Journal of Laparoendoscopic & Advanced Surgical Techniques最新文献

{"title":"Endosonography Overestimates Preoperative Staging of Primarily Resectable Esophageal Cancer Compared to Pathological T and N Status.","authors":"Aram Abu Hejleh, Julia Buttermann, Sonja Lang, Karl Knipper, Nikolai Schleußner, Hans Schlößer, Hans Fuchs, Philipp Kasper, Thomas Schmidt, Alexander Quaas, Christiane Bruns, Jin-On Jung, Seung-Hun Chon","doi":"10.1177/10926429261490767","DOIUrl":"https://doi.org/10.1177/10926429261490767","url":null,"abstract":"<p><strong>Background: </strong>Accurate preoperative staging of esophageal carcinoma guides the choice between neoadjuvant therapy and primary surgery. Endoscopic ultrasound (EUS) remains the principal modality for locoregional staging, yet its accuracy varies. We evaluated EUS diagnostic performance against final pathology in a homogeneous cohort undergoing primary esophagectomy at a high-volume center and identified factors influencing its reliability.</p><p><strong>Methods: </strong>This retrospective analysis included 295 patients with esophageal adenocarcinoma (78%) or squamous cell carcinoma (22%) who underwent oncological esophagectomy between 2006 and 2017, primarily without neoadjuvant therapy. Preoperative uTNM staging by EUS was compared with pathological pTNM. Predictors of staging concordance were assessed by multivariate logistic regression.</p><p><strong>Results: </strong>Overall T-stage accuracy was 57.2%. EUS correctly identified 85.9% of pT1 tumors but only 17.0% of pT2 and 64.6% of pT3 lesions. Tumors were overstaged in 36.6% and understaged in 6.1% of cases. Nodal staging accuracy was 65.8% (sensitivity 65%, specificity 68%). Younger age, female sex, shorter height, and ASA II status were independent predictors of reduced T-stage accuracy; no significant predictors emerged for N-stage.</p><p><strong>Conclusion: </strong>EUS accurately detects early-stage esophageal cancer but shows limited reliability for intermediate stages, particularly pT2 tumors, in this single-center study. Given the risk of misclassification, EUS findings should be interpreted cautiously and complemented by additional diagnostic tools to improve preoperative assessment and enable individualized treatment decisions.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261490767"},"PeriodicalIF":1.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992249","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 ICG-Foley: A Novel Indocyanine Green-Coated Foley Catheter for Enhanced Anatomic Identification During Robot-Assisted Laparoscopic Prostatectomy.","authors":"Chad Heflick, Orly Guerra, Igor Sorokin","doi":"10.1177/10926429261491068","DOIUrl":"https://doi.org/10.1177/10926429261491068","url":null,"abstract":"<p><strong>Background: </strong>Precise identification of the bladder neck and urethra during robot-assisted laparoscopic prostatectomy (RALP) is critical for continence preservation but remains challenging, particularly during the Retzius-sparing approach.</p><p><strong>Objective: </strong>To describe a novel indocyanine green (ICG)-coated Foley catheter (ICG-Foley) that enhances intraoperative identification of the bladder neck and urethra during RALP and to report preliminary functional outcomes.</p><p><strong>Methods: </strong>A 16Fr latex Foley catheter was soaked in ICG-saline solution (25 mg/210 mL) for 3 minutes before placement. The technique was evaluated in 4 consecutive patients undergoing RALP using the da Vinci SP and Xi robotic platforms.</p><p><strong>Results: </strong>The ICG-Foley provided consistent near-infrared fluorescence throughout all procedures, enabling clear identification of the bladder neck and apical urethra. All 4 patients achieved continence (≤1 pad/day) by 12 months.</p><p><strong>Conclusions: </strong>The ICG-Foley is a simple, low-cost adjunct that enhances real-time anatomic identification during RALP and may serve as a valuable tool for both experienced surgeons and those early in their learning curve.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261491068"},"PeriodicalIF":1.