Journal of Laparoendoscopic & Advanced Surgical Techniques最新文献

{"title":"Non-Cardiac Perioperative Mortality Factors at a Single Urban Veterans Affairs Medical Center.","authors":"J Alex Randall, Samuel O Dennis, Fred Brody","doi":"10.1089/lap.2024.0213","DOIUrl":"https://doi.org/10.1089/lap.2024.0213","url":null,"abstract":"<p><p><b><i>Background:</i></b> The Veterans affairs (VA) surgical quality improvement program was established to evaluate the quality of VA surgical care to over nine million United States Veterans. Patient demographics vary by region, with urban areas correlating with higher mortality rates. This study attempts to determine the factors associated with 30-day mortality at a single VA medical center in an urban setting. <b><i>Methods:</i></b> Patients included in the study were at least 18 years of age and underwent a surgical procedure between January 2013 and June 2023. Baseline demographics included preoperative comorbidities, American Society of Anesthesiology (ASA) class, and preoperative lab values. Clinical outcomes included postoperative mortality within 30 days of the procedure. Chi-square, <i>t</i>-test, ANOVA, and multivariate logistic regressions were used to determine relationships, using <i>P</i> < .05 to determine significance. <b><i>Results:</i></b> A total of 11,547 patients with complete data were included, of which 92 patients (0.8%) died within 30 days of surgery. A higher preoperative hematocrit was protective against 30-day mortality. A perioperative transfusion, bleeding disorder, chronic obstructive pulmonary disease (COPD), history of a myocardial infarction, higher ASA class, and an emergency procedure all increased the likelihood of perioperative mortality. <b><i>Conclusions:</i></b> Veterans who seek surgical care at Veterans Health Administration centers receive high quality care with a low mortality rate. Identifying risk factors for perioperative mortality provides the opportunity to stratify those veterans at highest risk.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141914465","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":"Bariatric Metabolic Surgery Might be More of a Benefit than a Risk During a Pandemic Outbreak.","authors":"Martín Andrada, Franco Signorini, Ignacio Rendeli, Nicolás Asis, Sofía Ramirez, Lucio Obeide, Federico Moser","doi":"10.1089/lap.2023.0535","DOIUrl":"https://doi.org/10.1089/lap.2023.0535","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> This report aimed to analyze the outcomes of patients with obesity who were on a bariatric program during the SARS-Cov-2 pandemic outbreak and compare those who received surgery with the ones who were not operated on. <b><i>Methods:</i></b> This was a retrospective study between 2020 and 2021. Patients were divided into two groups: those who underwent surgery (O) and those who were not operated (NO). The evolution of the risk factors identified for severe COVID infection and death was studied (ASMBS criteria). For this study, a follow-up period of 12 months was initiated. <b><i>Results:</i></b> In the O group, 83 patients were included and 99 were in the NO group. In the O group, patients with body mass index (BMI) > 35 Kg/m² before surgery resolved the condition in 73.5% (61) cases, and this was done in the first 30 days by 38 (45.7%). Type 2 diabetes mellitus remission was documented in 18 patients (85.7%) of the O group, and the mean time elapsed for remission was 102.2 days (<i>P</i> < .01). Hypertension remitted in 66.7% (20) of the patients in group O in 82.4 days (<i>P</i> < .01). The subgroup of patients with obesity and one high-risk associated condition (30.2%, 25) resolved both in 44% (11) cases and one in 48% (12) cases. In the group of patients with obesity and two high-risk associated conditions (15.6%, 13), 47% (6) patients resolved the three conditions, 38% (5) resolved two conditions, and 15% (2) resolved one condition. Among the NO group, no comorbidity resolutions were recorded (<i>P</i> < .01). Admission because of COVID infection was necessary for 7.1% of NO and 1.2% of O (<i>P</i> = .04). <b><i>Conclusion:</i></b> Bariatric metabolic surgery would not increase the risk of COVID infection or of suffering serious complications resulting from it. Patients undergoing bariatric metabolic surgery rapidly resolved high-risk comorbidities and had less need for hospitalization because of SARS-CoV-2 infection.