Journal Of Minimal Access Surgery[JOURNAL]
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200 papers
Bowel dysfunction after minimally invasive sphincter-preserving surgery for rectal cancer: A prospective study of prevalence, associated factors and quality of life.
Senthamizhselvan K, Mamidala RC, Mohan P … +1 more , Kalayarasan R
J Minim Access Surg · 2026 Mar · PMID 41821367 · Publisher ↗
INTRODUCTION: In rectal cancer patients, bowel dysfunction occurs despite undergoing minimally invasive sphincter-preserving surgery (MI-SPS). This study aimed to find the prevalence and factors associated with bowel dys...
INTRODUCTION: In rectal cancer patients, bowel dysfunction occurs despite undergoing minimally invasive sphincter-preserving surgery (MI-SPS). This study aimed to find the prevalence and factors associated with bowel dysfunction and quality of life (QoL) after MI-SPS for rectal cancer. PATIENTS AND METHODS: All rectal cancer patients who had robotic or laparoscopic sphincter-preserving surgery, subsequently underwent stoma closure and attended follow-up clinics from June 2022 to December 2024 were enrolled. Their current symptoms and demographic details were collected. They were subjected to anorectal manometry and a colonic transit study. Bowel dysfunction was assessed using a low anterior resection syndrome (LARS) score. The Memorial Sloan Kettering Bowel Function Instrument (MSK-BFI) questionnaire was used to assess QoL. RESULTS: A total of 73 patients were included. The major and minor LARS occurred in 49 (67.1%) and 18 (24.7%) patients, respectively. The following perioperative factors were significantly associated with the occurrence of bowel dysfunction, namely neoadjuvant chemoradiotherapy (NACTRT) (P = 0.023), type of surgery (P = 0.001), type of resection (P = 0.007), level of anastomosis (P = 0.001), the technique of anastomosis (P = 0.003), diverting stoma (P = 0.016), anastomotic complications (P = 0.009), the distance of tumour from the anal verge (P = 0.023) and the height of anastomosis from the anal verge (P = 0.023). There was no significant association between the colonic transit time and LARS (P = 0.9), whereas a higher LARS score was significantly associated with lower MSK-BFI scores (r = -0.82, P < 0.001). CONCLUSION: Bowel dysfunction after MI-SPS is strongly influenced by NACTRT, anastomotic level and perioperative factors. Higher LARS severity significantly impairs QoL.
Left-sided gall bladder: From surprise to safe exit.
Srikanth JK, Kalichetty RE, Dhumane P … +1 more , Cota A
J Minim Access Surg · 2026 Mar · PMID 41821354 · Publisher ↗
Left-sided gall bladder (LSGB) is a rare anatomical variant that increases the risk of bile duct injury, particularly when combined with other gall bladder pathology. A 57-year-old male with a several-year history of int...
Left-sided gall bladder (LSGB) is a rare anatomical variant that increases the risk of bile duct injury, particularly when combined with other gall bladder pathology. A 57-year-old male with a several-year history of intermittent post-prandial epigastric pain had hepatic steatosis and gall bladder polyps (largest 9 mm) on ultrasound, and hepatobiliary scintigraphy showed a reduced gall bladder ejection fraction consistent with biliary dyskinesia. Elective laparoscopic cholecystectomy was performed; at laparoscopy, the gall bladder was unexpectedly located to the left of the falciform ligament, confirming true LSGB. Ports were placed slightly lower than usual, and an epigastric port was alternated across the falciform ligament. Intraoperative ultrasound delineated a short cystic duct entering the common hepatic duct, and the critical view of safety was obtained. The cystic duct and artery were clipped close to the gall bladder, which was removed without bile spillage; recovery was uneventful and histology showed chronic cholecystitis without dysplasia. True LSGB with polyps and biliary dyskinesia can be managed safely by laparoscopy when surgeons adhere to the critical view of safety and use adjunctive imaging.
Comparison of single-incision totally extraperitoneal repair of inguinal hernia and conventional multi-port totally extraperitoneal repair: A retrospective study.
