Journal Of Minimal Access Surgery[JOURNAL]
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200 papers
Long-term nutritional outcomes after bariatric surgery: A multicentre study by the Obesity and Metabolic Surgery Society of India.
Bindal V, Raj PP, Khaitan M … +19 more , Agarwal P, Prasad A, Peters ANC, Narwaria M, Aggarwal S, Kular KS, Wadhawan R, Baig S, Bhaskar AG, Katakwar A, Goel D, Vikani M, Pandey D, Gupta S, Dhagat D, Jaithlia H, Siddiqui D, Arora B, Singh A
J Minim Access Surg · 2026 Apr · PMID 41972879 · Publisher ↗
INTRODUCTION: This study aimed to examine the impact of metabolic and bariatric surgery (MBS) on key micronutrients in patients with obesity over 10 years. PATIENTS AND METHODS: A retrospective chart review was carried o...
INTRODUCTION: This study aimed to examine the impact of metabolic and bariatric surgery (MBS) on key micronutrients in patients with obesity over 10 years. PATIENTS AND METHODS: A retrospective chart review was carried out for individuals who had MBS from February 2013 to May 2022 at 11 centres. The micronutrient (iron, Vitamin B12, Vitamin D3 and calcium) levels were collected before surgery and up to 10 years afterwards. RESULTS: The data from 1675 individuals with a mean age of 43.09 ± 11.93 years were analysed. The study population comprised 34.81% of males and 65.19% of females. There was an increase in the serum iron levels over 1 year (P < 0.01), 3 years (P < 0.01), 5 years (P = 0.2175), 7 years (P < 0.01) and 10 years (P = 0.0998) after surgery. Similar results were observed for Vitamin B12 levels at 1 year (P < 0.01), 3 years (P < 0.01), 5 years (P = 0.3083), 7 years (P = 0.2817) and 10 years (P = 0.2645). Vitamin D3 levels increased at 1 year (P < 0.01), 3 years (P < 0.01), 5 years (P < 0.01), 7 years (P = 0.0069) and 10 years (P = 0.8179). However, calcium levels exhibited a downwards trend at 5 years (P = 0.0008) post-surgery. CONCLUSIONS: A high prevalence of micronutrient deficiency was observed amongst patients preoperatively, which improved following MBS.
Self-adhesive mesh versus tacker-fixed polypropylene in transabdominal preperitoneal inguinal hernia repair: An observational cohort analysis of recurrence rates.
Bencosme N, Trujillo A, Franco C … +4 more , Mera D, Santiago F, David G, Cotta G
J Minim Access Surg · 2026 Apr · PMID 41972878 · Publisher ↗
INTRODUCTION: Laparoscopic repair has become the preferred approach for inguinal hernia due to its lower post-operative morbidity and faster recovery. However, the choice of mesh fixation remains a topic of debate. Self-...
INTRODUCTION: Laparoscopic repair has become the preferred approach for inguinal hernia due to its lower post-operative morbidity and faster recovery. However, the choice of mesh fixation remains a topic of debate. Self-adhesive meshes were developed to eliminate the need for mechanical fixation, aiming to reduce post-operative pain, though their long-term outcomes compared to traditional tacker fixation are still under investigation. This study aimed to compare recurrence rates and post-operative outcomes between self-adhesive and tacker-fixed polypropylene meshes in transabdominal preperitoneal (TAPP) inguinal hernia repair. PATIENTS AND METHODS: An observational cohort study including 400 patients who underwent TAPP laparoscopic repair between 2018 and 2023 in hospitals across Rio de Janeiro, Brazil. Demographic variables, hernia laterality, mesh type, complications and recurrence were recorded. Fisher's exact test and linear regression were used. P ≤ 0.05 was considered significant. Follow-up was 3 months. RESULTS: The sample consisted predominantly of males (89.5%), with bilateral hernias being the most common presentation (51.25%). Self-adhesive mesh was used in 72.5% of cases, and polypropylene mesh with tacker fixation in 27.5%. The overall recurrence rate was 6%, with no significant difference between mesh types (P = 0.249). The global complication rate was 4.25%, mainly post-operative pain (3.0%) and seroma (0.75%), with no significant differences between groups. CONCLUSIONS: Self-adhesive and tacker-fixed polypropylene meshes demonstrated comparable recurrence and complication rates in TAPP repair. Self-adhesive meshes remain a safe alternative that eliminates the need for mechanical fixation, although longer follow-up studies are required to assess late recurrence and long-term outcomes.
The role of percutaneous transhepatic cholangioscopy lithotripsy in the treatment of hepatolithiasis.