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894789","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 Feasibility of Electro-Vaporization of Ligamentum Teres Hepatis in Totally Laparoscopic Gastrectomy.","authors":"Fuyu Yang, Chenglin Tang, Fan He, Defei Chen, Saed Woraikat, Yong Luo, Gang Liao, Kun Qian","doi":"10.1089/lap.2024.0136","DOIUrl":"10.1089/lap.2024.0136","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> The ligamentum teres hepatis may block the field of vision during totally laparoscopic gastrectomy (TLG), especially in patients with obesity. <b><i>Aim:</i></b> We used electrocautery to increase the visual field of TLG by shrinking the ligamentum teres hepatis. This procedure is termed electro-vaporization of the ligamentum teres hepatis (EVLTH). <b><i>Methods:</i></b> Patients with body mass index (BMI) ≥24 who underwent total laparoscopic distal gastrectomy (TLDG) or total laparoscopic total gastrectomy (TLTG) between January 2020 and December 2023 were retrospectively enrolled. According to the scope of gastrectomy and whether the patients underwent EVLTH, the patients were divided into the TLDG-EVLTH, TLDG-NEVLTH, TLTG-EVLTH, and TLTG-NEVLTH groups. The clinical characteristics, surgical outcomes, and pathological features were compared between the TLDG-EVLTH and TLDG-NEVLTH groups and the TLTG-EVLTH and TLTG-NEVLTH groups. <b><i>Results:</i></b> This study included 65 patients who underwent TLDG (EVLTH: NEVLTH = 29:36) and 32 patients who underwent TLTG (EVLTH:NEVLTH = 15:17). There were no significant differences in clinical characteristics, surgical outcomes, and pathological features between the TLDG-EVLTH and TLDG-NEVLTH groups. However, the operation time in the TLTG-EVLTH group was significantly shorter than that in the TLTG-NEVLTH group, and the difference was statistically significant, although differences in other data were not statistically significant. <b><i>Conclusions:</i></b> EVLTH is a simple and safe procedure that reduces the operation time of TLTG in patients who are overweight and enhances the field of vision of TLG.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Gastrojejunostomy Versus Endoscopic Stenting as a Palliative Treatment for Gastric Outlet Obstruction.","authors":"Avihai Moscovici, Yehuda Hershkovitz, Steven Shamah, Noam Peleg, Ron Lavy, Amir Ben-Yehuda","doi":"10.1089/lap.2024.0162","DOIUrl":"10.1089/lap.2024.0162","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Gastric outlet obstruction (GOO) is a common complication in advanced stage upper gastrointestinal malignancies. The symptoms of severe nausea and protracted vomiting can lead to a decline in quality of life and cachexia. Symptoms of GOO can be effectively managed with either operative or nonoperative palliative interventions. In our article, we aim to compare laparoscopic gastrojejunostomy (GJ) to endoscopic stenting as palliative interventions for GOO. <b><i>Methods:</i></b> We retrospectively evaluated the charts of patients who underwent palliative procedure for gastric outlet obstruction. Group I included patients who underwent endoscopic stenting, and group II patients underwent Laparoscopic GJ. The groups' demographics (age, gender), length of procedure, length of stay, days to oral intake, overall survival, complications rate, and 30-day mortality rates were compared. <b><i>Results:</i></b> Overall, 38 patients were included in the study. Nineteen patients underwent endoscopic stenting and 19 underwent laparoscopic GJ. Comparing the groups, no significant differences were noted. Surgical time was significantly longer than the endoscopic procedures (83 minutes versus 25 minutes, <i>P</i> = .001). No significant differences were noted in days of oral intake initiation, overall survival and 30-day mortality rates. Five patients in the stenting group had complications (26.3%) versus none in the surgical group (<i>P</i> = .046). No postoperative complications were noted. <b><i>Conclusion:</i></b> Laparoscopic GJ is a safe and feasible treatment for GOO, demonstrating early resumption of oral intake. The relative short hospital stay, combined with an encouraging postoperative complications profile and low reintervention rate, should be kept in mind especially among patients with longer life expectancy.