Journal of Laparoendoscopic & Advanced Surgical Techniques最新文献

{"title":"Antiplatelet Therapy in Inguinal Hernia Repair: To Continue or Interrupt? A Systematic Review and Meta-Analysis.","authors":"Augusto Graziani E Sousa, Caroline Daleaste Wilmsen, Júlia Copetti Burmann, Júlia Martins da Silva Duarte, Raquel Nogueira, Flavio Malcher, Diego L Lima","doi":"10.1177/10926429261437019","DOIUrl":"10.1177/10926429261437019","url":null,"abstract":"<p><strong>Introduction: </strong>This study aims to perform a comprehensive systematic review and meta-analysis to evaluate the effect of antiplatelet therapy during inguinal hernia repair (IHR) and its respective outcomes.</p><p><strong>Methods: </strong>PubMed, Cochrane, and Embase were searched for studies comparing the use of antiplatelet agents in patients undergoing IHR. The results analyzed were hematoma, bruising, seroma, surgical site occurrences (SSOs), surgical site infection (SSI), operative time, length of stay (LOS), reoperation, hernia recurrence, and readmission. Statistical analysis was performed with Review Manager 5.4 using a random-effects model.</p><p><strong>Results: </strong>From 1588 records, 5 studies were included, encompassing 5610 patients (antiplatelet continuation <i>n</i> = 517), with 90% of patients submitted to open surgical repair and a mean follow-up time of 115 days. Overall analysis showed comparable results between groups regarding hematoma (risk ratio [RR]: 0.99; 95% confidence interval [CI]: 0.35 to 2.81; <i>P</i> = .98), bruising (RR: 1.89; 95% CI: 0.65 to 5.45; <i>P</i> = .24), seroma (RR: 1.00; 95% CI: 0.40 to 2.50; <i>P</i> = .99), SSO (RR: 1.09; 95% CI: 0.68 to 1.64; <i>P</i> = .72), reoperation (RR: 5.11; 95% CI: 0.62 to 42.26; <i>P</i> = .13), operative time (mean difference [MD] = 0.85 minutes; 95% CI: -0.47 to 2.16 minutes; <i>P</i> = .21), and LOS (MD = -0.28 days; 95% CI: -0.85 to 0.29 days; <i>P</i> = .34). Additionally, no statistically significant results were seen for SSI (RR: 0.39; 95% CI: 0.02 to 9.16; <i>P</i> = .56), readmission (RR: 0.46; 95% CI: 0.10 to 2.18; <i>P</i> = .32), and hernia recurrence rates (RR: 2.73; 95% CI: 0.25 to 29.45; <i>P</i> = .41).</p><p><strong>Conclusion: </strong>Antiplatelet therapy during IHR is safe and associated with comparable results between groups for SSO, reoperation, operative time, LOS, SSI, readmission, and hernia recurrence rates.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"451-458"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640389","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":"Artificial Intelligence Applications in General Surgery in the United States of America: A Bibliometric Analysis.","authors":"Clara Avelar Mendes de Vasconcellos, Elisa Guimarães Forchezatto, Gabriela Lyons, Thiago Souza E Silva, Raquel Nogueira, Flavio Malcher, Leandro Totti Cavazzola, Diego Laurentino Lima","doi":"10.1177/10926429261449958","DOIUrl":"https://doi.org/10.1177/10926429261449958","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) is rapidly transforming surgical practice, with applications spanning preoperative planning, intraoperative guidance, postoperative management, and surgical education. Despite accelerating research activity, the structure, thematic evolution, and funding landscape of AI research in general surgery remain incompletely characterized. This study aimed to systematically evaluate scientific production on AI in general surgery in the United States over the past 5 years using a bibliometric approach.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted following Preliminary Guideline for Reporting Bibliometric Reviews of the Biomedical Literature and Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines using Web of Science. English-language articles published between 2020 and 2025 with a U.S.-affiliated senior author and focused on AI use in general surgery were included. Publications were analyzed across five primary domains: authorship metrics, thematic endpoints, journal characteristics, country of origin, and funding patterns. Bibliometric indicators included H-index, citation counts, Article Influence Score (AIS), and Bradford's Law classification. Funding distribution across endpoints was evaluated using chi-square or Fisher's exact tests, with effect sizes estimated using Cramér's V and odds ratios. Temporal trends in endpoints and keywords were assessed using Poisson and negative binomial regression models.