Hu L, Lu G, Cheng Y … +1 more , Lai M
J Minim Access Surg · 2026 Apr · PMID 41972877 · Publisher ↗
INTRODUCTION: The objective of this meta-analysis was to analyse the role of percutaneous transhepatic cholangioscopy lithotripsy in the treatment of hepatolithiasis. PATIENTS AND METHODS: We searched for relevant studie...
INTRODUCTION: The objective of this meta-analysis was to analyse the role of percutaneous transhepatic cholangioscopy lithotripsy in the treatment of hepatolithiasis. PATIENTS AND METHODS: We searched for relevant studies in PubMed, EMBASE and Cochrane Library databases and analysed the complete stone clearance rate, complication rate, minor complication rate, severe complication rate, biliary haemorrhage rate and stone recurrence rate of the included literature. Finally, a meta-analysis was conducted on them using Stata software. RESULTS: Eventually, 17 studies were included, involving a total of 1962 patients with hepatolithiasis. The complete stone clearance rate, complication rate, minor complication rate, severe complication rate, biliary haemorrhage rate and recurrence rate of stones and/or cholangitis in the treatment of hepatolithiasis with percutaneous transhepatic cholangioscopy lithotripsy (PTCSL) were 85.4% (95% confidence interval [CI]: 78.5%-91.3%), 12.5% (95% CI: 7.8%-18.0%), 10.2% (95% CI: 4.2%-18.1%), 2.6% (95% CI: 0.8%-5.1%), 3% (95% CI: 1.7%-4.5%) and 31.4% (95% CI: 21.8%-41.8%), respectively. The results of the meta-analysis showed that PTCSL had a considerable complete stone clearance rate and a relatively low complication rate in the treatment of hepatolithiasis, but the recurrence rate of hepatolithiasis still needed attention. CONCLUSIONS: As a minimally invasive technique for the treatment of hepatolithiasis, PTCSL has been widely used in clinical practice and is one of the effective methods for the treatment of hepatolithiasis.
Initiating dissection to achieve the critical view of safety in minimally invasive cholecystectomy: A retrospective comparison of lower-end-first, Calot's triangle-first and salvage approaches.
Gupta AK
J Minim Access Surg · 2026 Apr · PMID 41972875 · Publisher ↗
INTRODUCTION: Laparoscopic cholecystectomy (LC) is the standard treatment for symptomatic gallstone disease. Achieving the critical view of safety (CVS) - clearing the hepatocystic triangle, freeing the gall bladder's lo...
INTRODUCTION: Laparoscopic cholecystectomy (LC) is the standard treatment for symptomatic gallstone disease. Achieving the critical view of safety (CVS) - clearing the hepatocystic triangle, freeing the gall bladder's lower third and identifying only the cystic duct and artery - is essential to prevent vasculobiliary injury. The guidelines advocate CVS but do not specify where to initiate dissection. We compared two dissection strategies. PATIENTS AND METHODS: We retrospectively analysed 350 consecutive laparoscopic cholecystectomies for acute cholecystitis (2020-2021 and 2024-2025) performed by two surgeons at community hospitals. In Method 1, n = 100, the lower third of the gall bladder was mobilised before dissecting Calot's triangle; in Method 2, n = 150, the triangle was dissected first and the lower gall bladder was then mobilised. Cases with severely inflamed or 'frozen' anatomy were treated with domedown or subtotal cholecystectomy (Method 3 salvage/bailout, n = 100). The outcomes included attainment of CVS, bile duct injury (BDI) and post-operative bile leak. RESULTS: CVS was documented in all Method 1 and Method 2 procedures, but not in the salvage group. No BDIs occurred. Post-operative bile leak rates were 2% for Methods 1 and 2 and 9% for Method 3; all salvage cases had intraoperative spillage and 3% required conversion to open surgery. Differences in leakage between the two planned techniques were not statistically significant. CONCLUSIONS: Both lower-end-first and Calot's triangle-first dissection strategies reliably achieve the critical view and allow the safe completion of LC. When inflammation prevents these approaches, domedown or subtotal cholecystectomy provides a safe bailout, with no BDI risk.
Comments on 'preliminary comparative outcomes of Versius robotic-assisted versus conventional laparoscopic cholecystectomy'.
Rizwan A, Qayyum A, Naz H
J Minim Access Surg · 2026 Apr · PMID 41972866 · Publisher ↗
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A novel technique of robotic excision of caesarean scar ectopic pregnancy with near-infrared guidance using the da Vinci Xi system.
Kattimani R, Sinha R, Rupa B … +2 more , Sakshi S, Anusha KR
J Minim Access Surg · 2026 Apr · PMID 41972864 · Publisher ↗
Surgical management of caesarean scar ectopic pregnancy (CSEP) can cause severe bleeding and bladder injury, especially when the vesicouterine plane is scarred with minimal residual myometrium. A 36-year-old multigravida...