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141555832","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 Efficacy of Hook Diathermy in the Dissection of the Mesocolorectum During Laparoscopic-Assisted Pull-Through for Hirschsprung Disease in Low-Resource Settings.","authors":"Tarek Abdelazeem Sabra, Sarah Magdy Abdelmohsen, Abdelhaleem Showkat Mohamed","doi":"10.1089/lap.2023.0369","DOIUrl":"10.1089/lap.2023.0369","url":null,"abstract":"<p><p><b><i>Background:</i></b> Surgical correction is the main line of treatment for the congenital disorder Hirschsprung's disease (HD). Laparoscopic techniques proved their safety and efficacy in previous studies. LigaSure™ is the gold standard for colorectal dissection. However, other sealing methods could be used during the unavailability of LigaSure. <b><i>Purpose:</i></b> This study aimed to assess the safety profile of the hook diathermy technique compared to LigaSure in colorectal dissection during laparoscopic-assisted pull-through for HD. <b><i>Materials and Methods:</i></b> This case-control study was held in the pediatric surgery department at Assiut University Hospitals between September 2017 and January 2023. The study included 57 HD patients who were surgically operated on during a laparoscopic-assisted pull-through. They were divided into 2 groups according to the sealing methods: the ligasure group included 25 patients, and the hook diathermy group included 32 patients. <b><i>Results:</i></b> Both groups had no statistically significant differences regarding age, sex, or weight. The transition zone was present in all patients, and most transition zones were rectosigmoid. No cases reported intraoperative blood transfusion or conversion to an open or transanal approach. Minimum intraoperative blood loss was reported in both groups, with no significant differences. As regards postoperative complications, including bleeding, leakage, perianal excoriation, and enterocolitis, no significant differences between both groups were found. <b><i>Conclusion:</i></b> The LigaSure and hook diathermy techniques are safe and effective sealing methods for colorectal dissection during laparoscopic-assisted pull-through for HD.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139998063","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":"Enhanced Recovery After Surgery versus Conventional Care in Cholecystectomy: A Systematic Review and Meta-Analysis.","authors":"Jiao Qin, Ling-Yan Gou, Wei Zhang, Xiao Pu, Ping Zhang","doi":"10.1089/lap.2024.0119","DOIUrl":"10.1089/lap.2024.0119","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> The primary objective of this study was to evaluate the safety and efficacy of the enhanced recovery after surgery (ERAS) protocol in cholecystectomy, comparing it with standard care. <b><i>Methods:</i></b> A comprehensive literature search was conducted in December 2023, using globally recognized databases such as PubMed, Embase, and the Cochrane Library. Various parameters were compared using Review Manager software. This study was duly registered with PROSPERO (CRD420223). <b><i>Results:</i></b> The meta-analysis included nine studies, encompassing a total of 1920 patients. The findings revealed that the ERAS group, in comparison to traditional care, experienced shorter hospitalization periods (weighted mean difference [WMD]: -1.23, 95% confidence interval [CI]: -1.98 to -0.47; <i>P</i> = .001), lower visual analog scale at 24 hours (WMD: -1.10, 95% CI: -1.30 to -0.90; <i>P</i> < .00001), faster time to first flatus (WMD: -4.48, 95% CI: -4.50 to -4.46; <i>P</i> < .00001), and reduced operative times (WMD: -9.94, 95% CI: -17.88 to -0.96; <i>P</i> = .03). In addition, there was a notable decrease in instances of postoperative nausea and vomiting (odds ratio [OR]: 0.46, 95% CI: 0.28 to 0.74; <i>P</i> = .002). No significant differences were observed in readmission rates, blood loss, postoperative complications, or bile leakage between the two care methods. <b><i>Conclusions:</i></b> This study substantiates that the ERAS protocol is an advantageous perioperative care strategy for patients undergoing cholecystectomy. It significantly outperforms traditional care in reducing the length of stay, decreasing the likelihood of postoperative nausea/vomiting, alleviating postoperative pain, and accelerating the time to the first flatus. These findings highlight the effectiveness of ERAS in enhancing patient outcomes in cholecystectomy.