Kitano Y, Yoshida J, Terasaki K … +2 more , Kurata T, Watanabe K
J Minim Access Surg · 2026 Mar · PMID 41821309 · Publisher ↗
INTRODUCTION: Mesh-based repair is the standard treatment of inguinal hernias. Transabdominal preperitoneal repair and totally extraperitoneal (TEP) repair are the established laparoendoscopic techniques. Although TEP av...
INTRODUCTION: Mesh-based repair is the standard treatment of inguinal hernias. Transabdominal preperitoneal repair and totally extraperitoneal (TEP) repair are the established laparoendoscopic techniques. Although TEP avoids intra-abdominal access, technical difficulty limits its adoption. Single-incision laparoscopic surgery (SILS) offers cosmetic and potential clinical advantages. However, evidence comparing SILS-TEP with conventional three-port TEP remains limited. This study aimed to evaluate the feasibility, safety and clinical outcomes of SILS-TEP compared with those of three-port TEP for inguinal hernia repair. PATIENTS AND METHODS: We retrospectively reviewed adult patients who underwent TEP hernia repair at our institute between April 2022 and June 2025. Patients were divided into SILS-TEP and three-port TEP groups. Demographics, hernia classification, operative details, pain, complications and recovery outcomes were analysed. Acute pain was assessed by post-operative analgesic use and chronic pain was defined as pain persisting for more than 3 months. Statistical significance was set at P < 0.05. RESULTS: A total of 102 patients (62 SILS-TEP, 40 3-port TEP) were evaluated. Patient characteristics and hernia types were similar between the groups. The operative time was significantly shorter in the SILS-TEP group than in the three-port TEP group (57.4 min vs. 70.3 min, P = 0.007). No differences were observed in analgesic use, complications or hospitalisation. No conversions, chronic pain or hernia recurrence were reported in either group. CONCLUSION: SILS-TEP was safely performed without compromising surgical quality. It demonstrated a shorter operative time and equivalent clinical outcomes compared to three-port TEP. SILS-TEP may be a feasible and cosmetically superior alternative for inguinal hernia repair.
Laparoscopic versus ultrasound-guided subcostal transversus abdominis plane block in sleeve gastrectomy: A randomised comparison of analgesic effectiveness and procedural feasibility.
Seyit H, Dolgun İ, Şener FN … +2 more , Mollaoglu MC, Alis H
J Minim Access Surg · 2026 Mar · PMID 41821301 · Publisher ↗
INTRODUCTION: Ultrasound-guided subcostal transversus abdominis plane (USG-subcostal TAP) block is commonly used for post-operative analgesia in laparoscopic sleeve gastrectomy (LSG). Laparoscopic-guided subcostal TAP (L...
INTRODUCTION: Ultrasound-guided subcostal transversus abdominis plane (USG-subcostal TAP) block is commonly used for post-operative analgesia in laparoscopic sleeve gastrectomy (LSG). Laparoscopic-guided subcostal TAP (L-subcostal TAP) offers a practical alternative, especially in resource-limited settings. However, comparative evidence in the LSG population is limited. PATIENTS AND METHODS: This prospective, randomised trial included 50 patients undergoing LSG, assigned to either L-subcostal TAP or USG-subcostal TAP groups. Pain scores at rest and during movement (Numeric Rating Scale), rescue analgesic requirements, antiemetic use and patient satisfaction (Quality Improvement in Post-operative Pain Survey) were assessed at post-operative 30 min, 1, 2, 6, 12 and 24 h. RESULTS: Pain scores were similar across the groups during the first 12 h. At 24 h, USG-subcostal TAP was associated with significantly lower pain scores at rest and during movement (P < 0.05). Additional analgesics were required in four patients in the L-subcostal TAP group, while none were needed in the USG group (P = 0.037). Satisfaction levels were high in both the groups, and no complications occurred. A negative correlation was found between satisfaction and the need for rescue analgesia. CONCLUSION: Both USG-subcostal and L-subcostal TAP blocks provide effective early post-operative analgesia in LSG. While USG-subcostal TAP had a longer duration of effect, L-subcostal TAP offers practical advantages including ease of use, shorter application time and no requirement for specialised equipment. In settings with limited access to ultrasound or trained personnel, L-subcostal TAP can be considered a safe and effective alternative within multimodal analgesia strategies.