Surgical management of caesarean scar ectopic pregnancy (CSEP) can cause severe bleeding and bladder injury, especially when the vesicouterine plane is scarred with minimal residual myometrium. A 36-year-old multigravida presented at 5 weeks 3 days period of gestation with vaginal bleeding. Beta-human chorionic gonadotropin (β-hCG) level was 23,190 mIU/mL. Imaging confirmed CSEP in the lower uterine segment with residual myometrial thickness of 1 mm. We performed a robotic-assisted excision of CSEP with Firefly technology for delineation of bladder margins, hence improving procedure safety and outcome. Following bladder mobilisation and hysterotomy, products of conception were excised and the uterine defect repaired. Estimated blood loss was 75 mL with no intraoperative complications and preserved bladder integrity. Post-operative recovery was uneventful, and β-hCG was negative by 3 months. Robotic excision with firefly guidance can enhance the identification of vesicouterine interface and facilitate safe bladder dissection.
Acute wrap migration after anti-reflux surgery: The devil is in the details.
Kalikar V, Patankar R, Supe A
J Minim Access Surg · 2026 Apr · PMID 41972853 · Publisher ↗
BACKGROUND: Laparoscopic anti-reflux surgery is a commonly performed surgery for gastro-oesophagal reflux disease and hiatus hernia. One of the life-threatening complications post fundoplication is acute migration of the...
BACKGROUND: Laparoscopic anti-reflux surgery is a commonly performed surgery for gastro-oesophagal reflux disease and hiatus hernia. One of the life-threatening complications post fundoplication is acute migration of the wrap, into the mediastinum thus leading to ischaemia and gangrene of the herniated stomach, the time of presentation being within 7 days from index surgery. We present a series of 10 patients who had acute trans-diaphragmatic migration of wrap (in three patients with wrap disruption, there was migration of the entire stomach). PATIENTS AND METHODS: The study design is a retrospective study design. All 10 patients underwent laparoscopic management of their acute migration within 24 h of presentation following an urgent computed tomography scan to define the anatomy, the type of migration and vascularity of the stomach, as well as to rule out any concomitant collapse of the affected lung. The median age was 41 (38-70 years), and 7 were females and 3 males. All patients underwent reduction of herniated wrap, crural repair and seven patients underwent a posterior partial fundoplication, two patients underwent gastropexy and one patient had proximal gastric resection in view of non-viability of the proximal stomach in view of delayed diagnosis. RESULTS: Postoperatively, all patients (except one patient) were started on liquids followed by soft diet for a week. At a follow-up of 2 years, only two patients are on intermittent proton pump inhibitor use, the rest all others are free of any symptoms with no evidence of recurrence of hiatal hernias on follow-up imaging. CONCLUSION: Acute transdiaphragmatic wrap migration (<7 days from index surgery) requires a high index of suspicion with an emergent laparoscopic repair, to avoid life-threatening complications. The principles of surgery are to recognise the cause, restore the anatomy back to normal. A secure crural closure and a partial wrap with anchoring the wrap to the crura is equally important to avoid wrap migrations with gastropexy as a bailout choice. The key is to avoid postoperative retching and vomiting by suitable anaesthesia and antiemetics postoperatively. The use of indocyanine green dye can be helpful whenever vascularity is a concern. And lastly, tailored use of mesh along with PoRSHA can be used for reinforcement of crural closure when the crura are thin or when the inter-hiatal distance is >5 cms to avoid recurrences.
Resection of pulmonary aspergilloma using uniportal video-assisted thoracoscopic surgery: Evaluation of prognostic factors in a single-centre experience.
Waguaf S, Boubia S
J Minim Access Surg · 2026 Apr · PMID 41972851 · Publisher ↗
INTRODUCTION: Uniportal video-assisted thoracoscopic surgery (U-VATS) is emerging as a promising approach for the treatment of pulmonary aspergilloma (PA). Nevertheless, it remains technically challenging and is associat...
INTRODUCTION: Uniportal video-assisted thoracoscopic surgery (U-VATS) is emerging as a promising approach for the treatment of pulmonary aspergilloma (PA). Nevertheless, it remains technically challenging and is associated with significant morbidity and a considerable risk of conversion to thoracotomy. This study aimed to evaluate the feasibility and safety of U-VATS in patients with PA and to identify prognostic factors that influence postoperative morbidity and conversion rates. PATIENTS AND METHODS: We retrospectively reviewed the medical records of 51 patients who underwent U-VATS resection for PA between 2017 and 2020. Patients were classified as having either simple or complex aspergilloma. Clinical, radiological and surgical variables were analysed to determine their impact on outcomes. RESULTS: Of the 51 patients, 31 were male, with a median age of 43.5 years. simple PA was present in 9 patients and complex PA (CPA) in 42. Tuberculosis was the most common underlying condition and was significantly associated with complex aspergilloma (P = 0.015). Haemoptysis was the most frequent symptom, and the upper lobes were the predominant sites of involvement. Lobectomy was performed in 74.5% of cases, and 29.4% required conversion to thoracotomy. Post-operative complications occurred in 19.6% of patients, predominantly in those with CPA. Multivariable analysis identified haemoptysis, tuberculosis, CPA, lobectomy and complete pleural adhesions as significant predictors of postoperative morbidity. Haemoptysis, tuberculosis, upper lobe location, complex CPA and pleural adhesions were independent predictors of conversion. CONCLUSION: Haemoptysis, tuberculosis, CPA and complete pleural adhesions are key prognostic factors associated with increased morbidity and higher rates of conversion in patients undergoing U-VATS for PA.
