Journal of Minimal Access Surgery最新文献

{"title":"Comparison of short-term oncologic outcomes in open, laparoscopic and robotic radical gastrectomy for the treatment of gastric cancer.","authors":"Sibel Yaman, Zafer Teke, Sercan Yüksel, Ugur Topal, Hüseyin Karatay, Hürü Ceren Gökduman, Erdal Karaköse, Hasan Bektaş","doi":"10.4103/jmas.jmas_254_24","DOIUrl":"10.4103/jmas.jmas_254_24","url":null,"abstract":"<p><strong>Aim: </strong>Surgical resection remains the cornerstone treatment for gastric cancer, which ranks as the fifth most common cancer globally. Although minimally invasive surgical techniques are gaining popularity, their safety and oncological adequacy remain subjects of ongoing debate. This study aims to contribute to the medical literature by comparing open, laparoscopic and robotic gastrectomy techniques in the treatment of gastric cancer, focusing on short-term oncological outcomes.</p><p><strong>Materials and methods: </strong>Patients aged 18 years and older who underwent surgery for gastric adenocarcinoma at our institution between April 2020 and September 2022 were included in the study. The patients were categorised into three groups based on the surgical approach: open gastrectomy, laparoscopic gastrectomy and robotic gastrectomy. Demographic data, intraoperative and post-operative findings, tumour characteristics and short-term morbidity and mortality outcomes were analysed retrospectively.</p><p><strong>Results: </strong>A total of 109 patients (37 females [33.9%] and 72 males [66.1%]) with a mean age of 63.1 ± 11.4 years were included. The operative time was significantly shorter in the open gastrectomy group compared to the laparoscopic and robotic groups (P = 0.012). The initiation of oral intake and post-operative hospital stay were significantly shorter in the robotic gastrectomy group (P < 0.001). At 1-year follow-up, disease-free survival rates were higher, and mortality rates were lower in the robotic gastrectomy group compared to the other groups (P = 0.030). Furthermore, the completion rate of adjuvant therapy was significantly higher in the robotic group than in the other groups (P = 0.008).</p><p><strong>Conclusion: </strong>In conclusion, minimally invasive surgical techniques, particularly robotic gastrectomy, provide a safe and oncologically adequate alternative to open surgery for the treatment of gastric cancer. These methods can be safely employed in selected patients by experienced teams at high-volume centres.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":"21 3","pages":"256-264"},"PeriodicalIF":1.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12327784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627428","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 totally extraperitoneal inguinal hernia repair.","authors":"Uday Shamrao Kumbhar, Bhagyasri Pourouchottamane, Abhinaya P Reddy","doi":"10.4103/jmas.jmas_369_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_369_24","url":null,"abstract":"<p><strong>Abstract: </strong>Inguinal hernia is one of the most common surgeries performed worldwide. The operative technique of inguinal hernia has evolved drastically to provide a better quality of life with minimal complications. One of the recent advances is robot-assisted inguinal hernia repair. Owing to its ease of surgery and better operative visualisation, it will soon become one of the most fruitful inventions. Many studies and reports are regarding robotic transabdominal preperitoneal repair. However, very few reports describe robotic totally extraperitoneal (rTEP) repair. This report mainly describes the surgical procedure of rTEP inguinal hernia repair and its challenges to aid fellow colleagues in performing and improvising the technique.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295173","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":"Outcome after flexible endoscopy structured training of surgeons in a novel hybrid format.","authors":"Sundaram Easwaramoorthy, Sakthivel Chandrasekar, Satyapriya DeSarkar, Kanagavel Manickavasakam, Vijay Borgoankar, Senthil Manickavasakam","doi":"10.4103/jmas.jmas_15_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_15_25","url":null,"abstract":"","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267687","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":"Robotic bariatric surgery with BORNS Simphoni: First experience.","authors":"Vivek Bindal, Dhananjay Pandey, Shailesh Gupta, Rajesh Saxena, Alexander Tobias Teichmann","doi":"10.4103/jmas.jmas_237_24","DOIUrl":"10.4103/jmas.jmas_237_24","url":null,"abstract":"<p><strong>Introduction: </strong>To overcome the challenges in laparoscopic bariatric surgery, robotic platforms are an attractive option. One such robotic platform is the BORNS Simphoni Robotic System, which has been evaluated for clinical use in this study.</p><p><strong>Patients and methods: </strong>This study includes seven severely obese patients undergoing robot-assisted sleeve gastrectomy at our centre on 10 March-9 May 2023, all performed by BORNS Simphoni Robotic System. This was a pilot study after all relevant approvals and the Clinical Trials Registry-India registration. Demographic data including body mass index (BMI), comorbidities, operative time, blood loss as well as postoperative hospital stay and results were recorded and analysed.