Journal of Minimal Access Surgery最新文献

{"title":"Minimally invasive tools are necessary for the modern practice of liver surgery.","authors":"Young-Dong Yu, Karim J Halazun, Rohit Chandwani, Benjamin Samstein","doi":"10.4103/jmas.jmas_377_23","DOIUrl":"10.4103/jmas.jmas_377_23","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive liver resection (MILR) is performed for other gastrointestinal applications. At our centre, all liver resections are systematically performed using a minimally invasive approach. This study aimed to describe our experience in minimising open surgery and emphasised the importance of minimally invasive surgery.</p><p><strong>Patients and methods: </strong>We retrospectively reviewed 260 patients who underwent liver surgery and compared the surgical outcomes between the open and MILR groups.</p><p><strong>Results: </strong>A total of 154 patients (68%) underwent MILR. The proportion of patients who underwent prior abdominal surgery and resection was higher in the open surgery group. However, the proportion of patients with liver cirrhosis was similar between the two groups. The MILR group was superior in terms of operative time, blood loss, Pringle manoeuvre rate and mean hospital stay. In addition, major complication and bile leak rates were lower in the MILR group. No significant differences in the tumour size, number of lesions or underlying liver pathology were observed between the two groups.</p><p><strong>Conclusion: </strong>Acceptable outcomes can be achieved even when the minimally invasive approach is considered the primary option for all patients who require liver resection. Minimally invasive tools are necessary for the modern practice of liver surgery; therefore, laparoscopic or robotic surgery should be included in the armamentarium of liver surgeons.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"249-253"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494004","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":"Hiatal sling liver retraction technique in bariatric and upper gastrointestinal surgeries - Our 15 year experience with 1874 surgeries.","authors":"Muvva Sri Harsha, Raj Palaniappan, Nikhilesh Krishna","doi":"10.4103/jmas.jmas_97_24","DOIUrl":"10.4103/jmas.jmas_97_24","url":null,"abstract":"<p><strong>Introduction: </strong>Liver retraction is an important aspect when performing minimal access surgeries, especially bariatric and upper gastrointestinal (GI) surgeries. Various liver retraction methods are available and have been tried. Here, we present our experience with our indigenous hiatal sling technique for liver retraction and compare it with Nathanson liver retractor which is a popular and commonly used liver retraction method.</p><p><strong>Patients and methods: </strong>This is a retrospective observational study of 1874 patients who underwent bariatric and upper GI surgeries over the last 15 years since September 2009. A secondary study was conducted amongst the two groups of patients who underwent upper GI and bariatric surgeries using hiatal sling technique and Nathanson retractor system for liver retraction between January 2023 and October 2023. End points measured were time taken, conversions and complication along with liver function tests (LFTs) such as aspartate aminotransferase (AST) and alanine transaminase measured between the two groups pre- and postoperatively day 0, day 1, day 3 and day 7.</p><p><strong>Results: </strong>In our series of 1874 patients, hiatal sling liver traction was possible without any difficulties in all except 2 patients with no associated liver injury and with adequate exposure. In the comparative study, patients in the hiatal sling group (Group B) had significantly lesser elevation in LFTs as compared to the patients in the Nathanson liver retraction group (Group A), with no adverse events in both the groups.</p><p><strong>Conclusion: </strong>Hiatal sling technique for liver retraction is an effective technique which provides adequate exposure of the hiatus and causes lesser liver insult compared to rigid liver retraction system like Nathanson liver retraction system. Hiatal sling does not interfere with surgeons' field causing less errors during surgery and thus making it more ergonomic friendly.