Laparoscopic Surgery Research Papers - Academia.edu (original) (raw)

2025, Surgical Endoscopy

Background Laparoscopic cholecystectomy (LC) is the standard of care for benign gallstone disease. There are no robust Indian data on the 30-day morbidity and mortality of this procedure. A prospective multicentre observational study was conducted by the Indian Association of Gastro-Intestinal Endo Surgeons (IAGES) to assess the 30-day morbidity and mortality of LC in India. Materials and methods Participating surgeons were invited to submit data on all consecutive LCs for benign diseases performed between 09/12/2020 and 08/03/2021 in adults. Primary outcome measures were 30-day morbidity and mortality. Univariate and multivariate analyses were performed to identify variables significantly associated with primary outcomes. Results A total of 293 surgeons from 125 centres submitted data on 6666 patients. Of these, 71.7% (n = 4780) were elective. A total LC was carried out in 95% (n = 6331). Laparoscopic subtotal cholecystectomy was performed in 1.9% (n = 126) and the procedure were converted to open in 1.4% of patients. Bile duct injury was seen in 0.3% (n = 20). Overall, 30-day morbidity and mortality were 11.1% (n = 743) and 0.2% (n = 14), respectively. Nature of practice, ischemic heart disease, emergency surgery, postoperative intensive care, and postoperative hospital stay were independently associated with 30-day mortality. Age, weight, body mass index, duration of symptoms, nature of the practice, history of Coronavirus Disease-2019, previous major abdominal surgery, acute cholecystitis, use of electrosurgical or ultrasonic or bipolar energy for cystic artery control; use of polymer clips for cystic duct control; conversion to open surgery, subtotal cholecystectomy, simultaneous common bile duct exploration, mucocele, gangrenous gall bladder, dense adhesions, intraoperative cholangiogram, and use of drain were independently associated with 30-day morbidity. Conclusion LC has 30-day morbidity of 11.1%, 30-day mortality of 0.2%, conversion to open rate of 1.4%, and bile duct injury rate of 0.3% in India.

2025

Purpose: Diaphragmatic hernia in adults is a rare but potentially lifethreatening condition that often presents diagnostic and surgical challenges. With the increasing adoption of minimally invasive techniques, laparoscopic repair has emerged as a promising approach, yet evidence-particularly in elderly patients and in rare hernia subtypes-remains limited. This study aimed to evaluate the safety, feasibility, and outcomes of laparoscopic diaphragmatic hernia repair performed by a single experienced surgeon at a single center over a seven-year period. Methods: A retrospective review was conducted of adult patients who underwent laparoscopic repair of diaphragmatic hernia at Dongguk University Ilsan Hospital between November 2017 and September 2023. Clinical data, including demographics, presenting symptoms, hernia characteristics, operative details, postoperative outcomes, and follow-up findings, were analyzed. Results: Eleven patients (10 females; mean age, 73.8 ± 14.4 years) underwent laparoscopic repair. Hernia types included hiatal hernia (n=6, 54.5%), Morgagni hernia (n=4, 36.4%), and Bochdalek hernia (n=1, 9.1%). One patient (9.1%) required conversion to open surgery due to intraoperative pneumothorax. The mean operative time was 242.4 ± 109.6 minutes, and the mean hospital stay was 16.2 ± 11.3 days. Postoperative complications occurred in 2 patients (18.1%), all minor (Clavien-Dindo grade ≤ IIIa), and resolved with conservative management. There were no major complications, no 30-day mortalities, and no clinical or radiological recurrences during a mean follow-up of 16.3 ± 7 months. Conclusion: Laparoscopic repair of adult diaphragmatic hernias is safe and feasible, even in elderly patients, and is associated with low morbidity and no mid-term recurrences.

2025, Zenodo (CERN European Organization for Nuclear Research)

Minimally invasive surgery has become a widely used surgical technique that improves patients' safety and optimizes health resources. Specifically, laparoscopic surgery uses small incisions through the abdomen to operate, for example a liver, with minimal postoperative complications and faster recoveries. However, the cognitive load and surgical skills required by surgeons increase when compared to open surgery. For these reasons, specific training models and new technologies are needed to assist surgeons. One of this kind of systems are Computer Assisted Surgery systems that enable the display of computer generated imagery of pre-and intra-operative data to assist surgeons during its surgical procedures, but in many hospitals either they are not used at a basic level due to socio-economic challenges or components still face considerable technical challenges that must be solved. In this paper we list some of the difficulties that CAS components face during a laparoscopic surgery and highlight the benefits that a new job profile, the computer assisted surgery system nurse could bring in several modelling and tracking scenarios.

2025, Dr. RK Mishra

Since the first reports of laparoscopic surgery for
inflammatory bowel disease from Peters in 1992, several
literatures have subsequently shown the potential advantage
of minimal access surgery for small bowel pathologies.
The increased use of laparoscopy in the management of
gastrointestinal problems continues to expand. Procedures
such as jejunostomies, diagnosis of intestinal obstruction or
ischemia, resection of the small bowel, and lysis of adhesions
can be managed with this technique.

