Technical considerations depending on the level of vascular ligation in laparoscopic rectal resection
AbstractAimIn addition to ischemia there is also anastomotic ends tension proven to be a risk factor for anastomotic leak. HT vascular ligation is accepted as a rule, in attempt to achieve tension-free anastomosis. LT is a preferred option, based on the more accurate preservation of proximal intestinal segment microperfusion and lower risk of damage to the hypogastric plexus. The aim of this study is evaluation of comparative indicators in high tie (HT) and low tie (LT) laparoscopic rectal resections.MethodsA prospective nonrandomized comparative cohort study of patients in our department with cancer of the rectum in clini...
Source: Surgical Endoscopy - April 19, 2021 Category: Surgery Source Type: research

Development of a novel educational tool to assess skills in laparoscopic liver surgery using the Delphi methodology: the laparoscopic liver skills scale (LLSS)
ConclusionsThe LLSS was developed for measuring the skill set for the education of safe and secure laparoscopic WRAS and LLS procedures in a dedicated training program. After validation, this scale could be also used as an assessment tool in the operating room and extrapolated as an operative roadmap to other complex procedures. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 19, 2021 Category: Surgery Source Type: research

Prolonged endoscopic retrograde cholangiopancreatography results in higher rates of pancreatitis and unplanned hospitalisation
AbstractBackground and AimAlthough complications from endoscopic retrograde cholangiopancreatography (ERCP) are well described, procedure duration has received scant attention. The relationship between ERCP duration and patient demographics, indications, results and complications were examined.MethodsA contemporaneously recorded database of 2572 consecutive ERCPs performed between 2008 and 2018 by a single endoscopist was analysed. Those taking under 40  min were compared with those taking over 40 min.ResultsOf 2572 cases, 2213 took under 40  min and 359 took over 40 min. Emergency cases (relative risk ...
Source: Surgical Endoscopy - April 19, 2021 Category: Surgery Source Type: research

Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) guidelines development: standard operating procedure
ConclusionsThis methodology can be used more widely by volunteer organizations to efficiently develop effective tools for practicing physicians. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 19, 2021 Category: Surgery Source Type: research

Failure to rescue following proctectomy for rectal cancer: the additional benefit of laparoscopic approach in a nationwide observational study of 44,536 patients
AbstractBackgroundThere is growing evidence that failure to rescue (FTR) is an important factor of postoperative mortality (POM) after rectal cancer surgery and surgical approach modified post-operative outcomes. However, the impact of laparoscopy on FTR after proctectomy for rectal cancer remains unknown. The aim of this study was to compare the rates of postoperative complications and FTR after laparoscopyvs open proctectomy for cancer.MethodsAll patients who underwent proctectomy for rectal cancer between 2012 and 2016 were included. FTR was defined as the 90-day POM rate among patients with major complications. Outcome...
Source: Surgical Endoscopy - April 19, 2021 Category: Surgery Source Type: research

The impact of the novel coronavirus pandemic on gastrointestinal operative volume in the United States
AbstractBackgroundIn March 2020, the Surgeon General recommended limiting elective procedures to prepare for the COVID-19 surge. We hypothesize a consequence of COVID-19 is reduced operative volume across the country. We aim to examine changes in volume of common gastrointestinal operations during COVID-19, including elective, urgent/emergent, and cancer operations. We also evaluate if hospitals with more COVID-19 admissions were most impacted.MethodsThe Vizient database was used to determine monthly operative volume from November 2019 to June 2020 for elective operations (hiatal hernia repairs, bariatric surgery), urgent ...
Source: Surgical Endoscopy - April 19, 2021 Category: Surgery Source Type: research

Prognostic risk factors associated with esophageal squamous cell carcinoma patients undergoing endoscopic submucosal dissection: a multi-center cohort study
AbstractBackgroundLong-term outcomes of endoscopic submucosal dissection (ESD) for esophageal squamous cell carcinoma (ESCC) have not been assessed in a large, multicenter cohort. We aimed to evaluate long-term outcomes of ESD for ESCC in a real-world setting.MethodsWe retrospectively recruited 659 patients who underwent ESD for ESCC at ten institutions from January 2007 to December 2015. Of these, 566 patients were analyzed and classified into three groups according to the pathologic invasion depth after ESD: epithelium/lamina propria mucosa (EP/LPM group: 454 patients), muscularis mucosa/submucosa invasion  ≤&t...
Source: Surgical Endoscopy - April 15, 2021 Category: Surgery Source Type: research