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560178","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":"Minimally Invasive Stapled Abdominal Wall Repair: A New Surgical Technique.","authors":"Gabriele Manetti, Maria Giulia Lolli, Elena Belloni, Giuseppe Nigri","doi":"10.1089/lap.2024.0190","DOIUrl":"10.1089/lap.2024.0190","url":null,"abstract":"<p><p><b><i>Background:</i></b> Diastasis recti (DR) is a common condition, especially in women after pregnancy, often associated with concomitant hernia defects and defined as a rupture of the midline and a separation of the rectus muscle more than 2 cm. Symptoms related to this are low back pain, urinary incontinence and pelvic prolapse, as well as abdominal bulging and core instability. We analyzed clinical and functional outcomes after treatment of DR alone or associated with midline hernias in 219 patients who underwent a midline reconstruction using miSAR^® technique (minimally invasive stapled abdominal wall reconstruction). <b><i>Methods:</i></b> Between April 2019 and April 2022, 219 patients were treated with miSAR^®. All patients were requested to quantify preoperative and postoperative functional symptoms (urinary incontinence, low back pain, abdominal swelling, and respiratory distress). <b><i>Results:</i></b> Twenty-seven men and 192 women underwent the miSAR^® technique. The mean body mass index was 23.9 kg/m². We performed the miSAR^® technique in patients affected by incisional midline hernia and umbilical hernia alone or associated with DR. Composite mesh was used in 91.8% of cases. The average operating time was 90 minutes. Seven percent of the patients had postoperative complications, including two retromuscular hematomas, two retromuscular seromas, and one postoperative bleeding event. Two patients were readmitted for bowel obstruction. After surgery, there was symptomatic improvement in urinary incontinence, low back pain, respiratory symptoms, and abdominal swelling; this improvement was confirmed at 6 months and at 1- and 2-year follow-up. At the 1-year follow-up, the overall recurrence rate was 2.83%. <b><i>Conclusion:</i></b> miSAR^® is a feasible and effective technique and shows promising results in the treatment of DR and ventral hernia. Possible enhancements include use of preoperative Botox to treat defects larger than 6 cm. Multicentric analysis is needed to validate the technique, and longer follow-up is required to assess the recurrence rate.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141894791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Repair of Pediatric Femoral Hernias.","authors":"Alexander L Chen, Spencer Wilhelm, Michael Sobolic, Pavan Brahmamdam, Begum Akay, Nathan M Novotny","doi":"10.1089/lap.2023.0372","DOIUrl":"10.1089/lap.2023.0372","url":null,"abstract":"<p><p><b><i>Background:</i></b> Current rates of reported pediatric femoral hernias remain exceedingly low, with their incidence reported to be <1%. The mainstay of repair has traditionally been through an open approach, and pediatric surgeons remain reluctant to repair otherwise. Owing to its rarity, consensus regarding management remains absent. Because of this, we present a scoping review on the use of laparoscopy and minimally invasive techniques to repair pediatric femoral hernias. <b><i>Methods:</i></b> A scoping literature review was performed using PubMed, Embase, Scopus, and Web of Science for related articles (keywords). Full-text articles and abstracts were then reviewed for relevance using inclusion and exclusion criteria with data extracted from each piece. <b><i>Results:</i></b> The search identified 268 articles published from 1992 to 2023. Eleven articles met our inclusion criteria. After reviewing their content, a total of 87 patients were identified. Of these, 42 laparoscopic repairs were reported. Three primary laparoscopic surgical techniques were described, with no recurrence reported. <b><i>Conclusion:</i></b> Laparoscopy remains a viable tool in diagnosing and managing femoral hernias. Various technically feasible options for laparoscopy and minimally invasive techniques have been described with excellent results and limited recurrence. However, given the quality of the data, further studies are needed to investigate the long-term durability of such repairs.