Laparoscopic revisional surgery following failure of primary laparoscopic Heller's myotomy for achalasia cardia: A single-centre series.
Rege SA, Sane D, Salvi V
J Minim Access Surg · 2026 Mar · PMID 41821296 · Publisher ↗
INTRODUCTION: Redyspahgia following laparoscopic has been documented with many causative factors. Peroral endoscopic myotomy, botulinum injections and dilatations have been suggested; however, relaparoscopic Hellers has...
INTRODUCTION: Redyspahgia following laparoscopic has been documented with many causative factors. Peroral endoscopic myotomy, botulinum injections and dilatations have been suggested; however, relaparoscopic Hellers has a role to play, not only to correct or extend the myotomy but allows take down of the improper fundal wrap if leading to dysphagia. We studied our series of 18 patients who had to be reoperated for lap hellers cardiomyotomy (LHCM). PATIENTS AND METHODS: The retrospective study was done over 15 years of patients presenting with dysphagia operated in the past for LHCM. A total of 18 patients were studied. Eckardt score following the primary surgery >3 were included and thoroughly investigated. The majority had dysphagia as complaints with primary surgery as LHCM. RESULT: 12 out of 18 patients had incomplete initial myotomy, 10 had incomplete extension on cardia, with one requiring epiphrenic diverticulectomy. All other than one were subjected for ReHellers Cardiomyotomy, which was done at 9 o'clock. The mean Eckardt scores were significantly reduced from the values of 6.38 ± 0.74 preoperatively to 2.0 ± 1.67 postoperatively (P < 0.01). Symptomatic improvement was seen in 88.8% patients with one patient had Eckardt score >6 and denoted as treatment failure. None had any symptoms of reflux. CONCLUSION: Laparoscopic redo surgery, although challenging provides excellent outcomes, using standardised steps in experienced hands, along with permitting to tackle multiple contributory causes of dysphagia and hence is safe, feasible and effective treatment option following the failure of index surgical myotomy in surgically fit patients.
Endoscopic thyroidectomy - Is it safe and reliable? - Experience and results at a tertiary care centre in India.
Rege SA, Vasa D, Shah S … +1 more , Salvi V
J Minim Access Surg · 2026 Mar · PMID 41821261 · Publisher ↗
INTRODUCTION: Minimal access thyroidectomy can be performed using several approaches, including transaxillary, breast-axilla and transoral endoscopic thyroidectomy (ET) vestibular approach (TOETVA). These techniques are...
INTRODUCTION: Minimal access thyroidectomy can be performed using several approaches, including transaxillary, breast-axilla and transoral endoscopic thyroidectomy (ET) vestibular approach (TOETVA). These techniques are designed to minimise visible scarring and enhance cosmetic outcomes. Endoscopy allows magnification, enabling improved visualisation of the recurrent laryngeal nerve (RLN) and parathyroid glands. PATIENTS AND METHODS: This retrospective study evaluates the safety, reliability and complication rates of ET and proposes criteria for selecting the optimal approach. 266 patients who underwent minimal access thyroidectomy from May 2016 to May 2025 were included. Fine-needle aspiration cytology indicated benign aetiology (Bethesda Class 2) in 171 patients, indeterminate aetiology (Bethesda Class 3 and 4) in 71 patients and 24 patients were highly suspicious or proven malignancy (Bethesda Class 5 and 6). The primary indication was a solitary thyroid nodule (STN) in 204 patients, multinodular or bilobar lesions in 62 patients and malignancy in 24 patients. RESULTS: TOETVA was performed in 227 patients (nodule sizes 2-6 cm, 86% <4 cm), unilateral transaxillary thyroidectomy in 31 patients (STN, 4-6 cm) and bilateral transaxillary thyroidectomy in 8 patients multinodular goitre [MNG], 4-6 cm). TOETVA had the shortest mean operative time (67.3 min), lowest blood loss and shortest post-operative hospital stay (mean 2.31 days). RLN identification was above 96% in all approaches owing to better magnification. Transaxillary approach was associated with more RLN paresis than the TOETVA approach (4.85% vs. 16.13%; P = 0.002). Parathyroid identification without adjuncts was 91.6%, 80.64% and 62.5%, respectively, with three approaches. No patients had permanent hypocalcaemia with the TOETVA approach, which was significantly better in total thyroidectomy cases than the bilateral transaxillary approach. 16.13% and 25% of patients had seroma with unilateral and bilateral transaxillary approach, respectively, despite drain placement, which accounted for longer hospital stay. CONCLUSION: ET is safe and reliable with appropriate patient selection and has a skilled endoscopic surgeon. The approach selection depends on the size of the nodule and the surgeon comfort and preference. However based on our study results and experience we recommend the following:STN/MNG <4 cm: TOETVA STN 4-6 cm: Unilateral transaxillary approach MNG 4-6 cm: Bilateral transaxillary approach.