2025, Gynecological Surgery

Although laparoscopic surgery is known to cause less postoperative pain when compared to laparotomy, some patients still suffer from excessive pain, especially during the first stages of recovery. The purpose of our study was to assess the effect of intraperitoneal nebulization of lidocaine during gynecological laparoscopic procedures on perioperative pain. The study was a prospective, randomized, double-blinded, placebo-controlled trial (Canadian task force classification I) that included 23 patients who underwent outpatient gynecological laparoscopic procedures. Patients were randomly assigned either to a study group that received 5 mg/kg of lidocaine intraperitonealy during surgery (n=15) or to a control group that received sterile water in the same manner (n=8). The fluid was infuslated along with the CO 2 through a Insuflow® device. All patients received the same anesthetic technique. Intraoperative pain as assessed by changes in the vital signs was treated with fentanyl. Postoperative pain was evaluated according to postoperative opioid requirements and by the Visual Analogue Scale (VAS) at 15 min, 1 h and 24 h postoperatively. The VAS score was found to be lower for the study group 1 h after surgery (p=0.023). There was no difference in the VAS scores at 15 min (p=0.9) and 24 h (p=0.11) after surgery. A correlation analysis showed no association between the amount of lidocaine insufflated and the severity of the postoperative pain. There was no difference in terms of fentanyl administration during surgery or opiod consumption following surgery between the groups. We concluded that continuous intraperitoneal insuflation of lidocaine using an Insuflow® device may significantly reduce pain in the initial stage of postoperative recovery.

2025, International Journal of Anesthesiology & Research

Carbon dioxide was shown to be affected by raising the intraabdominal pressure (IAP) above the venous pressure which prevents CO 2 resorption leading to hypercapnia. Hypercapnia acti-

2025, Journal of The Korean Surgical Society

Purpose: There are fewer patients with gastroesophageal reflux disease (GERD) in Korea compared with Western countries. The incidence of GERD has increased in recent years however, concerning many physicians. Here, we report our early experiences of using a recently introduced method of laparoscopic antireflux surgery for the treatment of GERD in Korean patients. Methods: Fifteen patients with GERD were treated using antireflux surgery between

2025, Journal of Pediatric Surgery

Introduction: Single-incision laparoscopic surgery (SILS) is a novel area of minimally invasive surgery using a single incision. The end result is a lone incision at the umbilicus for a perceived scarless abdomen. We report our early experience using the SILS technique for appendectomies in the pediatric population. Methods: A retrospective chart review was performed on our first patients to undergo SILS appendectomy (SILS-A) or laparoscopic appendectomy (LAP-A) during the same period at a freestanding children's hospital. Results: Thirty-nine patients were reviewed. Nineteen patients underwent SILS-A (8.7 ± 0.76 [SEM] years old), and 20 patients underwent LAP-A (10.5 ± 0.87 years old, 2-17). Ages were 19 months to 14 years in the SILS-A group, with 21% (4 patients) not older than 6 years. Median weight for SILS-A was 32 kg (14.5-80.3). Twelve patients had acute nonperforated appendicitis (62%). Mean duration of operation was 58 ± 5.6 (30-135) minutes vs 43 ± 3.6 (30-85) minutes for standard LAP-A. Two patients were converted to a transumbilical appendectomy, one for inability to maintain a pneumoperitoneum and one for extensive adhesions. Postoperative complications consisted of one wound seroma. No wound infections, hernias, readmissions, or difference in length of stay were noted. The SILS approach for acute appendicitis is feasible in the pediatric population even in patients as young as 19 months. Operating room times are somewhat longer than with LAP-A, but should decrease with improved instrumentation and experience. Larger studies and further technical refinements are needed before its widespread implementation.

2025

bjective: To evaluate the prevalence, distribution, and pathological characteristics of mesenteric lymph node involvement in patients undergoing D3 right hemicolectomy for right colon cancer (RCC). Methods: Hundred consecutive patients diagnosed with right colon adenocarcinoma who underwent D3 right hemicolectomy with complete mesocolic excision (CME) and central vascular ligation (CVL) between July 2022 and July 2024 were included. All resected specimens, including the complete mesocolon, were meticulously examined for lymph nodes and then pathologically assessed for metastatic involvement. Tumor stage, grade, presence of vascular or perineural invasion, and number of harvested and positive lymph nodes, were collected and analyzed. Results: Preliminary results indicated that a significant proportion of patients presented with positive mesenteric lymph nodes (MLNs). The mean number of harvested lymph nodes was 25.3 ± 4.1, with 40% of patients demonstrating nodal metastasis. Nodal involvement was predominantly observed in the pericolic and intermediate groups, with a small percentage of positive nodes in the D3 apical region [5%]. There was a statistically significant association between nodal status and tumor T stage (p<0.001), tumor differentiation (p=0.02), and the presence of vascular invasion (p=0.01). Conclusion: D3 right hemicolectomy effectively allows for the comprehensive evaluation of mesenteric lymph node involvement in right colon cancer.., (2025) Evaluation of mesenteric lymph nodes affection in right colonic cancer treated with D3 right hemicolectom

2025, medigraphic.com

Cuando se da a conocer la cirugía laparoscópica, en 1989, es aceptada rápidamente por la comunidad médica y pacientes por las ventajas que ofrece sobre la cirugía abierta tradicional. 1-4 A partir de entonces, este novel método quirúrgico no ha dejado de tener cambios y avances tecnológicos que nos sorprenden y facilitan cada vez más nuestra tarea como cirujanos. Una vez que se va ganando expe-Artemisa medigraphic en línea

