Journal of Laparoendoscopic & Advanced Surgical Techniques最新文献

{"title":"Multicenter Perioperative Results with a New Endoscopic Powered Stapler in Bariatric Surgery: A Retrospective Study.","authors":"Athar Khan, Laurent Layani, Nalini Kiran, Basel Nasrullah, Lyudmila Shchukina, Patrick Noel","doi":"10.1089/lap.2024.0358","DOIUrl":"10.1089/lap.2024.0358","url":null,"abstract":"<p><p><b><i>Background/Objectives:</i></b> Advancements in surgical stapling devices play a crucial role in improving outcomes for bariatric procedures. This study evaluates the performance and safety of a new endoscopic stapler (EnDrive® Beluga^TM) regarding perioperative results across multiple bariatric surgery types. <b><i>Methods:</i></b> A retrospective analysis was conducted on 112 patients who underwent bariatric procedures using the Beluga stapler at two centers in the United Arab Emirates and Kenya over a 6-month period (June-December 2023). Procedures included laparoscopic sleeve gastrectomy (LSG), laparoscopic Roux-en-Y gastric bypass (LRYGB), one anastomosis gastric bypass-mini gastric bypass (OAGB-MGB), and revisions. Perioperative outcomes, complications, and hemoglobin changes were assessed. <b><i>Results:</i></b> The cohort included 29 males and 83 females, with a mean age of 32.8 years and preoperative body mass index of 41.1 kg/m². Procedures performed were 88 primary LSG, 3 primary LRYGB, 12 primary OAGB-MGB, and 9 revision surgeries. No conversions, deaths, bleeding, or leaks occurred. Minor complications were observed in 4 patients. One patient required reoperation for intestinal obstruction. The mean hospital stay was 1.5 days. Hemoglobin levels showed minimal change from preoperative (12.8 g/dL) to postoperative day 1 (12.3 g/dL). <b><i>Conclusions:</i></b> The new Beluga endoscopic stapler demonstrated safe and effective performance across various bariatric procedures through this retrospective study, with low complication rates and minimal blood loss. Its enhanced articulation capabilities may offer advantages in specific cases. Further studies with larger groups, control groups, and longer follow-up periods are warranted to compare long-term outcomes with established stapling devices.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"198-203"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015409","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 3D Endovision System on Learning Process of Laparoscopic Transabdominal Preperitoneal Repair of Groin Hernia.","authors":"Hemanga Kumar Bhattacharjee, Don Jose K, Dharmendra Kumar Patel, Shafneed Chaliyadan, Washim Firoz Khan, Shivam Pandey, Mohit Joshi, Suhani Suhani, Rajinder Parshad","doi":"10.1089/lap.2024.0370","DOIUrl":"10.1089/lap.2024.0370","url":null,"abstract":"<p><p><b><i>Background:</i></b> Laparo-endoscopic hernia surgery is recommended by various international bodies. However, its uptake by general surgeon is low. We aim to assess the impact of Three Dimensional (3D) endovision system in learning laparoscopic transabdominal preperitoneal (TAPP) repair of groin hernia and transferability of skills acquired from 3D to the Two Dimensional (2D) environment. <b><i>Methodology:</i></b> Senior resident doctor with no previous experience in laparoscopic hernia surgery did 20 consecutive cases of TAPP repair using 3D endovision system followed by another five cases of TAPP repair using 2D endovision system. Total operating time, operating time during different phases of hernia surgery, faculty take over time, path length of needle holder, and scissors were recorded. Cumulative sum (CUSUM) and split group analysis were done to assess the learning process. Trainee's operating time was compared with that of experts' from previously published study of the same group. Data were compared between last block of five cases done using 3D system and cases done using 2D system for skill transferability. <b><i>Results:</i></b> CUSUM method provided inflection points of total operating time, hernia dissection and mesh placement at 9th case, and peritoneal suturing at 11th case in learning TAPP hernia. After 10th case, trainee's operating time was within the middle 50 percentage of experts operating time. Total operating time in last block of cases done under 3D vision and that of 2D endovision comparable, although peritoneal closure was significantly longer in 2D vision (<i>P</i> = .074, .2, .145, .001). <b><i>Conclusion:</i></b> Reduction on operating time appears after ninth case of TAPP hernia repair using the 3D endovision system. The skills acquired under 3D endovision system are transferable to perform the procedure under 2D endovision system, albeit incompletely. Use of 3D technology may facilitate adaptation of TAPP hernia repair by young surgeons.