Moustafa Elshafei, Alberto Aiolfi, Gianluca Bonitta, Davide Bona, Luigi Bonavina
{"title":"Learning Curve of the Laparoscopic RefluxStop Procedure for the Treatment of Gastroesophageal Reflux Disease.","authors":"Moustafa Elshafei, Alberto Aiolfi, Gianluca Bonitta, Davide Bona, Luigi Bonavina","doi":"10.1177/10926429251391166","DOIUrl":"https://doi.org/10.1177/10926429251391166","url":null,"abstract":"<p><p><b><i>Background:</i></b> The RefluxStop (RS) is an innovative surgical procedure for the treatment of gastroesophageal reflux disease (GERD). Prior research has demonstrated encouraging results in medium-term follow-ups, suggesting that this procedure is a worthwhile alternative to conventional laparoscopic antireflux surgery (LARS). Despite the standardization of the surgical technique, the procedure may be laborious and demanding even for an expert foregut surgeon. <b><i>Aim:</i></b> Evaluate the surgeon learning curve for the RS procedure. <b><i>Methods:</i></b> A single-center prospective study (December 2023-January 2025) was conducted. All the procedures were performed by one surgeon experienced in LARS. The cumulative summation (CUSUM) methodology was applied to visualize the learning curve. A broken-line regression model was employed to identify transitions between phases, thus defining competency (phase 1), proficiency (phase 2), and mastery (phase 3). <b><i>Results:</i></b> Fifty consecutive RS procedures were included. The mean age was 46.7 years (standard deviation [SD]: 11.4), and 68% patients were females. Heartburn (100%), regurgitation (88%), and dysphagia (28%) were common symptoms. Hiatal hernia axial length ranged from 2 to 5 cm. The mean preoperative GERD-HRQL was 39.1 (SD: 9.2). None of the patients underwent concomitant procedures, and the mean operative time was 70.6 minutes (SD: 17.3). The regression analysis found breakpoints at case 9.32 (95% CI: 8.5-9.9) and case 23.27 (95% CI: 22.9-23.8). Thus, the competency phase was achieved after 9 cases, followed by the proficiency phase, which was completed after an additional 14 cases (up to case 23). The surgeon achieved mastery of the RS procedure upon completing 23 cases. <b><i>Conclusions:</i></b> The CUSUM learning curve for the laparoscopic RS procedure demonstrates that a surgeon experienced in LARS requires 9 cases to overcome competency and 23 cases to master the technique.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356665","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}
Lauriane Edin, Marc-Henri Jean, Lucie Planche, Barbara Feigel-Guiller, Emeric Abet
{"title":"Impact of Age on Short-Term Results of Laparoscopic Sleeve Gastrectomy.","authors":"Lauriane Edin, Marc-Henri Jean, Lucie Planche, Barbara Feigel-Guiller, Emeric Abet","doi":"10.1177/10926429251389906","DOIUrl":"https://doi.org/10.1177/10926429251389906","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> A steady increase in the prevalence of obesity in patients over 50 years old has led to a growing number of laparoscopic sleeve gastrectomy (LSG) in this population. Yet the efficacy for those patients is still debated. We evaluated the impact of age on the short-term results of LSG. <b><i>Methods:</i></b> This retrospective study analyzed patients who underwent LSG between 2013 and 2020. Patients were divided into three groups: young (≤35 years, <i>n</i> = 35), intermediate (36-49 years, <i>n</i> = 58), and older age (≥50 years, <i>n</i> = 52). Body mass index (BMI), total weight loss (TWL), excess weight loss (EWL), and obesity-related comorbidities (ORC) were assessed 2 years after LSG. <b><i>Results:</i></b> The mean reduction in BMI, TWL, and EWL was 9.5 kg/m<sup>2</sup>, 21%-51.7% in the \"older age\" group, 11.9 kg/m<sup>2</sup>, 26.3%-64.6% in the \"intermediate\" group, and 13.3 kg/m<sup>2</sup>, 30.1%-74.4% in the \"young\" group, respectively. The LSG failure rate (EWL <50%) was 48.1% in the \"older age\" group, higher than in the \"young\" group (14.3%) (<i>P</i> = .001). The rate of remission or improvement in hypertension (HTN) was 31% in the ≥50 age group, significantly lower than in the other groups (36-49 years: 58%, ≤35 years: 100%) (<i>P</i> = .034). There was no significant difference between the groups in terms of other ORC. 10.5% of patients were lost to follow-up. <b><i>Conclusion:</i></b> Age appears to have a significant negative impact on weight loss results two years after LSG, with no impact on remission or improvement in ORC other than HTN.