2025, BJS Open

Background A central lymphadenectomy in right-sided colon cancer involves dissection along the superior mesenteric axis, but the extent is debated due to a lack of consensus and the fear of major complications. This randomized controlled trial compared the rate of postoperative morbidity in patients undergoing laparoscopic versus open right-sided colectomy with central lymphadenectomy. Methods This open, prospective, randomized controlled trial compared patients operated on with open and laparoscopic right-sided colectomy (cStages I–III) with a central lymphadenectomy at two Norwegian institutions between October 2016 and December 2021. Dissections were conducted along the superior mesenteric vein in the laparoscopic group, and along the left anterior border of the superior mesenteric artery in the open group, both according to complete mesocolic excision principles. Surgery was standardized and performed by three experienced surgeons for each study group. The primary outcome of int...

2025, … Klinikleri Journal of …

Splenozis genellikle dalağın travmatik rüptürü sonucu dalak dokusunun heteretopik ototransplantasyonudur. Asemptomatik olmasına rağmen bazen pelvik kitle ve ağrı ile bulunabilir ve kanser veya endometriyozisi taklit ederek jinekologların... more

2025, Dr. R K Mishra

Inguinal hernia results from a hole or defect in the muscles,
through which the peritoneum protrudes, forming the
sac (Figs. 1 to 5). Inguinal herniorrhaphy is one of the
most common operations that general surgeons perform.
Minimally invasive surgical approaches are increasingly
popular because they offer the potential for less
postoperative pain and a quick return to normal activities.
Laparoscopic herniorrhaphy is being done at a time when
laparoscopic cholecystectomy has shown definite benefits
over the open technique.

2025, Dr. R K Mishra

The esophageal hiatus is an elliptical opening in the diaphragmatic muscular portion. The crura of diaphragm originate from the anterior surface of the first four lumbar vertebrae on the right and L2–L3 on the left to insert anteriorly... more

The esophageal hiatus is an elliptical opening in the
diaphragmatic muscular portion. The crura of diaphragm
originate from the anterior surface of the first four lumbar
vertebrae on the right and L2–L3 on the left to insert
anteriorly into the transverse ligament of the central portion of diaphragm.

2025, Uva Clinical Research Lab 2025 © Uva Clinical Anaesthesia and Intensive Care ISSN 2827-7198

Roux-en-Y gastric bypass (RYGB) remains one of the most effective surgical interventions for morbid obesity, demonstrating profound and sustained weight reduction along with significant remission of obesity-related comorbidities such as type 2 diabetes mellitus, hypertension, and dyslipidemia. However, its therapeutic benefits are balanced by the risk of diverse early and late complications, ranging from anastomotic leaks and hemorrhage to micronutrient deficiencies and internal herniation. These complications necessitate a vigilant, multidisciplinary approach involving surgeons, nurses, dietitians, pharmacists, and allied health professionals. Early recognition and timely intervention are critical to improving patient outcomes and reducing morbidity and mortality. This article provides a comprehensive discussion of RYGB-associated complications, their clinical relevance, and the role of an integrated healthcare team in optimizing postoperative care and long-term monitoring. By fostering effective interprofessional collaboration and evidence-based clinical practice, healthcare teams can significantly enhance the safety, efficacy, and durability of bariatric surgical outcomes.

2025, Surgical endoscopy

Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but...

2025

IntroductionLaparoscopic cholecystectomy is now gold standard for the treatment of gall stone diseases. Studies have compared various parameters to prove it superiority over open cholecystectomy. AimThe aim of this study was to prove the superiority of any of the two procedures over the other in terms of above parameters in our patients from rural background. Materials and MethodsThe study included 81 patients which were randomized in two groups; ALaparoscopic BOpen Cholecystectomy group. Observations and ResultsWe observed a statistically significant difference between the two groups in terms of high level of CRP post operatively, average VAS score on post operative day 1 and 2 and the incidence of surgical site infections. ConclusionThe results of this study supports that Laparoscopic cholecystectomy appears to consist the merits to be the gold standard procedure for symptomatic gall stone diseases in rural population as well.

2025, Annals of surgical treatment and research

Purpose: Local anesthetic wound infusion has been previously investigated in postoperative pain management. However, a limited number of studies have evaluated its use in laparoscopic colorectal surgery. This study aims to evaluate whether ropivacaine wound infusion is effective for postoperative pain management after laparoscopic surgery in patients with colorectal cancer. Methods: This prospective study included 184 patients who underwent laparoscopic surgery for colorectal cancer between July 2012 and June 2013. The patients were grouped as the combined group (intravenous patient-controlled analgesia [IV-PCA] plus continuous wound infusion with ropivacaine, n = 92) and the PCA group (IV-PCA only, n = 92). Efficacy and safety were assessed in terms of numeric rating scale (NRS) pain score, opioid consumption, postoperative recovery, and complications. Results: The total quantity of PCA fentanyl was significantly less in the combined group than in the PCA group (P < 0.001). The NRS score of the combined group was not higher than in the PCA group, despite less opioid consumption. There were no differences between groups for postoperative recovery and most complications, including wound complications. However, the rate of nausea and vomiting was significantly lower in the combined group (P = 0.022). Conclusion: Ropivacaine wound infusion significantly reduced postoperative opioid requirements and the rate of nausea/ vomiting. This study showed clinical efficacy of ropivacaine wound infusion for postoperative pain control in colorectal cancer patients undergoing laparoscopic surgery.