Comparison of laparoscopic-guided transversus abdominis plane block and port-site local anaesthetic infiltration for post-operative pain relief in transabdominal preperitoneal inguinal hernia repair: A randomised controlled trial.
Ather H, Gupta N, Agrawal H … +3 more , Agarwal N, Kumar A, Singh RAK
J Minim Access Surg · 2026 Feb · PMID 41744486 · Publisher ↗
INTRODUCTION: Inguinal hernia repair is a common surgical procedure, and effective post-operative pain management is crucial for patient recovery. This study compares the efficacy of laparoscopic-guided transversus abdom...
INTRODUCTION: Inguinal hernia repair is a common surgical procedure, and effective post-operative pain management is crucial for patient recovery. This study compares the efficacy of laparoscopic-guided transversus abdominis plane (LTAP) block and port-site local anaesthetic infiltration (PSLAI) in post-operative pain relief after laparoscopic transabdominal preperitoneal (TAPP) inguinal hernia repair. This study was done to evaluate the effectiveness of LTAP versus PSLAI in controlling post-operative pain, reducing hospital stay duration and accelerating recovery following TAPP inguinal hernia repair. PATIENTS AND METHODS: A randomised controlled trial was conducted with 60 patients, divided into two groups: LTAP and PSLAI. Pain levels were measured using the Visual Analogue Scale at 6, 12, 24 h and at discharge. The need for rescue analgesia, hospital stay duration and time to return to normal activities were also assessed. RESULTS: The LTAP group showed significantly lower pain scores at all post-operative time points compared to the PSLAI group (P values from 0.0017 to 0.0154). In addition, the LTAP group had a significantly shorter hospital stay (P = 0.0002) and quicker return to daily activities (P = 0.002). The need for rescue analgesia was significantly lower in the LTAP group (P = 0.043). CONCLUSION: LTAP block provided superior pain relief, reduced hospital stays and facilitated faster recovery compared to PSLAI. This technique should be considered for enhanced post-operative management following TAPP inguinal hernia repair.
From manual parametric to artificial intelligence-based automation: A systematic review of recent advances in endoscopic surgical skills evaluation.
Dhanakshirur RR, Singh R, Berry P … +4 more , Jain H, Suri A, Kalra PK, Arora C
J Minim Access Surg · 2026 Feb · PMID 41744479 · Publisher ↗
Evaluating surgical skills is critical to surgical training. Numerous methods and scoring scales have recently emerged to assess skills. This study systematically reviews techniques used for evaluating endoscopic surgica...
Evaluating surgical skills is critical to surgical training. Numerous methods and scoring scales have recently emerged to assess skills. This study systematically reviews techniques used for evaluating endoscopic surgical skills. An online search was conducted, and all the surgical skills evaluation systems pertaining to endoscopic surgeries published between 2015 and 2024 were reviewed. Based on the screening, the skills evaluation systems were classified based on the type of evaluation strategy (manual or automatic), nature of techniques for automatic evaluation (parametric-based, machine learning/deep learning [ML/DL]), country of origin, surgical sub-speciality and evaluation parameters. The study revealed 46 different surgical skills evaluation systems developed for endoscopic surgeries by different institutions. 47.8% of the articles performed manual evaluation, and 52.2% performed automated evaluation. Among automated evaluation papers, 70.8% of them performed parametric-based, 16.7% ML and 12.5% of them DL. Further, 87.5% of automatic systems used 0-10 parameters, none used more than 20. For manual methods, 54.5% used 0-10 parameters, and 22.7% used over 20. Only 17.4% evaluated generalised skills, whereas 32.6% targeted general surgery-specific skills. Endoscopic skill evaluation is shifting from manual to automated approaches. However, limited public datasets constrain automation. Manual methods assess broader skill factors, whereas automatic methods focus on fewer parameters. There is a need for automatic evaluation techniques to adopt more detailed skill evaluation parameters. Furthermore, the study reveals the need for research to evaluate the skills of various surgical sub-specialities. The study emphasises the pressing need for active research in this area and serves as a foundation.