</p><p><strong>Results: </strong>Fifty-nine studies met inclusion criteria, comprising 20 reviews and 39 original investigations. Scientific production increased consistently from one study in 2019 to 17 in 2023 and 16 in 2024, demonstrating sustained growth. Surgical workflow recognition (<i>n</i> = 19) and clinical decision support (<i>n</i> = 18) were the predominant research domains, representing 63% of the included literature. Temporal analysis demonstrated significant annual growth in reviews (Incidence rate ratios [IRR] 2.09, <i>P</i> = .002) and workflow-focused studies (IRR 1.37, <i>P</i> = .031). Keyword analysis revealed sustained prominence of AI and machine learning, with limited emergence of new thematic directions. Most studies reported no funding (57.6%). Although overall funding distribution did not significantly differ across application categories (<i>P</i> = .846), clinically actionable AI applications were significantly more likely to receive funding compared with other research areas (OR 4.0, 95% CI 1.22-13.13; <i>P</i> = .029).</p><p><strong>Conclusion: </strong>AI research in U.S. general surgery is growing but remains concentrated in workflow and decision-support domains. Funding favors clinically actionable applications, highlighting the need for broader, equity-focused AI development.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261449958"},"PeriodicalIF":1.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857466","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 Transabdominal Preperitoneal and Totally Extraperitoneal Repair in Laparoscopic Inguinal Hernia: A Randomized, Clinical Trial on Postoperative Complications, Pain, and Functional Recovery.","authors":"Amin Khayreddine Ghouali, Fouad Benamara, Loubna Bouhmama, Khadija Larabi, Elhassen Ahmed Lachachi, Smain Nabil Mesli, Chakib Mohammed Abi-Ayad","doi":"10.1177/10926429261450400","DOIUrl":"https://doi.org/10.1177/10926429261450400","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic repair is recommended for inguinal hernia because it is associated with reduced postoperative pain and faster recovery compared with open repair. However, the choice between transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) techniques remains controversial.</p><p><strong>Methods: </strong>A prospective randomized, clinical trial was conducted between November 2021 and June 2025. Adult male patients with unilateral uncomplicated inguinal hernias were included. Patients were randomized in a 1:1 ratio to undergo TAPP or TEP repair. The primary endpoint was 30-day postoperative complications graded according to the Clavien-Dindo classification. Secondary endpoints included chronic pain, functional recovery, and recurrence.</p><p><strong>Results: </strong>A total of 144 patients were included and randomized, with 72 patients in each group. Briefly, 30-day postoperative complications were significantly more frequent after TAPP than TEP (19.4% versus 6.9%, <i>P</i> = .024). Most complications were minor (Grades I-II), and three Grade IIIa events required percutaneous aspiration. Chronic pain at 3 months was observed in 5.6% of patients after TAPP and 1.4% after TEP (<i>P</i> = .181). Time to return to normal activity did not differ significantly between groups. After a median follow-up of 26 months, the recurrence rate was 2.8% in both groups.</p><p><strong>Conclusion: </strong>TEP was associated with significantly lower short-term postoperative complications and shorter hospital stays, while long-term outcomes were comparable between techniques.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261450400"},"PeriodicalIF":1.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857476","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":"Advances in Adrenal Surgery: An Update.","authors":"Eren Berber","doi":"10.1177/10926429261449966","DOIUrl":"https://doi.org/10.1177/10926429261449966","url":null,"abstract":"<p><p>There are many advances that are happening in the management of adrenal tumors and the adrenalectomy procedure in general. This introduction to the special adrenal issue of the journal summarizes these new frontiers and gives a hint on the topics that will be covered in this special collaboration.