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"216-223"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025692","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 Laparoscopic Incisional Hernia Repair Following Liver Transplantation: An Updated Systematic Review and Meta-Analysis.","authors":"Valberto Sanha, João P G Kasakewitch, Diego L Lima, Raquel Nogueira, Leandro Totti Cavazzola, Prashanth Sreeramoju, Flavio Malcher","doi":"10.1089/lap.2024.0273","DOIUrl":"10.1089/lap.2024.0273","url":null,"abstract":"<p><p><b><i>Background:</i></b> Incisional hernias (IHs) represent a frequently encountered postoperative complication in patients undergoing liver transplantation. Traditionally, these hernias have been addressed through open surgical techniques. However, laparoscopic repair has been increasingly recognized for its association with a reduced complication rate in the management of ventral hernias. Our objective is to conduct a comparative analysis of the outcomes associated with open versus laparoscopic repair techniques in liver transplant recipients. <b><i>Methods:</i></b> We conducted a comprehensive literature review across multiple databases, including PubMed, Cochrane, LILACS, SciELO, and EMBASE, to identify studies that compare the efficacy of open and laparoscopic repair methods for IHs postliver transplantation. For the statistical analysis of gathered data, we used the Review Manager software, version 5.4. To evaluate the variability among the study outcomes, we assessed heterogeneity using the <i>I</i>² statistic. <b><i>Results:</i></b> After an initial screening of 334 studies, 6 studies with a combined total of 338 patients fulfilled our inclusion criteria. Our analysis revealed that laparoscopic repair tends to be associated with longer operation times, with a mean difference of 20.30 minutes (confidence interval [CI]: 2.14-38.46; <i>P</i> = .03). We observed no significant differences between laparoscopic and open repair regarding infection rates, recurrence rates, overall surgical complications, or hospital stay duration. <b><i>Conclusion:</i></b> Both surgical approaches yield comparable postoperative outcomes. However, laparoscopic repair is associated with an increased operation time duration. To substantiate these findings, further research involving prospective, randomized studies is necessary.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"210-215"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484571","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":"Rare Congenital Lung Lesions in Even Rarer Locations: A Single-Institution Experience with Extrathoracic Congenital Lung Lesions.","authors":"Yeu Sanz Wu, Juan Garcia, Nicholas Schmoke, Christopher Nemeh, Mark C Liszewski, Vincent Duron","doi":"10.1089/lap.2024.0384","DOIUrl":"https://doi.org/10.1089/lap.2024.0384","url":null,"abstract":"<p><p><b><i>Background:</i></b> Extrathoracic congenital lung lesions (CLLs) are a rare anomaly of lung development. Management and surgical approach are variable. We present our institutional experience with extrathoracic CLLs for the past 18 years. <b><i>Methods:</i></b> We retrospectively reviewed all patients younger than 18 years diagnosed with a CLL from January 2005 to June 2023. Only patients with suspected extrathoracic CLLs on prenatal imaging were included. <b><i>Results:</i></b> A CLL was identified in 381 patients and was extrathoracic in 25 patients (6.6%). Six patients (24%) with other congenital anomalies were excluded, and 3 were lost to follow-up. The prenatal course and delivery of the 16 study patients were unremarkable and all were asymptomatic. Larger lesions, both prenatally and postnatally, were more likely to undergo surgical resection (11.8 ± 8.2 cm³ versus 3.9 ± 3.3 cm³, <i>P</i> = .05; 6.1 ± 5.1 cm³ versus 2.5 ± 2.5 cm³, <i>P</i> = .10, respectively). Seven patients (7/16; 44%) underwent resection-5 thoracoscopic and 2 laparoscopic. Thoracoscopic transdiaphragmatic approach was favored for lesions extending >50% above the diaphragm. Five lesions were intradiaphragmatic, one infradiaphragmatic, and one intrathoracic. Four lesions (4/7; 57%) were hybrid lesions on pathology. No malignancy was identified. Nine patients (9/16; 56%) underwent surveillance. Imaging modality for surveillance varied. Duration of follow-up ranged from 0.5 to 83 months. <b><i>Conclusions:</i></b> We provide the largest case series to date describing both operative and nonoperative management of extrathoracic CLLs. Surveillance appears to be appropriate for small lesions. If surgical excision is pursued, the thoracoscopic approach is safe and preferred if diaphragmatic involvement is suspected.