Journal Of Minimal Access Surgery[JOURNAL]
Sun
200 papers
Outcomes of various bailout strategies for managing different categories of difficult laparoscopic cholecystectomy - An experience of over two decades from a single surgical unit at a tertiary care teaching hospital.
Krishna A, Rai SK, Jain M … +4 more , Prakash O, Misra MC, Kumar S, Bansal VK
J Minim Access Surg · 2025 Jul · PMID 40693924 · Publisher ↗
INTRODUCTION: A difficult laparoscopic cholecystectomy (LC), if not handled appropriately, can lead to devastating complications. We hereby describe our experience and outcomes of patients with difficult LC over the last...
INTRODUCTION: A difficult laparoscopic cholecystectomy (LC), if not handled appropriately, can lead to devastating complications. We hereby describe our experience and outcomes of patients with difficult LC over the last two decades, with various bailout strategies to achieve a very low conversion rate and bile duct injury rate. PATIENTS AND METHODS: This study was a retrospective analysis of patients labelled as difficult LC in a single surgical unit at a tertiary care teaching hospital from January 2004 to December 2020. The pre-operative, peri-operative and follow-up data of all these patients were obtained from a prospectively maintained electronic database. RESULTS: Between January 2004 and December 2020, 3726 patients underwent elective LC, of which 649 (17.4%) cholecystectomies were deemed difficult. Using the various bailout strategies, we were able to achieve a conversion rate of 4.9% and bile duct injury rate of 0.1% with an overall morbidity of 8%. CONCLUSION: When a difficult situation occurs, the benefit of removing the complete gall bladder is outweighed by the risk of a major injury, so a bailout strategy needs to be used. The present series reiterates the use of bailout strategies to not only decrease conversion but also achieve a minimal BDI rate.
Safety and feasibility of concomitant ventral hernia repair and total laparoscopic hysterectomy: A single-centre experience of over 1000 cases.
Christopher PJ, Subbiah R, Ramakrishnan P … +4 more , Natesan AV, Duraisamy KY, Palanivelu PR, Chinnusamy P
J Minim Access Surg · 2026 Jan · PMID 40693921 · Full text
INTRODUCTION: Laparoscopic ventral hernia surgery has become the standard of care for most surgeons, offering improved patient outcomes, shorter hospital stays, and fewer complications compared to open surgeries. However...
INTRODUCTION: Laparoscopic ventral hernia surgery has become the standard of care for most surgeons, offering improved patient outcomes, shorter hospital stays, and fewer complications compared to open surgeries. However, the benefits of combining Intraperitoneal Onlay Meshplasty (IPOM) with other surgeries are rarely discussed and not commonly practiced. This study examines the safety of placing mesh after Total Laparoscopic Hysterectomy (TLH) based on a single center's retrospective experience of over 1,000 cases spanning 15 years. MATERIALS AND METHODS: Data of all the patients who underwent concomitant TLH with IPOM were collected retrospectively. Details of the surgery, immediate post-op outcomes, long term follow ups with complications and recurrences were analysed. RESULTS: Between January 2006 and January 2021, we reviewed 1,273 cases, of which 1,058 met our inclusion and exclusion criteria. There were no open conversions. The mean patient age was 48.23 years with a standard deviation (SD) of 2.19. The mean BMI was 33.21 kg/m² with an SD of 1.83. The average defect size was 5.8 cm with an SD of 1.65. The mean operating time was 231 minutes with an SD of 10.15. The average hospital stay was 3.2 days with an SD of 0.84. There were no 30 day readmissions or mortality. Out of 1,058 cases, 782 patients had a minimum follow-up period of 2 years, conducted through telephone conversations or in-person hospital visits. An additional 155 patients had at least 1 year of follow-up, while 121 patients were lost to follow-up within the first year. The median follow-up duration for all patients was 2.8 years. 52 cases (4.9%) experienced postoperative seroma. We had only one case (0.094%) of mesh infection, which required mesh explantation. There were two instances of recurrence (0.189%): one patient underwent open repair after 24 months, and another underwent eTEP repair 32 months after the initial surgery. Both patients completed 1 year of follow-up post-second procedure and were doing well. CONCLUSION: Meshes can be safely placed in a clean, contaminated environment alongside total laparoscopic hysterectomy, with the discretion of the operating surgeon considering his expertise and judgment. We can conclude that combining ventral hernia repairs with TLH is safe and feasible with acceptable morbidity.