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992237","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":"Clinical Outcomes of Robotic and Laparoscopic Ileal Pouch-Anal Anastomosis in Ulcerative Colitis: A Retrospective Cohort from Two Tertiary Referral Centers.","authors":"Ahmet Anil Sahar, Cigdem Benlice, Orkun Harun Cebi, Afag Aghayeva, Ismail Hamzaoglu, Tayfun Karahasanoglu, Bilgi Baca","doi":"10.1177/10926429261490771","DOIUrl":"https://doi.org/10.1177/10926429261490771","url":null,"abstract":"<p><strong>Background: </strong>Robotic platforms may facilitate the technically demanding pelvic and multiquadrant components of ileal pouch-anal anastomosis (IPAA), but comparative evidence remains limited.</p><p><strong>Methods: </strong>We retrospectively compared 90-day outcomes after robotic (<i>n</i> = 36) and laparoscopic (<i>n</i> = 24) IPAA for ulcerative colitis performed by one surgical team at two tertiary referral centers between 2014 and 2025. The primary outcome was postoperative morbidity. Logistic regression adjusted for operative staging; an exploratory model additionally adjusted for age, sex, and body mass index.</p><p><strong>Results: </strong>Ninety-day morbidity occurred in 30.6% of robotic and 41.7% of laparoscopic patients (<i>P</i> = .377). Major morbidity, operative time, blood loss, length of stay, readmission, and reoperation did not differ significantly. The robotic approach was not associated with morbidity in the primary model (adjusted OR, 0.60; 95% CI, 0.20-1.80; <i>P</i> = .361).</p><p><strong>Conclusions: </strong>Robotic IPAA showed no evidence of increased short-term morbidity compared with laparoscopy in this single-team cohort.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261490771"},"PeriodicalIF":1.1,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992214","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 Transabdominal Repair of Incarcerated Morgagni Hernia in Adults.","authors":"Kailey Bova, Paul Vesco, Tamela Fonseca, Rebecca Lazensky, Maria Moreno, Tonya King, Margaret Blair Marshall","doi":"10.1177/10926429261486822","DOIUrl":"https://doi.org/10.1177/10926429261486822","url":null,"abstract":"<p><strong>Objective: </strong>Morgagni hernia (MH) is a rare congenital hernia where abdominal organs traverse an embryologic defect. Its presence is an indication for repair.</p><p><strong>Methods: </strong>A retrospective review was performed. Descriptive statistics characterized the sample. Categorical measures are reported as frequencies and percentages.</p><p><strong>Results: </strong>Ten patients underwent minimally invasive repair (MIR) of MH (laparoscopic = 2, robotic = 8). There were 4 men and 6 women aged 51-89, with a median of 75 years (IQR 66-78). Seven patients (70%) were symptomatic. MH was unilateral in 9 patients (6 = R, 3 = L) and bilateral in 1. Herniated organs included the colon and omentum for all patients, the small bowel in 2, and the stomach in 1. Length of stay (LOS) for robotic procedures ranged from 1 to 6 days with a median of 2 days (IQR 2-6), while LOS for laparoscopic procedures ranged from 4 to 8 days with a median of 6 days (IQR 4-8). Patient follow-up ranged from 1 to 62 months, with a median of 9.5 months (IQR 3.5-31.5). There were no complications or mortalities.</p><p><strong>Conclusion: </strong>The majority of adult patients identified with MH are symptomatic, the most common symptom being dyspnea. The colon and omentum are the most commonly herniated organs, although the small bowel and stomach also herniate. MH frequently occurs on the right but can occur on the left or, more rarely, bilaterally. Laparoscopic and robotic approaches to repair can be performed safely and effectively, although a robotic approach may be associated with shorter LOS. MIR is feasible and associated with minimal morbidity and mortality.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261486822"},"PeriodicalIF":1.