2025, Scientific Reports

Continuous wound infusion with local anesthesia is an effective method for reducing postoperative pain after laparoscopic colorectal surgery. However, most subcutaneous local anesthesia is delivered through continuous injection, which can be inconvenient for patients. This study compared the effectiveness of postoperative pain relief from the application of a local poloxamer 407-based ropivacaine hydrogel (Gel) to the incision site with continuous infusion-type ropivacaine administration (On-Q) in patients undergoing laparoscopic colorectal surgery. This prospective, randomized, non-inferiority study included 61 patients who underwent laparoscopic colorectal surgery with an incision length of 3–6 cm. All 61 patients were randomly assigned to the Gel group (poloxamer 407-based 0.75% ropivacaine, 22.5 mg) or the On-Q group (0.2% ropivacaine, 4 mg/hour for two days). Postoperative analgesia was induced in all patients with intravenous patient-controlled analgesia (IV-PCA). The outcome ...

2025, Journal of Clinical Medicine

Despite rapid advancements in laparoscopic surgical devices and techniques, pain remains a significant issue. We examined the efficacy of preemptive transversus abdominis plane (TAP) block for acute postoperative pain in patients undergoing laparoscopic colorectal cancer surgery. We retrospectively analyzed 153 patients who underwent laparoscopic colorectal cancer surgery with or without TAP block; among them, 142 were allocated to the TAP or non-TAP group. We performed between-group comparisons of demographic, clinical, and anesthetic data and pain scores at a postoperative anesthesia care unit (PACU) and at postoperative days 1, 3, and 5. There were no significant between-group differences in demographic and clinical characteristics. The mean arterial pressure, heart rate, and minimum alveolar concentration (MAC) were significantly lower in the TAP group at the start and end of surgery. The post-extubation bispectral index was significantly higher in the TAP group. There were no s...

2025, BMC cancer

The role of laparoscopic resection in patients with clinically suspicious T4 colorectal cancer remains controversial. The aim of this study was to compare the long-term and oncologic outcomes of laparoscopic resection and the open approach in clinical T4 colorectal cancer. Two hundred ninety-three consecutive patients undergoing curative surgery for colorectal cancer suspected to be T4 by computed tomography and/or magnetic resonance imaging were reviewed. Despite clinical suspicion of T4 disease in all cases, concordance with pathologic determination of T4 was only 37.9 %. Of the 71 patients in the laparoscopic group, four (5.6 %) were converted to the open technique. Patients in the laparoscopic group had significantly lower estimated blood loss (p < 0.001), fewer days to first flatus (p = 0.001), shorter length of hospital stay (p < 0.001), and fewer adverse events (14.1 % versus 31.5 %, p = 0.004). After a median follow-up of 36 months, 5-year disease-free survival was not...

2025, Revista Cubana de Urología

Se presenta un caso con fístula ureteral y urinoma retroperitoneal tratado por abordaje ureteral retrógrado endoscópico y drenaje percutáneo de la colección. Se exponen los estudios diagnósticos, técnica quirúrgica empleada y se concluye que el abordaje mínimamente invasivo debe ser la primera opción en estas lesiones ureterales. Palabras clave: cirugía mínimamente invasiva, endoscopia, fístulas urinarias, lesiones ureterales. An unusual case with ureteral fistulae and retroperitoneal urinoma is presented, managed by an endoscopic ureteric retrograde access and percutaneous drainage of the collection. The diagnostic studies performed and the surgical approach is showed. They determine that the first option offered to these kind of ureteral injuries should be the minimally invasive approach.

2025, Surgical Endoscopy

Introduction There has been a constant increase in the number of published surgical videos with preference for open-access sources, but the proportion of videos undergoing peer-review prior to publication has markedly decreased, raising questions over quality of the educational content presented. The aim of this study was the development and validation of a standard framework for the appraisal of surgical videos submitted for presentation and publication, the LAParoscopic surgery Video Educational GuidelineS (LAP-VEGaS) video assessment tool. Methods An international committee identified items for inclusion in the LAP-VEGaS video assessment tool and finalised the marking score utilising Delphi methodology. The tool was finally validated by anonymous evaluation of selected videos by a group of validators not involved in the tool development. Results 9 items were included in the LAP-VEGaS video assessment tool, with every item scoring from 0 (item not presented in the video) to 2 (ite...