</p><p><strong>Results: </strong>All 7 patients completed robot-assisted laparoscopic sleeve gastrectomy without laparotomy or conversion to other surgical methods. The total mean operation time was 100.6 ± 5.99 min (mean docking and console time of 12.1 ± 1.74 min and 76.7 ± 5.69 min, respectively), the mean intraoperative blood loss was 11.57 ± 1.78 ml and the mean post-operative hospital stay was 2.18 ± 0.37 days. The mean weight and BMI at the time of surgery were 118.13 ± 17.7 kg and 42.4 ± 4.9 kg/m 2 , respectively. During follow-up at 3, 6 and 12 months, the percentage of excess weight loss was 45.2% ±11.91%, 64.5% ±13.5% and 84.9% ±15.21%, respectively. The percentage of total weight loss at 3, 6 and 12 months was 17.9% ±3.87%, 25.9% ±5.75% and 34.01% ±5.36%, respectively. Significant resolution of comorbidities was noted in our series.</p><p><strong>Conclusion: </strong>We found BORNS Simphoni Robotic System to be safe and feasible to use for bariatric procedures in the pilot study. The clinical outcomes are similar when compared to published data on sleeve gastrectomy.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250500","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":"Ventral transabdominal preperitoneal plus repair for primary ventral hernia: How do I do it?","authors":"Jyoti Sharma, Devender Singh, Niharika Grover, Ankita Singh, Yashwant Singh Rathore, Piyush Ranjan, Sunil Chumber","doi":"10.4103/jmas.jmas_341_24","DOIUrl":"10.4103/jmas.jmas_341_24","url":null,"abstract":"<p><strong>Abstract: </strong>The optimal technique of ventral hernia repair is still debatable. While intraperitoneal onlay mesh repair is the most widely used method, extraperitoneal repair of ventral hernia is gaining popularity, mainly due to its proposed lesser pain and complication profile. This article describes one such method, ventral transabdominal preperitoneal plus repair and also discusses its benefits and post-operative outcomes.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250501","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":"Did scarless thyroidectomy meet expectations? An evaluation in the aspect of cosmesis: A single-centre prospective study.","authors":"Mehmet Taner Unlu, Ozan Caliskan, Isik Cetinoglu, Yasin Cakir, Nurcihan Aygun, Mehmet Uludag","doi":"10.4103/jmas.jmas_27_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_27_25","url":null,"abstract":"<p><strong>Objective: </strong>Thyroidectomy is among the most commonly performed endocrine surgeries. Concerns regarding cosmetic outcomes and pain management have led to various surgical innovations. This study compares post-operative patient satisfaction based on cosmesis and expectations between open thyroidectomy (conventional open thyroidectomy [COT]) and transoral endoscopic thyroidectomy vestibular approach (TOETVA).</p><p><strong>Patients and methods: </strong>Female patients aged 18-65 years who underwent thyroidectomy for benign conditions were included. Patients were divided into two groups: COT and TOETVA, with 20 patients in each. Post-operative evaluations were conducted on days 15 and 30 using the Vancouver Scar Scale, the modified Stony Brook Scar Evaluation Scale and general/visual satisfaction questionnaires.</p><p><strong>Results: </strong>Participants rated their surgeries on a scale of 1 (poor) to 4 (excellent) on days 15 and 30. No significant difference in visual scores was observed between groups. However, overall satisfaction scores were higher in the COT group on day 15 (3.5 ± 0.5 vs. 2.7 ± 0.9, P = 0.004) and day 30 (3.7 ± 0.5 vs. 3.1 ± 0.8, P = 0.021). Satisfaction scores and incision site oedema showed no significant differences between groups, but hyperaemia was significantly lower in the TOETVA group on day 30. Scar length was also significantly shorter in the TOETVA group.</p><p><strong>Conclusion: </strong>Higher satisfaction in the COT group may result from post-operative pain and transient chin numbness in the TOETVA group, alongside short follow-up period. Longer-term studies could better evaluate these differences. The lack of a significant difference in satisfaction suggests that patients' expectations-shaped by the surgical approach they independently choose-may significantly influence their overall satisfaction. While satisfaction scores were similar, TOETVA provides a notable cosmetic advantage due to hidden incisions, making it particularly appealing for patients with aesthetic concerns. This technique represents a significant advancement in achieving patient-centred outcomes.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053555","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":"Is the Mayo adhesive probability score predictive of post-operative Clavien-Dindo complication grade in laparoscopic adrenalectomy?","authors":"Burhan Baylan, Yasin Sarıkaya","doi":"10.4103/jmas.jmas_257_24","DOIUrl":"https://doi.org/10.4103/jmas.jmas_257_24","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic adrenalectomy (LA) continues to be considered the optimum approach to the surgical treatment of small benign adrenal tumours. The present study explores the correlation between the Mayo adhesive probability (MAP) score, derived from computed tomography images and delineating such perinephric fat characteristics as thickness and adhesiveness, and post-operative complications in patients undergoing LA.