Journal of Laparoendoscopic & Advanced Surgical Techniques最新文献

{"title":"Comparison of Surgical Outcomes of Emergent Laparoscopic Cholecystectomy for Acute Cholecystitis Between Attending Surgeons and Residents: A Retrospective Study in Single Medical Center.","authors":"Ching-Wei Tu, Ding-Ping Sun, Khaa-Hoo Ong, Jie-Pu Chen, Chung-Han Ho, Chih-Ying Lu","doi":"10.1089/lap.2024.0393","DOIUrl":"https://doi.org/10.1089/lap.2024.0393","url":null,"abstract":"<p><p><b><i>Background:</i></b> With improvements in skills and evidence of safety, emergent laparoscopic cholecystectomy is routinely performed for acute cholecystitis, if indicated, at our hospital. However, resident operations are concerned with the dilemmas of training programs and patient safety. Hence, our aim was to clarify the safety and feasibility of emergency laparoscopic cholecystectomy performed by attending surgeons and residents. <b><i>Materials and Methods:</i></b> Our study was a retrospective review of 923 patients, who underwent laparoscopic cholecystectomy between January 2021 and June 2022 at our hospital. We excluded combined surgery, single-port methods, laparoscopic common bile duct exploration, elective surgery, and patients with Mirizzi symptoms. Of the 191 patients who underwent emergency laparoscopic cholecystectomy, 118 were operated on by residents, and 73 were operated on by attending surgeons. Patient demographics, surgical and postoperative outcomes, and length of hospital stay were compared between the groups. <b><i>Results:</i></b> No significant differences were observed in sex, age, body mass index (BMI), or surgical history. Older age (60 versus 52 years) and higher BMI (26.29 versus 25.46) were observed in the attending group, and the severity was greater than that in the resident group. No significant differences were observed in the operative results, including mortality (both groups, <i>n</i> = 0), morbidity, blood loss, or length of stay. However, the operation time was significantly shorter in the attending group obviously (86.41 versus 117.89 minutes, <i>P</i> < .0001) significantly. <b><i>Conclusion:</i></b> Emergent laparoscopic cholecystectomy for acute cholecystectomy performed by a resident under supervision appears feasible and safe. The resident operator was associated with increased operative times, however, not complications. This study confirms that residents can also finish surgery in precisely selected cases, and the more important concept is knowing the limits of asking for help.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626642","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":"Robot-Assisted Pull-Through for Anorectal Malformations: Comparative Observational Study of Functional Outcomes with an Open Approach.","authors":"Quentin Ballouhey, Pierre Meignan, Pauline Lopez, Karim Braik, Jenna Houari, Laurent Fourcade, Alexis Belgacem, Hubert Lardy","doi":"10.1089/lap.2024.0215","DOIUrl":"https://doi.org/10.1089/lap.2024.0215","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Robotic surgery has gained acceptance in the field of pediatric surgery but is still under assessment. Some limitations of this device are particularly encountered when performing specific tasks in small cavities, such as neonatal pelvis. The aim of this study was to compare the functional results of robot-assisted anorectal pull-through (RAARP) with posterior sagittal anorectoplasty (PSARP) in children with \"high\" types of anorectal malformations (ARMs). <b><i>Materials and Methods:</i></b> In this multicenter experience, we reviewed the patients operated for ARMs using the da Vinci® system between 2007 and 2020 in our national robotic program. Two groups of patients according to the surgical technique (robotic versus open) were compared based on the postoperative outcomes and long-term functional results using Kelly and Krickenbeck scores at 3 years of age. <b><i>Results:</i></b> Ten patients operated using RAARP were compared with 10 patients operated using PSARP (mean weight 8.1 ± 1.2 kg versus 8.6 ± 1.1 kg, respectively). The two groups were comparable in terms of the ARM classification and patient demographics. The clinical Kelly score was significantly lower for the PSAAP group (<i>P</i> = .012). The Krickenbeck constipation score was significantly lower for the RAARP group (<i>P</i> = .02), whereas no statistical difference was found for the soiling score and voluntary bowel movements. <b><i>Conclusions:</i></b> A concomitant laparoscopic approach using a robotic platform appears to be an alternative technique to the criterion standard for performing anorectal malformation surgery with satisfactory functional results. The enhanced potential of preserving perirectal nerves requires confirmation through longer follow-up studies focusing on functional assessment.