Journal of Laparoendoscopic & Advanced Surgical Techniques最新文献

{"title":"Clinical Utility of a Small Diameter Reload in Pediatric Appendectomies.","authors":"Elisabeth T Tracy, Sabino Zani, Neetha P Desai, Sylvain Anselme, Christopher Derderian","doi":"10.1177/10926429261427703","DOIUrl":"10.1177/10926429261427703","url":null,"abstract":"<p><strong>Introduction: </strong>Appendectomies are common among pediatric patients. This study aimed to assess the safety and utility of a two-row stapler reload in pediatric appendectomies.</p><p><strong>Methods: </strong>A prospective registry was used to collect study data at two U.S. centers to evaluate Signia™ Small Diameter Reload (SDR) ligating the appendiceal stump and mesoappendix. Incidence of hemostatic and leak interventions was collected as the primary measure.</p><p><strong>Results: </strong>SDR was fired 100 times across 95 patients with no intervention needed for hemostatic or leaks due to staple-line integrity concerns or device failures. No device-related complications or deficiencies occurred within 30 days of the operation.</p><p><strong>Conclusion: </strong>The two-row stapler reload demonstrated safety and efficacy in pediatric appendectomies. Outcomes were consistent across patient age, patient weight, type of appendicitis, and stapler handle used.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"472-476"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327896","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":"Rouviere's Sulcus Anatomy and Its Overall Impact on Operative Time and Complications in Laparoscopic Cholecystectomy: A Longitudinal Observational Study.","authors":"Srinivasa Swamy Bandaru, Ahmed Omer Maasher, Yasir Adam Fadlalla, Qahtan Ahmed Al Dulaimi, Somar Sleman Ajeka, Fadi Hassan Al Masalmeh, Chaitanya Garg, Pawan Sah, Mohammed Omara, Abubaker Elawad, Udithi Bandaru","doi":"10.1177/10926429261435976","DOIUrl":"10.1177/10926429261435976","url":null,"abstract":"<p><strong>Background: </strong>Rouviere's sulcus (RS) is widely regarded as an important extra biliary landmark during laparoscopic cholecystectomy (LC), yet its visibility, anatomical variability, and true impact on operative safety remain debated. This study evaluates RS morphology, its incidence of absence, and its influence on operative metrics and complications in a 2-year cohort.</p><p><strong>Methods: </strong>A longitudinal observational study was conducted at a single public hospital in the United Arab Emirates, including all elective and emergency LC cases from 2024 to 2025. Electronic medical records and operative videos were reviewed to document RS type, presence or absence, critical view (CV) dissection time, total operative time, and perioperative complications. Statistical analyses included Kruskal-Wallis, Mann-Whitney U, χ²/Fisher's exact tests, and Spearman correlation.</p><p><strong>Results: </strong>Among 130 LC cases, RS was identifiable in 85.4%, with 14.6% absence (95% CI: 9.56-21.70). RS morphology (open, slit, scar, and closed) showed no significant effect on CV dissection or operative time (<i>P</i> > .08). However, RS absence was associated with a significantly longer CV dissection time (median 20 versus 18 minutes; <i>P</i> = .030), while the increase in operative time did not reach significance. Demographic factors and comorbidities showed no association with RS type or visibility. Complications were infrequent (4.6%) and unrelated to RS presence. CV dissection time strongly correlated with total operative duration (ρ = 0.834).</p><p><strong>Conclusions: </strong>RS was present in most patients, and its absence modestly prolonged CT dissection but did not significantly affect overall operative time or complication rates. While RS can aid orientation, it should complement rather than replace established safety strategies such as the Critical View of Safety and bailout techniques. Multicenter studies are warranted to further clarify the clinical utility of RS morphology.