Journal of Laparoendoscopic & Advanced Surgical Techniques最新文献

{"title":"First Description of Redo Gastric Per-Oral Endoscopic Myotomy for Refractory Gastroparesis: Technical Conduct and Outcomes.","authors":"Mélissa V Wills, Valentin Mocanu, Sol Lee, Salvador Navarrete, John Rodriguez, Andrew Strong, Jerry Dang, Matthew Allemang, Matthew Kroh","doi":"10.1177/10926429251384091","DOIUrl":"https://doi.org/10.1177/10926429251384091","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Gastroparesis is a progressive disease that may require endoscopic or surgical intervention, such as gastric per oral endoscopic myotomy (G-POEM), when conservative measures are ineffective or not tolerated. Limited data exist on redo G-POEM safety and effectiveness. We describe outcomes of patients undergoing repeat G-POEM for refractory gastroparesis. <b><i>Methods:</i></b> A retrospective review of patients who underwent redo G-POEM at our center from 2008 to 2024. Data included demographics, gastroparesis etiology, previous treatments, Gastroparesis Cardinal Symptom Index (GCSI), gastric emptying studies (GES), and clinical outcomes. <b><i>Results:</i></b> Three patients (mean age at first G-POEM 52.3 ± 19 years) were identified. All procedures were technically successful, and all 3 patients survived to discharge without major complications. Patient A (sarcoidosis-induced gastroparesis) had transient symptomatic improvement after the first G-POEM, but symptoms deteriorated the following year. GES showed initial improvement (26% to 14% 4-hour retention) but returned to baseline (26%) after the second G-POEM. She ultimately required jejunostomy tube placement. Patient B (idiopathic gastroparesis) with a history of renal transplant showed no objective improvement in GES after either procedure (40% to 41% 4-hour retention) and remained noncompliant with dietary recommendations. He died at age 35 from cardiac arrhythmia 2 years after the second G-POEM. Patient C (postsurgical gastroparesis) had improvement in GES after the first G-POEM (88% to 53% 4-hour retention) but then deteriorated to 73% despite symptomatic improvement. After symptom recurrence, redo G-POEM provided an excellent symptomatic response, but she remained total parenteral nutrition-dependent until death 4 years later. <b><i>Conclusion:</i></b> While redo G-POEM is technically feasible and safe, our case series demonstrates poor long-term clinical outcomes across different gastroparesis etiologies. All 3 patients experienced treatment failure, with 2 requiring permanent nutritional support and 1 showing a lack of symptomatic response. These findings may suggest limited utility of redo G-POEM and highlight the need for careful patient selection.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202041","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 Effect of Liver Size on Early Postoperative Complications in Patients Undergoing Laparoscopic Sleeve Gastrectomy.","authors":"Uğur Özsoy, Murat Yildirim, Bulent Koca, Alı Ihsan Saglam, Ali Genç, Namik Ozkan","doi":"10.1177/10926429251383002","DOIUrl":"https://doi.org/10.1177/10926429251383002","url":null,"abstract":"<p><p><b><i>Aim:</i></b> The aim of the study was to show whether the complications of hepatomegaly increase in patients undergoing LSG. <b><i>Material Method:</i></b> This study was designed as a retrospective study. LSG surgeries performed between 2014 and 2024 were examined. Complications were determined by examining blood test results, radiological images, and epicrisis information. Complications were classified according to the Clavian-Dindo classification. The patients were divided into two groups according to the presence of hepatomegaly. Groups were compared according to complications. <b><i>Results:</i></b> The study was conducted with a total of 972 patients. Of the patients, 303 (31.1%) were male and 669 (68.8%) were female. The mean age was 37.7 years (range: 18-65). Of all patients, 623 (64%) had hepatomegaly, and 349 (36%) had normal liver size. In the hepatomegaly group, 26 patients had major complications, while 3 patients in the non-hepatomegaly group had them. It was found that major complications were significantly higher in the hepatomegaly group compared to the non-hepatomegaly group (<i>P</i> < .05). Minor complications were observed in 129 patients in the hepatomegaly group and 66 patients in the non-hepatomegaly group. The difference between the two groups for the minor complications was not significant (<i>P</i> > .05).In addition, the average surgery duration and hospital stay were statistically significantly higher in the hepatomegaly group (<i>P</i> < .05). <b><i>Conclusions:</i></b> Hepatomegaly significantly increases the major complications after LSG.