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261449966"},"PeriodicalIF":1.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857241","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":"Safety and Outcomes of Surgical Resection in Primary Tracheal Tumors: A Single-Center Experience.","authors":"Mustafa Vedat Doğru, Umut Kilimci, Gizem Özçıbık Işık, Oğuzhan Bayraktar, Efsun Gonca Uğur Chousein, Mehmet Akif Özgül, Merih Dilan Albayrak, Mehmet Ali Bedirhan, Celal Buğra Sezen, Özkan Saydam","doi":"10.1177/10926429261449960","DOIUrl":"https://doi.org/10.1177/10926429261449960","url":null,"abstract":"<p><strong>Introduction: </strong>Primary tracheal tumors are rare pathologies that pose significant diagnostic and therapeutic challenges due to their low incidence, nonspecific symptoms, and technical complexity of surgical management. This study aimed to evaluate the clinical characteristics, surgical outcomes, and oncological results of patients treated for primary tracheal tumors at a single experienced center.</p><p><strong>Methods: </strong>A retrospective analysis was conducted of patients who underwent surgical treatment for primary tracheal tumors between October 2010 and October 2025. Patients treated for tracheal stenosis or managed with nonsurgical modalities alone were excluded. Demographic data, tumor characteristics, surgical approaches, perioperative outcomes, pathological findings, adjuvant treatments, and survival data were analyzed.</p><p><strong>Results: </strong>Nineteen patients (63.2% female, 36.8% male) with a mean age of 58.4 years were included. Surgical approach was individualized according to tumor localization and consisted of collar incision, collar incision combined with partial sternotomy, thoracotomy, or video-assisted thoracoscopic surgery. No difference was seen in the means of complication, survival, operation time, or length of hospital stay between continuous or interrupted sutures with PDS or polypropylene materials. Postoperative complications occurred in three patients (15.8%), including wound infection in two patients and anastomotic dehiscence complicated by pneumonia in one patient, which resulted in postoperative mortality. Malignant pathology was identified in 84.2% of patients, and selected cases with tumor-positive surgical margins received adjuvant radiotherapy. No tumor recurrence was observed, and 89.5% of patients were alive at the end of follow-up. Mean overall survival was 157.7 months.</p><p><strong>Conclusions: </strong>In the management of primary tracheal tumors, early diagnosis, appropriate patient selection, surgical treatment performed in experienced centers, and the use of a multimodal treatment approach when indicated constitute the key determinants of successful oncological and functional outcomes.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261449960"},"PeriodicalIF":1.1,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857485","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":"Mesh Fixation Strategy and Recovery Trajectories after Unilateral Totally Extraperitoneal Inguinal Hernia Repair: A Defect-Size-Stratified Analysis.","authors":"Kanan Ismayilzada, Koray Topgul, Babek Tabandeh","doi":"10.1177/10926429261450042","DOIUrl":"https://doi.org/10.1177/10926429261450042","url":null,"abstract":"<p><strong>Background: </strong>Mesh fixation strategy is a modifiable intraoperative factor that may influence postoperative recovery following totally extraperitoneal (TEP) inguinal hernia repair. Although self-fixating meshes were developed to avoid penetrating fixation and potentially reduce pain, their effect on multidimensional recovery trajectories remains unclear.</p><p><strong>Methods: </strong>This retrospective cohort study included consecutive adults undergoing elective unilateral TEP repair at a tertiary referral center. Patients were grouped according to fixation strategy: self-fixating mesh or polypropylene mesh secured with absorbable tacks. The primary outcome was early quality of recovery measured using the Quality of Recovery-15 (QoR-15) questionnaire at postoperative week 1. Secondary outcomes included longitudinal QoR-15 and visual analog scale (VAS) pain scores at postoperative months 1 and 3, analgesic consumption, and time to functional recovery. Recovery trajectories were analyzed using linear mixed-effects models, with additional stratification by defect size (<20 mm versus ≥20 mm).