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"440-444"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147533641","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 Liver Venous Deprivation Ready to Replace Portal Vein Embolization?","authors":"Salvatore Gruttadauria, Duilio Pagano, Sergio Li Petri, Fabrizio di Francesco, Pasquale Bonsignore, Sergio Calamia, Alessandro Tropea, Ivan Vella, Caterina Accardo, Irene Vitale, Federica Chimenti, Roberto Miraglia","doi":"10.1177/10926429261437235","DOIUrl":"10.1177/10926429261437235","url":null,"abstract":"<p><p>Portal vein embolization (PVE) is the standard strategy to increase future liver remnant (FLR) before major hepatectomy, but its limitations-variable hypertrophy, slower kinetics, and clinically relevant dropout from insufficient FLR growth or tumor progression-have accelerated interest in alternative approaches. Liver venous deprivation (LVD), combining portal inflow deprivation with ipsilateral hepatic venous outflow occlusion, has a strong physiological rationale: It may intensify regenerative signaling and reduce compensatory collateralization within the embolized liver, thereby promoting faster FLR increase. Emerging observational evidence and multicenter experiences suggest that dual-vein strategies can shorten time to adequate FLR and may improve the probability of timely resection in selected high-risk candidates, without a clear safety penalty when performed in experienced centers. However, current data are heterogeneous in patient selection, technique, and endpoints; volumetric hypertrophy does not always translate into functional gain, particularly in injured or cholestatic livers. Therefore, LVD is not yet ready to universally replace PVE, but it is increasingly reasonable as a first-line alternative in carefully selected patients, ideally supported by multidisciplinary selection, standardized reporting, and functional FLR assessment. Ongoing randomized trials and harmonized outcome definitions will be decisive to establish whether LVD should become the new reference or remain a complementary option.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"459-462"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516384","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":"Portable Neonatal Esophageal Atresia Simulator Improves MIS Acquisition Amongst Surgical Trainees: A Randomized Control Crossover Trial.","authors":"Georges Kamil Tinawi, Gabriella Natalie Alexandra, Michael Reeves, Spencer W Beasley, Jonathan M Wells","doi":"10.1177/10926429261428659","DOIUrl":"10.1177/10926429261428659","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgical (MIS) skills are increasingly expected of surgical trainees; however, opportunities to practice these outside the operating theater are limited. Current pediatric surgery trainees have limited exposure to thoracoscopic repair of esophageal atresia (OA/TOF) during their training. We evaluated the utility of a neonatal OA/TOF simulator for the acquisition and retention of MIS skills amongst surgical trainees.</p><p><strong>Methods: </strong>Randomized controlled cross-over trial of 20 surgical trainees in New Zealand. Participants were block-randomized into two groups: SIM versus NO-SIM groups. Each group had 12 weeks of access to the take-home Symulus neonatal OA/TOF simulator before crossover. During the intervention period, participants practiced three MIS tasks in a self-directed manner: ring transfer (RT), needle pass (NP), and anastomotic suture (AS). Modified objective structured assessment of technical skills (OSATS) scores were recorded at baseline, mid-point, and study completion.</p><p><strong>Results: </strong>OSATS scores were highest for the RT task, followed by NP and AS tasks. A significant increase in OSATS scores was observed for the NP (<i>P</i> = .017) and AS tasks (<i>P</i> < .001). The SIM group, who had earlier access to the simulator, appeared to outperform the NO-SIM group at all time points, although this difference did not reach statistical significance. While the RT and NP scores converged over time, the AS scores (representing a higher level of skill) diverged over time.</p><p><strong>Conclusions: </strong>Our analysis demonstrates the effectiveness of this OA/TOF simulator in facilitating the acquisition and retention of MIS skills via self-directed learning. These findings support the integration of similar surgical simulators into current training programs to enhance MIS skill acquisition in a low-risk, accessible setting; particularly for those procedures where the complexity is high, but the frequency of cases is low.