Validation of a simple technique of volumetric analysis of complex incisional hernias without 3D CT scan reconstruction
ConclusionSA and Vol. estimates demonstrated high level of agreement with SA and Vol. measurements using 3D reconstruction. SA and Vol. estimates can be obtained using simple mathematical formulas using easily obtained linear variables negating the need for the time and effort consuming 3D reconstruction. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 15, 2021 Category: Surgery Source Type: research

Short-term outcome in robotic vs laparoscopic and open rectal tumor surgery within an ERAS protocol: a retrospective cohort study from the Swedish ERAS database
ConclusionsIn this multicenter cohort study, robotic surgery was associated with shorter LOS compared to both laparoscopic and open surgery and had lower conversion rates vs laparoscopic surgery. The rate of complications was similar between groups. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 15, 2021 Category: Surgery Source Type: research

Endoscopic full-thickness resection versus endoscopic submucosal dissection in the treatment of colonic neoplastic lesions  ≤ 30 mm—a single-center experience
AbstractEndoscopic full-thickness resection (FTR) is a novel technique of endoscopic treatment of colorectal neoplastic lesions not suitable for endoscopic polypectomy or mucosal resection. FTR appears to be a reasonable alternative to technically demanding endoscopic submucosal dissection (ESD) for lesions  ≤ 30 mm. However, comparison between FTR and ESD has not been published yet and their mutual positioning in the treatment algorithm is still unclear. The purpose of the analysis was to evaluate efficacy and safety of FTR in the treatment of colorectal lesions ≤ 30 mm by compa...
Source: Surgical Endoscopy - April 15, 2021 Category: Surgery Source Type: research

The risk scoring system for assessing the technical difficulty of endoscopic submucosal dissection in cases of remnant gastric cancer after distal gastrectomy
ConclusionsWe developed a validated risk-scoring model for predicting the technical difficulty of ESD for RGC after DG that can contribute to its safer and more reliable performance. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 14, 2021 Category: Surgery Source Type: research

Indications and outcomes of colorectal hybrid endoscopic submucosal dissection: a large multicenter 10-year study
AbstractBackground and AimsHybrid endoscopic submucosal dissection (ESD) is a colorectal lesion resection procedure that includes both planned and salvage procedures. Previous colorectal hybrid ESD studies have involved single institutions or few operators over a short timeframe, and the size for indication has not been established. In this multicentre study, we investigated the clinical outcomes of hybrid ESD for colorectal tumors that met the 30  mm lesion size criterion.MethodsFrom January 2008 to December 2018, colorectal hybrid ESD was performed for 172 lesions (diameter range,  ≥ 20– 
Source: Surgical Endoscopy - April 13, 2021 Category: Surgery Source Type: research

Feasibility and safety of a new endoscopic synthetic sealant nebulizing device over gastric endoscopic submucosal dissections
ConclusionsSafety and feasibility profiles of Glubran 2 nebulizing ENDONEB device over ESD surfaces were excellent. Further evidences and human trials are needed to investigate its effectiveness in ESDs ’ eschars sealing and, thus, in delayed micro-perforations and bleedings prevention and treatment. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 13, 2021 Category: Surgery Source Type: research

Robotic complete mesocolic excision versus conventional robotic right colectomy for right-sided colon cancer: a comparative study of perioperative outcomes
This study aims to compare the short-term outcomes of robotic complete mesocolic excision (RCME) versus conventional robotic right colectomy (RRC) for right-sided colon cancer.MethodsConsecutive patients who underwent robotic surgery for right-sided colon cancer in a public quaternary and a private tertiary healthcare centre between November 2018 and June 2020 were included. Clinical, perioperative and histopathological variables were collected and analysed.ResultsFifty-one patients were included; 25 (49%) of them had an RCME. The groups were evenly distributed in terms of demographic characteristics and tumour location. O...
Source: Surgical Endoscopy - April 12, 2021 Category: Surgery Source Type: research

Laparoscopic adrenalectomy vs. radiofrequency ablation for the treatment of primary aldosteronism. A single center retrospective cohort analysis adjusted with propensity score
AbstractBackgroundLaparoscopic adrenalectomy (LA) is the gold standard treatment for unilateral primary aldosteronism. However, satisfactory results have also been published with radiofrequency ablation (RFA). The aim of this study was to compare LA and RFA for the treatment of primary aldosteronism.MethodsA retrospective cohort study of the patients who underwent LA or RFA in a single center was performed. Morbidity and long-term effectiveness (cure rate and blood pressure control) were analyzed. A multivariate analysis with a propensity score was also performed.ResultsThirty-four patients were included in the study, 24 i...
Source: Surgical Endoscopy - April 12, 2021 Category: Surgery Source Type: research

