strong>Results: </strong>A total of 158 patients underwent laparoscopic transperitoneal adrenalectomy. The majority patients were females (64.5%). The median tumour size was 5 cm (range, 1-18 cm). The diagnosis in the majority of the patients was pheochromocytoma (56.3%). The mean operative time was 80 min (range: 45-210 min). The most common complication was bleeding in 6 (3.7%) patients, which required laparotomy. The median duration of post-operative hospital stay was 3 days (range: 1-13). There was no 30-day mortality. The mean follow-up period was 15 months (range: 6-72 months), during which two patients developed local recurrence.</p><p><strong>Conclusion: </strong>The advantages of laparoscopic surgery are well established and have been extensively explored for the management of adrenal lesions. A multidisciplinary approach to management, consisting of endocrinologists, surgeons and anaesthesiologists is preferred. Pre-operative evaluation, optimisation and accurate selection of patients are crucial for successful laparoscopic adrenalectomy.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"46-50"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886275","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":"Totally laparoscopic partial splenectomy and gastropexy for a splenic cyst in a wandering spleen.","authors":"Taher Saifuddin Merchant, Hussain Kotawala","doi":"10.4103/jmas.jmas_212_23","DOIUrl":"10.4103/jmas.jmas_212_23","url":null,"abstract":"<p><strong>Abstract: </strong>With only seven reported cases until 2019 as noted by Lim et al ., cases of a wandering spleen (WS) accompanied by splenic cyst (SC) are exceptionally rare. Furthermore, both entities are notoriously 'silent' until they present as an emergency with complications, often warranting total splenectomy. Management of SC in a WS eventually depends on its clinical presentation, disease type and functional reservoir of the spleen. However, it is desirable to operate electively and perform a spleen salvage with splenic reposition surgery. Our case describes the first totally laparoscopic partial splenectomy and intraperitoneal fixation of the spleen by means of gastropexy for a large non-parasitic SC in a WS. Partial splenectomy instead of just a cystectomy tackles the risk of cyst recurrence, and a gastropexy over other splenic repositioning techniques would allow the spleen to remain as an intraperitoneal organ.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"77-79"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492634","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":"Sliding hiatus hernia (intrathoracic sleeve migration) post-laparoscopic sleeve gastrectomy: A case series and review of literature.","authors":"Maher Ali Alqattan, Roshan George Varkey, Abdulmenem Abualsel","doi":"10.4103/jmas.jmas_119_24","DOIUrl":"10.4103/jmas.jmas_119_24","url":null,"abstract":"<p><strong>Abstract: </strong>Intrathoracic sleeve migration (ITSM) is a complication that uncommonly occurs post-sleeve gastrectomy, with an incidence rate anecdotally ranging from 5% to 45%. Its treatment has established difficulties by bariatric surgeons worldwide. Sixteen cases were shown in this case series that commonly encountered the symptoms of weight gain, gastro-oesophageal reflux disease (GERD), epigastric pain, globus sensation, nausea and vomiting as their initial complaints before their diagnosis. Moreover, these symptoms began a few years after the gastric sleeve. The confirmatory results through gastrografin and computed tomography abdomen were performed where relevant findings of Grade I or II GERD, sliding hiatal hernia and post-sleeve anatomy were appreciated. In literature, the most common modality used to treat ITSM was the conversion to Roux-en-Y bypass. However, other treatment modalities were also utilised for the cases presented due to the different patients' preferences, including mini-gastric bypass and laparoscopic hiatal hernia repair with/without posterior cruroplasty and buttress plication with the falciform ligament. In addition, anchoring to pre-pancreatic fascia post-gastric sleeve has been shown to prevent such presentations further in the future. Postoperatively, all patients were stable with no complications acutely or after 3 months follow-up. Hence, this concludes that despite Roux-en-Y being considered the golden standard treatment of ITSM, laparoscopic hiatal hernia repair with cruroplasty and plication reflects an equivalent, cost-effective and valuable alternative to treating relevant patients.