A retrospective analysis of post-operative mesh infection after laparoscopic inguinal hernia repair and preventive measures.
Kataria P, Gupta SV, Bansal LK … +3 more , Jain A, Bishnoi S, Kapur N
J Minim Access Surg · 2025 Jul · PMID 40693917 · Publisher ↗
INTRODUCTION: Post-operative mesh infection is a rare but serious complication of laparoscopic hernia surgery. In this study, we share our experience of post-laparoscopic hernia repair mesh infections, with a review of t...
INTRODUCTION: Post-operative mesh infection is a rare but serious complication of laparoscopic hernia surgery. In this study, we share our experience of post-laparoscopic hernia repair mesh infections, with a review of the literature and possible preventive steps that can be taken to for such a dreaded complication. PATIENTS AND METHODS: This retrospective observational study was done from January 2014 to 30 June 2024. We reviewed the prospectively maintained data of all the patients who underwent laparoscopic inguinal hernia surgery. Thousand eight hundred and twenty patients underwent laparoscopic hernia repair, and we found case records of six patients who experienced surgical site infections (SSIs) following laparoscopic inguinal mesh hernioplasty. RESULTS: The rate of SSI or the mesh infection was 0.34% (6 cases). All were male with 4 of them in the age group between 51 and 60 years. One patient (16.66%) had undergone totally extraperitoneal repair, whereas 5 patients (83.33%) had undergone transabdominal preperitoneal repair. All the patients presented with mesh infection within the first 4 weeks of surgery. Three (50%) of patients presenting with post-mesh infection had different comorbidities. Four (66.6%) patients of post-laparoscopic inguinal hernia repair mesh infection underwent mesh explantation and the remaining 2 (33.33%) were treated conservatively. CONCLUSION: Intra-abdominal abscess and mesh infection, though rare, are serious complications of laparoscopic hernia repair. Prevention remains the best approach, and the surgical team must ensure adherence to key preventive measures at each stage.
Application of an improved continuous single-layer pancreaticojejunostomy technique in laparoscopic pancreaticoduodenectomy.
Zhou X, Bu X, Yu F … +2 more , Zhang Y, Xia L
J Minim Access Surg · 2025 Jul · PMID 40693916 · Publisher ↗
Laparoscopic pancreaticoduodenectomy (LPD) is a minimally invasive approach for pancreatic head and ampullary tumours, with pancreaticojejunostomy (PJ) critically influencing post-operative outcomes. This study aimed to...
Laparoscopic pancreaticoduodenectomy (LPD) is a minimally invasive approach for pancreatic head and ampullary tumours, with pancreaticojejunostomy (PJ) critically influencing post-operative outcomes. This study aimed to compare a modified continuous single-layer PJ technique with the conventional two-layer method in LPD. A retrospective cohort study of 22 patients undergoing LPD compared the surgical outcomes between the modified group (n = 12) and the conventional group (n = 10). Baseline characteristics were well-matched between the two groups. The modified group demonstrated significantly shorter anastomosis time (19.08 vs. 23.1 min, P < 0.001) and lower abdominal infection rates (0 vs. 3 cases, P = 0.041). No significant differences were observed in clinically relevant post-operative pancreatic fistula or bleeding. Conclusively, the modified continuous single-layer PJ technique appears safe and feasible, offering efficiency advantages without compromising short-term outcomes. However, large-scale randomised controlled trials are warranted to validate safety, efficacy and long-term prognostic implications.
Comparison of post-operative pain in laparoscopic extended-view total extraperitoneal inguinal hernioplasty using self-gripping mesh versus polypropylene mesh fixed with absorbable tackers - A parallel-arm, double-blinded randomised control trial.
Kada SV, Kumbhar US, Vijayakumar C … +1 more , Reddy AA
J Minim Access Surg · 2025 Jul · PMID 40693911 · Publisher ↗
INTRODUCTION: To compare short- and mid-term outcomes in patients undergoing laparoscopic extended-view totally extraperitoneal (eTEP) inguinal hernia repair using either self-gripping mesh or polypropylene mesh with abs...