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626645","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 Impact of Enhanced Recovery After Surgery Compliance in Colorectal Surgery for Cancer.","authors":"Ana Sarah Portilho, Maria Luiza Viana Olivé, Rodrigo Moisés de Almeida Leite, Francisco Tustumi, Victor Edmond Seid, Lucas Soares Gerbasi, Rafael Vaz Pandini, Lucas de Araújo Horcel, Sérgio Eduardo Alonso Araujo","doi":"10.1089/lap.2024.0317","DOIUrl":"10.1089/lap.2024.0317","url":null,"abstract":"<p><p><b><i>Background:</i></b> This study aimed to assess the impact of Enhanced Recovery After Surgery (ERAS) compliance and to identify which components of this protocol are most likely to affect postoperative outcomes in patients undergoing colorectal cancer surgery. <b><i>Methods:</i></b> This is a retrospective cohort evaluating patients who underwent elective colon resection. ERAS compliance was assessed based on adherence to the protocol components. The study examined the following outcomes: postoperative complications, readmission rates, mortality, conversion to open surgery, stoma creation, and length of hospital stay. <b><i>Results:</i></b> Of the 410 patients studied, 59% achieved ≥75% compliance. Comparison between compliance groups (<75% versus ≥75%) showed significant differences in overall complications (<i>P</i> = .002), severe complications (<i>P</i> = .001), and length of hospital stay (<i>P</i> < .001). The area under the receiver operating characteristic curve for predicting the absence of severe complications based on ERAS compliance was 0.677 (95% confidence interval: 0.602-0.752). Logistic regression analyses demonstrated that ERAS compliance was significantly associated with a reduced risk of severe complications (<i>P</i> < .001), as well as that the following items: avoiding prophylactic drains (<i>P</i> < .001), minimal use of postoperative opioids (<i>P</i> = .045), avoidance of postoperative salt and water overload (<i>P</i> < .001), postoperative nutritional support (<i>P</i> = .048), and early mobilization (<i>P</i> = .025). <b><i>Conclusion:</i></b> High ERAS compliance is associated with improved postoperative outcomes in colorectal cancer surgery. Key protocol components for preventing severe complications include avoiding prophylactic drains, minimal postoperative opioid use, avoiding salt and water overload, nutritional support, and early mobilization.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"185-197"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558639","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":"Choledochal Cyst in Children Under Six Months: Is Da Vinci Robot-Assisted Surgery More Advantageous?","authors":"Sai Chen, Zhigang Gao, Qingjiang Chen","doi":"10.1089/lap.2024.0031","DOIUrl":"10.1089/lap.2024.0031","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Surgery for choledochal cysts (CDC) in children younger than 6 months is relatively rare. We report our experience and compare the results between Da Vinci robot-assisted hepaticojejunostomy (RAHJ) and laparoscopic-assisted hepaticojejunostomy (LAHJ) in children younger than 6 months to treat CDC. <b><i>Methods:</i></b> A retrospective study was conducted on all children under 6 months of age who underwent RAHJ or LAHJ at the Children's Hospital, Zhejiang University School of Medicine, from July 2018 to November 2023. <b><i>Results:</i></b> We reviewed 34 patients who underwent RAHJ surgery and 50 patients who underwent LAHJ surgery (<i>P</i> = .243). RAHJ group of the median operation time was 182 minutes (range 161-221), and LAHJ group was 168 minutes (range 143-191) (<i>P</i> = .02). The RAHJ group had a significantly shorter median postoperative hospital stay of 9 days (range 7-10) than the LAHJ group, 11 days (range 10-14), <i>p</i> < .001. The median hospitalization cost in the RAHJ group was significantly higher than that in the LAHJ group (75,474 CNY versus 28,984 CNY, <i>p</i> < .01). The median follow-up time was 18 months in the RAHJ group and 48 months in the LAHJ group (<i>p</i> < .01). All patients in the RAHJ group recovered well and were discharged. One patient in the LAHJ group developed biliary fistula 21 days after surgery and recovered well after reoperation. <b><i>Conclusions:</i></b> For children under 6 months old, on the basis of no consideration of cost, RAHJ has fast postoperative recovery and fewer postoperative complications, which is more recommended.