</p><p><strong>Results: </strong>A total of 134 patients were included (56 tack fixation, 78 self-fixating mesh). Early recovery at week 1 was comparable between groups. Mixed-effects modeling demonstrated significant improvement over time in both groups, without an independent association between fixation strategy and overall QoR-15 trajectory. However, in defects ≥20 mm, self-fixating mesh was associated with higher QoR-15 scores. Pain scores improved over time in both groups, with small but statistically significant differences favoring self-fixating mesh.</p><p><strong>Conclusions: </strong>In unilateral TEP repair, fixation strategy does not substantially influence overall early and short-term recovery. However, in larger defects (≥20 mm), self-fixating mesh may provide modest recovery advantages, suggesting a context-dependent rather than uniform effect.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261450042"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845486","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":"Learning Curves and Proficiency Milestones in Robotic Ventral Hernia Repair: A Systematic Review by Surgical Technique.","authors":"Gabriela Lyons, Vitor Dos Santos Neves, Maria Clara Morais, Denise Padilha Abs de Almeida, Raquel Nogueira, Leandro Totti Cavazzola, Flavio Malcher, Diego L Lima","doi":"10.1177/10926429261449956","DOIUrl":"https://doi.org/10.1177/10926429261449956","url":null,"abstract":"<p><strong>Aim: </strong>Robotic ventral hernia repair (VHR) has enabled minimally invasive management of complex abdominal wall hernias. As robotic procedures involve distinct technical demands and require progressive skill acquisition, understanding learning curves (LCs) is essential to define proficiency thresholds, optimize surgical training, and ensure safe implementation of these techniques. This systematic review compared LCs in robotic VHR across surgical techniques.</p><p><strong>Methods: </strong>A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of major medical databases (PubMed/MEDLINE, EMBASE, Web of Science, Lilacs, and the Cochrane Library) was performed through August 2025, including cohort studies on adult patients undergoing elective robotic VHR.</p><p><strong>Results: </strong>Seven retrospective cohort studies were included, comprising six single-surgeon series: one robotic intraperitoneal underlay mesh (rIPUM), one robotic transversus abdominis release (rTAR), one robotic transabdominal preperitoneal (rTAPP), three robotic enhanced-view totally extraperitoneal (r-eTEP), and one population-based analysis including 12,609 cases. The single-surgeon series predominantly involved patients with class I obesity (mean body mass index range: 31.0-33.0 kg/m²). LC assessment was heterogeneous, employing cumulative sum (CUSUM), risk-adjusted CUSUM (RA-CUSUM), chronological case grouping, and multivariable regression modeling. Across single-surgeon studies, operative efficiency improved earlier than complication-adjusted or technical quality outcomes. Operative-time (OT) proficiency thresholds were reported at 26 cases for rIPUM, 29-38 for r-eTEP, 46 for rTAPP, and 49 cases for rTAR. However, stabilization of complication-adjusted performance required higher volumes, ranging from 51 to 64 cases. Prior experience substantially shortened the LC, reducing OT proficiency for r-eTEP to just 8 cases. In contrast, population-level analysis suggested that 16-19 robotic cases were required to achieve recurrence-related reoperation rates comparable to open or laparoscopic repair.</p><p><strong>Conclusion: </strong>LCs in robotic VHR follow a two-phase, technique-dependent pattern. While operative efficiency is achieved earlier, optimal patient outcomes require higher case volumes.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261449956"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845466","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":"A Simplified Surgical Technique for Thoracoscopic Repair of Congenital Diaphragmatic Hernia.","authors":"Jiepin Wang, Yuting Zhang, Haozhong Xu, Junxiang Wang, Xiuliang Wang, Chi Zhang, Zhen Zheng, Dong Xiao","doi":"10.1177/10926429261449965","DOIUrl":"https://doi.org/10.1177/10926429261449965","url":null,"abstract":"<p><strong>Introduction: </strong>The current surgical approaches for treating congenital diaphragmatic hernia (CDH) are challenging. Thoracoscopic transcutaneous closure of CDH is described, of which a retrospective study was conducted to investigate the safety and effectiveness.