Video-assisted thoracoscopic surgery for catamenial pneumothorax: Insights from a single-centre experience.
Puri HV, Bangeria S, Asaf MBB … +4 more , Bishnoi S, Pulle MV, Chopra R, Kumar A
J Minim Access Surg · 2026 Feb · PMID 41744474 · Publisher ↗
INTRODUCTION: Catamenial pneumothorax (CP) is a rare cause of recurrent spontaneous pneumothorax in women of reproductive age, typically linked to endometriosis. It usually occurs 24 h before or within 72 h of the onset...
INTRODUCTION: Catamenial pneumothorax (CP) is a rare cause of recurrent spontaneous pneumothorax in women of reproductive age, typically linked to endometriosis. It usually occurs 24 h before or within 72 h of the onset of menstruation, along with hormonal changes leading to lung collapse. PATIENTS AND METHODS: This retrospective study analysed the data from 11 patients who underwent video-assisted thoracoscopic surgery (VATS) for CP at a tertiary care centre from March 2012 to December 2023. Pre-operative assessment included detailed history, physical examination, imaging and haematological investigations. Surgery was performed using a three-port VATS technique and involved resection of diaphragm (all 11 patients) along with diaphragmatic plication and wedge resection of the lung in 1 patient each. This was followed by talc pleurodesis in all the patients. Post-operative care included adequate pain relief, early mobilisation, active physiotherapy and monitoring air leaks. RESULTS: The mean patients' age was 18.9 years. Seven patients had pneumothorax within 24 h before menstruation and four within 72 h after. At surgery (VATS), diaphragmatic fenestrations were found in all the patients, with five having diaphragmatic endometriosis also. One patient had multiple blebs and another one exhibited visceral pleural endometriosis. The average surgery duration was 154 min, with minimal blood loss. All patients had uneventful recovery and no recurrences were observed during a median follow-up of 54 months. CONCLUSION: VATS is an effective, minimally invasive approach for the management of CP, with excellent surgical outcomes, shortened convalescence and no recurrence in our study.
Incorporation of measurement markings on laparoscopic instruments to facilitate intraoperative flap creation and mesh placement in transabdominal preperitoneal hernia repair.
Karthik N
J Minim Access Surg · 2026 Feb · PMID 41744465 · Publisher ↗
Abstract loading — click title to view on PubMed.
Cystic biliary atresia mimicking choledochal cyst: A diagnostic challenge in an infant.
Riquelme M, Rodriguez-Gomez JA, Cendejas-Higuera A … +1 more , Cantu-Zendejas A
J Minim Access Surg · 2026 Feb · PMID 41744464 · Publisher ↗
Cystic biliary atresia (CBA) is a rare subtype of biliary atresia (BA), characterised by cystic dilation of the extrahepatic biliary tract. It can radiologically mimic choledochal cysts, often delaying accurate diagnosis...
Cystic biliary atresia (CBA) is a rare subtype of biliary atresia (BA), characterised by cystic dilation of the extrahepatic biliary tract. It can radiologically mimic choledochal cysts, often delaying accurate diagnosis and timely management. We report the case of a 2-month-old male infant who presented with cholestatic jaundice and an extrahepatic cystic lesion suggestive of a choledochal cyst. Initial imaging, including magnetic resonance cholangiopancreatography, revealed a cystic structure in the common bile duct. Intraoperative cholangiography demonstrated a dilated extrahepatic biliary tree without contrast passage to the duodenum; intraoperative biliary exploration confirmed distal ductal obliteration, consistent with CBA with intact proximal ducts. A laparoscopic hepaticoduodenostomy was initially performed; however, due to persistent bile leak and intra-abdominal collection, conversion to open Roux-en-Y hepaticojejunostomy was required. Histopathology confirmed the diagnosis of BA. This case underscores the importance of maintaining a high index of suspicion for CBA in neonates with cystic biliary lesions and highlights the role of intraoperative findings in guiding definitive surgical management.