INTRODUCTION: To compare short- and mid-term outcomes in patients undergoing laparoscopic extended-view totally extraperitoneal (eTEP) inguinal hernia repair using either self-gripping mesh or polypropylene mesh with absorbable tackers. PATIENTS AND METHODS: A prospective, parallel-arm, double-blinded randomised controlled trial was conducted at a tertiary care centre between April 2023 and July 2024. Adults with primary unilateral uncomplicated inguinal hernias were randomly assigned to receive self-gripping or polypropylene mesh with tackers. Pain was assessed using the Visual Analogue Scale (VAS) at 12 h and on post-operative days 1, 2, 7, 30 and at 3 months. The secondary outcomes included short-term complications, chronic pain, recurrence and quality of life (QoL) using the HerQLes questionnaire. Data were analysed using t-tests or Mann-Whitney U-test for the continuous variables and Chi-square or Fisher's exact tests for the categorical variables. P < 0.05 was considered statistically significant. RESULTS: Sixty-two patients were randomised equally. The mean VAS score at 12 h was 4.68 ± 0.94 in the polypropylene mesh group versus 4.58 ± 0.92 in the self-gripping mesh group (P = 0.657). No statistically significant difference in pain was observed at any assessed time point. Chronic pain at 3 months was negligible (mean VAS <1), and no recurrences were detected. Short-term complications and quality-of-life scores (HerQLes) were comparable between the two groups. CONCLUSIONS: Laparoscopic eTEP hernia repair with either self-gripping mesh or polypropylene mesh fixed with absorbable tackers yields similar short- and mid-term outcomes regarding post-operative pain, complications, recurrence and QoL. Both techniques are safe and effective for primary unilateral inguinal hernia repair.
Comparative outcome of metal versus plastic stents for the management of walled-off pancreatic necrosis - An updated meta-analysis of randomised studies.
Giri S, Gore P, Khatana G … +3 more , Mishra C, Sundaram S, Bhardwaj V
J Minim Access Surg · 2025 Oct · PMID 40693902 · Full text
OBJECTIVE: The choice of the stent for managing walled-off pancreatic necrosis (WOPN) is a topic of debate with varying reported outcomes between metal and plastic stents. The present meta-analysis aimed to compare the e...
OBJECTIVE: The choice of the stent for managing walled-off pancreatic necrosis (WOPN) is a topic of debate with varying reported outcomes between metal and plastic stents. The present meta-analysis aimed to compare the efficacy and safety of metal and plastic stents for the drainage of WOPN. PATIENTS AND METHODS: A comprehensive search of literature from inception to December 2024 was done on three databases for randomised controlled trials comparing metal and plastic stents for drainage of WOPN. Risk ratios with 95% confidence intervals (CIs) were calculated for all the dichotomous outcomes. Continuous variables were analysed using mean difference (MD). RESULTS: A total of 821 records were identified, of which seven studies were included in the final analysis. The procedural duration was significantly lower with metal stents with an MD of-11.32 min (95% CI: -17.75--4.88). However, there was no difference between the two groups in terms of stent-related periprocedural adverse events, bleeding, serious bleeding, treatment success, need for necrosectomy, number of necrosectomies, number of reinterventions, need for percutaneous drainage, need for surgery, duration of hospitalisation, mortality, stent dysfunction, recurrence of WOPN, endocrine and exocrine insufficiency. The procedural costs were significantly higher for metal compared with plastic stents (MD 2.4 × 10 3 $, 95% CI: 1.2-3.7), with no significant difference in the overall cost. CONCLUSION: Except for a significantly shorter procedural duration, metal stents do not offer any significant advantage over plastic stents for WOPN drainage. Further studies are required before routinely recommending metal stents for WOPN drainage.
Minimally invasive oesophagectomy for corrosive oesophageal strictures - A single-centre experience from central India.
Deshpande GA, Tirpude B, Bhanarkar H … +3 more , Kodape G, Advaitha M, Gajbhiye R
J Minim Access Surg · 2026 Jan · PMID 40693897 · Full text
INTRODUCTION: Corrosive ingestion is a common cause for benign oesophageal stricture in the developing countries. There is limited literature available on the minimally invasive surgical approach for the management of th...