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"66-70"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838807/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478411","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 intra-peritoneal onlay mesh plus versus robotic transabdominal pre-peritoneal for primary ventral hernias: Our technique and outcomes.","authors":"Vivek Bindal, Dhananjay Pandey, Shailesh Gupta","doi":"10.4103/jmas.jmas_4_24","DOIUrl":"10.4103/jmas.jmas_4_24","url":null,"abstract":"<p><strong>Introduction: </strong>Intra-peritoneal onlay mesh repair (IPOM) still remains the most common approach for laparoscopic repair of small to medium sized hernias worldwide. In this study, we compare our early outcomes of an established procedure, i.e. laparoscopic IPOM plus to robotic transabdominal pre-peritoneal (rTAPP) for small to medium sized primary ventral hernia. To compare laparoscopic IPOM plus with rTAPP in terms of pain score, time to ambulate, hospital stay, time to return to work as well as the expenses.</p><p><strong>Patients and methods: </strong>This is a retrospective analysis of prospectively collected data at our centre between July 2021 and June 2022. Operative time including docking time was recorded. Cost analysis was done in both set of patients. Pain scores were assessed using Visual Analogue Scale (VAS) at regular intervals for up to 3 months and then at the end of 1 year. Time to ambulate, return of bowel function and return to work were documented. Any complication or recurrence during the study period was recorded.</p><p><strong>Results: </strong>Mean operative time for IPOM plus and rTAPP groups was 59.00 and 73.55 min, respectively. Mean pain score for IPOM at 6, 12 and 24 h was 7.35, 6.81 and 5.77, while for rTAPP, it was 4.73, 3 and 2.55, respectively. VAS scores at 1 week, 1 month and 3 month also showed similar trends. Mean time to ambulate in minutes for IPOM and rTAPP group was 357.69 and 223.64, respectively. Mean hospital stay in days for IPOM and rTAPP was 2.12 and 1.18, respectively. Mean time to return to work in days was 11.77 and 8.45 for IPOM and rTAPP groups, respectively. Expenditure wise, cost of TAPP was more and statistically significant, owing to the use of robotic platform. The mean overall cost of laparoscopic IPOM plus and rTAPP in rupees was 187,177.69 and 245,174.55, respectively.</p><p><strong>Conclusion: </strong>Robotic TAPP appears an excellent alternative to laparoscopic IPOM plus. Larger studies with long-term follow-up data are further required to reinforce it.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"25-33"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879705","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 lateral pancreaticojejunostomy in the current era: A narrative review.","authors":"Theakarajan Rajendran, Maktum Naik, Hirdaya Hulas Nag","doi":"10.4103/jmas.jmas_153_24","DOIUrl":"10.4103/jmas.jmas_153_24","url":null,"abstract":"<p><strong>Abstract: </strong>Chronic pancreatitis is a benign disease which causes recurrent abdominal pain and loss of pancreatic function. Lateral pancreaticojejunostomy (LPJ) is a commonly performed drainage procedure for this condition. While usually performed through an open approach, there have been few cases of laparoscopic approaches for this condition. A literature review was conducted to understand the current status of laparoscopic longitudinal pancreatojejunostomy (LLPJ). We conducted a comprehensive literature search using PubMed, Embase and Cochrane Library to find the articles published until 1 st October 2023. We excluded studies involving paediatric patients or robotic assisted surgeries. Our evaluation focussed on pain relief scores, morbidity, hospital stay length, mortality rates and the development of endocrine and exocrine deficiencies in the patients. The patients in the analysis had a mean age of 36.5 and a male to female ratio of 1.4:1. The mean main pancreatic duct diameter was 11.5 mm. Tropical pancreatitis was identified as the primary cause. The surgical procedure was performed using 4 ports with minimal bleeding and a 13% morbidity rate. The conversion rate was 15%. The average operative time was 260 min and the mean hospital stay was 5.7 days. The results for pain control were excellent, as 90% of patients did not report pain in most series at the end of 3 years. The laparoscopic surgical management of chronic calcific pancreatitis with LPJ offers a safe and effective solution for pain relief in carefully chosen patients. However, further comprehensive studies with large sample sizes are essential to establish a more conclusive comparison between LLPJ and open surgery.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"1-6"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752172","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}