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187421","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 Short-Term Outcomes of Robot-Assisted Distal Gastrectomy Using the KangDuo Surgical Robot-01 System and Laparoscopic Gastrectomy.","authors":"Qiancheng Wang, Shiyang Jin, Zeshen Wang, Pengcheng Sun, Yuming Ju, Guanyu Zhu, Kuan Wang","doi":"10.1177/10926429251383719","DOIUrl":"https://doi.org/10.1177/10926429251383719","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study aimed to assess the effectiveness, safety, and feasibility of a novel robotic surgical system-the KangDuo Surgical Robot-01 (KD-SR-01)-for treating clinical stage I-III distal gastric cancer (GC) by comparing it to conventional laparoscopic gastrectomy (LG). <b><i>Methods:</i></b> From September to December 2023, 15 patients with distal GC underwent gastrectomies using the KD-SR-01 (KD group). An additional 15 cases of LG performed by the same surgeon during the same period were selected as the control group (LG group). Preoperative, intraoperative, and postoperative data were analyzed and compared between the two groups. <b><i>Results:</i></b> Both groups achieved the same surgical success rate, with no conversions to open surgery. The KD group exhibited significantly less blood loss (30 [20-60] mL versus 50 [30-200] mL, <i>P</i> < .001) and reported a lighter workload (27.5 ± 3.0 versus 30.1 ± 2.6, <i>P</i> = .011) compared to the LG group. Although the operation time in the KD group was significantly longer (213.3 ± 30.1 minutes versus 166.0 ± 32.8 minutes, <i>P</i> < .001), it was not significantly different from the LG group when excluding the device docking time of KD-SR-01 (179.7 ± 24.5 minutes versus 166.0 ± 32.8 minutes, <i>P</i> = .207). There were no significant differences in postoperative hospital stay (7.7 ± 1.5 days versus 7.3 ± .8 days, <i>P</i> = .357) and complication rates (26.7% versus 40.0%, <i>P</i> = .700) between the two groups. <b><i>Conclusion:</i></b> The KD-SR-01 is safe and effective for treating distal GC and may be a viable alternative to conventional LG.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187381","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 Celiac Artery Stenosis on Pancreatic Fistula Incidence after Pancreatoduodenectomy.","authors":"Mert Guler, Omer Akay, Husnu Sevik, Ibrahim Taskin Rakici, Ceyda Turan Bektas, Rabia Kucukarslan, Mert Mahsuni Sevinc, Ufuk Oguz Idiz","doi":"10.1177/10926429251382789","DOIUrl":"https://doi.org/10.1177/10926429251382789","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Celiac artery stenosis (CAS) may exacerbate postoperative complications by impairing arterial perfusion in upper abdominal organs. This study evaluated the prevalence of CAS in patients undergoing pancreaticoduodenectomy and its association with clinically significant postoperative pancreatic fistula (POPF). <b><i>Methods:</i></b> A retrospective analysis of 151 patients who underwent pancreaticoduodenectomy between 2017 and 2022 was conducted. CAS was assessed via preoperative computed tomography with a stenosis threshold of ≥50%. Multivariate logistic regression identified risk factors for POPF. <b><i>Results:</i></b> CAS ≥50% was observed in 17.2% of patients, and Grade B/C POPF occurred in 17.9%. In patients with a CAS ≥50%, the risk of POPF was significantly increased (Odds Ratio: 16.458, 95% Confidence Interval: 4.575-59.203, <i>P</i> < .001). A pancreatic duct diameter of less than 3 mm and a soft pancreatic texture were found to be associated with POPF in the univariate analysis (<i>P</i> = .029, <i>P</i> = .032, respectively). Additionally, the prevalence of smoking and the median age were higher in patients with a CAS ≥50 (respectively, <i>P</i> = .011 and <i>P</i> = .052). <b><i>Conclusions:</i></b> CAS is an independent risk factor for clinically significant POPF. Preoperative CAS identification and management are vital to minimizing postoperative complications. Further studies are needed to confirm these findings.