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349682","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":"The Current Status of Bariatric Surgery in Latin America: Progress, Gaps, and Future Perspectives.","authors":"Mariano Palermo","doi":"10.1177/10926429251383704","DOIUrl":"https://doi.org/10.1177/10926429251383704","url":null,"abstract":"","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349718","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}
Caroline Daleaste Wilmsen, Augusto Graziani E Sousa, Raquel Nogueira, Flavio Malcher, Diego Laurentino Lima
{"title":"Do Anticoagulants Have an Impact on the Clinical Outcomes of Ventral Hernia Repair? A Systematic Review and Meta-Analysis.","authors":"Caroline Daleaste Wilmsen, Augusto Graziani E Sousa, Raquel Nogueira, Flavio Malcher, Diego Laurentino Lima","doi":"10.1177/10926429251389911","DOIUrl":"https://doi.org/10.1177/10926429251389911","url":null,"abstract":"<p><p><b><i>Aim:</i></b> This study aims to perform a comprehensive systematic review and meta-analysis to evaluate the impact of anticoagulation (AC) therapy on clinical outcomes during ventral hernia repair (VHR). <b><i>Materials and Methods:</i></b> A thorough online search was conducted using PubMed, Cochrane, and Embase databases. Studies comparing the use of AC therapy following VHR were included. The results analyzed were bleeding-related reoperation, hemorrhagic/thrombotic complications, length of stay, and transfusion rates. Statistical analysis was performed with Review Manager 5.4 using a random-effects model. <b><i>Results:</i></b> From 1278 records, 4 studies were included, encompassing 41,868 patients (anticoagulants use = 4804; no AC = 32,649), with 25% on anticoagulant therapy submitted to minimally invasive surgery (MIS). Additionally, 90% of patients using anticoagulants underwent mesh placement. Overall analysis showed increased hemorrhagic/thrombotic complications (risk ratios [RR]: 2.3; 95% confidence interval [CI]: 1.13-4.8; <i>P</i> = .02), bleeding-related reoperation (RR: 6.5; 95% CI: 4.3-9.9; <i>P</i> < .00001), and longer hospital stays (mean difference: 1.69 days; 95% CI: .66 to 2.72 days; <i>P</i> = .001) in patients using anticoagulant medications. However, there was no increased risk of transfusion (RR: 2.14; 95% CI: 0.58-7.95; <i>P</i> = .26) between groups. <b><i>Conclusions:</i></b> The use of anticoagulant therapy following VHR is associated with increased hemorrhagic/thrombotic complications, bleeding-related reoperations, prolonged hospitalization, and similar transfusion rates. Further research is still required to validate these findings and explore the impact of MIS on anticoagulated patients following VHR.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337999","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}
Stefano Olmi, Davide Moioli, Francesca Ciccarese, Matteo Uccelli, Adelinda Angela Giulia Zanoni, Riccardo Giorgi, Alberto Oldani, Marta Bonaldi, Carolina Rubicondo, Alessandro Del Carro, Yong Ha Lee, Giovanni Cesana
{"title":"LIRA Technique Versus IPOM Plus for Laparoscopic Repair of Ventral Hernia: An Observational Comparative Analysis.","authors":"Stefano Olmi, Davide Moioli, Francesca Ciccarese, Matteo Uccelli, Adelinda Angela Giulia Zanoni, Riccardo Giorgi, Alberto Oldani, Marta Bonaldi, Carolina Rubicondo, Alessandro Del Carro, Yong Ha Lee, Giovanni Cesana","doi":"10.1177/10926429251385785","DOIUrl":"https://doi.org/10.1177/10926429251385785","url":null,"abstract":"<p><p><b><i>Background:</i></b> The aim of this study is to compare the postoperative outcomes of laparoscopic intracorporeal rectus aponeuroplasty (LIRA) technique with the defect closure technique using sutures and intraperitoneal mesh (IPOM plus), evaluating recurrence and bulging