RAS-NOTECHS: validity and reliability of a tool for measuring non-technical skills in robotic-assisted surgery settings
ConclusionsRAS-NOTECHS is the first observational tool for multidisciplinary NTS in RAS. In preliminary application, it has been shown to be reliable. Since RAS is rapidly increasing and challenges for effective and safe teamwork remain at the forefront of quality and safety of surgical care, RAS-NOTECHS may contribute to training and improvement efforts in technology-facilitated surgeries. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 12, 2021 Category: Surgery Source Type: research

Pancreaticobiliary maljunction in Turkish patients: a multicenter case series
This study was conducted in adult and pediatric PBM patients who were referred to three tertiary reference centers of Turkey for endoscopic retrograde cholangiopancreatography (ERCP) between July 2007 and May 2020. The clinical presentations, types of PBM, ERCP findings, surgical histories, and the postoperative courses, including the development of biliary malignancies, were retrospectively reviewed.ResultsThe study group included 47 (31 adult and 16 children) patients. Type D PBM was more frequent (13/41: 27.7%) than that reported in Eastern studies. Type A PBM was more common in the adults (51.6% vs. 12.5%,p 
Source: Surgical Endoscopy - April 12, 2021 Category: Surgery Source Type: research

Reduction in postoperative complications by robotic surgery: a case –control study of robotic versus conventional laparoscopic surgery for gastric cancer
ConclusionsRG reduces the incidence of postoperative complications compared with conventional LG and this tendency may be enhanced in technically complicated procedures with demanding anastomosis or D2 lymphadenectomy. Patients requiring such procedures would most benefit from RG. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 12, 2021 Category: Surgery Source Type: research

Experience with 10  years of a robotic surgery program at an Academic Medical Center
This study examines the 10-year experience of a robotic program at a single academic institution.Study designAll robotic operations performed at our institution from August 2005 to December 2016 were reviewed. Data were collected from the robotic system and hospital databases.ResultsA total of 3485 robotic operations were performed. Yearly case volume nearly quadrupled. There have been 37 robotic-trained surgeons in 5 specialties performing 53 different operations. Rate of conversion to open was 4.2%. American Society of Anesthesiologists (ASA) class increased over time, with ASA class 3 increasing from 20% of patients to ...
Source: Surgical Endoscopy - April 12, 2021 Category: Surgery Source Type: research

Trans-anal minimally invasive surgery (TAMIS) versus trans-anal endoscopic microsurgery (TEM): a comparative case –control matched-pairs analysis
ConclusionThe present study shows that TEM and TAMIS are equally effective in terms of quality of local excision and perioperative complication. TAMIS resulted less operative time consuming compared to TEM. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 12, 2021 Category: Surgery Source Type: research

Comparison of intraocular pressure during laparoscopic totally extraperitoneal (TEP) versus transabdominal preperitoneal (TAPP) inguinal hernia repair
ConclusionsThere was no significant intraoperative IOP change during laparoscopic inguinal hernia repair. Both the TEP and TAPP techniques can be performed safely without increasing intraoperative IOP. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 12, 2021 Category: Surgery Source Type: research

A long-term follow-up study of minimally invasive Ivor Lewis esophagectomy with linear stapled anastomosis
ConclusionsMIILE with linear stapled anastomosis is a safe procedure with a low anastomotic complication rate and favorable long-term functional and survival outcomes. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 9, 2021 Category: Surgery Source Type: research

Early endoscopic assessment after esophagectomy can predict anastomotic complications: a novel scoring system
ConclusionPrediction of anastomotic complications enables early detection and treatment which often limits the clinical extent of the complication. Early postoperative endoscopy is safe and a relatively simple procedure. The combined endoscopy score is an accurate tool to predict anastomotic complications. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 9, 2021 Category: Surgery Source Type: research

Nerve autofluorescence in near-ultraviolet light markedly enhances nerve visualization in vivo
AbstractBackgroundDuring surgery, surgeons must accurately localize nerves to avoid injuring them. Recently, we have discovered that nerves fluoresce in near-ultraviolet light (NUV) light. The aims of the current study were to determine the extent to which nerves fluoresce more brightly than background and vascular structures in NUV light, and identify the NUV intensity at which nerves are most distinguishable from other tissues.MethodsWe exposed sciatic nerves within the posterior thigh in five 250 –300 gm Wistar rats, then observed them at four different NUV intensity levels: 20%, 35%, 50%, and 100%. Brightnes...
Source: Surgical Endoscopy - April 9, 2021 Category: Surgery Source Type: research