INTRODUCTION: Corrosive ingestion is a common cause for benign oesophageal stricture in the developing countries. There is limited literature available on the minimally invasive surgical approach for the management of this condition. This study analyses our experience of managing corrosive oesophageal strictures by combined thoraco-laparoscopic approach. PATIENTS AND METHODS: A retrospective analysis of 24 patients (22 - gastric conduit and 2 - colonic conduit) who underwent minimally invasive oesophagectomy for corrosive oesophageal strictures from January 2019 to December 2023 was done. RESULTS: The median age of the patients in the study group was 30.5 years (range 18-60 years). Eighteen patients had a history of accidental corrosive ingestion, and 6 patients with suicidal intent. Post-operative complications included chest infections in 6, recurrent laryngeal nerve paresis in 2, anastomotic leak in 2 and anastomotic stricture in 4 patients. There was one mortality. CONCLUSION: Minimal invasive oesophagectomy for corrosive stricture is technically challenging and needs expertise. It not only permits the native and physiological route for conduit placement but also avoids complications related to retained diseased oesophagus.
Stapler-assisted endoscopic mini- or less-open sublay technique: How do I do it?
Zahalka A, Kanani F, Shaqqur W … +4 more , Asem A, Bar-Haim R, Iskhakov A, Dayan K
J Minim Access Surg · 2025 Jul · PMID 40693876 · Publisher ↗
BACKGROUND: This study evaluates the clinical efficacy of the endoscopic mini- or less-open sublay (EMILOS) technique with stapler-assisted fascial closure for ventral hernia repair. MATERIALS AND METHODS: Twelve patient...
BACKGROUND: This study evaluates the clinical efficacy of the endoscopic mini- or less-open sublay (EMILOS) technique with stapler-assisted fascial closure for ventral hernia repair. MATERIALS AND METHODS: Twelve patients underwent EMILOS with stapler-assisted fascial closure between July 2022 and August 2024 with a mean follow-up of 12.4 months. RESULTS: The cohort (7 females and 5 males; mean age: 58.9 ± 16.3 years and body mass index: 27.8 ± 3.5 kg/m²) underwent repair for various ventral hernias (mean defect: 4.9 cm × 5.2 cm). The mean operative time was 95 min. Complications included seroma (17%), surgical site infection (8%) and small bowel obstruction requiring reoperation (8%). The hernia recurrence rate was 8%. Patients reporting excellent quality of life increased from 17% preoperatively to 50% postoperatively. CONCLUSIONS: EMILOS with stapler-assisted closure offers a safe, efficient approach with favourable short-term outcomes, particularly for obese patients and medium-sized hernias. The technique combines enhanced visualisation with efficient fascial closure, yielding an 8% recurrence rate that compares favourably with alternatives. Larger studies with extended follow-up are needed to establish long-term efficacy.
Feasibility and outcomes of laparoscopic management in perforation peritonitis: A prospective cohort study with propensity score matching.
Soni S, Parihar YK, Chaudhary R … +7 more , Sharma N, Rodha MS, Lodha M, Gupta MK, Kothari N, Baksi A, Puranik AK
J Minim Access Surg · 2026 Apr · PMID 40693814 · Full text
BACKGROUND: Perforation peritonitis remains a significant cause of morbidity and mortality in emergency surgical patients. Conventionally, open laparotomy has been the preferred approach. However, with advancements in mi...
BACKGROUND: Perforation peritonitis remains a significant cause of morbidity and mortality in emergency surgical patients. Conventionally, open laparotomy has been the preferred approach. However, with advancements in minimally invasive techniques, laparoscopic management has emerged as a potential alternative. The study aims to assess the feasibility and effectiveness of laparoscopic surgery compared to open laparotomy in managing perforation peritonitis. PATIENTS AND METHODS: A prospective observational study was conducted from January 2022 to May 2023 for patients diagnosed with perforation peritonitis. A total of 140 patients were recruited, 110 patients underwent laparotomy while 30 patients underwent laparoscopic management. Propensity score matching (PSM) in 1:1 ratio was applied to balance confounding variables, resulting in two matched groups of 28 patients each. Operative time, length of post-operative stay, post-operative Visual Analogue Scale score, morbidity and mortality rates were compared. RESULTS: The mean operative time was significantly longer in the laparoscopic group (217.43 ± 86.10 min) compared to the laparotomy group (182.46 ± 31.63 min; P = 0.049). However, patients in the laparoscopic group experienced a significantly shorter hospital stay (4.39 ± 2.04 days vs. 8.68 ± 3.45 days; P < 0.001) and lower post-operative pain scores at all time points ( P < 0.012). The 30-day morbidity rate was lower in the laparoscopic group (10% vs. 32%), with fewer surgical site infections and reoperations. CONCLUSION: Laparoscopy is a feasible and effective alternative to laparotomy in selected cases of perforation peritonitis, offering benefits such as reduced post-operative pain and shorter hospital stay. Despite technical challenges, improved surgical expertise and patient selection can enhance its role in emergency surgical settings.