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"477-482"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391209","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":"Hybrid Minimally Invasive Management of Thoracic Esophageal Perforations: Technical Feasibility in Selected Patients.","authors":"Quentin Chenevas-Paule, Emmanuel Devant, Pierre Yves Sage, Julio Abba, Edouard Girard, Mircea Chirica","doi":"10.1177/10926429261437684","DOIUrl":"10.1177/10926429261437684","url":null,"abstract":"<p><strong>Background: </strong>Thoracic esophageal perforation (EP) is a life-threatening emergency. While minimally invasive techniques have been successfully utilized, the heterogeneity of clinical presentations (perforation location, delays in treatment, tissue quality, etc.) has prevented the establishment of a standardized management approach. We present our experience with a minimally invasive management protocol combining thoracoscopy and endoscopy.</p><p><strong>Methods: </strong>Between December 2023 and January 2025, 5 patients with thoracic EP underwent a thoracoscopic approach. Primary closure via direct suturing, lavage, and drainage was performed when feasible. Persistent leaks were addressed with endoscopic interventions, including vacuum-assisted therapy and stent placement. A retrospective review of patient medical records was conducted.</p><p><strong>Results: </strong>Of the five perforations, four were right-sided, and one was left-sided. Three cases were spontaneous, while two were iatrogenic (one following bariatric surgery and the other after endoscopic dilation). One patient had a perforation associated with malignancy, and another was on long-term high-dose steroid therapy. Management was initiated within 24 hours after the onset of symptoms in 3 patients and after 48 hours in 2 patients. Persistent leaks occurred in 3 patients (two late presentations and one corticosteroid impregnation). There were no fatalities. Esophageal preservation was achieved in all cases, and all patients resumed oral intake by the end of follow-up.</p><p><strong>Conclusions: </strong>Thoracic EP can be effectively managed using minimally invasive techniques. Avoiding thoracotomy and complex surgical procedures may offer significant benefits for critically ill patients.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"463-469"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147610242","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":"<i>Letter:</i> Erector Spinae Plane Block May Facilitate Earlier Return to Daily Activities after Open Inguinal Hernia Repair: Preliminary Findings.","authors":"Tolga Karaçay, Başak Altıparmak, Efsane Karcı Şınga, Kaan Mircalı, Melike Korkmaz Toker","doi":"10.1177/10926429261438354","DOIUrl":"10.1177/10926429261438354","url":null,"abstract":"","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"470-471"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516447","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":"Transanal TME Video Quality on YouTube Versus WebSurg and the Development of a Procedure-Specific TaTME StepScore: A Cross-Sectional Validation Study.","authors":"Alp Omer Canturk, Bahaeddin Umur Aka, Murat Coskun, Erhan Eroz, Adem Senturk, Emre Gonullu","doi":"10.1177/10926429261435688","DOIUrl":"10.1177/10926429261435688","url":null,"abstract":"<p><strong>Background: </strong>Video-based learning is a central tool in minimally invasive surgical training; however, the educational/reporting quality and reliability of online content must be evaluated using objective criteria. This study aimed to compare the educational quality of transanal total mesorectal excision (TaTME) videos published on YouTube and WebSurg and to test the validity of the TaTME-specific StepScore scale.</p><p><strong>Methods: </strong>A cross-sectional content analysis was performed across platforms (total <i>n</i> = 30; YouTube = 15, WebSurg = 15). Videos were scored using Laparoscopic Surgery Video Educational Guidelines (LAP-VEGaS) (0-18), Journal of the American Medical Association (JAMA) (0-4), modified DISCERN (mDISCERN) (5-25), and total mesorectal excision (TME) StepScore (14 steps, 0-28). Correlations were examined using Spearman's ρ with false discovery rate adjustment. Logistic regression and ROC/AUC were used to predict LAP-VEGaS ≥ 11 adequacy; the optimal threshold was determined using the Youden index.</p><p><strong>Results: </strong>Total scores and LAP-VEGaS ≥ 11 rates were similar across platforms (YouTube 66.7%; WebSurg 60.0%). StepScore showed a strong correlation with LAPVEGaS and mDISCERN and a moderate correlation with JAMA. Each +1 point increase in StepScore increased the odds of a LAP-VEGaS score ≥ 11. According to the Youden analysis, a StepScore ≥ 15 was found to be the best threshold.