Large epiphrenic oesophageal diverticulum with hiatus hernia: Excellent outcome with laparoscopic transhiatal approach.
Jhaveri RH, Dhanani DS, Patel CB … +1 more , Tiwari VT
J Minim Access Surg · 2026 Feb · PMID 41744404 · Publisher ↗
Epiphrenic oesophageal diverticulum (ED) is a rare condition often associated with oesophageal motility disorders, most notably achalasia cardia. Symptoms include dysphagia, regurgitation, chest pain, halitosis and respi...
Epiphrenic oesophageal diverticulum (ED) is a rare condition often associated with oesophageal motility disorders, most notably achalasia cardia. Symptoms include dysphagia, regurgitation, chest pain, halitosis and respiratory symptoms. Surgical management includes diverticulectomy, Heller's cardiomyotomy and partial fundoplication. While thoracic approaches were traditionally used, the laparoscopic transhiatal approach offers distinct advantages. We report the case of a 69-year-old female presenting with dysphagia, foul-smelling regurgitation and chest pain. Her Eckardt score was seven. Investigations revealed a large left-sided epiphrenic diverticulum, type 2 achalasia and a sliding hiatal hernia. She underwent laparoscopic transhiatal diverticulectomy using an endoscopic stapler, Heller's cardiomyotomy, crural repair and anterior Dor fundoplication. Intraoperative endoscopy was used to guide stapling, assess adequacy of the myotomy and check mucosal integrity. The surgery and post-operative course were uneventful. The patient was started on oral liquids on post-operative day 1 and was discharged on day 5. Follow-up at 1 and 3 months revealed complete resolution of symptoms with Eckardt scores of 2 and 0, respectively. No post-operative complications were observed during the 5-month follow-up. Diverticulectomy using an endostapler, Heller's cardiomyotomy and Dor's fundoplication, performed through a laparoscopic transhiatal approach with intraoperative upper gastrointestinal endoscopy monitoring, is a safe and effective method of treating symptomatic ED.
Laparoscopic management of cystic lesion of the hepatoduodenal ligament.
Singh K, Joshua LM, Saxena P … +1 more , Gupta A
J Minim Access Surg · 2026 Feb · PMID 41744369 · Publisher ↗
Cystic neoplasms of the hepatoduodenal ligament are exceedingly rare lesions that pose significant diagnostic and therapeutic challenges due to their nonspecific clinical presentation and complex anatomical location. The...
Cystic neoplasms of the hepatoduodenal ligament are exceedingly rare lesions that pose significant diagnostic and therapeutic challenges due to their nonspecific clinical presentation and complex anatomical location. These lesions, which include cystic lymphangiomas, hydatid cysts and benign cystic neoplasms, often mimic other cystic abdominal masses, complicating preoperative diagnosis. We present a case of a 29-year-old male with a cystic lymphangioma located in the hepatoduodenal ligament, highlighting the role of advanced imaging and laparoscopic excision in effective management. This report underscores the importance of high clinical suspicion, comprehensive imaging and meticulous surgical technique in addressing these uncommon cystic neoplasms.
Don't repeat the cardiovascular and thoracic surgery - Cardiology shift: Surgeons should lead endoscopic ultrasonography-guided gastroenterostomy.
Vineet K, Tripathi M
J Minim Access Surg · 2026 Feb · PMID 41744362 · Publisher ↗
Abstract loading — click title to view on PubMed.
Emergency laparoscopic transabdominal preperitoneal repair of bilateral pantaloon hernia presenting with acute small bowel obstruction.
Dey S, Banerjee K, Agrawal A … +2 more , Singh RK, Karmakar S
J Minim Access Surg · 2026 Feb · PMID 41744344 · Publisher ↗
Pantaloon hernia (PH) is defined as ipsilateral direct and indirect inguinal hernias. Bilateral PH is an exceedingly rare occurrence. Here, we report a case of a 73-year-old man with a painful, irreducible right groin sw...