Evaluating the feasibility of two-port laparoscopic cholecystectomy: A minimally invasive approach.
Chu X, Chen F, Yu Y … +2 more , Ding G, Cao L
J Minim Access Surg · 2025 Jul · PMID 40693812 · Publisher ↗
OBJECTIVE: To establish a two-port minimally invasive laparoscopic cholecystectomy (LC) technique that minimises surgical scarring and alleviates post-operative pain. METHODS: A cohort study was conducted, enrolling pati...
OBJECTIVE: To establish a two-port minimally invasive laparoscopic cholecystectomy (LC) technique that minimises surgical scarring and alleviates post-operative pain. METHODS: A cohort study was conducted, enrolling patients meeting the inclusion criteria to undergo two-port minimally invasive LC. The outcomes were compared with those of patients who underwent conventional LC performed by other medical teams. The clinical and pathological data were collected. Visual Analogue Scale scores were used to assess incision pain on post-operative days 1 and 15. Statistical analyses were performed to compare pain scores between the groups. RESULTS: Between November 2020 and June 2021, 56 patients met the screening criteria and were enrolled in the study group. Of these, 42 patients successfully underwent two-port LC, while 14 cases were converted to conventional three-port LC. No post-operative complications, such as bleeding or bile leakage, occurred, and all patients were discharged without incident. On day 1 post-surgery, the average incision pain score in the two-port LC group was 1.4 ± 0.95, significantly lower than 1.8 ± 1.32 in the conventional LC group (P = 0.02). On day 15 post-surgery, 13 patients (23.2%) in the two-port LC group reported subxiphoid incision pain, compared to 63 patients (41.4%) in the conventional LC group. CONCLUSION: For patients meeting indications for conventional LC, early implementation of two-port minimally invasive LC achieved a success rate of 75%. Compared to conventional LC, this technique did not significantly shorten operative time or reduce the complication rates. However, it decreased the number of incisions to two, reduced scar size from 10 mm to 3 mm and significantly alleviated post-operative pain. It is worthy of clinical application and promotion.
Laparoscopic Roux-en-Y hepaticojejunostomy for post-cholecystectomy type IIIb benign biliary stricture with internal duodenal fistula: A case report with surgical video.
Agarwal L, Rathore KS, Varshney VK … +4 more , Soni SC, Selvakumar B, Varshney P, Agarwal A
J Minim Access Surg · 2025 Jul · PMID 40653723 · Full text
Laparoscopic cholecystectomy (LC) is a widely performed procedure, but it can be complicated by iatrogenic bile duct injuries, leading to benign biliary strictures (BBS). This report details the case of a 38-year-old man...
Laparoscopic cholecystectomy (LC) is a widely performed procedure, but it can be complicated by iatrogenic bile duct injuries, leading to benign biliary strictures (BBS). This report details the case of a 38-year-old man with a Bismuth type IIIb BBS and an internal duodenal fistula following LC. He underwent a totally laparoscopic Roux-en-Y hepaticojejunostomy (RYHJ), a technically demanding procedure, particularly in the presence of complex biliary strictures. The surgery involved meticulous dissection and the creation of a wide hepaticojejunostomy. The patient had an uneventful recovery, with discharge on the post-operative day 4. At 18-month follow-up, he remains asymptomatic with normal liver function. This case demonstrates the feasibility and effectiveness of laparoscopic RYHJ in managing complex BBS, offering the advantages of minimally invasive surgery, including reduced post-operative pain and shorter hospital stay, while ensuring favourable long-term outcomes.
A study on the impact of short structured laparoscopy training course: Fellowship of Indian Association of Gastrointestinal Endo Surgeons.
Easwaramoorthy S, Chandrasekar S, Manickavasakam K … +3 more , Sridhar P, Govindan G, Sundarrajan H
J Minim Access Surg · 2025 Jul · PMID 40653722 · Full text
INTRODUCTION:: Since the invention of laparoscopic cholecystectomy, there have been tremendous developments in minimal access surgery and an increasing need for well-structured laparoscopic training courses. There is a n...