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"268-273"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123026","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":"Application of an improved continuous single-layer pancreaticojejunostomy technique in laparoscopic pancreaticoduodenectomy.","authors":"Xiaodong Zhou, Xuefeng Bu, Feng Yu, Yongjun Zhang, Leizhou Xia","doi":"10.4103/jmas.jmas_236_24","DOIUrl":"10.4103/jmas.jmas_236_24","url":null,"abstract":"<p><strong>Abstract: </strong>Laparoscopic pancreaticoduodenectomy (LPD) is a minimally invasive approach for pancreatic head and ampullary tumours, with pancreaticojejunostomy (PJ) critically influencing post-operative outcomes. This study aimed to compare a modified continuous single-layer PJ technique with the conventional two-layer method in LPD. A retrospective cohort study of 22 patients undergoing LPD compared the surgical outcomes between the modified group ( n = 12) and the conventional group ( n = 10). Baseline characteristics were well-matched between the two groups. The modified group demonstrated significantly shorter anastomosis time (19.08 vs. 23.1 min, P < 0.001) and lower abdominal infection rates (0 vs. 3 cases, P = 0.041). No significant differences were observed in clinically relevant post-operative pancreatic fistula or bleeding. Conclusively, the modified continuous single-layer PJ technique appears safe and feasible, offering efficiency advantages without compromising short-term outcomes. However, large-scale randomised controlled trials are warranted to validate safety, efficacy and long-term prognostic implications.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"329-332"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692156","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":"Evaluation of 1-year follow-up data of reoperative sleeve gastrectomy and one-anastomosis gastric bypass after laparoscopic gastric plication.","authors":"Şükrü Salih Toprak, Ceyhun Pekin","doi":"10.4103/jmas.jmas_85_25","DOIUrl":"10.4103/jmas.jmas_85_25","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic gastric plication (LGP) technique requires a high rate of reoperative bariatric surgery (RBS) because of failure to lose weight, regaining weight, inadequate remission of comorbidities and complications. RBSs have higher perioperative complication and mortality rates when compared to primary bariatric procedures. The present study aimed to compare post-operative complications and body mass index (BMI) changes in one-anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG) operations following LGP.</p><p><strong>Patients and methods: </strong>The study had a retrospective, single-centre and cohort design. Group OAGB ( n = 12) and Group SG ( n = 16) were compared for post-operative 1 st -month complications, operation times, discharge times, time from primary surgery to RBS and post-operative 1, 3, 6 and 12 th -month BMI changes. Post-operative complications were evaluated using the Comprehensive Complication Index (CCI).</p><p><strong>Results: </strong>The mean operation times in OAGB and SG were 77.50 ± 9.77 and 53.75 ± 8.08 min, discharge times were 3.83 ± 0.72 and 2.38 ± 0.62 days and the time from primary surgery to RBS was found to be 26.17 ± 7.96 and 36.44 ± 14.69 months, respectively. These differences were statistically significant. No statistically significant differences were detected between the CCI values at the end of the 1 st post-operative month and the BMI changes at the 1 st , 3 rd , 6 th and 12 th months of post-operative surgery in both groups.</p><p><strong>Conclusions: </strong>OAGB had similar outcomes for post-operative 1 st -month CCI values and post-operative 1 st -month, 3 rd -month, 6 th -month and 12 th -month BMI changes when compared with SG. According to our findings, OAGB can be considered a clinically effective and safe surgical procedure for RBS after LGP compared to SG.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"297-304"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147291058","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":"Late intra-abdominal abscess after laparoscopic appendectomy in a child.","authors":"Digant Pathak, Noopur Gupta, Vivek Manchanda","doi":"10.4103/jmas.jmas_361_23","DOIUrl":"10.4103/jmas.jmas_361_23","url":null,"abstract":"<p><strong>Abstract: </strong>Appendectomy is the most common surgical emergency managed by laparoscopic surgeons and is usually a straightforward procedure with minimal morbidity. However, rare complications can arise in the immediate post-operative period. We report a late occurrence of intra-abdominal abscess 2 years after laparoscopic appendectomy probably related to silk suture used to ligate the base of the appendix during index surgery. The patient recovered after laparoscopic drainage of the abscess and retrieval of silk suture.