Laparoscopic anterior hepatic transection for resecting lesions originating in the paracaval portion of the caudate lobe (with videos)
ConclusionAlthough technically challenging, laparoscopic anterior hepatic transection is still a safe and feasible procedure for resecting paracaval-originating lesions in select patients. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 9, 2021 Category: Surgery Source Type: research

Operating costs, fiscal impact, value analysis and guidance for the routine use of robotic technology in abdominal surgical procedures
ConclusionRA techniques do not produce significant clinical enhancements than similar surgical techniques with identical outcomes while their costs are much higher. The produced value analysis does not support the routine use of RA techniques for inguinal hernia repair and cholecystectomy. RA techniques for hysterectomies and colectomies are also performed at much higher cost than open and laparoscopic techniques, should only be routinely used with appropriate clinical justification and by cost efficient surgical providers. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 9, 2021 Category: Surgery Source Type: research

Evaluation of the learning curve of robot-assisted laparoscopic ventral mesh rectopexy
Conclusions36 to 55 procedures are required to complete the learning curve for RVMR. The implementation of robotic surgery does not inflict any additional risks on patients at the beginning of a surgeon ’s learning curve. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 9, 2021 Category: Surgery Source Type: research

Comparison of biannual and annual endoscopic gastric cancer surveillance after endoscopic resection
ConclusionsThere was no significant difference in the detection rate of MGC between biannual and annual endoscopic surveillance after ER of EGC or HGD. However, biannual surveillance showed a higher detection rate during the first 3  years, especially for patients with moderate to severe gastric atrophy. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 9, 2021 Category: Surgery Source Type: research

Elective ventral hernia repair provides significant abdominal wall quality of life improvements in older patients
AbstractBackgroundAn increasing proportion of ventral hernia patients are over age 65. These patients are frequently offered watchful waiting rather than surgical intervention due to their frail state or perioperative risk. However, many in this age group suffer from significant quality of life impacts that are not well understood.MethodsWe performed a retrospective cohort study using data from the Abdominal Core Health Quality Collaborative (ACHQC), including adults undergoing elective ventral hernia repair from 2013 to 2019. Median differences in Hernia-Related Quality of Life Survey (HerQLes) summary scores at baseline,...
Source: Surgical Endoscopy - April 8, 2021 Category: Surgery Source Type: research

Initial experience using a handheld fully articulating software-driven laparoscopic needle driver in TAPP inguinal hernia repair
ConclusionsAfter only a 10 case initial experience, a laparoscopic hand-held articulating needle driver is comparable to standard laparoscopy to complete suture mesh fixation and peritoneal closure for TAPP inguinal hernia repair. Further, the feasibility of suture mesh fixation minimizes the need for costly tacker devices. This instrument appears to be a promising tool in this largely minimally invasive era of hernia repair. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 6, 2021 Category: Surgery Source Type: research

Learning curve of three European centers in laparoscopic, hybrid laparoscopic, and robotic pancreatoduodenectomy
ConclusionThis analysis of the learning curve of three European centers found a shorter learning curve with hybrid PD as compared to laparoscopic and robotic PD. In implementation of a MIPD program, a stepwise approach might be beneficial. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 6, 2021 Category: Surgery Source Type: research

Learning curve of robot-assisted transabdominal preperitoneal (rTAPP) inguinal hernia repair: a cumulative sum (CUSUM) analysis
AbstractBackgroundRobot-assisted transabdominal preperitoneal inguinal hernia repair (rTAPP-IHR) is a safe and feasible approach for hernias of varying etiology. We aim to present a single surgeon ’s learning curve (LC) of this technique based on operative times, while accounting for bilaterality and complexity.MethodsThis is a retrospective cohort analysis of patients who underwent rTAPP-IHR over a period of 5 years. Patients who underwent primary, recurrent, and complex (previous posterior repair, previous prostatectomy, scrotal, incarcerated) repairs were included. Cumulative and risk-adjusted cumulative sum analy...
Source: Surgical Endoscopy - April 6, 2021 Category: Surgery Source Type: research