INTRODUCTION:: Since the invention of laparoscopic cholecystectomy, there have been tremendous developments in minimal access surgery and an increasing need for well-structured laparoscopic training courses. There is a need to analyse the real benefit of short training courses. The study was conducted to find whether a focused 3-day structured laparoscopy training course conducted by the Indian Association of Gastrointestinal Endo Surgeons (IAGES) could improve the cognitive and technical skills of surgeons in essential laparoscopic surgery. MATERIALS AND METHODS:: The Indian Association of Gastrointestinal Endo Surgeons conducted this prospective study during 2023–2024. Five hundred and fifty one candidates under the examination category in 14 consecutive courses were considered as the study groups to compare their pre- and post-test multiple-choice question (MCQ) scores to find the improvement in their knowledge base. A survey of candidates using Google Forms was also done at 6 months to find out the impact of the course. The following outcome measures were analysed: Improvement in the mean score in post-test MCQ when compared to pre-test MCQ. We compared the pre- and post-test scores after categorising the candidates into three grades according to the marks scored by them. Grade A: Above 75% marks. Grade B: 50%–75% marks. Grade C: <50% marks. Quality of laparoscopy training modules including hands-on suture training module and live demonstration of laparoscopic procedures. The volume of laparoscopic procedures done before and after the course. STATISTICAL ANALYSIS USED:: The paired -test. RESULTS:: There were 551 examination category candidates for FIAGES during this study period with pre- and post-test scores (grades) available for evaluation. Four hundred and fourteen candidates submitted the 15-question Google Forms which were also taken for further analysis of the impact of the training course. After the FIAGES course, it was evident that most of the participants obtained Grade A in the post-test as compared to the pre-test (5.4% vs. 41.4%), and only very few participants obtained Grade C (0.9%). It was also evident that the candidates started performing more basic laparoscopic cases after the FIAGES score ( < 0.001). CONCLUSIONS:: The FIAGES course has established itself as a famous well-structured laparoscopic training course. It improved the knowledge base of the registrants and also helped with their career progress. Efforts are on the way to make FIAGES with a more elaborate course curriculum to enable accreditation by statutory bodies.
Laparoscopic cholecystectomy in elderly patients: Avoid or expedite? - A comparative cohort study.
Mondragon M, Mohamedahmed AY, Zaman S … +4 more , Farquharson J, Raja U, Ijaz A, Singh-Ranger D
J Minim Access Surg · 2025 Jul · PMID 40653721 · Full text
INTRODUCTION: Although laparoscopic cholecystectomy (LC) has become the gold standard for treating gall bladder stones (GBS), its safety in elderly patients is still questioned. This study aimed to assess the outcome of...
INTRODUCTION: Although laparoscopic cholecystectomy (LC) has become the gold standard for treating gall bladder stones (GBS), its safety in elderly patients is still questioned. This study aimed to assess the outcome of LC in patients 70 and older compared to younger patients. PATIENTS AND METHODS: The medical records of 548 patients undergoing LC were evaluated retrospectively. Patients' demographics and post-operative complications were recorded. Furthermore, patients were divided according to the CEPOD into emergency and elective patients, and complications were recorded according to Clavien-Dindo (CD) classifications. Data analysis was performed with SPSS software version 27. RESULTS: Patients were divided into the elderly patients group (≥70 years of age, n = 185) and the young patients group (<70 years of age, n = 363). The ≥70-year-old group showed a significantly higher number of patients who required emergency admission with GBS symptoms (P = 0.001), emergency LC (P = 0.01) and conversion to open (P = 0.02). The two groups showed comparable post-operative complications: bile leak (P = 0.26), collection (P = 0.11) and re-operation (P = 0.60), post-operative endoscopic retrograde cholangiopancreatography (P = 1.0), GBS pancreatitis (P = 0.33) and death (0.30). CD I-II complications were higher in the ≥ 70-year-old group compared to the <70-year-old group in elective (P = 0.01) and emergency (P = 0.03) LC. However, CD ≥3 complications were higher in the ≥70-year-old group than the <70-year-old group in the emergency LC (P = 0.01) and comparable in the elective LC (P = 0.12). CONCLUSION: LC is safe and efficient in elderly patients. Elective LC should be expedited in elderly patients to avoid emergency admissions and emergency LC, which are associated with higher complication rates.
Comparison of short-term oncologic outcomes in open, laparoscopic and robotic radical gastrectomy for the treatment of gastric cancer.
Yaman S, Teke Z, Yüksel S … +5 more , Topal U, Karatay H, Gökduman HC, Karaköse E, Bektaş H
J Minim Access Surg · 2025 Jul · PMID 40653720 · Full text
AIM: Surgical resection remains the cornerstone treatment for gastric cancer, which ranks as the fifth most common cancer globally. Although minimally invasive surgical techniques are gaining popularity, their safety and...