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040790","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":"Educational Level of Laparoscopic Radical Nephrectomy Videos on YouTube^TM.","authors":"Rıdvan Kayar, Kemal Kayar, Emre Tokuc, Emrah Özsoy, Muhammet Çiçek, Selamettin Demir, Ramazan Topaktaş","doi":"10.1089/lap.2024.0175","DOIUrl":"10.1089/lap.2024.0175","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study aims to evaluate the educational quality and appropriateness of laparoscopic radical nephrectomy videos on YouTube using the LAParoscopicsurgery Video EducationalGuidelineS (LAP-VEGaS) criteria. It focuses on understanding the role of online resources in medical education and objectively assessing their quality. <b><i>Methods:</i></b> A search was conducted on YouTube™ for \"laparoscopic radical nephrectomy\" on August 15, 2023, leading to the selection of the first 125 videos. Videos were chosen based on length (over 1 minute), content (laparoscopic radical nephrectomy), language (English), and nonindustry sponsorship. The LAP-VEGaS criteria, encompassing 16 items under five main categories: video introduction, case presentation, procedures, outcomes, and educational content, were used for evaluation, assigning 0 or 1 point per criterion. <b><i>Results:</i></b> Out of 100 videos meeting the criteria, they were divided into two groups: personal uploads by expert surgeons (Group-1) and institutional uploads by hospitals and organizations (Group-2). Group-2 videos had longer durations and higher LAP-VEGaS scores. The transperitoneal approach was preferred in 88% of the videos, and 84% were right laparoscopic nephrectomies. Group-2 had significantly higher LAP-VEGaS scores (6.3 ± 2.2) compared with Group-1 (4 ± 2.1) (<i>P</i> < 0,001). The number of videos published over the years increased, while LAP-VEGaS scores fluctuated. <b><i>Conclusion:</i></b> Assessing laparoscopic radical nephrectomy videos on YouTube™ using the LAP-VEGaS criteria helped understand the role of online sources in medical education. Institutional uploads were found to be more successful in educational aspects, emphasizing the need for continuous quality review of online medical education materials. This study also guides how to evaluate and improve medical education materials on online platforms.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879675","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":"Assessing Surgeons' Attitude to Teaching Intra-Corporeal Anastomosis.","authors":"Meet Patel, Zainab Naseem, Christopher J Young","doi":"10.1089/lap.2024.0192","DOIUrl":"10.1089/lap.2024.0192","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> There is a controversy in minimally invasive colorectal procedures regarding choosing optimal technique between intra-corporeal (ICA) and extra-corporeal anastomosis (ECA). Previous studies recognize the short-term benefits in right hemicolectomy with intra-corporeal approach; however, ICA can result in increased operative difficulty. The aim of this study is to understand attitudes towards teaching ICA in colorectal procedures and how this varies between subspeciality training. <b><i>Methods:</i></b> Active members of General Surgeons Australia were contacted through email to participate in a voluntary, unincentivized survey. Demographic details were collected and participants were asked to rate agreement for simulation-based training for increasing adoption of ICA through a Likert scale and when preferences for teaching ICA. Descriptive statistics were completed to describe frequencies and ordinal regression was completed to determine factors for Likert scale question. <b><i>Results:</i></b> There were 43 respondents and most participants recognized that ECA was easier to teach trainees and should be taught first. 53.5% of respondents recognized that simulation-based training would assist the adoption of ICA. Surgeons who routinely close bowel or enteric defects intra-corporeally are 354% more likely to show an interest in simulation-based training for adopting ICA, however, surgeons who are not involved in teaching trainees did not show an interest in simulation-based training. <b><i>Conclusion:</i></b> There is significant agreement that ECA forms the basis to learn ICA and simulation-based training would assist with the uptake of ICA. However, a multimodal approach, including expanding training avenues and providing financial incentives, would be necessary to enhance the adoption of ICA in colorectal surgery.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":null,"pages":null},"PeriodicalIF":1.1,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903438","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}