Journal of Minimal Access Surgery最新文献

{"title":"A new method of pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy: A retrospective analysis of 93 cases.","authors":"Junhan Li, Jianqiang Xiang, Jie Zhu, Mengnan Wang, Meng Lin, Haibiao Wang, Hong Li","doi":"10.4103/jmas.jmas_59_24","DOIUrl":"10.4103/jmas.jmas_59_24","url":null,"abstract":"<p><strong>Introduction: </strong>Pancreaticojejunostomy have been studied and modified for more than a hundred years. We investigated a new method of pancreaticojejunostomy to explore its value in laparoscopic pancreaticoduodenectomy.</p><p><strong>Patients and methods: </strong>A retrospective analysis was conducted on the clinical data of 93 patients who underwent laparoscopic pancreaticoduodenectomy with 'Shunt-block combined' pancreaticojejunostomy at Ningbo Medical Center Lihuili Hospital from April 2017 to February 2023.</p><p><strong>Results: </strong>All patients successfully completed the surgery, with two cases requiring conversion to open surgery. The average operation time was 328.5 (180-532) min, the average intraoperative blood loss was 182.9 (50-1000) mL and the average laparoscopic pancreaticojejunostomy time was 29.6 (20-39) min. There were no cases of grade C pancreatic fistula postoperatively, 10 cases of grade B pancreatic fistula, 43 cases of biochemical fistula and 40 cases without detected pancreatic fistula.</p><p><strong>Conclusion: </strong>'Shunt-block combined' pancreaticojejunostomy was a safe and effective method for pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"34-38"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494003","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":"Ileal perforation by a solidified root pulp - Minimally invasive surgery management.","authors":"Anmol Galhotra, Deepa Kizhakke Veetil, Randeep Wadhawan, Arun Bhardwaj, Naveen Verma","doi":"10.4103/jmas.jmas_312_23","DOIUrl":"10.4103/jmas.jmas_312_23","url":null,"abstract":"<p><strong>Abstract: </strong>Foreign body (FB) ingestion results in perforation in 1% of cases and is associated with significant morbidity and rarely mortality. This case reports the delayed presentation of distal ileal perforation following accidental ingestion of solidified root pulp. A 46-year-old male presented to the emergency department with complaints of right iliac fossa pain, clinical diagnosis of appendicitis was made. Computed tomography of the abdomen revealed an FB in the distal ileum with contained perforation. Revised history was suggestive of FB aspiration during root canal therapy 3 weeks back. The patient underwent diagnostic laparoscopy, removal of FB and primary closure of the perforation. FB was revealed to be solidified root pulp macroscopically and hyalinised material microscopically. Localised perforation following ingestion of FB results in significant morbidity due to delayed diagnosis. With the increasing number of dental procedures, this becomes relevant globally as well. Varied clinical presentations pose diagnostic challenges to the clinician.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"86-88"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142576801","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":"Transvaginal natural orifice specimen extraction surgery for left-sided colorectal resection: A single-centre cohort study.","authors":"Ruben Gregory Xavier, Tao-Wei Ke, William Tzu-Liang Chen","doi":"10.4103/jmas.jmas_108_24","DOIUrl":"10.4103/jmas.jmas_108_24","url":null,"abstract":"<p><strong>Introduction: </strong>Transvaginal natural orifice specimen extraction surgery (NOSES) is an innovative and feasible approach for left-sided colorectal resections in females. This study aimed to report our experience with transvaginal NOSES for left-sided laparoscopic colorectal resections.</p><p><strong>Patients and methods: </strong>We analysed data for all patients with transvaginal extraction performed for left-sided laparoscopic colorectal resections between 2011 and 2021 at a tertiary teaching hospital in Taiwan.</p><p><strong>Results: </strong>The 18 post-menopausal patients were of a mean age of 69.2 ± 10.14 years. The lesions were located at the descending ( n = 5), sigmoid colon ( n = 12) and rectum ( n = 1). The operative time was 262.5 ± 83.91 min, and the blood loss was 34 ± 35.98 mL. All patients had an end-to-end anastomosis, and the anastomotic height was 15.06 ± 8.57 cm. Two patients received diversion stoma. The mean length of hospital stay was 5.1 days (standard deviation ± 2.42; range: 3-12 days). There were no cases of clinical infection. The pathology was malignancy ( n = 14, 77.8%), diverticulitis ( n = 2, 11.2%) and benign ( n = 2, 11.2%). In cancers, they were Stage I ( n = 1, 7.1%), IIa ( n = 1, 7.1%), IIIb ( n = 15, 78.7%) and IV ( n = 1, 7.1%). Malignant specimens ( n = 14) were mostly moderately differentiated ( n = 11, 78.6%), with two poorly differentiated (14.3%) and one well-differentiated (7.1%). The lymph nodes harvested were 16.1 ± 8.11. The widest dimension of the lesion was 3.43 cm ± 1.28 (range: 1.5-6) and the length of the specimen was 14.69 cm ± 5.01 (range: 8-27).</p><p><strong>Conclusion: </strong>Transvaginal NOSES is safe and feasible for left-sided colorectal resection. Factors to consider are the characteristics of the specimen, anal canal and vagina.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"51-59"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886279","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":"Is the double-ligation method safe and effective in laparoscopic paediatric inguinal hernia repair? A retrospective cohort study.","authors":"Jong Hyuk Yun, Myoung Won Son, Geum Jong Song, Moon-Soo Lee","doi":"10.4103/jmas.jmas_232_23","DOIUrl":"10.4103/jmas.jmas_232_23","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic paediatric hernia repair has since been performed more frequently. Recently, a double-ligation method was introduced to prevent recurrence in laparoscopic surgery. The objective of our study was to compare the postoperative outcomes of patients who underwent double and single ligations.</p><p><strong>Patients and methods: </strong>We performed a retrospective review of patients with inguinal hernia who underwent laparoscopic paediatric inguinal hernia repair from 2014 to 2018 at our institution. Patients were divided into two groups and underwent single ligation and double ligation.</p><p><strong>Results: </strong>Three hundred and six patients (single-ligation group: 142 and double-ligation group: 164) were included. Four patients experienced recurrence, and the recurrence rate was 1.29%. The recurrence rate was significantly higher in the single-ligation group. There were no statistically significant differences in the postoperative complications between the two groups.</p><p><strong>Conclusion: </strong>Double-ligation method in laparoscopic paediatric hernia repair was relatively safe and helpful.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"11-18"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11838802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492626","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":"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}