A novel minimally invasive approach for hepatic hydatid cyst - Percutaneous aspiration injection reaspiration using 5-mm laparoscopic trocar.
Ahire P, Gada PB, Gutte A … +1 more , Manoj A
J Minim Access Surg · 2026 Apr · PMID 41972850 · Publisher ↗
Hepatic hydatid cysts are traditionally managed with antihelminthic coverage and definitively by surgical methods or Percutaneous Aspiration Injection Reaspiration (PAIR). Surgical methods of management include laparosco...
Hepatic hydatid cysts are traditionally managed with antihelminthic coverage and definitively by surgical methods or Percutaneous Aspiration Injection Reaspiration (PAIR). Surgical methods of management include laparoscopic or open techniques like excision or pericystectomy, marsupialisation, omentoplasty or partial hepatectomy. In thick walled, intraparenchymal and posteriorly situated hydatid cysts which are not amenable to conventional PAIR or laparoscopic techniques, our modification of PAIR can be useful. Under USG guidance, 5mm laparoscopic trocars are inserted into the cyst and aspiration, injection of scolicidal agent and reaspiration is done using a laparoscopic suction cannula. Drain is left in situ to ensure complete drainage. This modification of PAIR is suitable for a subset of patients who can benefit from this minimally invasive method. This prevents them from undergoing open surgery which is associated with a lot of morbidity.
Comparison of short-term outcomes between totally minimally invasive and minimally invasive-assisted Billroth-II gastrectomy for distal gastric cancer: A systematic review and meta-analysis.
Jiang Y, Guo Y, Dong Y … +3 more , Deng M, Li G, Fang Y
J Minim Access Surg · 2026 Apr · PMID 41972848 · Publisher ↗
INTRODUCTION: Minimally invasive Billroth-II distal gastrectomy is one of the most frequently recommended curative resections for patients with lower- and middle-third gastric cancer. However, the efficiency and benefits...
INTRODUCTION: Minimally invasive Billroth-II distal gastrectomy is one of the most frequently recommended curative resections for patients with lower- and middle-third gastric cancer. However, the efficiency and benefits of totally minimally invasive and minimally invasive-assisted distal gastrectomy with Billroth-II anastomosis are still controversial. This meta-analysis was conducted to compare the short-term outcomes of the two surgical procedures. PATIENTS AND METHODS: We conducted an internet search of the PubMed, Web of Science, Cochrane Medline and Embase databases up to May 2023. The parameters related to surgical outcomes, post-operative recovery, post-operative complications and surgical stress response were subjected to subsequent statistical calculations. Review Manager 5.3 software was used to perform the meta-analysis. RESULTS: A total of seven retrospective studies were included in this meta-analysis. No significant differences were observed in the operative time, number of anastomoses, number of retrieved lymph nodes or surgical stress response indices of white blood cells and C-reactive protein. We detected a lower estimated blood loss, a shorter incision, an earlier time to first flatus and a shorter post-operative hospital stay in patients who underwent totally minimally invasive Billroth-II distal gastrectomy. CONCLUSION: Compared with minimally invasive-assisted Billroth-II distal gastrectomy, totally minimally invasive Billroth-II distal gastrectomy is a feasible and safe radical operation with acceptable surgical outcomes that may offer shorter post-operative recovery times.
The evolving landscape of metabolic surgery: An evidence-based review.
Dholakia V, Das S, Nundy S
J Minim Access Surg · 2026 Apr · PMID 41972326 · Publisher ↗
INTRODUCTION: Obesity is increasingly recognised as a complex, adiposity-based chronic endocrine disease rather than a simple metric of excess weight. In India, the prevalence of the 'thin-fat' phenotype - characterised...