rates at least one year postoperatively. The secondary objective is to compare postoperative complications: seroma and pain at 30 days, 6 months, and 1 year post-surgery. <b><i>Methods:</i></b> Patients with midline primary ventral and incisional hernias between 4 and 10 cm were included. A CT scan was performed on all patients to assess the correct spatial values preoperatively and at 1 month, 6 months, and 12 months postoperatively. Pain was evaluated using the visual analog scale. <b><i>Results:</i></b> A total of 50 patients underwent LIRA, and 48 patients underwent IPOM plus between January 2022 and May 2023. The mean defect area in the LIRA group was larger than in the IPOM plus group (63.5 ± 37.5 cm<sup>2</sup> versus 55.2 ± 33.9 cm<sup>2</sup>). In the LIRA group, 2/48 instances of bulging (4.4%) occurred, whereas in the IPOM plus group, there were 6/50 instances of bulging (21.3%) and 2/50 recurrences (6.4%). One month post-surgery, a clinical seroma was observed in 8/48 patients (16%) and 9/50 patients (18.7%) in the LIRA and IPOM plus groups, respectively, with complete resolution at 6 months. Postoperative pain was found to be lower in the LIRA group. <b><i>Conclusions:</i></b> In this study, the LIRA technique demonstrated lower rates of bulging, recurrence, and postoperative pain compared with IPOM plus at 1 year of follow-up. Further multicentric prospective studies with a larger patient sample and longer follow-up are necessary to draw definitive conclusions.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337969","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}
Serdar Çulcu, Selim Tamam, Gökhan Gökten, Fırat Tekeş, Ezgi Altınsoy, İsmail Can Tercan, Ramazan Erdem Er, Aslı Bozer, Ali Ekrem Ünal, Salim Demirci
{"title":"Beyond Oncologic Benefit: Diabetes Remission Following Long-Limb Roux-en-Y Reconstruction in Laparoscopic Gastric Cancer Surgery.","authors":"Serdar Çulcu, Selim Tamam, Gökhan Gökten, Fırat Tekeş, Ezgi Altınsoy, İsmail Can Tercan, Ramazan Erdem Er, Aslı Bozer, Ali Ekrem Ünal, Salim Demirci","doi":"10.1177/10926429251389908","DOIUrl":"https://doi.org/10.1177/10926429251389908","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Few studies have compared conventional Roux-en-Y (RNY) reconstruction with oncometabolic surgical techniques for postoperative glycemic control in patients with gastric cancer and type 2 diabetes. This study evaluates the impact of long-limb (oncometabolic) RNY reconstruction on type 2 diabetes remission and glycemic control compared with the conventional method in patients undergoing laparoscopic radical gastrectomy. <b><i>Materials and Methods:</i></b> Between 2020 and 2024, 44 patients with gastric cancer and type 2 diabetes were enrolled at our institution. Of these, 19 patients underwent laparoscopic radical gastrectomy with oncometabolic RNY reconstruction, and 25 patients received conventional RNY reconstruction. Demographic data (age, gender, and BMI), preoperative glycemic parameters (fasting blood sugar and HbA1c), and tumor characteristics were recorded. Comparative analysis assessed diabetes treatment outcomes in the first postoperative year, including antidiabetic medication use, insulin requirements, and diabetes remission rates. <b><i>Results:</i></b> Diabetes remission occurred in 52.6% of the oncometabolic surgery group compared with 20% in the conventional RNY group (<i>P</i> = .024). Multivariate logistic regression showed that oncometabolic surgery increased remission likelihood by 5.75 times (OR = 5.75; 95% CI: 1.17 to 28.21; <i>P</i> = .03). Antidiabetic medication use decreased by 78.9% in the oncometabolic group versus 24% in the conventional group (<i>P</i> = .001). Insulin requirements dropped from 36.8% to 5.3% in the oncometabolic group (<i>P</i> = .031). <b><i>Conclusions:</i></b> Oncometabolic surgery provides significant advantages in gastric cancer patients not only from an oncological perspective but also from a metabolic perspective.