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901431","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":"Clinical Relevance of Preoperative Upper Gastrointestinal Endoscopy before Sleeve Gastrectomy: A Retrospective Cohort Study of 30-Day Outcomes.","authors":"Hasan Eroğlu, Ahmed Taha, İskender Eren Demirbaş, Özgür İbiş","doi":"10.1177/10926429261486299","DOIUrl":"https://doi.org/10.1177/10926429261486299","url":null,"abstract":"<p><strong>Background: </strong>Routine preoperative upper gastrointestinal endoscopy before sleeve gastrectomy remains debated. This study evaluated whether selected endoscopic and histopathologic findings were associated with 30-day outcomes after sleeve gastrectomy, with specific attention to reflux-related events and severity-stratified staple-line leak.</p><p><strong>Methods: </strong>We retrospectively analyzed 315 adults who underwent laparoscopic sleeve gastrectomy at a tertiary referral center between June 2016 and December 2019. All patients underwent preoperative esophagogastroduodenoscopy with Sydney-protocol biopsies. Postoperative outcomes were assessed within 30 days. The leak was classified as limited/minimal when managed with antibiotics alone and as major when invasive intervention or death occurred.</p><p><strong>Results: </strong>Postoperative reflux symptoms occurred in 47 patients (14.9%). Staple-line leak was diagnosed in 13 patients (4.1%) after oral intake using clinical findings, inflammatory markers, and contrast-enhanced computed tomography; routine postoperative day 1 upper gastrointestinal contrast passage studies were normal in all leak patients. Ten leaks were limited/minimal and resolved with antibiotics alone, whereas 3 patients (0.95%) had major leaks requiring percutaneous/endoscopic or surgical intervention. Hiatal hernia was associated with postoperative reflux symptoms, and previous upper abdominal surgery was associated with leak. Associations involving endoscopic bile reflux/possible pyloric dysfunction were exploratory because objective motility testing was unavailable.</p><p><strong>Conclusions: </strong>Preoperative endoscopy may identify selected foregut abnormalities relevant to early outcomes after sleeve gastrectomy, particularly reflux-related anatomy. Leak-related findings should be interpreted cautiously because event numbers were small; severity-stratified reporting provides a more clinically meaningful interpretation than an undifferentiated leak rate.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261486299"},"PeriodicalIF":1.1,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908011","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":"Robotic Versus Laparoscopic Ileal Pouch-Anal Anastomosis for Ulcerative Colitis: A Systematic Review and Comparative Meta-Analysis.","authors":"Thaís Henriques Abud, Maria Eduarda Caetano Batista de Paiva, Mateus Lima Ulisses Trindade, Camila Sigaud Frizzo, Lucas Monteiro Delgado, Claudia Theis, Sergio Mazzola Poli de Figueiredo, Fernanda Bellotti Formiga, Bernardo Fontel Pompeu","doi":"10.1177/10926429261485235","DOIUrl":"https://doi.org/10.1177/10926429261485235","url":null,"abstract":"<p><strong>Background: </strong>Ileal pouch-anal anastomosis (IPAA) is the standard restorative procedure for patients with ulcerative colitis requiring colectomy. Although robotic-assisted surgery has gained increasing acceptance in colorectal surgery, its role in IPAA remains uncertain.</p><p><strong>Methods: </strong>A systematic search was conducted across PubMed, Scopus, and the Cochrane Central Register of Controlled Trials up to May 2026. Pooled odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity was assessed using the <i>I</i>² statistic. Sensitivity analyses were conducted to analyze outcomes with moderate or substantial heterogeneity.