AIM: Surgical resection remains the cornerstone treatment for gastric cancer, which ranks as the fifth most common cancer globally. Although minimally invasive surgical techniques are gaining popularity, their safety and oncological adequacy remain subjects of ongoing debate. This study aims to contribute to the medical literature by comparing open, laparoscopic and robotic gastrectomy techniques in the treatment of gastric cancer, focusing on short-term oncological outcomes. MATERIALS AND METHODS: Patients aged 18 years and older who underwent surgery for gastric adenocarcinoma at our institution between April 2020 and September 2022 were included in the study. The patients were categorised into three groups based on the surgical approach: open gastrectomy, laparoscopic gastrectomy and robotic gastrectomy. Demographic data, intraoperative and post-operative findings, tumour characteristics and short-term morbidity and mortality outcomes were analysed retrospectively. RESULTS: A total of 109 patients (37 females [33.9%] and 72 males [66.1%]) with a mean age of 63.1 ± 11.4 years were included. The operative time was significantly shorter in the open gastrectomy group compared to the laparoscopic and robotic groups (P = 0.012). The initiation of oral intake and post-operative hospital stay were significantly shorter in the robotic gastrectomy group (P < 0.001). At 1-year follow-up, disease-free survival rates were higher, and mortality rates were lower in the robotic gastrectomy group compared to the other groups (P = 0.030). Furthermore, the completion rate of adjuvant therapy was significantly higher in the robotic group than in the other groups (P = 0.008). CONCLUSION: In conclusion, minimally invasive surgical techniques, particularly robotic gastrectomy, provide a safe and oncologically adequate alternative to open surgery for the treatment of gastric cancer. These methods can be safely employed in selected patients by experienced teams at high-volume centres.
Minimally invasive surgery for giant splenic cysts.
Aoun R, Akel R, Genety M
J Minim Access Surg · 2025 Jul · PMID 40653719 · Full text
Patients diagnosed with solitary non-parasitic splenic cysts were mainly described in the literature as case reports or case series. This study aims to analyse data from published articles about this condition. We perfor...
Patients diagnosed with solitary non-parasitic splenic cysts were mainly described in the literature as case reports or case series. This study aims to analyse data from published articles about this condition. We performed a systematic review using the PRISMA protocol. PubMed/MEDLINE, Embase and the Google Scholar Library were searched up to the end of May 2024. Fifty-five patients were included in this study. 31 (56.36%) patients are female, and the mean age is 29.13 years. 32 (58%) patients experienced abdominal pain and 5 (9%) patients were asymptomatic. Sizes of the cysts varied between 67 and 250 mm. Most of the patients underwent laparoscopic fenestration of the cyst (54.55%), and all the pathological results were benign lesions. 3 minor complications (5.45%) were observed and recurrence of the cyst occurred in 3 patients (5.45%). Solitary non-parasitic splenic cysts are uncommon. They are benign lesions but can become symptomatic and therefore require surgery. Minimally invasive surgery is a safe option with a very low morbidity and mortality.
Comparison of laparoscopic verse open oesophagogastric devascularisation with splenectomy in portal hypertension: A meta-analysis.
Zhang H
J Minim Access Surg · 2025 Jul · PMID 40653718 · Full text
To assess the efficacy and safety in treating portal hypertension by laparoscopic oesophagogastric devascularisation with splenectomy. I searched the randomised controlled trials about the efficacy and safety of laparosc...