</p><p><strong>Conclusion: </strong>Popular TaTME videos on YouTube and WebSurg appear similar in terms of educational/reporting quality. The procedure-specific StepScore is consistent with general quality measures and can predict LAP-VEGaS ≥ 11 adequacy with a practical ≥15 point target. Using StepScore for video assessment and as a step-by-step instructional checklist may contribute to improving TaTME training standards.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"433-439"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147533590","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":"Image-Guided Robotic-Assisted Waterjet Ablation of Prostate (Aquablation) Versus Convective Water Vapor Thermal Therapy (Rezūm) in Patients with Prostate Volume Less than 80 Grams.","authors":"Dolev Perez, Ariel Mamber, Michael Pasherstnik, Dmitry Koulikov, Ala Eddin Natsheh, Ofer Z Shenfeld, Ilan Z Kafka, Yehuda Warszawer, Andres Malinger, Boris Chertin","doi":"10.1177/10926429261434787","DOIUrl":"10.1177/10926429261434787","url":null,"abstract":"<p><strong>Purpose: </strong>Aquablation and Rezūm are established minimally invasive surgical therapies for benign prostatic hyperplasia (BPH) in men with moderate-sized prostates. However, direct real-world data comparing outcomes of these techniques in prostates <80 g remain limited. This study aimed to evaluate and contextualize perioperative and functional outcomes of Aquablation and Rezūm in a prospective, nonrandomized cohort.</p><p><strong>Methods: </strong>We conducted a prospective, nonrandomized comparative cohort study between 2023 and 2025 at a single tertiary center. Treatment allocation was based on the patient's informed preference following standardized counseling. Men with moderate-to-severe lower urinary tract symptoms and prostate volume <80 g were included. Outcomes included the International Prostate Symptom Score, quality of life (QoL), irritative symptoms, urinary continence, sexual function, perioperative parameters, complications, and retreatment. Between-group comparisons were exploratory and interpreted descriptively due to baseline differences.</p><p><strong>Results: </strong>A total of 428 patients were analyzed, including 324 who underwent Aquablation and 104 who underwent Rezūm. Baseline characteristics differed between groups, with Aquablation patients being older and having larger prostates and higher comorbidity burden. Both procedures resulted in significant and durable improvements in lower urinary tract symptoms and QoL. Aquablation demonstrated numerically greater symptom improvement and faster reduction in irritative symptoms, while Rezūm was associated with shorter operative time and same-day discharge. Erectile and ejaculatory function were largely preserved in both cohorts. Perioperative complication and retreatment rates were low and comparable.</p><p><strong>Conclusion: </strong>In this real-world, nonrandomized cohort, both Aquablation and Rezūm provided meaningful and durable symptom relief with preservation of sexual function in men with prostates <80 g. Given baseline imbalances and patient-preference-based allocation, outcomes should be interpreted as descriptive of real-world performance rather than as definitive comparative superiority. These findings support both modalities as effective minimally invasive options, with treatment selection guided by patient characteristics, expectations, and resource considerations.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"417-422"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500479","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":"Impact of Endoscopic Surgical Skill Qualification System on Surgical Technique and Training in Japan: Insights from an Eight-Year Survey.","authors":"Shota Eguchi, Yoshio Nagahisa, Kenji Yamaguchi, Yukio Inamura, Michio Okabe, Toshihiko Masui","doi":"10.1177/10926429261438097","DOIUrl":"10.1177/10926429261438097","url":null,"abstract":"<p><strong>Background: </strong>The Endoscopic Surgical Skill Qualification System (ESSQS), established by the Japanese Society for Endoscopic Surgery, provides a centralized video-based framework for certifying advanced laparoscopic surgeons. Its impact on surgical practice and education in inguinal hernia repair has not been fully clarified.