</p><p><strong>Results: </strong>Six comparative observational studies involving 946 patients were included; 460 underwent robotic-assisted IPAA, and 486 underwent laparoscopic IPAA. No significant differences were observed between approaches regarding anastomotic leak (OR: 0.69; 95% CI: 0.37 to 1.28; <i>P</i> = .234), bleeding (OR: 0.59; 95% CI: 0.21 to 1.64; <i>P</i> = .309), Clavien-Dindo grade III or higher complications (OR: 1.17; 95% CI: 0.57 to 2.41; <i>P</i> = .670), conversion to open surgery (OR: 0.46; 95% CI: 0.16 to 1.34; <i>P</i> = .156), postoperative ileus (OR: 1.11; 95% CI: 0.65 to 1.91; <i>P</i> = .705), overall morbidity (OR: 1.17; 95% CI: 0.84 to 1.63; <i>P</i> = .361), reoperation (OR: 1.06; 95% CI: 0.27 to 4.19; <i>P</i> = .933), or 30-day readmission (OR: 0.83; 95% CI: 0.59 to 1.17; <i>P</i> = .278). Likewise, no significant differences were identified in operative time (MD 26.3 minutes; 95% CI: -1.9 to 54.4; <i>P</i> = .07) or hospital stay (MD -0.5 days; 95% CI: -1.5 to 0.5; <i>P</i> = .34). Sensitivity analyses did not materially alter the direction or statistical significance of the pooled estimates despite moderate to high heterogeneity in selected outcomes.</p><p><strong>Conclusion: </strong>Available observational evidence suggests that robotic-assisted IPAA yields short-term outcomes comparable to those of laparoscopic IPAA; however, the certainty of evidence is very low, and definitive conclusions are constrained by the observational nature of the available data.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261485235"},"PeriodicalIF":1.1,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892803","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 Task-Specific Performance Rating Scale for Laparoscopic Intracorporeal Suturing and Knot Tying: Development and Initial Evaluation.","authors":"Xiang Xia, Zihan Zhou, Yihong Lu, Zhengqian Bian, Qiushi Tang, Zizhen Zhang","doi":"10.1177/10926429261486295","DOIUrl":"https://doi.org/10.1177/10926429261486295","url":null,"abstract":"<p><strong>Background: </strong>Laparoscopic intracorporeal suturing and knot tying is a core minimally invasive surgical skill, but generic global rating instruments may not identify the task-specific technical errors needed for targeted feedback. We developed an 8-item performance rating scale for a standardized simulator task and evaluated its measurement properties.</p><p><strong>Methods: </strong>In a cross-sectional cohort, 82 participants across 5 training levels completed 1 interrupted laparoscopic suture consisting of 1 needle pass, 3 intracorporeal knots, and final cutting. Deidentified videos were independently scored by 3 raters. Interrater reliability was estimated using 2-way random effects, absolute-agreement intraclass correlation coefficients (ICCs). Between-level performance was assessed using Kruskal-Wallis tests, Holm-adjusted pairwise comparisons, and Spearman correlation. Twelve learners completed the task before and after standardized training.</p><p><strong>Results: </strong>Quality scores differed across training levels (<i>P</i> < .001) and correlated strongly with level (Spearman rho = 0.872, <i>P</i> < .001). Completion time decreased with level (rho = -0.897, <i>P</i> < .001). Total-score reliability was excellent (ICC[2,1] = 0.960; ICC[2,3] = 0.986). After training, mean quality score increased by 5.83 points, and completion time decreased by 29.17 seconds (both <i>P</i> < .001).</p><p><strong>Conclusions: </strong>The scale provides a reliable, reproducible method for video-based assessment of laparoscopic intracorporeal suturing and knot-tying performance. Its principal current use is to differentiate novice and early-stage operators and to track progress during simulator-based practice. More demanding tasks and multicenter evaluation are needed before use for advanced proficiency decisions.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261486295"},"PeriodicalIF":1.1,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889085","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":"Beyond HbA1c: Multivariate Clustering and Propensity-Weighted Analysis Identify High-Risk Patients with Diabetes Undergoing Bariatric Surgery.","authors":"Fathima Ruba Shamnad, Juan S Barajas-Gamboa, Alfredo D Guerron, Javed Raza, Juan Pablo Pantoja, Juan Cruz Lopez Meyer, Safa Botros Hegazin, Cynthia Salloum, Carlos Abril, John Rodriguez","doi":"10.1177/10926429261486261","DOIUrl":"https://doi.org/10.1177/10926429261486261","url":null,"abstract":"<p><strong>Introduction: </strong>Preoperative glycemic control is a key concern in bariatric surgery. However, the extent to which suboptimal HbA1c levels impact short-term postoperative morbidity remains uncertain. This study evaluated the association between preoperative HbA1c categories and 30-day postoperative morbidity in a large Middle Eastern bariatric surgery cohort, using propensity score weighting and unsupervised clustering to refine risk stratification.