Flank incisional hernia after lateral approach spine operations: presentation and outcomes after repair
ConclusionsThis is the largest study addressing incisional flank hernias after LIF, an under-represented complication in the spine literature. We show that the patients present early, within months of their operation, and yet most hernias are not diagnosed for over a year. Although LIF is considered a minimally invasive procedure, the morbidity from hernia complications cannot be overlooked. These flank hernias are difficult to repair with suboptimal outcomes. We prefer robotic approach with primary closure of the defect and extraperitoneal sublay mesh, whenever possible. Prevention is key. To help reduce risk of hernia, w...
Source: Surgical Endoscopy - April 6, 2021 Category: Surgery Source Type: research

The impact of obesity and morbid obesity on urgent/emergency colorectal resections: a regional database analysis
AbstractBackgroundThe obesity rate is projected to reach 50% by 2030. Obesity may be modifiable prior to elective colorectal surgery, but there is no opportunity for weight loss when patients present for urgent/emergency operations. The impact of obesity focused on urgent/emergent colorectal operations has not been fully characterized. The study aim was to determine outcomes of obese patients who undergo urgent/emergency colorectal surgery and differences when compared with elective outcomes.MethodsThis is a retrospective cohort study of 30-day outcomes for normal (BMI 18.5 –25), obese (BMI 30–39.9), and morbid...
Source: Surgical Endoscopy - April 6, 2021 Category: Surgery Source Type: research

Traction-assisted endoscopic submucosal dissection reduces procedure time and risk of serious adverse events: a systematic review and meta-analysis
AbstractBackground and aimsConventional endoscopic submucosal dissection (C-ESD) is a technically demanding procedure with prolonged procedure times and higher risk of adverse events. To overcome the procedural difficulty of ESD, several traction-assisted techniques (T-ESD) have been developed to improve visualization of the submucosa in hopes to facilitate safe and effective dissection. The aim of this study was to conduct a meta-analysis that compares short-term outcomes (30-day) of T-ESD to C-ESD.MethodsClinical studies published up to April 2020 comparing the efficacy and safety of T-ESD and C-ESD were identified using...
Source: Surgical Endoscopy - April 6, 2021 Category: Surgery Source Type: research

Long-term outcomes of endoscopic resection followed by additional surgery after non-curative resection in undifferentiated-type early gastric cancer: a nationwide multi-center study
ConclusionsESD followed by additional surgery after non-curative resection showed comparable cancer-specific outcomes to initial surgery in UD EGC. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 6, 2021 Category: Surgery Source Type: research

Deep learning-based automatic surgical step recognition in intraoperative videos for transanal total mesorectal excision
ConclusionsTo the best of our knowledge, this is the first study based on automatic surgical step classification for TaTME. Our deep learning model self-learned and recognized the classification steps in TaTME videos with high accuracy after training. Thus, our model can be applied to a system for intraoperative guidance or for postoperative video indexing and analysis in TaTME procedures. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 6, 2021 Category: Surgery Source Type: research

At-home hands-on surgical training during COVID19: proof of concept using a virtual telementoring platform
ConclusionsSAGES was successfully able to transition and in-person hands-on course to a virtual at-home format. This innovative approach to continuing professional development will be necessary during the times of the COVID19 pandemic, but may be a helpful option for rural surgeons and others with travel restrictions in the future to continue their professional development without the need to travel away from their practice. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 6, 2021 Category: Surgery Source Type: research

Factors predictive of the successful treatment of choledocholithiasis
ConclusionsThe variables identified in this study, when considered in conjunction with the results of previously published studies, can be used to guide the choice of therapeutic methods for patients with choledocholithiasis in the future, given the significant difference in outcomes between the two groups. In the future, a prospective study should be performed to determine whether the same factors are predictive of the success of other methods of treatment (surgical or percutaneous). (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 6, 2021 Category: Surgery Source Type: research

Driving ability after right-sided inguinal hernia surgery
ConclusionsBased on our finding of significantly impaired BRT in patients following right-sided Lichtenstein hernia repair, it seems wise to recommend that such patients refrain from driving for 2 weeks after surgery. No such impairment was found in patients following TEP surgery. Consequently, it is deemed safe for them to resume driving 2 days after the procedure. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 6, 2021 Category: Surgery Source Type: research

Safety comparison of minimally invasive abdomen-only esophagectomy versus minimally invasive Ivor Lewis esophagectomy: a retrospective cohort study
This study included 17 patients undergoing MIAE and 32 patients treated with MIILE. There were a fewer median number of lymph nodes resected (p 
Source: Surgical Endoscopy - April 6, 2021 Category: Surgery Source Type: research