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":"22 3","pages":"321-322"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609166","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 laparoscopic total extraperitoneal mesh repair gold standard approach to inguinal hernia? A large case series with operative complications, post-operative outcome and recurrence rate after laparoscopic TEP mesh repair for inguinal hernias.","authors":"M P Harsha, S N Panda, Soumyadip Das","doi":"10.4103/jmas.jmas_165_24","DOIUrl":"10.4103/jmas.jmas_165_24","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic extraperitoneal mesh hernia repair is better approach for inguinal hernia with its low complication rate, early recovery and negligible recurrence rate. The aim of this case series is to study intraoperative complications, post-operative outcome and recurrence rate after laparoscopic total extraperitoneal mesh repair for inguinal hernias.</p><p><strong>Patients and methods: </strong>This is a retrospective observational data. We have performed laparoscopic total extra peritoneal repair (TEP) for 152 consecutive patients presented with inguinal hernia at Surgical Outpatient Department, Command Hospital (Eastern Command), Kolkata, using 10-mm infraumbilical midline port and two 5-mm working lateral ports inserted lateral to the inferior epigastric artery. None of them required eTEP. All the hernias are repaired with flat, light-weight, macroporous polypropylene mesh 15 cm × 15 cm for unilateral hernias and 30 cm × 15 cm mesh for bilateral hernia covering myopectineal orifice and anchored with single absorbable tacker to lacunar ligament to each side. All patients were assessed for intraoperative complications such as bleeding, peritoneal breach, injury to vessels, vas deferens and bowel, total operative time and post-operative complications such as chronic pain, seroma, surgical site infection (SSI) and recurrence. Follow-up was done after 10 days, 1 month and 6 months.</p><p><strong>Results: </strong>There were one hundred and fifty-two patients with a mean age of 47.8 years, oldest 78 and youngest 20 years; among them, 141 were males and 11 were females; 125 had unilateral and 27 had bilateral hernia. Four had minor intraoperative bleeding, 5 had intraoperative peritoneal breach and required accessor intra-abdominal port and required peritoneal repair. None of them had any chronic pain. Seven had seroma which is managed with serial aspirations. Seven patients developed SSI, of which 4 underwent mesh explanation and 3 resolved with ultrasonography-guided aspiration and pre-peritoneal amikacin infiltration. None of the patients had recurrence even after mesh explanation.</p><p><strong>Conclusions: </strong>The laparoscopic total extraperitoneal mesh repair for inguinal hernia is minimal invasive approach. With same port placement, bilateral inguinal hernias can be repaired with ease. Laparoscopic TEP repairs inguinal hernia with less post-operative complications, no pain and nil recurrence, less hospital stay and patients can get back to their routine activities since the next day. It can be considered as gold standard laparoscopic approach for inguinal hernia.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"283-287"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311433","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":"Umbilical pilonidal sinus with the urachal tract: A case managed with umbilicus-preserving laparoscopic urachal cyst and tract excision.","authors":"Agrawal Kavita Khemchand, Ajay Kundal, Puja Saxena, Ravneet Kaur Gill","doi":"10.4103/jmas.jmas_22_24","DOIUrl":"10.4103/jmas.jmas_22_24","url":null,"abstract":"<p><strong>Abstract: </strong>The umbilical pilonidal sinus (UPS) is a rare clinical entity and is not easily diagnosed unless there is a high suspicion. Pilonidal sinuses are most frequently seen around the gluteal cleft, but occasionally can be observed on other areas of the body, including the breast, webs of fingers, axilla and umbilicus. UPS is one of the rarest subtypes. Risk factors for UPS are similar to those for gluteal cleft pilonidal cysts and include young age, male gender, obesity, hairy body and poor personal hygiene. The traditional approach of treatment is usually conservative or surgical excision of the sinus with or without umbilectomy through the open technique. We discuss a case of UPS in an adult male having a concurrent urachal cyst with the urachal tract. We report our experience in laparoscopic management of this case after the failure of a conservative approach, with favourable outcomes at 1-year follow-up.