</p><p><strong>Materials and methods: </strong>In thoracoscopic transcutaneous closure, a thoracoscope and operating forceps are placed through two intercostal ports to expose the defect, followed by stepwise thoracic pressure elevation to facilitate herniated organ reduction. A fascial closure device is introduced through a small skin incision to encircle the diaphragmatic rim in two semicircular passes, and the suture is then tightened extracorporeally to close the defect.</p><p><strong>Results: </strong>Over a 8-year period, 33 TTC repairs were performed for CDH, including 31 Bochdalek and 2 Morgagni cases. Bochdalek repairs were completed in a mean operative time of 53.68 ± 45.81 minutes (range, 10-200 minutes), with a median age of 1 day and median weight of 3.25 kg. Among them, two patients experienced recurrence at 3 months and 7 months postoperatively. During hospitalization, four patients developed pneumothorax, and one patient developed chylothorax. The two Morgagni cases were repaired in 35 and 30 minutes at 5 and 6 months of age. Respiratory support was a median of 59 hours (range, 0-352 hours) in patients who required respiratory assistance, intensive care unit stay was a median of 15 days (range, 1-91 days) in patients admitted to the intensive care unit, and hospital stay was a median of 15 days (range, 2-91 days). All patients had uneventful wound healing without rib-development complications during follow-up.</p><p><strong>Conclusion: </strong>Thoracoscopic transcutaneous closure is a feasible and effective technique to treat CDH. While possessing the advantages of minimally invasive surgery, it shortens the operative time and learning curve.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261449965"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845484","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 YouTube a Reliable Source for Minimally Invasive Inguinal Hernia Repair Training? A Comparative Analysis of Robotic and Laparoscopic TAPP Videos.","authors":"Vitor Neves, Thiago Souza E Silva, Marina Eguchi, Victor Perim, João Pedro G Kasakewitch, Diego L Lima, Vahagn Nikolian","doi":"10.1177/10926429261449963","DOIUrl":"https://doi.org/10.1177/10926429261449963","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;YouTube has become a widely used tool for surgical education, offering open access to procedural videos for trainees and professionals alike. However, the reliability and pedagogical quality of these publicly available resources remain uncertain. In the context of minimally invasive inguinal hernia repair, we hypothesized that robotic (RT) surgery videos provide superior educational value compared with laparoscopic (LAP) ones. This study aimed to systematically evaluate and compare the quality of RT and LAP transabdominal preperitoneal (TAPP) inguinal hernia repair videos available on YouTube.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Based on &lt;i&gt;a priori&lt;/i&gt; sample size calculation for moderate effect size (Cohen's &lt;i&gt;d&lt;/i&gt; = 0.5), we determined that 63 videos per group would be required for adequate statistical power. On March 19, 2025, a structured search was performed on YouTube using the term &lt;i&gt;\"Transabdominal preperitoneal repair for inguinal hernia&lt;/i&gt;.\" This strategy generated an initial pool of 300 potentially eligible videos, which were screened sequentially until the predetermined sample size of 63 videos per group was achieved. Eligible content featured TAPP repairs via RT or LAP approach. Duplicates, non-inguinal TAPP procedures, videos consisting exclusively of animations, conference lectures, or irrelevant videos were excluded. The primary objective was to evaluate videos containing operative demonstrations of surgical procedures. After this selection, two blinded hernia surgeons independently assessed all videos using a newly developed 21-item qualitative evaluation tool and the validated LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS) score, a tool for evaluating surgery videos submitted to presentations and publications. Group comparisons were conducted using Welch's &lt;i&gt;t&lt;/i&gt;-test and Mann-Whitney &lt;i&gt;U&lt;/i&gt; test. Effect size was reported using Cohen's &lt;i&gt;d&lt;/i&gt;. Both assessment tools demonstrated adequate inter-rater agreement and internal consistency, supporting their reliability for evaluating educational video content.