2025, IJNRD

Background: Gallstone disease, also known as cholelithiasis, constitutes a major health problem worldwide. Though previously considered uncommon in African countries, its incidence is on the rise due to urbanization and improved diagnostic capabilities. The aims of this study were to evaluate the clinical profile and operative outcomes of gallstone disease among adults admitted to Hiwot Fana Specialized University Hospital (HFSUH) and Jegol General Hospital (JGH) in Harar, Ethiopia. Methodology: A retrospective cross-sectional study was conducted on 180 adult patients admitted between December 2017 and November 2021 from Registry book. Data were analyzed using descriptive statistics and multivariate logistic regression to identify factors associated with postoperative complications. Result: Out of 180 patients, 67.2% were female, with the majority (83.8%) aged between 40-59 years. The most common symptom was right upper quadrant pain (77.2%), followed by nausea/vomiting (70.5%) and fatty food intolerance (79.3%). Open cholecystectomy was the predominant surgical method (79.8%), while laparoscopic procedures were rare (4.4%). Postoperative complications occurred in 13.3% of patients, primarily

2025

ABSTRACTLaparoscopic surgery has evolved as a key technique for cancer diagnosis and therapy. While characterization of the tissue perfusion is crucial in various procedures, such as partial nephrectomy, doing so by means of visual inspection remains highly challenging. Spectral imaging takes advantage of the fact that different tissue components have unique optical properties to recover relevant information on tissue function such as ischemia. However, clinical success stories for advancing laparoscopic surgery with spectral imaging are lacking to date. To address this bottleneck, we developed the first laparoscopic real-time multispectral imaging (MSI) system featuring a compact and lightweight multispectral camera and the possibility to complement the conventional RGB (Red, Green, and Blue) surgical view of the patient with functional information at a video rate of 25 Hz. To account for the high inter-patient variability of human tissue, we phrase the problem of ischemia detectio...

2025, Surgical endoscopy

2025, Clinical case reports

We report the first case of wound infection caused by Trueperella bernardiae after laparoscopic surgery. The patient was treated with oral amoxicillin/clavulanate which was continued for 1 week after discharge with a successful clinical... more

2025, International Journal of Reproduction, Contraception, Obstetrics and Gynecology

Hysterectomy is the most common major surgical procedure underwent by women. 1 It is the surgical removal of the uterus. It may also involve removal of the cervix, ovaries, fallopian tubes and other surrounding structures.

2025, Archives of Surgery

2025

Introduccion. La enfermedad tromboembolica venosa (ETV) es considerada la causa mas frecuente de muerte evitable en hospitales. Objetivo. Determinar el cumplimiento y la adecuacion de las recomendaciones de tromboprofilaxis en internacion quirurgica. Material y metodos . Estudio observacional descriptivo de pacientes internados en servicios quirurgicos que requirieron procedimientos mayores o menores entre septiembre y noviembre de 2016. Se clasifico el peligro de ETV segun el riesgo quirurgico (traumatologia y cirugia de torax) y segun la escala de Caprini (el resto). La tromboprofilaxis postoperatoria fue considerada “adecuada” si se cumplian las recomendaciones; “inadecuada por defecto” cuando, presentando criterios de indicacion, no se cumplian, e “inadecuada por exceso” cuando, no presentando criterios, se indicaba tromboprofilaxis. Resultados. Se estudiaron 259 pacientes (43%, cirugia general; 19%, urologia; 14%, ginecologia; 13%, traumatologia; 11%, otros). Edad promedio, 50,...

2025, Revista espanola de enfermedades digestivas : organo oficial de la Sociedad Espanola de Patologia Digestiva

The authors present the case of a 71-year-old man with a history of a Billroth-II subtotal gastrectomy due to a mixed adenocarcinoma, stage pT4aN3aM0 (TNM classification), with adjuvant chemotherapy. Subsequent endoscopic and imaging evaluations revealed no signs of recurrence. Five years later, the patient was admitted with obstructive jaundice.

2025, Digestive Surgery

Laparoscopic surgery has recently been gaining acceptance as an alternative approach for patients with inflammatory bowel disease. There is increasing evidence demonstrating the multiple potential benefits of laparoscopy including faster recovery, reduced costs, and lower morbidity. For patients with acute colitis, a laparoscopic subtotal colectomy and end ileostomy have been shown to be feasible and safe in experienced hands. When indicated, many of these patients may be able to safely undergo a subsequent laparoscopic approach for construction of an ileo-anal pouch. Although still controversial, an elective laparoscopic restorative proctocolectomy with ileo-anal pouch anastomosis has also been shown to be feasible with functional outcomes at least similar to those obtained with an open approach. However, larger randomized series of patients are needed with longer follow-up in order to draw definite conclusions. For Crohn’s disease, a laparoscopic approach is ideal for stoma creati...

2025, Gynecological Surgery

2025, World Journal of Advanced Research and Reviews

Introduction: Insulinomas are the most common category of pancreatic endocrine tumors, with an incidence of 1-7 cases per million people. Material and Methods: Most are intrapancreatic, benign and solitary. Therefore, they have an excellent prognosis after surgical resection. However, the localization diagnosis of insulinomas still poses a challenge to surgeons and radiologists. Results: We present two cases showing classical appearances on helical CT In these two cases the tumors were occult and could not be found by either abdominal enhanced spiral computed tomography (CT) or ultrasonography. We would like to emphasize the need for performing helical CT whenever the diagnosis is suspected, due to the ability to image the pancreas in the early arterial as well as in the equilibrium phase. Conclusions: We reminded of surgeons that insulinomas represent the most frequently found functioning endocrine tumors .Therefore, they have an excellent prognosis after surgical resection. Howeve...