</p><p><strong>Methods: </strong>Between 2016 and 2023, a nationwide questionnaire combining multiple-choice and open-ended items was distributed to all surgeons certified in endoscopic hernia repair under ESSQS. Of 120 eligible surgeons, 103 (85.8%) responded. Data included surgical techniques, dissection methods, mesh selection, fixation practices, and video submissions required for certification. Trends were analyzed across early (2016-2019) and late (2020-2023) cohorts.</p><p><strong>Results: </strong>The surgical techniques used in the certification examination were transabdominal preperitoneal inguinal hernia repair (TAPP) (<i>n</i> = 99) and totally extraperitoneal inguinal hernia repair (<i>n</i> = 4). Gauze-assisted dissection became standard (>80% adoption). Use of L-sized mesh increased significantly in the late cohort compared with the early cohort (56.0% vs 85.7%; <i>P</i> = .00175), reflecting progressive standardization. Median video duration was 63 minutes, and the median number of cases before certification was approximately 100. Mesh fixation methods remained stable, with a median of 5-6 tacks per case.</p><p><strong>Conclusions: </strong>The ESSQS has contributed to the standardization of surgical education and practice in Japan, particularly in TAPP hernia repair, and this framework-rarely seen in Western qualification systems-underscores the importance of structured evaluation in advancing both technical proficiency and educational quality. This study was approved by our Institutional Review Board (Approval No. 4763) and the Medical Ethics Committee of Kurashiki Central Hospital.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"445-450"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147516400","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":"Comparison of Clinical Outcomes Between Da Vinci Robot-Assisted and Laparoscopic Intersphincteric Resection for Ultra-Low Rectal Cancer.","authors":"ChangZhong Fang, Jiming Lian, Nanhui Yu, Shuang Liu","doi":"10.1177/10926429261435555","DOIUrl":"10.1177/10926429261435555","url":null,"abstract":"<p><p>Preserving anal function in ultra-low rectal cancer surgery remains challenging in terms of technique and perioperative management. With advancements in minimally invasive techniques, Da Vinci robot-assisted intersphincteric resection (ISR) has been increasingly utilized, yet its clinical benefits remain unclear. This retrospective cohort study included 142 patients who underwent ISR at the Second Xiangya Hospital of Central South University from January 2019 to December 2024, divided into the robot-assisted ISR (RoISR) group (<i>n</i> = 71) and the laparoscopic ISR (LaISR) group (<i>n</i> = 71). Perioperative outcomes, postoperative complications, pain scores (numerical rating scale [NRS]), Wexner scores, quality of life (Functional Assessment of Cancer Therapy-Colorectal [FACT-C] scale), and long-term survival outcomes were compared. Results showed that RoISR had a longer operative time (220.27 ± 32.21 versus 179.63 ± 23.88 minutes, <i>P</i> < .001) but earlier time to first flatus (1.77 ± 1.50 versus 2.32 ± 1.67 days, <i>P</i> = .041) and shorter hospital stay (8.25 ± 3.38 versus 9.77 ± 4.63 days, <i>P</i> = .027), with comparable blood loss and costs. The 30-day complication rate was lower in the RoISR group (7.04% versus 19.72%, <i>P</i> = .027), including reduced anastomotic complications (1.41% versus 5.63%) and bleeding (0% versus 4.23%). NRS pain scores were lower in the RoISR group at 12 hours (3.56 ± 0.84 versus 4.79 ± 1.11, <i>P</i> < .001), 24 hours (1.90 ± 0.85 versus 2.35 ± 1.02, <i>P</i> = .05), and 48 hours (1.07 ± 0.87 versus 1.61 ± 0.80, <i>P</i> < .001). Wexner scores showed greater improvement in the RoISR group at 3 months (9.49 ± 2.26 versus 10.45 ± 2.10, <i>P</i> = .01) and 6 months (7.18 ± 1.88 versus 7.94 ± 1.96, <i>P</i> = .02). Emotional functioning on the FACT-C scale was significantly better in the RoISR group (<i>P</i> = .028). Kaplan-Meier analysis indicated no significant differences in overall survival or recurrence-free survival (RFS) between groups. In conclusion, RoISR offers advantages in perioperative recovery, reduced complications, and improved aspects of quality of life, with long-term survival outcomes comparable to LaISR.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"423-432"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147500542","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}