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524862","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 Common Bile Duct Exploration for Choledocholithiasis in the Elderly: A Systematic Review and Meta-Analysis.","authors":"Lucas Monteiro Delgado, Bernardo Fontel Pompeu, Caio Mendonça Magalhães, Eric Pasqualotto, Gabriel Henrique Acedo Martins, Abraão Alcantara de Medeiros Filho, Lucas Soares de Souza Pinto Guedes, Sergio Mazzola Poli de Figueiredo","doi":"10.1089/lap.2024.0382","DOIUrl":"https://doi.org/10.1089/lap.2024.0382","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Laparoscopic common bile duct exploration (LCBDE) is a well-established and effective minimally invasive surgical approach for managing choledocholithiasis. However, its safety in the elderly population is not well established. Therefore, this study compares surgery-related outcomes in elderly patients undergoing LCBDE. <b><i>Methods:</i></b> We systematically searched PubMed, Embase, and Cochrane Library for studies comparing elderly and young patients undergoing LCBDE. Binary outcomes were compared using odds ratios (ORs), with 95% confidence intervals (CIs). Heterogeneity was assessed with <i>I</i>² statistics. Statistical analysis was performed using Software R, version 4.3.3. <b><i>Results:</i></b> Twelve studies comprising 3791 patients were included, of whom 1411 patients (37%) were from the elderly group. Elderly patients were associated with an increase in mortality (OR: 3.42; 95% CI: 1.08-10.85; <i>P</i> = .04; <i>I</i>² = 0%), overall postoperative complications (OR: 1.60; 95% CI: 1.11-2.22; <i>P</i> = .01; <i>I</i>² = 52%), and pneumonia (OR: 4.37; 95% CI: 2.00-9.55; <i>P</i> < .01; <i>I</i>² = 0%) rates. However, there were no significant differences between groups in remnant stones (OR: 1.37; 95% CI: 0.70-2.68; <i>P</i> = .36; <i>I</i>² = 0%) and recurrent stones (OR: 1.37; 95% CI: 0.64-2.95; <i>P</i> = .42; <i>I</i>² = 0%) pancreatitis (OR: 0.98; 95% CI: 0.16-5.95; <i>P</i> = .98; <i>I</i>² = 0%) and bile leakage (OR: 1.24; 95% CI: 0.75-2.07; <i>P</i> = .40; <i>I</i>² = 0%). <b><i>Conclusion:</i></b> In this meta-analysis, elderly patients who underwent LCBDE experienced increased mortality, overall complications, and pneumonia rates compared with young patients. Furthermore, there were no significant differences between the groups in remnant and retained stones, pancreatitis, and bile leakage.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505778","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":"Single-Port Laparoscopic Choledochal Cyst Radical Surgery Using Mucosal Eversion Technique in Small-Diameter Hepaticojejunostomy.","authors":"Wen-Feng Tang, Xi-Si Guan, Xiao-Li Xie, Jia-Kang Yu, Wei Zhong, Zhe Wang","doi":"10.1089/lap.2024.0379","DOIUrl":"https://doi.org/10.1089/lap.2024.0379","url":null,"abstract":"<p><p><b><i>Background:</i></b> Single-port laparoscopic choledochal cyst (CDC) excision and Roux-en-Y hepaticoenterostomy (SPCH) exhibits several advantages over conventional laparoscopic techniques in the management of CDCs. However, performing small-diameter hepaticojejunostomy during single-port laparoscopy presents significant challenges, thereby increasing the risk of anastomotic complications. In this study, we employed the mucosal eversion (ME) technique to alleviate the difficulties associated with executing small-diameter hepaticojejunostomy during SPCH and report the preliminary outcome of a prospective case cohort. <b><i>Methods:</i></b> Patients diagnosed with CDC and found common hepatic duct diameter was smaller than 5 mm during SPCH were included. ME was performed on these patients. Clinical information, Magnetic resonance imaging image data, and surgical information data were collected, and patients were followed up for at least 1 year to assess surgical outcomes and postoperative complications. <b><i>Results:</i></b> A consecutive cohort of 16 patients was included from August 2020 to July 2023. All 16 patients successfully underwent ME during SPCH. The median age at surgery was 14.25 months, with an average hepaticojejunostomy diameter of 6.75 mm (ranging from 5 to 8 mm). The mean operation time was 266.25 minutes, and the average posthospital stay was 6.31 days (ranging from 4 to 9 days). During a follow-up period of 12-47 months, no cases of anastomotic leakage or stenosis were observed in this cohort. <b><i>Conclusions:</i></b> The ME technique is easy to execute and outcomes are reliable. It constitutes an efficacious approach to enhancing the prognosis of small-diameter biliary-enteric anastomosis in patients with CDCs undergoing SPCH.