To assess the efficacy and safety in treating portal hypertension by laparoscopic oesophagogastric devascularisation with splenectomy. I searched the randomised controlled trials about the efficacy and safety of laparoscopic oesophagogastric devascularisation with splenectomy in treating portal hypertension from PubMed (1998~2023.02), Wanfang Data (1990~2023.02), China National Knowledge Infrastructure (1979~2023.02), Whip (1989~2023.02) and International Statistical Institute (1998~2023.02). I extracted the data from these trials, and I got the meta-analysis from RevMan 5.3 software. Seventeen randomised control trials involving 1326 patients were included (671 patients in the laparoscopic oesophagogastric devascularisation with splenectomy in the portal hypertension group and 655 patients in the open resection group). Compared with open resection group, this Meta-analysis showed that laparoscopic esophagogastric devascularization with splenectomy in portal hypertension group could reduce the intraoperative bloodloss (P < 0.05), shorten the postoperative time of recovery of intestinal peristalsis (P < 0.05), reduce the postoperative drainage volume (P < 0.05), reduce the drainage tube removal time (P < 0.05), shorten the postoperation hospital stay (P < 0.05), shorten the total hospitalization cost (P = 0.05), shorten the postoperative ambulation (P < 0.05), shorten the postoperative complication rate (P < 0.05). But there was no significant difference in the operation time (P > 0.05). However, there was no significant difference in the operation time (P > 0.05). Compared with open resection group, the total effect of laparoscopic oesophagogastric devascularisation with splenectomy in the treatment of portal hypertension is better. Laparoscopic oesophagogastric devascularisation with splenectomy in the treatment of portal hypertension is acceptable.
Robotic totally extraperitoneal inguinal hernia repair.
Kumbhar US, Pourouchottamane B, Reddy AP
J Minim Access Surg · 2025 Jun · PMID 40515378 · Publisher ↗
Inguinal hernia is one of the most common surgeries performed worldwide. The operative technique of inguinal hernia has evolved drastically to provide a better quality of life with minimal complications. One of the recen...
Inguinal hernia is one of the most common surgeries performed worldwide. The operative technique of inguinal hernia has evolved drastically to provide a better quality of life with minimal complications. One of the recent advances is robot-assisted inguinal hernia repair. Owing to its ease of surgery and better operative visualisation, it will soon become one of the most fruitful inventions. Many studies and reports are regarding robotic transabdominal preperitoneal repair. However, very few reports describe robotic totally extraperitoneal (rTEP) repair. This report mainly describes the surgical procedure of rTEP inguinal hernia repair and its challenges to aid fellow colleagues in performing and improvising the technique.
Outcome after flexible endoscopy structured training of surgeons in a novel hybrid format.
Easwaramoorthy S, Chandrasekar S, DeSarkar S … +3 more , Manickavasakam K, Borgoankar V, Manickavasakam S
J Minim Access Surg · 2025 Jun · PMID 40495536 · Publisher ↗
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Ventral transabdominal preperitoneal plus repair for primary ventral hernia: How do I do it?
Sharma J, Singh D, Grover N … +4 more , Singh A, Rathore YS, Ranjan P, Chumber S
J Minim Access Surg · 2025 Jun · PMID 40485615 · Publisher ↗
The optimal technique of ventral hernia repair is still debatable. While intraperitoneal onlay mesh repair is the most widely used method, extraperitoneal repair of ventral hernia is gaining popularity, mainly due to its...
The optimal technique of ventral hernia repair is still debatable. While intraperitoneal onlay mesh repair is the most widely used method, extraperitoneal repair of ventral hernia is gaining popularity, mainly due to its proposed lesser pain and complication profile. This article describes one such method, ventral transabdominal preperitoneal plus repair and also discusses its benefits and post-operative outcomes.
Intrapancreatic accessory spleen mimicking a pancreatic neuroendocrine tumour - An important but almost forgotten differential diagnosis.
Filardi KFXC, Júnior JDM, Costa TN … +5 more , Montagnini A, Dominguez-Rosado I, Chan C, Jukemura J, Herman P
J Minim Access Surg · 2025 Jul · PMID 40485610 · Full text
Intrapancreatic accessory spleen (IPAS) is a rare condition resulting from the failure of embryological splenic buds to fuse. Found in approximately 1.1% to 3.4% of the population, IPAS can present significant diagnostic...
Intrapancreatic accessory spleen (IPAS) is a rare condition resulting from the failure of embryological splenic buds to fuse. Found in approximately 1.1% to 3.4% of the population, IPAS can present significant diagnostic challenges, often mimicking pancreatic tumours such as pancreatic neuroendocrine tumours. We report two cases of IPAS, each illustrating different diagnostic approaches and outcomes. These cases highlight the importance of considering IPAS in differential diagnoses for hypervascular pancreatic tail lesions. Advanced imaging techniques such as magnetic resonance imaging, computerised tomography, technetium-99m scintigraphy and endoscopic ultrasound-guided fine-needle aspiration are critical in distinguishing IPAS from malignant conditions, potentially preventing unwarranted surgical interventions. Comprehensive diagnostic protocols combining multiple modalities are recommended to enhance diagnostic accuracy and optimise patient outcomes.
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