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139240","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 Application of Robotic-Assisted Surgery in Renal Disorders of Infants and Toddlers: A Retrospective Cohort Analysis.","authors":"Chao Yang, Chi Zhang, Jialin Liu, Changkun Mao","doi":"10.1177/10926429251377438","DOIUrl":"https://doi.org/10.1177/10926429251377438","url":null,"abstract":"<p><p><b><i>Objective:</i></b> While robotic-assisted surgery (RAS) has shown benefits in urology, its use in infants and toddlers remains relatively restricted. This study aims to evaluate the safety and feasibility of robotic surgery for renal disorders in this age group. <b><i>Methods:</i></b> A retrospective analysis was performed on the clinical data of 122 patients under the age of 3 who underwent robotic and laparoscopic surgeries (LSs) for renal disorders at our institution between December 2021 and September 2023. The analysis included demographic information, surgical techniques, and postoperative complications. <b><i>Results:</i></b> The study included 122 patients aged between 2.2 and 35.8 months. Of these, 66 patients underwent RAS (RAS group), whereas 56 patients underwent laparoscopic surgery (LS group). In cases of ureteropelvic junction obstruction (UPJO), RAS group showed shorter operative times and less blood loss than LS (<i>P</i> < .001). For the patients with renal dysplasia who underwent nephrectomy and ureterectomy, no significant differences were observed between the RAS and LS groups in terms of operative time, intraoperative blood loss, or hospital stay (<i>P</i> > .05). In patients with duplicated kidneys, RAS also demonstrated advantages in operative time (<i>P</i> = .001), blood loss (<i>P</i> = .019), and hospital stays (<i>P</i> < .001). However, RAS group incurred higher hospital costs (<i>P</i> < .001), with no significant difference in complication rates (<i>P</i> > .05). <b><i>Conclusion:</i></b> Although RAS incurs higher costs compared with LS, it remains both safe and feasible for the treatment of renal disorders in infants and toddlers. Notably, RAS shows significant advantages in managing UPJO and complete duplicated kidneys.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139243","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":"Implementation of Robotic Telesurgery in Brazil: The First Experimental Remote Surgery Performed Between Two Brazilian Cities.","authors":"Marcelo de Paula Loureiro, Paolo Salvalaggio, Mariano Palermo, Thais Andrade Costa Casagrande, Kendi Chikude, Reitan Ribeiro, Luiz Augusto Militao da Silva, Wagner de Paula Loureiro, Guido Lemos de Souza Filho, Denio Mariz Timoteo de Sousa, Gualter Lisboa Ramalho, Leandro Totti Cavazzola","doi":"10.1177/10926429251377012","DOIUrl":"https://doi.org/10.1177/10926429251377012","url":null,"abstract":"<p><p><b><i>Background:</i></b> Telesurgery represents a revolutionary milestone in medicine, allowing surgeons to perform complex procedures at a distance through advanced robotic systems. Although the first telesurgery in Brazil was performed in 2000 with a single-arm robotic platform between São Paulo and Baltimore (USA), no telesurgery had ever been conducted between two distinct Brazilian cities with a state-of-the-art robotic system. The aim is to report the first telesurgery performed between two Brazilian cities, connecting Scolla-Surgical Training Center in Campo Largo and CEONC Hospital in Cascavel, both in the state of Paraná, approximately 600 km apart, using high-performance fiber optic technology with 5G redundancy to perform robotic cholecystectomy in a swine model. <b><i>Methods:</i></b> A prospective experimental study was conducted using a 40 kg swine (<i>Sus scrofa</i>) as an animal model. Connectivity was established through high-speed fiber optic cable, allowing minimal latency and real-time data transmission. A robotic cholecystectomy was performed remotely, with continuous monitoring of delay parameters and connection quality. <b><i>Results:</i></b> Telesurgery was performed without complications, demonstrating the technical feasibility and safety of the procedure between two Brazilian cities. Transmission delays remained within acceptable limits for robotic surgery, and no technical or surgical complications were observed during the procedure. Image quality and responsiveness of robotic commands remained stable throughout the surgery. <b><i>Conclusion:</i></b> This study establishes a historic milestone in Brazilian medicine, demonstrating that telesurgery between Brazilian cities is technically feasible and safe. The results open promising perspectives for expanding access to specialized surgical care in remote regions of Brazil, potentially revolutionizing the distribution of medical expertise in the country and Latin America.