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473154","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":"Diagnosis of Acute Appendicitis with Machine Learning-Based Computer Tomography: Diagnostic Reliability and Role in Clinical Management.","authors":"Osman Sibic, Erkan Somuncu, Serhan Yilmaz, Ercan Avsar, Emre Bozdag, Adem Ozcan, Mahmut Ozan Aydin, Cenk Ozkan","doi":"10.1089/lap.2024.0374","DOIUrl":"https://doi.org/10.1089/lap.2024.0374","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> Acute appendicitis (AA) is a common surgical emergency affecting 7-8% of the population. Timely diagnosis and treatment are crucial for preventing serious morbidity and mortality. Diagnosis typically involves physical examination, laboratory tests, ultrasonography, and computed tomography (CT). This study aimed to evaluate the effectiveness of artificial intelligence (AI) in analyzing CT images for the early diagnosis of AA and prevention of complications. <b><i>Methods:</i></b> CT images of patients who underwent surgery for AA at the General Surgery Clinic of Kanuni Sultan Suleyman Health Application and Research Center between January 1, 2019, and June 31, 2023, were analyzed. A total of 1200 CT images were evaluated using four different AI models. The model performance was assessed using a confusion matrix. <b><i>Results:</i></b> The median age of the patients was 28 years, with a similar sex distribution. No significant differences were observed in terms of age or sex (<i>P</i> = .168 and <i>P</i> = .881, respectively). Among the AI models, MobileNet v2 showed the highest accuracy (0.7908) and precision (0.8203), whereas Inception v3 had the highest F-score (0.7928). In the receiver operating characteristic analysis, MobileNet v2 achieved an area under the curve (AUC) of 0.8767. <b><i>Conclusion:</i></b> AI's role in daily life is expanding. In the present study, the highest sensitivity and specificity were 77% and 86%, respectively. Supporting CT imaging with AI systems can enhance the accuracy of AA diagnoses.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450836","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":"One Less: Single-Incision Laparoscopic Appendectomy Facilitates Postoperative Opioid Avoidance.","authors":"Paul M Jeziorczak, Casey J Goodyear, Olivia A Perham, Riley S Frenette, Charles J Aprahamian","doi":"10.1089/lap.2022.0489","DOIUrl":"https://doi.org/10.1089/lap.2022.0489","url":null,"abstract":"<p><p><b><i>Background:</i></b> Opioid use has become an epidemic problem. There has been a recent push toward strategies that minimize postoperative opioid use. Appendectomy is one of the most common procedures performed in the pediatric population. Single-incision appendectomy through the umbilicus is a safe and well-tolerated procedure. The aim of this project was to review opioid utilization in children who have undergone single incision appendectomy for perforated and nonperforated appendicitis. <b><i>Methods:</i></b> A retrospective review, approved by the University of Illinois College of Medicine Institutional Review Board, of 500 patients at a single institution under the age of 18 who had an appendectomy between May 1, 2018, and December 1, 2021, was performed. A final population cohort of 432 was assembled after excluding non-single-incision cases (67) and non-appendectomy cases (1). Outcomes of interest were length of stay, age, appendix perforation status, and opioids at discharge status. All patients were sent home without opioids. <b><i>Results:</i></b> A total of 432 patients underwent a single incision laparoscopic appendectomy, with an overall average length of stay of 2.1 days, average age of 11.1 years, and zero patients were sent home on opioids. The perforated appendix population (<i>n</i> = 169) yielded a less than 4-day stay, an average age of 10.33 years, and 61.5% male. Meanwhile, the nonperforated appendix population (<i>n</i> = 264) revealed a 0.8-day stay, an average age of 11.59, years and 54.2% male. The differences between perforated and nonperforated appendectomies are significant for average length of stay (<i>P</i> < .001) and average age (<i>P</i> < .01). <b><i>Conclusion:</i></b> Being cognizant of opioid utilization in the management of postoperative pain control is important to address the current opioid crisis. The single incision laparoscopic approach for pediatric appendectomy can potentially decrease the need for postoperative narcotics. No children were sent home with narcotics in our population. The procedure is well tolerated and can be performed with traditional laparoscopic equipment.