INTRODUCTION: Obesity is increasingly recognised as a complex, adiposity-based chronic endocrine disease rather than a simple metric of excess weight. In India, the prevalence of the 'thin-fat' phenotype - characterised by high visceral adiposity and early-onset metabolic syndrome at lower body mass index thresholds - necessitates aggressive, regionally tailored interventions. While novel pharmacotherapies have expanded treatment options, metabolic and bariatric surgery (MBS) remains the most durable intervention for severe obesity. PATIENTS AND METHODS: Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search of PubMed, Scopus and Google Scholar (2000-2025) was conducted. We prioritised Level I and II evidence, including randomised controlled trials with ≥5 years of follow-up, meta-analyses and global registry reports. A total of 81 studies were included to critically evaluate comparative surgical effectiveness, metabolic outcomes and complication profiles. RESULTS: Long-term data (e.g. SLEEVEPASS and STAMPEDE) confirm MBS achieves superior comorbidity remission compared to intensive medical therapy. Laparoscopic Roux-en-Y gastric bypass provides superior long-term remission of dyslipidaemia, hypertension and gastro-oesophageal reflux disease compared to laparoscopic sleeve gastrectomy (SG), though it carries higher mechanical and nutritional risks. To balance profound metabolic correction with the severe nutritional sequelae of classic malabsorptive procedures (biliopancreatic diversion with duodenal switch), emerging single-anastomosis variants (one-anastomosis gastric bypass and single anastomosis duodenal-ileal bypass with SG) demonstrate promising efficacy and improved gastrointestinal profiles. CONCLUSION: The MBS landscape is undergoing a paradigm shift. Optimal obesity management is evolving beyond rigid anatomical algorithms towards precision medicine, driven by the synergistic integration of dual glucagon-like peptide-1/glucose-dependent insulinotropic polypeptide receptor agonists, procedure personalisation based on metabolic phenotyping and robust lifelong surveillance registries tailored to regional demographics.
Laparoscopic Ladd's procedure for triple obstruction in an adult: Ladd's band duodenal obstruction, chronic midgut volvulus through an internal hernia and a novel intestinal malrotation variant with concomitant post-superior mesenteric artery reverse rotation.
Varama A, Srisan N, Vejchapipat P … +2 more , Manasnayakorn S, Vacharathit V
J Minim Access Surg · 2026 Apr · PMID 41969141 · Publisher ↗
Intestinal malrotation is a rare congenital anomaly that typically presents during infancy; adult presentations are uncommon and often manifest with vague, chronic gastrointestinal (GI) symptoms. We report a unique case...
Intestinal malrotation is a rare congenital anomaly that typically presents during infancy; adult presentations are uncommon and often manifest with vague, chronic gastrointestinal (GI) symptoms. We report a unique case of a woman in her 30s who presented with acute bilious vomiting, severe malnutrition and a 2-year history of post-prandial vomiting and weight loss. Imaging revealed high-grade distal duodenal obstruction, mesenteric swirling and an absent right colon. Laparoscopic exploration demonstrated Ladd's band duodenal obstruction, pre-superior mesenteric artery (SMA) malrotation or non-rotation with concomitant post-SMA reverse rotation and a separate bowel segment involved in a chronic midgut volvulus through an internal hernia defect - a combination not previously described. A laparoscopic Ladd's procedure with internal hernia reduction was carried out. Laparoscopic management of complex cases of intestinal malrotation is feasible. Clinicians should maintain a high index of suspicion for congenital anomalies in adults who present with duodenal obstruction or recurrent, unexplained GI symptoms.
Initial experience with laparoscopic associating liver partition and portal vein ligation for staged hepatectomy for various liver malignancies.
Imperial RES, Wang Z, Guo Y … +4 more , Chua DW, Tan HL, Lim KI, Goh BKP
J Minim Access Surg · 2026 Apr · PMID 41968925 · Publisher ↗
INTRODUCTION: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) enables curative resection in patients with insufficient future liver remnant (FLR), compromised liver function and elevat...
INTRODUCTION: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) enables curative resection in patients with insufficient future liver remnant (FLR), compromised liver function and elevated ICG retention. While minimally invasive techniques have been explored, the laparoscopic approach remains controversial. This study aims to evaluate the feasibility and short-term outcomes of laparoscopic ALPPS. PATIENTS AND METHODS: We retrospectively analysed six consecutive patients who underwent laparoscopic ALPPS by a single surgeon from 2022 to 2025 at Singapore General Hospital. Indications included radiologically or histologically confirmed liver malignancy with indocyanine green retention at 15 min (ICG-R15) >15% or inadequate standardised FLR (sFLR). Demographics, operative details and peri-operative outcomes were evaluated. ICG-R15 and sFLR were assessed before both stages, and median outcomes were reported. RESULTS: Six patients (four males and two females, median age 67 [58-71]) underwent ALPPS for hepatocellular carcinoma ( n = 4), colorectal liver metastasis ( n = 1) and Klatskin tumour ( n = 1). Five patients with a median tumor size of 7.5 cm (2.9-17.5) completed both stages laparoscopically - four right hepatectomy, and one extended right hepatectomy and bile tumour thrombectomy. One patient with a Klatskin tumour had failed portal vein embolisation and underwent salvage ALPPS. Stage 1 portal vein ligation was performed laparoscopically, followed by open caudate and right hepatectomy during Stage 2. All patients demonstrated sufficient hypertrophy (median sFLR 36.33%-52.53%) and ICG clearance from 16.3% to 17.1%. Median interval between the stages was 8.5 days. There was no 90-day mortality, and one patient (16.7%) had major morbidity (Clavien-Dindo grade >2). All patients achieved R0 resection. CONCLUSION: Our initial experience demonstrates that laparoscopic ALPPS is a feasible and effective strategy for patients with various liver malignancies.