2025

Introduction. Pancreatic endocrine tumors (PETs) are primarily well-differentiated tumors composed of cells that resemble normal islet cells but that arise from pancreatic ductal cells. They are classified as functioning or nonfunctioning according to their associated clinical symptoms; insulinoma, gastrinoma, and glucagonoma are the most common functioning PETs. Insulinomas are the most common category of pancreatic endocrine tumors, with an annual incidence of 1-4 cases per million people. Most are intrapancreatic, benign and solitary. Therefore, they have an excellent prognosis after surgical resection. However, the localization diagnosis of insulinomas still poses a challenge to surgeons and radiologists.

2025, Surgery for Cerebral Stroke

The options for treating unruptured aneurysms in elderly patients have increased, and are discussed herein. We statistically analyzed the outcomes of 69 unruptured aneurysms in patients aged under 75 and over 76 years old treated between October 2013 and March 2016. Treatment in those under 75 years old resulted in modified Rankin Scale (mRS) scores of 0-1. In contrast, treatment in those over 76 years old resulted in mRS scores of 4 in 1 patient with a cerebral infarction and 1 with a cerebral hemorrhage (40%, 2/5) (p＜0.05). An aneurysm in a 79-year-old was treated with refuge embolization, and she is now well. We conclude that unruptured aneurysms in patients over 76 years old should be managed carefully. If necessary, refuge coil embolization is an option.

2025

The past thirty years have seen increasingly rapid advances in the field of laparoscopic surgery, in part because of the use of robots. A well-known example is the da Vinci surgical system. However, far too little attention has been paid to Hand Assisted Laparoscopic Surgery (HALS), a surgery in which the surgeon introduces the non-dominant hand into the abdomen of the patient. The risk of collision between the hand of the surgeon and the tool moved by the robot is the reason why these robots for laparoscopic surgery are not appropriate for HALS. On the other hand, in recent years, there has been an increasing interest in wearables, which have been introduced in our daily life. This interest and the lack of surgery robots for HALS are the reasons to develop a sensing glove which co-works with a collaborative robot in this kind of surgery. The aim of this paper is to study the use of a sensing glove which will provide information of the movements of the surgeon's hand to the collaborative robot. This information determinates the actions that the robot will carry on. The first step was to define different movements of the hand which could be identified. An algorithm identifies these movements using the data given by the sensing glove. For the purpose of algorithm accuracy measurement, 4 persons wearing the sensing glove made a sequence with different movements. The evidence from this study suggests that a sensing glove can be used to send information of the movements of the surgeon's hand to a collaborative robot during a HALS. • Mathematics of computing➝ Probability and statistics • Hardware➝ Communication hardware, interfaces and storage ➝ Sensors and actuators. statistics • Hardware➝ Communication hardware, interfaces and storage ➝ Sensor devices and platforms.

2025

Pseudocysts of the spleen are rare entities with cystic lesions of the spleen being uncommon in general. It is estimated that splenic cysts occur in about 0, 07% of the population 1. In general, splenic cystic lesions are discovered incidentally or by mass effect. In the literature, only a limited number of splenic cysts are reported. We report a case of splenic pseudocyst with mass effect where we used laparoscopic fenestration of the pseudocyst with omentopexy as a treatment of choice. Case presentation: The patient is a 62-year-old male with no previous history of trauma. He visited his GP for abdominal pain with flaring towards the left shoulder accompanied by early satiety, occasional obstipation, and breathing difficulties. He was referred to our hospital after enhanced computed tomography showed a 15 × 13 cm splenic cyst with displaced stomach and pancreatic tail medially and left kidney downward. Management options were discussed with the patient and he opted for a laparoscopic approach. In this case, we performed laparoscopic fenestration of the pseudocyst with omentopexy. Clinical discussion: Until recently splenectomy was the surgical treatment of choice for all large or symptomatic cystic lesions of the spleen 2, however with growing knowledge about the protective role of the spleen an approach with spleen protection is advocated. Conclusion: There are many advantages to the laparoscopic approach of splenic cystic lesions and it may be the treatment of choice for this uncommon surgical problem.

2025, Sensors

Minimally invasive surgery (MIS) techniques are growing in quantity and complexity to cover a wider range of interventions. More specifically, hand-assisted laparoscopic surgery (HALS) involves the use of one surgeon’s hand inside the patient whereas the other one manages a single laparoscopic tool. In this scenario, those surgical procedures performed with an additional tool require the aid of an assistant. Furthermore, in the case of a human–robot assistant pairing a fluid communication is mandatory. This human–machine interaction must combine both explicit orders and implicit information from the surgical gestures. In this context, this paper focuses on the development of a hand gesture recognition system for HALS. The recognition is based on a hidden Markov model (HMM) algorithm with an improved automated training step, which can also learn during the online surgical procedure by means of a reinforcement learning process.

2025, Electronics

Robotic platforms are taking their place in the operating room because they provide more stability and accuracy during surgery. Although most of these platforms are teleoperated, a lot of research is currently being carried out to design collaborative platforms. The objective is to reduce the surgeon workload through the automation of secondary or auxiliary tasks, which would benefit both surgeons and patients by facilitating the surgery and reducing the operation time. One of the most important secondary tasks is the endoscopic camera guidance, whose automation would allow the surgeon to be concentrated on handling the surgical instruments. This paper proposes a novel autonomous camera guidance approach for laparoscopic surgery. It is based on learning from demonstration (LfD), which has demonstrated its feasibility to transfer knowledge from humans to robots by means of multiple expert showings. The proposed approach has been validated using an experimental surgical robotic platfo...