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"318-320"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879715","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":"Pyeloplasty for pelviureteric junction obstruction in anomalous kidneys: A long-term follow-up experience at a tertiary care centre.","authors":"Lalit Kumar, Rishi Nayyar, Brusabhanu Nayak, Prabhjot Singh, Rajeev Kumar, Amlesh Seth","doi":"10.4103/jmas.jmas_79_24","DOIUrl":"10.4103/jmas.jmas_79_24","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the feasibility, safety, and effectiveness of different pyeloplasty procedure approaches for pelvicureteric junction (PUJ) obstruction in kidney anomalies. The presence of difficult, unfamiliar and anomalous anatomy makes pyeloplasty challenging in these conditions.</p><p><strong>Patients and methods: </strong>We conducted a retrospective review of pyeloplasty in patients with congenital anomalous kidneys at our national tertiary referral centre. Seventeen patients who had pyeloplasty for PUJ obstruction from December 2013 to July 2019 were included.</p><p><strong>Results: </strong>Seventeen cases had anomalous kidneys consisting of horseshoe kidneys in nine patients, ectopic non-fused kidneys in four patients, ectopic fused kidneys in three patients and duplex kidneys in one patient. The mean follow-up duration was 34 months (4-70 months). The robotic approach was most commonly used in nine patients followed by a laparoscopic and open approach, each in four patients, respectively. Only one patient had an intraoperative complication. One patient required conversion to an open approach. The mean operative duration in open, laparoscopic and robotic approaches was 102 min, 105 min and 140 min, whereas the mean hospital stay was 6.50 days, 3.25 days and 4.22 days, respectively. Post-operative complications occurred in 29.41% of patients with Clavien grade ≥3 complications in one case only (5.88%). Success was 94.12% without any salvage intervention.</p><p><strong>Conclusion: </strong>Pyeloplasty is a feasible, effective and safe procedure even in complex cases of renal anatomic anomalies with PUJ obstruction. With increasing experience, minimally invasive techniques though technically demanding provide equivalent success rates with better cosmetic outcomes and faster convalescence.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"254-260"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752178","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":"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":"333-336"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493065/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of short-term outcomes between totally minimally invasive and minimally invasive-assisted Billroth-II gastrectomy for distal gastric cancer: A systematic review and meta-analysis.","authors":"Yuxing Jiang, Yuyang Guo, Yi Dong, Meiyu Deng, Gaoming Li, Yong Fang","doi":"10.4103/jmas.jmas_114_24","DOIUrl":"10.4103/jmas.jmas_114_24","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive Billroth-II distal gastrectomy is one of the most frequently recommended curative resections for patients with lower- and middle-third gastric cancer. However, the efficiency and benefits of totally minimally invasive and minimally invasive-assisted distal gastrectomy with Billroth-II anastomosis are still controversial. This meta-analysis was conducted to compare the short-term outcomes of the two surgical procedures.</p><p><strong>Patients and methods: </strong>We conducted an internet search of the PubMed, Web of Science, Cochrane Medline and Embase databases up to May 2023. The parameters related to surgical outcomes, post-operative recovery, post-operative complications and surgical stress response were subjected to subsequent statistical calculations. Review Manager 5.3 software was used to perform the meta-analysis.</p><p><strong>Results: </strong>A total of seven retrospective studies were included in this meta-analysis. No significant differences were observed in the operative time, number of anastomoses, number of retrieved lymph nodes or surgical stress response indices of white blood cells and C-reactive protein. We detected a lower estimated blood loss, a shorter incision, an earlier time to first flatus and a shorter post-operative hospital stay in patients who underwent totally minimally invasive Billroth-II distal gastrectomy.</p><p><strong>Conclusion: </strong>Compared with minimally invasive-assisted Billroth-II distal gastrectomy, totally minimally invasive Billroth-II distal gastrectomy is a feasible and safe radical operation with acceptable surgical outcomes that may offer shorter post-operative recovery times.</p>","PeriodicalId":48905,"journal":{"name":"Journal of Minimal Access Surgery","volume":" ","pages":"227-236"},"PeriodicalIF":1.2,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677971","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}