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"252-256"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933419","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":"Frozen Section Doughnuts Obtained with a 5 mm Stapling Device Improve Outcomes in Laparoscopic Endorectal Pull-Throughs for Hirschsprung's Disease.","authors":"John M Hallett, Clair Evans, Gregor Walker, Tim Bradnock","doi":"10.1089/lap.2023.0511","DOIUrl":"10.1089/lap.2023.0511","url":null,"abstract":"<p><p><b><i>Background:</i></b> A primary pull-through for Hirschsprung's disease (HD) requires confirmation of normal ganglionic bowel by intraoperative biopsies to determine the level of resection. Despite this, aganglionic bowel that is not fully resected (so-called \"transition zone pull-throughs\") is reported in 15%-19% of patients. We hypothesize that this may result from insufficient biopsies sent for intraoperative diagnosis. <b><i>Methods:</i></b> A new biopsy protocol has been developed in our institution for patients undergoing a laparoscopic-assisted endorectal pull-through for HD. Laparoscopic seromuscular biopsies are taken as per standard practice and are reported intraoperatively to identify the most distal site of ganglionic bowel. A 5 mm laparoscopic stapling device is used to divide the bowel at the proposed proximal resection margin and 2 cm distally. If there is any evidence of abnormality in the first doughnut, a second, more proximal doughnut is taken. <b><i>Results:</i></b> Between 2015 and 2020, 21 patients underwent a primary laparoscopic endorectal pull-through for HD using the doughnut biopsy protocol. Sixteen patients were male. The mean patient age at the time of surgery was 3 months (range 1-6 months), and the mean weight at the time of surgery was 6.5 kg (range 4.1-8.54 kg). In all 21 cases, initial laparoscopic biopsies were reported showing normal ganglionic bowel; in two cases (10%), the laparoscopic doughnut influenced the proximal resection margin. In both cases, aganglionic tissue was identified intraoperatively in the doughnuts, and a second, more proximal doughnut was sent. No patients had transition zone resections on final histology (mean clear margin 45.55 mm, range 11-72 mm). <b><i>Conclusions:</i></b> In conclusion, intraoperative frozen sections taken from doughnuts of bowel retrieved using 5 mm laparoscopic stapling devices are safe and have resulted in a 0% rate of transition zone pull-throughs while reducing the potential of spillage of enteric contents. We would recommend this protocol for all patients undergoing primary endorectal pull-throughs.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"247-251"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958187","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":"Optimizing Prostate Cancer Surgery for Seniors: Single-Port Robotic-Assisted Platform.","authors":"Hakan Bahadir Haberal, Luca Lambertini, Giulio Avesani, Greta Pettenuzzo, Matteo Pacini, Fabio Maria Valenzi, Muhannad Aljoulani, Ruben Calvo Sauer, Juan Ramon Torres-Anguiano, Simone Crivellaro","doi":"10.1089/lap.2024.0387","DOIUrl":"10.1089/lap.2024.0387","url":null,"abstract":"<p><p><b><i>Background:</i></b> The Da Vinci single-port (SP) platform is being used more frequently in radical prostatectomy (RP). In this study we aimed to compare the complications and oncological outcomes of the Da Vinci SP platform in robotic-assisted radical prostatectomy (SP-RARP) between elderly and young age-groups and to further examine differences between young-old and old-old patients. <b><i>Materials and Methods:</i></b> Data from 193 patients who underwent SP-RARP between December 2018 and June 2024 were analyzed. Patients were categorized into two age-groups: young (18-64 years) and elderly (65+ years). The elderly group was further divided into young-old (65-69 years) and old-old (70+ years) subgroups. The analysis considered variables related to patient characteristics, intraoperative outcomes, complications, and postoperative oncological outcomes. <b><i>Results:</i></b> The median age of the patients at the time of surgery was 64 (9.5) years. The intraoperative complication rate of 1.6%, with no cases requiring conversion to open surgery. The overall incidence of postoperative adverse events was 24.4%, and the 30-day readmission rate was 11.4%. Intraoperative complications and 30-day readmission rates were similar between groups (<i>P</i> = .593 and <i>P</i> = .821, respectively), while the postoperative complication rate was significantly higher in the younger patient group (<i>P</i> = .012). The median length of hospital stay (LOS) was 7 (22) hours and 110 (57%) patients were discharged on the same day (SDD). LOS and SDD rates were similar between groups (<i>P</i> = .389 and <i>P</i> = .529, respectively). The 3-year and 5-year biochemical recurrence (BCR)-free survival rates were 80.5% and 75.1%, respectively. The BCR-free survival rates were similar between both young and elderly patients and between the young-old and old-old groups (<i>P</i> = .751, <i>P</i> = .765, respectively). <b><i>Conclusion:</i></b> SP-RARP is a feasible option for elderly patients, delivering acceptable oncological outcomes with a low incidence of postoperative complications.