Clinical outcomes of video-assisted thoracoscopic surgery, talc pleurodesis and indwelling catheterisation for malignant pleural effusion: A retrospective comparative study.
Dubus T, Ozturk EB, Cangel G … +1 more , Ceyran O
J Minim Access Surg · 2026 Apr · PMID 41968919 · Publisher ↗
INTRODUCTION: Malignant pleural effusion (MPE) is a common complication of advanced cancer that impairs quality of life. The present study compared the outcomes of three procedures: tube thoracostomy with talc pleurodesi...
INTRODUCTION: Malignant pleural effusion (MPE) is a common complication of advanced cancer that impairs quality of life. The present study compared the outcomes of three procedures: tube thoracostomy with talc pleurodesis, video-assisted thoracoscopic surgery (VATS) with talc and indwelling pleural catheter (IPC). PATIENTS AND METHODS: In this retrospective study, 76 MPE patients were assigned to tube + talc ( n = 29), VATS + talc ( n = 27) or IPC ( n = 20). Outcomes included pleurodesis success, complications, hospitalisation, 30-day reintervention, mortality and overall survival. Eastern Cooperative Oncology Group (ECOG) performance score and serum albumin were analysed as prognostic factors using Cox regression. RESULTS: IPC had the shortest hospital stay (3 days) and the highest 30-day reintervention rate (20%, P = 0.030). Pleurodesis success was 84.6% in both the tube and VATS groups. Median survival differed among groups (66 days for IPC, 95 days for tube and 118 days for VATS; P = 0.041); however, procedure type was not an independent predictor of survival, and these differences should be interpreted cautiously. ECOG ≥2 (hazard ratio [HR]: 1.74, P = 0.020) and albumin <3.0 g/dL (HR: 1.60, P = 0.040) were identified as independent predictors of poorer survival. CONCLUSION: Treatment selection should primarily be based on functional and nutritional status rather than expected survival benefit. ECOG performance status and serum albumin levels should play a central role in guiding individualised management strategies.
Our short-term results in patients who underwent sphincter-saving trans-sphincteric surgery by excising the invasive proximal sphincteric segment due to advanced lower rectal cancer with external anal sphincteric invasion.
Yücesoy AN, Pehlivan T, Yavuz E … +3 more , Yiğitbaş H, Gülçiçek OB, Öztaş B
J Minim Access Surg · 2026 Apr · PMID 41968917 · Publisher ↗
INTRODUCTION: One of the most essential contraindications of the sphincter-saving surgery in lower rectal cancer cases operated with the intersphincteric dissection technique, which is the most commonly used sphincter-sa...
INTRODUCTION: One of the most essential contraindications of the sphincter-saving surgery in lower rectal cancer cases operated with the intersphincteric dissection technique, which is the most commonly used sphincter-saving surgical method, is an external anal sphincteric invasion. This article includes the short-term results of the lower rectal cancer cases with external anal sphincteric invasion who underwent proximal segmental sphincteric excision while performing the sphincter-sparing rectal resection in the trans-sphincteric plane. PATIENTS AND METHODS: Sphincter-sparing surgery by excising the invasive proximal sphincteric segment in the trans-sphincteric plane was performed in 8 male and 3 female patients with advanced lower rectal adenocarcinoma, whose external anal sphincter invasion was seen in the pre-operative magnetic resonance imaging results after neoadjuvant chemoradiotherapy. RESULTS: In the post-operative periods of the patients, perineal fistula developed at the anterior perineal incision line in four patients and anastomotic stenosis developed in three patients. Anastomotic stenosis developed patients were the patients who were already being followed up due to perineal fistula. No evidence of external sphincteric invasion was found in the post-operative histopathological evaluation of two patients. Post-operative anal manometric sphincteric pressure measurements revealed partial decreases in resting and maximal squeeze anal pressures. It was observed that the patients whose ileostomy was closed had adequate continence. CONCLUSION: Despite high complication rates, it is possible to perform sphincter-preserving surgery with excision of the invasive proximal segment with trans-sphincteric surgery in locally advanced rectal cancer. Trans-sphincteric rectal resection techniques should be considered as alternative sphincter-saving surgical procedures in lower rectal cancer cases with external sphincteric invasion by considering that the invasive proximal segment can be resected.