</p><p><strong>Methods: </strong>This retrospective cohort analysis included 1778 bariatric surgery patients operated between 2019 and 2024 at a tertiary referral center in the United Arab Emirates. Patients were stratified into two groups: controlled HbA1c (≤6.5%, <i>n</i> = 1557) and elevated HbA1c (>6.5%, <i>n</i> = 221). Baseline demographics, perioperative parameters, and 30-day outcomes were extracted from a prospectively maintained registry. Statistical analysis included inverse probability weighting using propensity scores to adjust for age, BMI, and sex. Principal component analysis (PCA) followed by K-means clustering was performed on age and HbA1c to identify multivariate patient subgroups. Both unweighted and weighted analyses were performed.</p><p><strong>Results: </strong>Elevated HbA1c patients were older than those with controlled HbA1c (43.2 ± 12.1 versus 34.6 ± 10.8 years, <i>P</i> < .001 unweighted; 43.2 ± 12.1 versus 42.1 ± 12.0 years, <i>P</i> = .364 weighted). BMI was modestly higher in the elevated group but not significant after weighting. Thirty-day complication rates were low across all groups. The highest risk was observed in patients >60 years with diabetes (8.1%), while patients ≤20 years had negligible complications. In adults 21-60 years, complication rates increased modestly with HbA1c (normal 3.9%-5.3%, prediabetes 3.9%-6.3%, diabetes 6.5%-8.6%). No deaths occurred. Other complications, including deep/organ-space SSI, pneumonia, pulmonary embolism, renal failure, myocardial infarction, transfusion, gastrointestinal bleeding, readmission, and reoperation, were rare and showed no significant differences across HbA1c strata (all <i>P</i> > .05).</p><p><strong>Conclusion: </strong>Elevated HbA1c was not an independent predictor of short-term morbidity after bariatric surgery. PCA-cluster analysis identified a distinct high-risk subgroup: older diabetic patients, who demonstrated the greatest vulnerability to short-term complications. These findings suggest that perioperative risk assessment should move beyond HbA1c cutoffs alone and incorporate multivariate patient profiling to guide individualized care.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261486261"},"PeriodicalIF":1.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882144","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":"Clinical Outcomes of Magnesium-Based Balloon-Expandable Biodegradable Stenting for Benign Biliary Strictures: A Single-Center Retrospective Cohort Study.","authors":"Mariano Eduardo Giménez, Chiara Innocenzi, Ignacio Corteggiano, Juliana Maria Racedo, Lucas Fehlauer, Samantha Robert, Pablo Acquafresca, Eduardo Houghton, Mariano Palermo","doi":"10.1177/10926429261486279","DOIUrl":"https://doi.org/10.1177/10926429261486279","url":null,"abstract":"<p><strong>Background: </strong>Benign biliary strictures, most commonly anastomotic after hepaticojejunostomy or related to bile duct injury, are conventionally managed with balloon dilation, multiple plastic stents, or covered metal stents, all of which typically require repeated procedures. Magnesium-based balloon-expandable biodegradable stents (UNITY-B) have been proposed as a single-step alternative, but dedicated cohort data are limited.