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;From 300 videos screened, 126 met inclusion criteria (63 RT, 63 LAP). RT videos scored significantly higher than LAP videos on the newly developed qualitative evaluation tool (mean score 0.54 vs. 0.44; &lt;i&gt;P&lt;/i&gt; &lt; .001; Cohen's &lt;i&gt;d&lt;/i&gt; = -0.60), indicating a moderate effect size. Similarly, RT videos demonstrated higher LAP-VEGaS scores (7.46 vs. 6.34), although this difference did not reach statistical significance (&lt;i&gt;P&lt;/i&gt; = .091). These findings suggest that RT videos present superior adherence to technical and educational standards, respectively. Both assessment tools demonstrated adequate inter-rater agreement and internal consistency, supporting their reliability for evaluating educational video content.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;YouTube contains a large repository of TAPP repair videos, but quality is inconsistent. The new qua","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261449963"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845501","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":"Comparative Effectiveness of Three Fluid-Filled Intragastric Balloons for Obesity Management: A Single-Center Retrospective Cohort Study.","authors":"Adedire Timilehin Adenuga, Oluwatosin Wuraola Akande, Nwamaka Chidera Bob-Ume, Gloria Igoni Pedro, Isaiah Oluwasegun Atoyebi, Shekina Iyefu Adanu, Tiwalade Adediji","doi":"10.1177/10926429261449967","DOIUrl":"https://doi.org/10.1177/10926429261449967","url":null,"abstract":"<p><strong>Objective: </strong>Endoscopic bariatric therapies, including intragastric balloons (IGBs) are effective minimally invasive options for obesity management, particularly for patients who are not candidates for bariatric surgery. This study aimed to compare the safety profiles, weight loss outcomes, and tolerability of three fluid-filled IGB systems used in routine clinical practice.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adults who underwent intragastric balloon placement at a single private bariatric center between January 2023 and January 2025. Data were derived from a prospectively maintained clinical database. Patients received one of three fluid-filled balloons: Allurion, Medsil, or Spatz3. Baseline demographic and anthropometric characteristics, weight loss outcomes, premature balloon removal, and readmission rates were assessed through completion of treatment. Comparative analyses across balloon types were performed using appropriate parametric and nonparametric statistical tests.</p><p><strong>Results: </strong>A total of 113 patients were included (mean age 34.9 ± 9.3 years; 91.2% female). Mean baseline body mass index (BMI) was 40.0 ± 7.9 kg/m². Balloon distribution was Allurion (<i>n</i> = 13), Medsil (<i>n</i> = 40), and Spatz3 (<i>n</i> = 60). Overall mean absolute weight loss was 14.0 ± 8.3 kg, corresponding to a mean BMI reduction of 5.0 ± 3.0 kg/m². Mean percentage total body weight loss was highest in the Spatz3 group (13.1 ± 7.3%), followed by Medsil (12.0 ± 6.2%) and Allurion (9.8 ± 3.9%); however, differences were not statistically significant (<i>P</i> = .33). Premature balloon removal due to intolerance occurred in 10.6% of patients, with no significant differences between balloon types. No major complications were observed.</p><p><strong>Conclusion: </strong>All three fluid-filled intragastric balloons demonstrated meaningful weight loss with acceptable safety and tolerability profiles. While the Spatz3 balloon achieved numerically greater weight loss, outcomes were comparable across devices without major adverse events. These findings support the role of IGBs as effective endoscopic bariatric therapies within a comprehensive obesity management framework.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261449967"},"PeriodicalIF":1.1,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845503","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}