Laparoscopic segmental colectomy for a rare case of extraluminal amoeboma masquerading as stromal tumour of the colon.
Shenoy KG, Thomas M, Jeur AS … +2 more , Ramesh BS, Jan N
J Minim Access Surg · 2026 Apr · PMID 41954450 · Full text
Entamoeba histolytica is known to cause infectious colitis that presents with diarrhoea or dysentery. Extra intestinal manifestations result in amoebic abscesses to involve organs such as the liver, lungs or brain. Very...
Entamoeba histolytica is known to cause infectious colitis that presents with diarrhoea or dysentery. Extra intestinal manifestations result in amoebic abscesses to involve organs such as the liver, lungs or brain. Very rarely, it may present like a pseudotumour due to a mass formation if the primary infection was untreated or inadequately treated. We, herein, report a rare case of extraluminal amoebic pseudotumour in a young female with a diagnosis of a gastrointestinal stromal tumour of hepatic flexure of the transverse colon on pre-operative imaging and per operative findings, but final histopathological examination of the resected specimen proved it to be an amoeboma. The rarity of this case was the extraluminal presentation, unlike other reported cases of intraluminal pseudotumour. After an extensive literature search, we believe that this is the first reported case of extraluminal pseudotumour of the transverse colon managed by laparoscopic segmental colectomy.
Long-term outcomes of endoscopic pilonidal sinus treatment: A single tertiary centre experience.
Singla L, Kalaiselvan R, Samad A … +2 more , Chadwick M, Rajasundram R
J Minim Access Surg · 2026 Apr · PMID 41954449 · Full text
INTRODUCTION: Pilonidal sinus disease commonly affects young adults and presents a clinical challenge due to high recurrence rates. This study aims to evaluate long-term outcomes following Endoscopic Pilonidal Sinus Trea...
INTRODUCTION: Pilonidal sinus disease commonly affects young adults and presents a clinical challenge due to high recurrence rates. This study aims to evaluate long-term outcomes following Endoscopic Pilonidal Sinus Treatment (EPSIT) performed at a UK district general hospital. PATIENTS AND METHODS: We conducted a retrospective observational study of all adult patients who underwent EPSIT by a single colorectal surgeon between January 2015 and May 2022. Patients with acute abscesses or previous extensive surgery were excluded. Outcomes included healing rate, recurrence and need for further intervention, assessed through structured clinical follow-up and telephone review until March 2024. RESULTS: Eighty-seven patients (62 men, median age: 31 years) underwent EPSIT. Twenty-one procedures were performed under local anaesthesia. The median follow-up was 62 months (range: 24-108). Short-term healing was achieved in 70 patients (84%), with 13 requiring additional intervention (repeat EPSIT or flap). At long-term follow-up, 52 patients were fully evaluated. Of these, 41 (79%) achieved durable healing after a single EPSIT. Six had recurrence and were managed conservatively, and four patients await surgery. Twenty-five patients were lost to follow-up. If assuming the best-case scenario (all healed), the overall long-term success rate would be 76%; worst-case scenario (none healed) gives 47%. Healing was confirmed clinically or through patient self-report of complete resolution of discharge and symptoms. CONCLUSION: EPSIT is a minimally invasive approach with promising long-term results when carefully selected patients are treated by trained surgeons. However, high attrition rates limit interpretation. Larger comparative studies with standardised outcome definitions and inclusion of patient-reported outcomes (pain and cosmesis) are required.
The effectiveness of the Braun anastomosis in the management of severe hypoalbuminaemia occurring after a single anastomosis sleeve ileal bypass.
Toprak SS, Gültekin Y, Pekin C
J Minim Access Surg · 2026 Apr · PMID 41954448 · Full text
INTRODUCTION: The global escalation of morbid obesity has expanded the scope of bariatric and metabolic surgery in addressing obesity and its associated comorbidities. This pilot study retrospectively evaluates the effic...