2025, BMC Surgery

Background: Open cholecystectomy through a small incision is an alternative to laparoscopic cholecystectomy. : From 1 January 2002 through 31 December 2003, all operations upon the gallbladder in a district hospital with emergency admission and responsibility for surgical training were done as intended small-incision open cholecystectomy. Results: 182 women and 90 men with a median age of 56 (interquartile range 45 to 68 years) underwent cholecystectomy for symptomatic gallbladder disease, 170 as elective and 102 as emergency cases. Trainee surgeons assisted by consultants or registrars having passed an examination for open cholecystectomy performed surgery in 194 cases (71%). The common bile duct was explored in 52 patients. Total postoperative morbidity was six percent. Median postoperative stay was one day and mean total (pre-and postoperative) hospital stay 3.1 days. 32 operations (12%) were done as day surgery procedures. Nationally in Sweden in 2002, mean total hospital stay was 4.4 days, and 13% of all cholecystectomies were performed on an outpatient basis. Open, small-incision cholecystectomy for all patients is compatible with short hospital stay, evidence-based gall-bladder surgery, and training of surgical residents.

2025

Background: Ventral hernias represent a significant clinical problem, particularly in adults with previous abdominal surgeries. Surgical repair remains the only definitive treatment, with mesh reinforcement being the standard of care. While laparoscopic repair has gained popularity for its minimally invasive nature and favorable short-term outcomes, debate continues regarding its superiority over open repair. Objective: To compare the outcomes of laparoscopic versus open ventral hernia repair in terms of postoperative pain, operative time, hospital stay, complications, and recurrence. Methods: This prospective comparative study included 109 patients undergoing ventral hernia repair at Apollo Health City, Hyderabad, between December 2017 and November 2019. Patients underwent either laparoscopic or open mesh repair based on clinical suitability and patient preference. Postoperative pain was evaluated using the Visual Analogue Scale (VAS) on days 1, 3, and 7. Operative time, hospital stay, complications, and recurrence were documented and analyzed. Results: The laparoscopic group (n=64) showed significantly lower VAS scores on all postoperative days (p<0.001), shorter operative time (79.37 vs. 96 minutes, p<0.001), and reduced hospital stay (2.39 vs. 3.42 days, p<0.001) compared to the open group (n=45). Intraoperative bleeding was significantly less in the laparoscopic group. Recurrence was lower in the laparoscopic group (1.56% vs. 6.67%), though not statistically significant (p=0.163). Conclusion: Laparoscopic repair offers superior short-term outcomes over open repair for ventral hernias, including less pain, faster recovery, and lower complication rates. Further randomized multicenter trials with long-term follow-up are warranted to establish definitive guidelines.

2025, PubMed

Introduction: In 1994, Claudio Bassi reported a case of medical treatment for infected pancreatic necrosis (IPN); then since 1996 numerous articles of case series were published with treatment only with antibiotics with good outcomes. Objectives: To present our experience in the management of patients with IPN with antibiotics (without drainage). Methods: We retrospectively reviewed cases with a diagnosis of IPN from January 2018 to October 2020, focusing on those cases that were treated conservatively (hydro-electrolyte, nutritional support and antibiotics). The diagnosis was made by observing gas in the retroperitoneum by CT or by clinical deterioration of the patient with pancreatic necrosis without another focus. Fine needle aspiration was not performed. Results: We identified 25 patients with a diagnosis of IPN; eleven were treated conservatively. According to Atlanta, modified in 2012, 3 were classified severely and the rest moderately severe. All received antibiotics for at least 3 weeks. None required parenteral nutrition. The mean hospital stay was 38 days. Three patients were readmitted. 8 underwent cholecystectomy after having resolved the condition; the rest were already cholecystectomized. There were no deaths in this series. Conclusions: IPN can be treated conservatively without drainage with good results in selected cases.

2025, European Journal of Medical and Health Sciences

Background: The routine use of abdominal ultrasonography and computed tomography scan has increased the detection of asymptomatic renal cysts. Laparoscopy is usually suitable for treating large symptomatic renal cysts. Objective: To report a case of laparoscopic treatment of a man with large left renal cyst mimicking chest infection. Case presentation: A 75-year-old man, known hypertensive who had empirical treatment for chest infection without resolution of symptoms of cough and chest pain. He was on treatment for storage and voiding lower urinary tract symptoms with 10mg alfuzocin. Abdominal ultrasound and computed tomography scan confirmed a large left renal cortical cyst that measured 380mls. He subsequently had transperitoneal laparoscopic deroofing and excision of the renal cyst with operation finding of 300mls of straw coloured fluid excluding spillage. The immediate postoperative period was uneventful, and he was discharged home in a stable condition on the second day. The aspirate yielded no growth while the cytology report of cystic fluid was acute-on-chronic inflammation. Histology was reported as chronic pyelonephritis with cystic degeneration. Conclusion: Large renal cyst should be considered as differential diagnosis of unresolved chest infection and is safely treated by laparoscopic deroofing and excision.