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139270","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":"Surgical Treatment of Acute Symptomatic Postesophagectomy Diaphragmatic Hernia.","authors":"Pamela Milito, Stefano Siboni, Andrea Lovece, Eleonora Vico, Roberta De Maron, Valentina Milani, Marco Sozzi, Daniele Bernardi, Emanuele Asti","doi":"10.1177/10926429251381432","DOIUrl":"https://doi.org/10.1177/10926429251381432","url":null,"abstract":"<p><p><b><i>Background:</i></b> Postesophagectomy diaphragmatic hernia (PEDH) is a rare yet potentially life-threatening complication following esophagectomy, particularly when acute symptoms such as ischemia or organ perforation arise. Prompt diagnosis and emergency surgical intervention are crucial. This study reports the experience of a tertiary care center in managing acute symptomatic PEDH. <b><i>Methods:</i></b> We performed a retrospective analysis of patients who underwent esophagectomy for cancer at our institution between 2013 and 2023. Early PEDH was defined as hernia onset within 30 days postoperatively. Patients presenting with respiratory symptoms, volvulus, ischemia, or perforation underwent emergency surgery. Primary outcomes included the method of diaphragmatic repair, use of mesh, and surgical success. <b><i>Results:</i></b> Out of 358 patients, 11 (3.1%) developed PEDH requiring emergency surgery. Five cases were early PEDH and 3 developed an anastomotic leak. Organ or omental resection was performed in 4 patients. Laparoscopic repair was successful in 8 cases, while 2 patients required laparotomy and thoracotomy. Cruroplasty was performed in 8 patients, in 2 a mesh was added and in 6 the falciform ligament was used to buttress the closure. Mortality was nil. Recurrence rate was 18%. No preoperative risk factors for PEDH were identified. <b><i>Conclusions:</i></b> Diaphragmatic hernia is a rare but serious complication after esophagectomy, often associated with high morbidity and mortality. Early recognition is critical and life-saving. In high-volume centers, laparoscopic repair is the preferred approach and the decision to perform cruroplasty with or without mesh reinforcement should be individualized based on patient characteristics.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139259","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":"Preventing Postsurgical Lymphoceles: Efficacy of Preventing Lymphocele Ensuring Absorption Transperitoneally Technique in Robot-Assisted Laparoscopic Prostatectomy.","authors":"Bulent Onal, Mehmet Hamza Gultekin, Kadir Can Sahin, Ahmet Vural, Goktug Kalender, Emre Akkus","doi":"10.1177/10926429251381449","DOIUrl":"https://doi.org/10.1177/10926429251381449","url":null,"abstract":"<p><p><b><i>Background:</i></b> Lymphocele is an important condition commonly seen in the follow-up of patients who underwent radical prostatectomy and extended pelvic lymph node dissection (ePLND) for prostate cancer. Since the formation and treatment of lymphocele may have negative consequences in terms of patient-care and health expenditure. Several techniques have been used to prevent lymphocele. In this study, we aimed to investigate the efficacy of the previously described preventing lymphocele ensuring absorption transperitoneally (P.L.E.A.T.) technique and compare the outcomes of patients who underwent this technique. <b><i>Methodology:</i></b> The data of patients who underwent robot-assisted laparoscopic radical prostatectomy with ePLND for prostate cancer between 2017 and 2023 in our institution were retrospectively analyzed. Patients were divided into two groups according to the application of the P.L.E.A.T. technique in their operations. All patients were followed up with the same protocol. Patient characteristics and postoperative follow-up data were statistically analyzed. <b><i>Results:</i></b> Data of 78 patients (26 patients in the P.L.E.A.T. group and 52 patients in control group) were evaluated retrospectively. There were no statistically significant differences between the groups in terms of demographic and clinical characteristics, including age, prostate-specific antigen levels, body mass index, American Society of Anaesthesiologists score, D'Amico risk classification, or the number of lymph nodes removed. Analysis of postoperative data revealed statistically significant differences between the two groups in total amount of drainage (<i>P</i> < .05), drain removal day (<i>P</i> < .05), and length of hospital stay (<i>P</i> < .05). <b><i>Conclusions:</i></b> Our experience with the P.L.E.A.T. technique showed potential advantages in line with the literature, with a considerable reduction in total drain amount, drain removal day, and length of stay.