</p><p><strong>Methods: </strong>We retrospectively reviewed 22 consecutive UNITY-B stent-placement procedures performed in 21 patients with benign biliary strictures at a single center (April 2024-February 2026). The primary endpoint, clinical success (freedom from stricture recurrence during follow-up), was estimated using the Kaplan-Meier method at the patient level (<i>n</i> = 21), with a procedure-level sensitivity analysis (<i>n</i> = 22) and a competing-risks sensitivity analysis (Aalen-Johansen estimator) accounting for two unrelated deaths. Technical success and stent-related complications, assessed within 30 days after stent placement, were evaluated at the procedure level.</p><p><strong>Results: </strong>Median age was 58.0 years (interquartile range 51.0-70.0); 76.2% of strictures were anastomotic at a hepaticojejunostomy. Technical success was achieved in 22/22 procedures (100%), with no stent-related complications within 30 days. Stricture recurrence occurred in 6/21 patients (28.6%) at a median of 7.0 months; all underwent reintervention. Kaplan-Meier freedom from recurrence was 90.5% (95% CI 67.0-97.5%) at 6 months and 66.0% (95% CI 38.7-83.3%) at 12 months. Two deaths, unrelated to the procedure, occurred during follow-up.</p><p><strong>Conclusions: </strong>In this small, retrospective, single-arm cohort, magnesium-based balloon-expandable biodegradable biliary stenting was technically feasible, with no stent-related complications observed within 30 days after stent placement, and freedom from recurrence in approximately two-thirds of patients at 1 year. These findings are hypothesis-generating; prospective comparative studies with longer follow-up are needed before this approach can be positioned relative to established alternatives.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"10926429261486279"},"PeriodicalIF":1.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882262","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 Efficacy of Robotic Adrenalectomy: Korean Nationwide Comparative Data Analysis Focusing on Robotic Modality, Surgical Approach, and Tumor Characteristics.","authors":"Jae-Wook Chung, Kisoo Lee, Taek Sang Kim, Dongho Shin, Ho Seok Chung, Tae Gyun Kwon, Young Hwii Ko, Wansuk Kim","doi":"10.1177/10926429251411372","DOIUrl":"10.1177/10926429251411372","url":null,"abstract":"<p><strong>Purpose: </strong>Despite insufficient evidence of safety, single-port robotic surgery is becoming increasingly popular. This retrospective study compared the surgical efficacy of single-port robotic adrenalectomy (RA) and conventional multi-port RA.</p><p><strong>Materials and methods: </strong>Data were collected from 303 patients who underwent RA across seven centers from January 2018 to June 2024.</p><p><strong>Results: </strong>The mean age of the patients was 51.6 ± 12.8 years, and 41.3% (125/303) of them were male. Left-sided adrenal tumors were present in 58.1% (176/303) of the patients. Clinical tumor size was 3.5 ± 2.0 cm. Robotic partial adrenalectomy, retroperitoneal, and single-port RAs were performed in 96 (31.7%), 57 (18.8%), and 42 (13.9%) patients, respectively. A Jackson-Pratt drain was not inserted in 69 cases (22.8%), and hospital stay was 4.3 ± 1.7 days. Given the different patient selection criteria for multi-port and single-port RAs, propensity score matching (PSM) was conducted according to the laterality of the procedure, tumor size, and tumor characteristics. After PSM, intraoperative and postoperative (≥30 days) complication rates were not different between the multi-port and single-port RA groups. The incidence of complications was not significantly different between the two groups when the tumor size was stratified as 4 cm (2.0% versus 3.7%). Multivariate logistic regression analysis revealed that the surgical method (multi-port versus single-port) was not associated with perioperative complications. Instead, it depended on whether the tumor was a cortical carcinoma or a pheochromocytoma.</p><p><strong>Conclusion: </strong>Both multi- and single-port RAs are safe. In certain patients, single-port RA can be an alternative surgical option.</p>","PeriodicalId":50166,"journal":{"name":"Journal of Laparoendoscopic & Advanced Surgical Techniques","volume":" ","pages":"671-676"},"PeriodicalIF":1.1,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718872","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}