2025, The American Journal of Surgery

Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre -including this research content -immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active. Low-cost devices to prevent SARS-CoV-2 infection during open and laparoscopic surgery

2025, Rev Mex Cir …

Abreviaturas: CTL (Colectomía Totalmente Laparoscópica) TUD (Técnica de un disparo)

2025, Latest Developments in Medical Robotics Systems

Minimally invasive surgery has experienced a significant expansion in the last decades. Robotic surgery has evolved in parallel to traditional laparoscopic surgery offering additional technical advantages. Some specific aspect of Hepatobiliary Surgery led to a limited implementation of minimally invasive liver surgery in the early years of laparoscopic surgery whilst we are experiencing an exponential increase in the use of minimally invasive approaches to this type of intervention. In this chapter we describe the key aspect of robotic liver surgery with a meticulous description of the supporting evidence, its limitation and future perspectives.

2025, Surgical Endoscopy

Background: Cholecystoenteric fistula (CF) is a rare complication of cholelithiasis. The aim of this study was to evaluate the safety and risk of complications when the laparoscopic approach is applied in patients with CF. Methods: A questionnaire was mailed to all surgeons with experience of >100 cholecystectomies working in Naples, Italy, and the neighboring area. Results: Between February 1990 and May 1999, 34 patients presented with cholecystoenteric fistula (0.2% of >15,000 laparoscopic cholecystectomies performed in the same period). These patients were allocated into two groups: the LT group (those who underwent laparotomic conversion after the diagnosis of CF), which consisted of 20 patients, four men and 16 women, with a mean age of 66.5 ± 9.3 years (range, 46-85) and the LS group (laparoscopically treated patients), which consisted of 14 patients, three men and 11 women, with a mean age of 65.6 ± 8.8 years (range, 51-74). They types of CF observed were as follows: in the former group of patients, cholecystoduodenal fistulas (n ‫ס‬ 11, 55%), cholecystocolic fistulas (n ‫ס‬ 5, 25%), cholecystojejunal fistulas (n ‫ס‬ 3, 15%), and cholecystogastric fistulas (n ‫ס‬ 1, 5%); in the latter group, cholecystoduodenal fistulas (n ‫ס‬ 8, 5.1%), and cholecystocolic fistulas (n ‫ס‬ 4, 28.6) and cholecystojejunal fistulas (n ‫ס‬ 2, 14.3%). Stapler closure of CF was done in four LT patients and three LS patients with cholecystoduodenal fistula; it was also done in three LT patients and three LS patients with cholecystocolic fistula. Hand-sutured fistulectomy was performed in six LT patients and three LS patients with cholecystoduodenal fistula, in two LT patients with cholecystocolic fistula, and in all patients with cholecystojejunal or cholecystogastric fistula. There were no deaths or intraoperative complications in

2025, HPB : the official journal of the International Hepato Pancreato Biliary Association

Recent studies have suggested that the difficulty of laparoscopic liver resections are related to both patient and tumour factors, however the available difficulty scoring systems only incorporate tumour factors. The aim of this study was to assess the opinion of laparoscopic liver surgeons regarding the factors that affect the perceived difficulty of laparoscopic liver resections. Using a Visual Analogue Scale an international survey of laparoscopic liver surgeons was undertaken to assess the perceived difficulty of 26 factors previously demonstrated to affect the difficulty of a laparoscopic liver resection. 80 surgeons with a combined experience of over 7000 laparoscopic liver resections responded to the survey. The difficulty of laparoscopic liver surgery was suggested to be increased by a BMI > 35 by 89% of respondents; neo-adjuvant chemotherapy by 79%; repeated liver resection by 99% and concurrent procedures by 59% however these factors have not been included in the previo...

2025, International Journal of Medicine and Public Health

Background: Abdominal pain, whether acute or chronic, is a common but often challenging presentation in surgical practice. Despite improvements in imaging and laboratory tests, many patients still present with inconclusive findings that create a diagnostic dilemma. In such cases, especially in limited-resource settings, delayed or incorrect diagnosis can lead to serious outcomes such as missed intestinal ischemia, atypical appendicitis, concealed perforations, biliary or pancreatic disorders, pelvic infections, or abdominal tuberculosis mimicking malignancy. Aims: The present study aims to assess the role of diagnostic laparoscopy in patients with abdominal pain and diagnostic dilemma, focusing on its effectiveness in identifying intra-abdominal pathology where conventional tests are inconclusive, while also evaluating its utility in avoiding unnecessary laparotomies and documenting its complications, limitations, and failure rates. Materials and Methods: This prospective observational study was conducted in the Department of Surgery at TMMC & RC, Moradabad, over a period of 18 months until June 2024, including a total of 92patients. Results: In this study of 92 patients with abdominal pain and diagnostic dilemma, most were aged 41-60 years (63.04%) with a male predominance (60.9%). Laparoscopy provided diagnostic findings in 82.6% of cases, most commonly revealing an inflamed appendix (59.8%), followed by abdominal lymphadenopathy (7.6%) and appendicular lump (5.4%). Conclusion: This study shows that diagnostic laparoscopy is a reliable tool for evaluating abdominal pain with diagnostic dilemma, providing accurate assessment, confirming appendicitis as the commonest pathology, enabling targeted biopsies, and demonstrating strong correlation with histopathology with high accuracy.