INTRODUCTION: The global escalation of morbid obesity has expanded the scope of bariatric and metabolic surgery in addressing obesity and its associated comorbidities. This pilot study retrospectively evaluates the efficacy of Braun anastomosis in the management of nausea, vomiting and hypoalbuminaemia following single anastomosis sleeve ileal (SASI) bypass surgery. PATIENTS AND METHODS: Nineteen patients who underwent SASI bypass for obesity and Type 2 diabetes mellitus between June 2020 and June 2023 and subsequently developed nausea, vomiting and hypoalbuminaemia were included. Braun anastomosis was performed as a revision procedure. Pre-operative and post-operative assessments at 1, 6 and 12 months included serum albumin, haemoglobin A1c and body mass index (BMI). RESULTS: Pre-operative mean serum albumin levels of 1.86 ± 0.24 g/dL increased significantly to 3.38 ± 0.15 g/dL by the 6th post-operative month (P < 0.001). BMI decreased from a pre-operative mean of 32.58 ± 2.26 kg/m2 to 27.60 ± 1.53 kg/m2 at 6 months postoperatively (P < 0.001). Haemoglobin A1c showed a non-significant reduction from 6.40% ±0.60% preoperatively to 6.20% ±0.37% at 6 months postoperatively (P = 0.250). Bile reflux, present preoperatively, resolved by the 6th post-operative month. A marked reduction in nausea and vomiting was also noted following the revision surgery. CONCLUSIONS: Braun anastomosis was effective in managing the complications following SASI bypass, leading to significant improvements in serum albumin and BMI. Further studies are required to assess the long-term safety of SASI and the role of Braun anastomosis in the management of post-SASI complications. These results suggest that Braun anastomosis may play a valuable role in optimising the outcomes following SASI bypass.
Minimally invasive adrenalectomy for the treatment of large pheochromocytoma: A single-centre experience.
Çarkıt S, Öz B, Karaağaç M … +3 more , Gök M, Akcan A, Öztürk A
J Minim Access Surg · 2026 Apr · PMID 41954447 · Full text
INTRODUCTION: Pheochromocytoma (PHEO) arises from the chromophil cells of the adrenal medulla. Surgical resection is the primary treatment for PHEO. Our work aimed to investigate the efficacy and safety of minimally inva...
INTRODUCTION: Pheochromocytoma (PHEO) arises from the chromophil cells of the adrenal medulla. Surgical resection is the primary treatment for PHEO. Our work aimed to investigate the efficacy and safety of minimally invasive surgery in patients with large PHEO. PATIENTS AND METHODS: This study included patients who were referred to our centre, General Surgery Outpatient Clinic, between January 2007 and December 2023, who were interviewed by a multidisciplinary endocrine board, who were diagnosed with PHEO by clinical and laboratory examination and who decided to undergo unilateral laparoscopic adrenalectomy. RESULTS: A total of 275 patients had laparoscopic unilateral adrenalectomy during the research period. A total of 75 patients were operated on for PHEO. The PHEO group with a tumour size <6 cm consists of 46 patients, while the PHEO group with a tumour size >6 cm consists of 29 patients. The groups showed similar complications, conversion rates and hospital stays. We used multiple regression analysis to identify the independent predictors of prolonged operation time. The tumour size 6-8 cm (odds ratio [OR], 3.214; 95% confidence interval [CI], 1.240-10.819; P < 0.021) and the tumour size ≥8 cm (OR, 6.343; 95% CI, 1.175-34.237; P < 0.031) were the significant predictors of prolonged operation time. CONCLUSION: Minimally invasive surgery can be considered the treatment of choice for <6 cm and ≥6 cm PHEO. Tumour size ≥8 cm and tumour size ≥6-8 cm for PHEO are predictive risk factors for prolonged operative time in LA.
Minimising dissection and securing mesh in giant inguinoscrotal hernia repair: A modified laparoscopic transabdominal pre-peritoneal technique.
Motiwala MA, Singh D, Pandey V … +3 more , Grover N, Ranjan P, Chumber S
J Minim Access Surg · 2026 Apr · PMID 41945561 · Publisher ↗
Giant inguinoscrotal hernias (EHS L3) present technical challenges during laparoscopic repair, including difficulty in complete sac dissection, increased risk of seroma formation, injury to cord structures and potential...
Giant inguinoscrotal hernias (EHS L3) present technical challenges during laparoscopic repair, including difficulty in complete sac dissection, increased risk of seroma formation, injury to cord structures and potential mesh migration in markedly dilated deep inguinal rings (EHS L3). We present a retrospective cohort of seven patients with primary indirect giant inguinoscrotal hernias operated between January and July 2024 using a modified transabdominal pre-peritoneal (TAPP) technique involving dissection of the hernia sac only up to the deep inguinal ring with abandonment of the distal sac, combined with intracorporeal deep ring closure before mesh placement. This aims to minimise dissection-related morbidity and secure mesh position, in line with the Pascal's law principles. In seven patients with primary indirect giant inguinoscrotal hernias (mean deep ring diameter 4.0 cm and range 3.5-5 cm), all underwent TAPP repair with this modification. The mean follow-up was 15 months, during which no recurrences, clinically significant seromas or cord-related complications were observed. This simple, reproducible technique may enhance the outcomes in large L3 hernias by reducing dead space and optimising mesh stability.
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