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"240-246"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061294","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":"Abdominoperineal Resection in Prone Versus Supine Position: A Systematic Review and Meta-Analysis.","authors":"Bernardo Fontel Pompeu, Eric Pasqualotto, Beatriz D'Andrea Pigossi, Matheus Reginato Araujo, Lucas Monteiro Delgado, Lucas Soares de Souza Pinto Guedes, Sergio Mazzola Poli de Figueiredo, Fernanda Bellotti Formiga","doi":"10.1089/lap.2024.0372","DOIUrl":"10.1089/lap.2024.0372","url":null,"abstract":"<p><p><b><i>Background:</i></b> Abdominal perineal resection (APR) remains the gold standard for lower rectal cancer involving the anal sphincter. However, the optimal patient position remains unclear. While lithotomy or Lloyd-Davies are commonly used, APR and extra-levator abdominal perineal excision (ELAPE) in a prone jackknife position have been linked to better oncological outcomes. <b><i>Methods:</i></b> We searched PubMed, Embase, the Central Register of Clinical Trials, and Web of Science for randomized controlled trials (RCTs) and observational studies published up to February 2024. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was assessed using <i>I</i>² statistics. Statistical analysis was performed with R Software version 4.4.1. <b><i>Results:</i></b> Two RCTs and 26 observational studies, including 4529 patients, were analyzed. Among them, 2249 (49.7%) underwent APR or ELAPE in the prone position and 2280 (50.3%) in the supine position. The prone position was associated with reduced surgical specimen perforation (5.3% versus 9.4%; OR: 0.44; 95% CI: 0.39-0.78; <i>P</i> < .001), lower positive circumferential resection margins (CRMs) rates (9.8% versus 14.3%; OR: 0.69; 95% CI: 0.53-0.89; <i>P</i> < .001), and decreased intraoperative bleeding (mean difference: -63.7 mL; 95% CI: -104.5, -22.8; <i>P</i> < .01). No significant differences were observed in operative time, urinary retention, urinary injury, wound infections, perineal dehiscence, Clavien-Dindo ≥3, reoperation, local recurrence, distal recurrence, or overall survival. <b><i>Conclusion:</i></b> The prone position during APR is associated with reduced specimen perforation, lower positive CRM rates, and less intraoperative bleeding without significant differences in other clinical outcomes.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"224-239"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558634","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":"Evaluation of Risk Factors Leading to Conversion from Laparoscopic Cholecystectomy to Open Surgery: A Retrospective Controlled Study.","authors":"Burak Dinçer, Sinan Ömeroğlu, Aydın Eray Tufan, Mehmet Ali Uzun","doi":"10.1089/lap.2024.0366","DOIUrl":"10.1089/lap.2024.0366","url":null,"abstract":"<p><p><b><i>Background:</i></b> Laparoscopic cholecystectomy (LC) is one of the most frequently performed operations in surgical practice. Despite increasing experience and technological advances, conversion to open surgery is still necessary in some cases. Although several studies have identified factors associated with increased risk of conversion, debates continue in the literature. This study aimed to evaluate the factors affecting the risk of conversion to open cholecystectomy. <b><i>Materials and Methods:</i></b> Patients who underwent surgery for cholelithiasis between 2020 and 2023 were analyzed retrospectively. Patients who underwent open cholecystectomy, those who had cholecystectomy as part of another surgical procedure, and patients with gallbladder malignancy (except incidental cases) were excluded from the study. Patients were analyzed based on demographic, clinical, laboratory, radiological, and histopathological data. This study was registered at ClinicalTrials.gov (NCT06244589). <b><i>Results:</i></b> A total of 1695 patients were included in the study. The median age was 50 years, and 66.6% of patients were female. Conversion from LC to open surgery occurred in 44 patients (2.6%). Multivariate analysis identified male sex, a history of major abdominal surgery, the need for emergency surgery due to acute cholecystitis, an elevated leukocyte count, and gallbladder wall thickening on abdominal ultrasonography as independent risk factors for conversion to open cholecystectomy. <b><i>Conclusion:</i></b> Male gender, previous major abdominal surgery, emergency surgery due to acute cholecystitis, high leukocyte count, and gallbladder wall thickening on abdominal ultrasonography are independent risk factors for conversion from LC to open surgery. It should be kept in mind in the treatment of patients planned for LC.