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450837","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":"Does the 5-Item Modified Frailty Index Predict Adverse Outcomes after Retrograde Intrarenal Surgery? A Case-Control Study by the RIRSearch Group.","authors":"Cem Başataç, Muhammed Fatih Şimşekoğlu, Kerem Teke, Mustafa Bilal Tuna, Önder Çınar, Hacı Murat Akgül, Oktay Özman, Hakan Çakır, Duygu Sıddıkoğlu, Cenk Murat Yazıcı, Eyüp Burak Sancak, Bülent Önal, Haluk Akpınar","doi":"10.1089/lap.2024.0353","DOIUrl":"https://doi.org/10.1089/lap.2024.0353","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> We aim to assess whether severely frail patients have an increased risk of complications and worse surgical outcomes after retrograde intrarenal surgery. <b><i>Methods:</i></b> The data of 340 consecutive patients undergoing retrograde intrarenal surgery to treat upper tract urinary stones were analyzed retrospectively. The 5-item modified frailty index (mFI-5) was used to assess the frailty status. Using a cutoff value of score 2 in the mFI-5 score, patients were divided into two groups: patients with an mFI-5 score <2 were assigned to a non-frail (Group 1) group, and patients with an mFI-5 score ≥2 were assigned to a frail (Group 2) group. The patients' demographics, stone characteristics, operative outcomes, and complication rates were compared between the groups. The primary objective was to examine whether the surgical outcomes were much better in non-frail patients. <b><i>Results:</i></b> After matching confounding factors, Group 1 comprised 255 patients, and Group 2 comprised 85 patients. The baseline characteristics were similar between the groups. There were no statistically significant differences in terms of the median operation time and length of hospital stay among groups. There were no significant differences between groups for intraoperative complication rates (7.6% and 9.4%, respectively; <i>P</i> = .47) and postoperative complication rates (13.8% and 11.8%, respectively; <i>P</i> = .71), and stone-free rates (70.9% versus 72.9%, respectively; <i>P</i> = .73). <b><i>Conclusions:</i></b> Retrograde intrarenal surgery is an efficient and feasible treatment option for upper urinary tract stones in severely frail patients.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417037","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":"Laparoscopy for Gastrointestinal Perforation in Neonates: A New Animal Model for Training.","authors":"Victoria Leones de Matos, Elisa Siano, Esperança Vidal Quipungo, Alice Miranda, Peter Etlinger, Jorge Correia-Pinto","doi":"10.1089/lap.2024.0342","DOIUrl":"https://doi.org/10.1089/lap.2024.0342","url":null,"abstract":"<p><p><b><i>Background:</i></b> Gastrointestinal (GI) perforation in the neonatal period can result from different conditions with varying degrees of severity. Optimal timing for surgery is challenging to establish and laparoscopy has been proposed as a diagnostic tool to minimize surgical delays and refine surgical indications. However, no standard animal model is universally accepted for training laparoscopic management of neonatal GI perforations. We aimed to define a small-sized animal model and (1) assess the effectiveness of laparoscopy in identifying GI perforations and (2) evaluate the viability of intracorporeal suturing, in a confined working space. <b><i>Methods:</i></b> In total, 30 Sprague Dawley rats underwent laparoscopy. In Part I, a random GI perforation was performed. In Part II, the perforation was identified and sutured. The surgeon of Part II remained blinded during Part I. The suture line was assessed for leaks and strictures once the rats were euthanized. <b><i>Results:</i></b> In Part I, 29 perforations were created: 22 in the ileum, 3 in the colon, 2 in the jejunum, 1 in the stomach, and 1 in the duodenum. In one rat, the GI tract was left intact. In Part II, all 29 perforations were identified and sutured. The average duration of Part II was 53 ± 16 minutes. During suture evaluation, a leak was observed in two cases, and a stricture in two additional cases. <b><i>Conclusions:</i></b> Laparoscopy was technically feasible and highly sensitive in detecting isolated GI perforation in a rat model. This model holds particular value for training laparoscopic skills in a space-limited setting. Further investigation is needed to see if a learning curve can be achieved.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392344","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}