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330837","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":"The Complexity of the Transition from Open to Laparoscopic then to Robotic Liver Surgery.","authors":"Salvatore Gruttadauria, Fabrizio di Francesco","doi":"10.1177/10926429251390430","DOIUrl":"https://doi.org/10.1177/10926429251390430","url":null,"abstract":"<p><p>This piece reflects on the significant evolution in liver surgery over the past five years, building upon a previous series we published in your journal in 2020. We discuss the current state of robotic liver surgery, presenting data on its adoption in Italy and the United States, outcomes compared to open and laparoscopic techniques, and its groundbreaking potential in liver transplantation. The editorial is based on robust, recent literature and aims to provide a balanced and insightful perspective for your readership.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330917","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 Left Lateral Segmentectomy for Symptomatic Hepatic Cysts: A Case Series.","authors":"Mitsuru Yanagaki, Kenei Furukawa, Koichiro Haruki, Tomohiko Taniai, Yoshihiro Shirai, Shinji Onda, Michinori Matsumoto, Norimitsu Okui, Masashi Tsunematsu, Toru Ikegami","doi":"10.1177/10926429251390339","DOIUrl":"https://doi.org/10.1177/10926429251390339","url":null,"abstract":"<p><p>Large hepatic cysts can cause abdominal pain, pressure symptoms, or liver dysfunction. Although laparoscopic fenestration is the standard surgical approach, recurrence remains a concern. As laparoscopic hepatectomy techniques have advanced, we have adopted laparoscopic left lateral segmentectomy as a curative treatment for symptomatic cysts located in the left lateral segment. Between 2018 and 2023, 4 patients underwent laparoscopic left lateral segmentectomy for symptomatic hepatic cysts at our institution. All procedures were performed using five ports. Cystic fluid was aspirated as much as possible, and hepatic transection was conducted under the total Pringle maneuver using ultrasonic dissectors. Small vessels were sealed, while larger vessels and Glissonean pedicles were clipped or divided with linear staplers. Resected specimens were retrieved via an extended umbilical incision. Surgical and postoperative parameters were analyzed to evaluate the safety and efficacy of the procedure. The cohort included 1 male and 3 female patients, with a mean age of 63 years. Presenting symptoms included abdominal pressure (3 cases) and epigastric pain (1 case). The mean maximum cyst diameter was 16.3 cm, and the average aspirated volume was 950 mL. The mean operative time was 232 minutes, and the mean blood loss was 48 g. No postoperative complications were observed. The average postoperative hospital stay was 6 days. All patients experienced symptom resolution without delayed complications during follow-up. Laparoscopic left lateral segmentectomy might be a safe and curative surgical option for symptomatic hepatic cysts located in the left lateral segment.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145330851","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}
Wojciech Ciesielski, Tomasz Klimczak, Kacper Pawlak, Anna Sawina, Michał Kulig, Marta Cichończyk, Adam Durczyński, Janusz Strzelczyk, Piotr Hogendorf
{"title":"Improving Procedural Efficiency in Direct Peroral Cholangioscopy: A Retrospective Analysis of Intubation Time and Success Rates Across Five Techniques.","authors":"Wojciech Ciesielski, Tomasz Klimczak, Kacper Pawlak, Anna Sawina, Michał Kulig, Marta Cichończyk, Adam Durczyński, Janusz Strzelczyk, Piotr Hogendorf","doi":"10.1177/10926429251385767","DOIUrl":"https://doi.org/10.1177/10926429251385767","url":null,"abstract":"<p><p><b><i>Background:</i></b> Direct peroral cholangioscopy (DPOC) offers enhanced visualization and therapeutic capabilities in biliary tract procedures. However, comparative data on intubation methods and procedural efficiency remain limited. This study aimed to evaluate the success rate, complication rate, and intubation time across five different biliary intubation techniques used in DPOC. <b><i>Methods:</i></b> This retrospective study analyzed 36 consecutive patients who underwent DPOC between December 2021 and March 