Optimal drainage of anastomosis stricture after living donor liver transplantation
ConclusionsEBS with an FC-SEMS is comparable with EBS with a PS or PTBD in terms of biliary stricture resolution and 12-month recurrence rates. The use of FC-SEMSs is potentially effective and safe for biliary AS resolution after LDLT. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - April 1, 2021 Category: Surgery Source Type: research

Oncological safety of transanal total mesorectal excision (TaTME) for rectal cancer: mid-term results of a prospective multicentre study
ConclusionsThere is currently a lack of evidence in the literature regarding TaTME and oncological outcomes with no data available from randomized clinical trials. In the meantime, the reported results from different multicentre series are controversial. This study showed positive mid-term outcomes at 2 years of follow-up and supported notable oncological outcomes with TaTME. However, it must be emphasized that previous experience in minimally invasive and transanal surgeries is essential for surgeons before intending to perform TaTME. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - March 8, 2021 Category: Surgery Source Type: research

Efficacy of different endoscopic treatments in patients with gastroesophageal reflux disease: a systematic review and network meta-analysis
ConclusionIn terms of short-term reduction of the HRQL score and heartburn score in patients with GERD, TIF and Stretta may be comparable to each other, and both may be more effective than PPIs. TIF may increase the LES pressure in comparison with Stretta and PPIs. PPIs may reduce the percentage of time pH  
Source: Surgical Endoscopy - March 8, 2021 Category: Surgery Source Type: research

Handheld robotic needle holder training: slower but better
AbstractBackgroundHandheld robotic laparoscopic instruments fill the gap between robotic and conventional instruments, combining the advantages of degrees of freedom and low price. The difficulty and value in learning these new instruments require detailed investigation.MethodsForty novice surgeons with no laparoscopic experience were randomly assigned to two groups: conventional instrument group (Group Conv) and robotic instrument group (Group Rob). The same training protocol was used in both groups: after viewing a standard operation film, laparoscopic suture training was administered using the corresponding instruments....
Source: Surgical Endoscopy - March 8, 2021 Category: Surgery Source Type: research

Establishment and validation of a model to determine the progression risk of low grade intraepithelial neoplasia
ConclusionSex, multi-site, hyperemia, ulcer and morphology are independent risk factors for the prolongation or progression of patients with gastric LGIN. These factors are objective and easy to obtain data. Based on this, a predictive model is constructed, which can be used in management of patients. The model can be used to identify high-risk groups in patients with LGIN that may progress to gastric cancer. Strengthening follow-up or endoscopic treatment to improve the detection rate of early cancer or reduce the incidence of gastric cancer can provide a reliable basis for the treatment of LGIN. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - March 8, 2021 Category: Surgery Source Type: research

Development of an artificial intelligence system using deep learning to indicate anatomical landmarks during laparoscopic cholecystectomy
ConclusionsIntraoperative landmark indication successfully identified four landmarks during LC, which may help to reduce the incidence of BDI, and thus, increase the safety of LC. The novel system proposed in the present study may prevent BDI during LC in clinical practice. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - March 8, 2021 Category: Surgery Source Type: research

An easier option for “invisible scar” thyroidectomy: hybrid-transoral endoscopic thyroidectomy submental access (H-TOETSA)—experience on twenty-two consecutive patients
ConclusionH-TOETSA was feasible and resulted to have some technical and clinical advantages maintaining the purpose to avoid a visible scar on the neck. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - March 8, 2021 Category: Surgery Source Type: research

Long-term outcomes of patients with recurrent squamous cell carcinoma of the esophagus undergoing salvage endoscopic resection after definitive chemoradiotherapy
ConclusionsSalvage ER might be effective local treatment in patients with local failure after dCRT. For the patients with clinical N stage, frequent surveillance should be performed. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - March 8, 2021 Category: Surgery Source Type: research

Intrahepatic cholangiocarcinoma as the new field of implementation of laparoscopic liver resection programs. A comparative propensity score-based analysis of open and laparoscopic liver resections
ConclusionsOur results confirm feasibility, safety, and oncological efficiency of the laparoscopic approach in the management of ICC. However, this surgery is often complex and should be only considered in centers with large experience in laparoscopic liver surgery. (Source: Surgical Endoscopy)
Source: Surgical Endoscopy - March 8, 2021 Category: Surgery Source Type: research