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139215","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 Role of Renal Pelvis Urine Attenuation Value in Forecasting Infection Risk After Mini-Percutaneous Nephrolithotomy.","authors":"Huseyin Burak Yazili, Ufuk Caglar, Ahmet Halis, Oguzhan Yildiz, Arda Meric, Resit Yusuf, Omer Sarilar, Faruk Ozgor","doi":"10.1177/10926429251381201","DOIUrl":"https://doi.org/10.1177/10926429251381201","url":null,"abstract":"<p><p><b><i>Objective:</i></b> To evaluate whether renal pelvis urine density (RPUD), measured on preoperative computed tomography (CT), predicts infectious complications following percutaneous nephrolithotomy (PCNL). <b><i>Methods:</i></b> This retrospective study included patients who underwent PCNL between June 2019 and June 2024 at a tertiary care center. Patients with preoperative infection signs, drainage devices, or incomplete data were excluded. All included patients had sterile urine cultures preoperatively. RPUD was measured on noncontrast CT by two independent urologists, and interobserver agreement was calculated. Patients were grouped according to the presence of postoperative infectious complications (fever, sepsis, or septic shock). Demographic and perioperative variables were compared. Logistic regression was used to identify independent predictors of infection. <b><i>Results:</i></b> A total of 226 patients were analyzed. Patients with postoperative infections had significantly higher RPUD values (13.7 versus 6.0 Hounsfield units, <i>P</i> = .001) and longer operative times (70 versus 50 minutes, <i>P</i> = .001). On multivariate analysis, both RPUD (odds ratio: 1.238) and operative time (odds ratio: 1.055) were independent predictors. ROC analysis showed that an RPUD cutoff of 9.250 predicted infection with 80.0% sensitivity and 80.1% specificity (AUC: 0.875). Interobserver reliability for RPUD was excellent (intraclass correlation coefficient: 0.942). <b><i>Conclusions:</i></b> Preoperative RPUD is a reliable, noninvasive radiological marker for predicting infectious complications after PCNL. Routine measurement of RPUD may improve preoperative risk stratification and optimize perioperative management. These findings should be validated in future prospective, multicenter studies.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092771","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":"Evaluating Trainee Performance and Surgical Safety: A Comparison of Supine and Left Lateral Positioning in Pediatric Laparoscopic Appendectomy.","authors":"Vaibhav Pandey, Shashi Prakash Mishra, Indra Singh Choudhary, Bhanumurthy Marripati Kaushik, Amit Gupta, Ruchira Nandan","doi":"10.1177/10926429251378093","DOIUrl":"10.1177/10926429251378093","url":null,"abstract":"<p><p><b><i>Background:</i></b> Laparoscopic appendectomy is the preferred treatment for acute appendicitis, offering reduced morbidity and quicker recovery compared with open surgery. The positioning of the patient during surgery can significantly impact both the ergonomics for the surgeon and the operational outcomes. This study compares the conventional supine positioning with an innovative left lateral decubitus approach for surgical efficiency and recovery outcomes. <b><i>Methods:</i></b> This prospective, comparative study included 30 pediatric patients undergoing interval appendectomy at the Department of Pediatric Surgery, from October 2023 to March 2024. Patients were randomly assigned to undergo appendectomy either in the traditional supine position (Group A) or a modified left lateral position (Group B). The study measured operative times, complication rates, and surgical outcomes using the modified Objective Structured Assessment of Technical Skills (OSATS). <b><i>Results:</i></b> The study consisted of 15 patients in each group, with comparable demographics and baseline characteristics. Group B showed a significant reduction in mean operating time (55.25 ± 3.62 minutes) compared with Group A (62.45 ± 4.15 minutes) (<i>P</i> < .001). There were fewer complications in Group B, with no serosal tears reported compared with a 15.3% incidence in Group A. The modified OSATS scores were higher in Group B, indicating better flow of operation and overall performance. <b><i>Conclusion:</i></b> The left lateral positioning in pediatric laparoscopic appendectomy demonstrated a potential to enhance surgical efficiency, reduce operative time, and minimize complications compared with the traditional supine approach. These findings suggest that the left lateral position could be considered a preferable alternative in pediatric appendectomy, particularly beneficial for surgical trainees due to improved ergonomics.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145071162","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}