</p><p><strong>Patients and methods: </strong>Data of patients who underwent LA between 2013 and 2023 were subjected to a retrospective analysis, and MAP scores were calculated for all patients. Intraoperative and post-operative surgical outcomes, as well as any complications, were categorised using Modified Clavien-Dindo grading, and the relationship between their MAP scores and outcomes was analysed.</p><p><strong>Results: </strong>The mean body mass index, rate of overweight patients, Clavien-Dindo scores of II, III or IV, surgical time, hospitalisation duration, transfusion requirement and post-operative blood loss of the group of patients with MAP scores of 2-3 were significantly higher than those in the group with MAP scores in the 0-1 range (P < 0.05). Each one-point increase in MAP score led to a 2.559-times greater probability of a Clavien-Dindo Grade > I (95% confidence interval: 1.391-4.708, P < 0.05).</p><p><strong>Conclusion: </strong>A high MAP score is associated with Grade II and higher Clavien-Dindo complications in LA.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036051","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":"Early outcomes of robotic transabdominal preperitoneal repair of inguinal hernias: A single surgeon's experience.","authors":"Ramkaran Chaudhary, Akshat Dutt, Indra Singh Choudhary, Anupam Singh Chauhan, Aditya Baksi, Naveen Sharma","doi":"10.4103/jmas.jmas_221_23","DOIUrl":"https://doi.org/10.4103/jmas.jmas_221_23","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive techniques for inguinal hernia repair are becoming more popular due to their advantages over open surgery. These techniques aim to strengthen weakened tissue and result in reduced complications, shorter hospital stays and faster recovery. Robotic surgery provides better visualisation and ergonomics for surgeons and less post-operative pain for patients. This study evaluates the early outcomes of robotic transabdominal preperitoneal repair (rTAPP) for inguinal hernia.</p><p><strong>Patients and methods: </strong>The study included patients who underwent rTAPP for inguinal hernias. Patients with ventral or umbilical hernias were excluded. Data on patient and hernia characteristics, surgical details and outcomes were collected and analysed. The procedure was performed under general anaesthesia, with specific port placements. A mesh was used to cover the hernia defect the patients were followed up after discharge telephonically as well as through scheduled visits to the clinics.</p><p><strong>Results: </strong>Forty-five patients underwent rTAPP for inguinal hernias between November 2019 and March 2023. The majority of patients were males (97.78%). The average age was 48.2 years. Most of the patients (80%) had unilateral defects. Only one patient had a recurrent hernia. The average operative time was 140 min. The complications were minimal. Three patients had post-operative seroma, and one had a repaired vas deferens injury with no adverse symptoms or fertility issues post-surgery.</p><p><strong>Conclusion: </strong>rTAPP is a safe and feasible modality for treating inguinal hernias. It also offers a better three-dimensional visualisation of anatomy, thereby reducing complications due to faulty technique. It may serve as the procedure of choice for young surgeons seeking to learn robotic skills.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047761","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":"Comment on: Laparoscopic transperitoneal adrenalectomy for adrenal tumours of 6 cm or greater: A single-centre experience.","authors":"Emre Hepsen","doi":"10.4103/jmas.jmas_129_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_129_25","url":null,"abstract":"","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017608","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":"Simple and cost-effective liver retraction technique for laparoscopic right adrenalectomy - An initial experience from a tertiary care centre.","authors":"Saarim Bari, Kushagra Gaurav, Akshay Anand, Abhinav Arun Sonkar","doi":"10.4103/jmas.jmas_49_25","DOIUrl":"https://doi.org/10.4103/jmas.jmas_49_25","url":null,"abstract":"<p><strong>Abstract: </strong>Liver retraction is a critical step for optimal surgical exposure and preventing liver injury during right laparoscopic adrenalectomy (LA), due to the complex relationship of the suprarenal gland with the inferior vena cava and liver. Current retraction methods require specialised instruments like Nathanson and robotic retractors, which are challenging to procure in developing countries due to limited funding and resources. To overcome these challenges, we propose a technique for liver retraction using locally available basic laparoscopic tools, making LA more feasible in resource-limited settings. The patient was laid in the reverse Trendelenburg position and then laterally rotated to the left. Port 1, port 2 and port 3 were placed in a triangular configuration with the camera lying in situ in port 2, while ports 1 and 3 serve as working ports. Port 4 was made in the epigastrium, and a Maryland forceps or laparoscopic needle holder was introduced beneath the right liver lobe, supporting the liver uniformly. This surgical technique is characterised by its simplicity, feasibility and cost-effectiveness. It ensures reliable liver retraction while providing ergonomic benefits for surgeons and upholding both surgical safety and operational efficiency.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004147","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}