2024. Indications included cholelithiasis, cholangiocarcinoma, proximal migration of biliary prostheses, and self-expandable metallic stent (SEMS) occlusion. Five intubation methods were assessed: freehand, freehand with overtube, intraductal balloon, intraductal balloon with overtube, and intraductal balloon with overtube plus SEMS. Primary outcomes were technical success, intubation time, and complications. <b><i>Results:</i></b> All 36 procedures achieved successful biliary intubation (100% technical success) with no reported complications (0%). Mean intubation time differed significantly between methods (<i>P</i> < .001), with the shortest time observed in the intraductal balloon group (mean 73.3 seconds) and the longest in the freehand group (mean 202.25 seconds). No significant differences in intubation time were observed across clinical indications (<i>P</i> = .31). <b><i>Conclusions:</i></b> DPOC is a safe and effective procedure for various biliary pathologies, with accessory-assisted methods-particularly balloon-based techniques-demonstrating greater procedural efficiency. These findings support broader adoption of DPOC and tailored selection of intubation strategies based on anatomical and clinical context.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240192","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}
Mehmet Fatih Şahin, Oktay Özman, Kerem Teke, Muhammet Fatih Şimşekoğlu, Murat Akgül, Cem Başataç, Önder Çınar, Hakan Çakır, Duygu Sıddıkoğlu, Cenk Murat Yazıcı, Eyüp Burak Sancak, Barbaros Başeskioğlu, Haluk Akpınar, Bülent Önal
{"title":"The Impact of Preoperative JJ Stent Diameter on Retrograde Intrarenal Surgery: A RIRSearch Group Study.","authors":"Mehmet Fatih Şahin, Oktay Özman, Kerem Teke, Muhammet Fatih Şimşekoğlu, Murat Akgül, Cem Başataç, Önder Çınar, Hakan Çakır, Duygu Sıddıkoğlu, Cenk Murat Yazıcı, Eyüp Burak Sancak, Barbaros Başeskioğlu, Haluk Akpınar, Bülent Önal","doi":"10.1177/10926429251377021","DOIUrl":"10.1177/10926429251377021","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> A JJ stent placed before retrograde intrarenal surgery (RIRS) may passively dilate the ureter and facilitate ureteral access sheath (UAS) implantation. No studies have examined the significance of preoperative JJ stent diameter, even though numerous studies have shown that UAS insertion is simpler in patients with them. Our study examines the relationship between preoperative ureteral stent caliber and UAS placement and RIRS results. <b><i>Materials and Methods:</i></b> A total of 655 patients with known preoperative double-J stent size before RIRS were analyzed. The patients were categorized into two groups based on their preoperative stent diameter (Group 1: 4.8 Fr and Group 2: 6 Fr). Demographic and clinical data of the patients, stone characteristics, surgical data, perioperative and postoperative complications, duration of hospitalization, and stone-free rates (SFRs) were analyzed for comparison. <b><i>Results:</i></b> The groups contained 323 and 332 patients. The demographic data of the two groups were similar. There was no statistically significant difference between SFR, UAS insertion rate, hospitalization time, and complications. The success rate of placing a UAS with a higher caliber was statistically significantly higher in those with a 6 Fr JJ stent than in those with a 4.8 Fr stent (<i>P</i> = <b>.001</b>). The operation time was also shorter in the group with a thicker stent (<i>P</i> = <b>.003</b>). <b><i>Conclusions:</i></b> Our data suggest that while the preoperative JJ stent diameter does not significantly affect overall UAS insertion success, complication rates, or postoperative stone-free status, using a 6 Fr stent facilitates the placement of larger UAS calibers and may decrease operation time. Consequently, although both stent diameters are efficacious, selecting a 6 Fr stent may provide procedural benefits without jeopardizing safety or results.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"792-797"},"PeriodicalIF":1.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034553","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}