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"204-209"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484570","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 Use of 8-mm Powered Articulation Endostapler for Sublobar Resection in Children. Preliminary Case Series.","authors":"Carlos Delgado-Miguel, Ennio Fuentes, Pablo Aguado, Ricardo Díez","doi":"10.1089/lap.2024.0298","DOIUrl":"10.1089/lap.2024.0298","url":null,"abstract":"<p><p><b><i>Background:</i></b> Video-assisted thoracoscopic surgery (VATS) is considered the treatment of choice in children with subpleural bullous lesions, in which endoscopic staplers are routinely used. Recently, a new generation of electronically powered stapling systems was developed. Our aim is to compare the use of a new 8-mm electronic endostapler with a 12-mm nonelectronic conventional device in thoracoscopic sublobar resection in children. <b><i>Methods:</i></b> We performed a retrospective single-center study in patients under 18 years who underwent VATS sublobar resection of subpleural bullae in our institution between January 2022 and December 2023. They were divided into two groups according to the type of endostapler used (8 mm electronic or 12 mm non-electronic). Demographic, clinical, intraoperative and postoperative outcomes were analyzed. <b><i>Results:</i></b> We included 8 patients (4 in each group), with a median age of 13.2 years (interquartile range [IQR]: 10.7-15.4 years), without demographic or clinical differences between them. Median surgery time was 42 minutes (IQR 35-55 minutes) in the 8-mm electronic group compared with 53 minutes (IQR 45-65 minutes) in the 12-mm group. There were no intraoperative complications and no reconversions to open surgery. Median length of drainage therapy did not show significant differences between them (3 days in both groups; <i>P</i> = .512). No postoperative complications were reported. <b><i>Conclusion:</i></b> Preliminary results of the 8-mm electronic endostapler appear to be comparable with the conventional mechanical stapler. Advantages include smaller incisions, as well as one-handed, push-button operation, which eliminates the manual firing force and possibly enables more precise resection. Further studies are still needed.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"266-270"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371435","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":"Open Versus Minimally Invasive Morgagni Hernia Repair in Pediatric Surgery: A Review.","authors":"Dorsa Safari, Zahra Mohajer, Farbod Ghobadinezhad, Bahar Ashjaei","doi":"10.1089/lap.2024.0262","DOIUrl":"10.1089/lap.2024.0262","url":null,"abstract":"<p><p><b><i>Background:</i></b> Morgagni hernia (MH), a rare type of congenital diaphragmatic hernia, does not have an established protocol for surgical repair. <b><i>Materials and Methods:</i></b> A MEDLINE search with terms related to various surgical approaches to repair MH in children was conducted. Articles comprising robotic-assisted surgery, laparoscopy, laparotomy, thoracoscopy, and thoracotomy over the last 20 years were assessed. <b><i>Results:</i></b> This narrative review provides an overview of MH in the pediatric population, covering the epidemiology, diagnosis, and management of this rare diaphragmatic hernia. We discuss various surgical techniques, including open and minimally invasive approaches, and compare their advantages and limitations in childhood MH repair. In addition, we address arguments for and against controversial topics such as hernia sac excision and patch reinforcement. <b><i>Conclusions:</i></b> Regarding MH in children, transabdominal repair is superior to transthoracic due to improved visualization of bilateral defects and easier reduction of the hernia contents. Laparoscopy has been reported as a popular approach. Single-site laparoscopy has gained attention due to better outcomes than standard three-port laparoscopy. Considering a limited number of children in the literature who underwent robotic MH repair, perioperative complications were reported to be minor.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"257-265"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069305","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}