Pantaloon hernia (PH) is defined as ipsilateral direct and indirect inguinal hernias. Bilateral PH is an exceedingly rare occurrence. Here, we report a case of a 73-year-old man with a painful, irreducible right groin swelling associated with vomiting and features of small bowel obstruction with bilateral groin swelling noted clinically. Contrast-enhanced computed tomography revealed an indirect hernia on the right containing obstructed small bowel and a left inguinal hernia partially containing the urinary bladder. Diagnostic laparoscopy revealed a bilateral PH with right-sided obstruction. After reducing the obstructed small bowel and checking its viability, the transabdominal pre-peritoneal approach was undertaken to repair the hernial orifices. The post-operative recovery was uneventful, and the patient was discharged on post-operative day 3. Serial follow-ups revealed no complications. This case highlights that, with experience, laparoscopic repair of bilateral PH in emergencies is safe, feasible and a practical alternative to open surgery.
Small bowel obstruction secondary to intraluminal bleeding after Roux-en-Y gastric bypass.
Hassanesfahani M, Shah D
J Minim Access Surg · 2026 Feb · PMID 41744335 · Publisher ↗
Small bowel obstruction (SBO) is a known complication of Roux-en-Y gastric bypass (RYGB) but rarely results from intraluminal bleeding (ILB) and hemobezoar formation. ILB-related SBO usually occurs in the first 72 h afte...
Small bowel obstruction (SBO) is a known complication of Roux-en-Y gastric bypass (RYGB) but rarely results from intraluminal bleeding (ILB) and hemobezoar formation. ILB-related SBO usually occurs in the first 72 h after surgery and may be potentiated by prophylactic anticoagulation or non-steroidal anti-inflammatory drugs. We present the case of a 41-year-old female with prior sleeve gastrectomy who underwent robotic-assisted RYGB and developed early post-operative abdominal pain, distention and tachycardia. Computed tomography demonstrated SBO with hyperdense intraluminal contents distal to the jejunojejunostomy. Emergency re-exploration revealed a consolidated haematoma obstructing the bowel lumen, managed successfully with enterotomy and clot evacuation; anastomotic revision was unnecessary. Post-operative recovery was complicated by an intra-abdominal abscess, managed percutaneously. This rare case highlights the importance of early recognition of ILB as a cause of SBO, prompt imaging and timely surgical management to prevent ischaemia or perforation or anastomotic dehiscence.
Wernicke's encephalopathy after laparoscopic sleeve gastrectomy.
Abecia MR, de Salas MM, Cuiñas AÁ … +7 more , Felgueras MDC, Lara RJC, Arnaiz AM, Melús SN, Pelayo MP, Corral RB, Ramiro JM
J Minim Access Surg · 2026 Feb · PMID 41744310 · Publisher ↗
Bariatric surgery is one of the causes of Wernicke's encephalopathy. It is more frequent in techniques with malabsorption and less common in surgeries such as sleeve gastrectomy. We present the case of a 48-year-old pati...
Bariatric surgery is one of the causes of Wernicke's encephalopathy. It is more frequent in techniques with malabsorption and less common in surgeries such as sleeve gastrectomy. We present the case of a 48-year-old patient with a body mass index of 55 who, after a sleeve gastrectomy with cholecystectomy, suffered an episode of prolonged vomiting and was hospitalised with confusion, amnesia and limb weakness associated with low thiamine levels. After a diagnosis based on clinical manifestations and low blood thiamine levels, treatment with intravenous thiamine was started with an adequate evolution. Clinical suspicion is essential for prompt treatment to reduce the risk of serious sequelae or death.
Transitioning from single-boom to modular multi-cart robotic platforms: Practical implications for colorectal surgery.
Osseis M, Mouawad C
J Minim Access Surg · 2026 Feb · PMID 41744301 · Publisher ↗
The transition from single-boom robotic systems to modular multi-cart platforms introduces distinct ergonomic and workflow implications for colorectal surgery. Modular architectures offer individualised docking, greater...
The transition from single-boom robotic systems to modular multi-cart platforms introduces distinct ergonomic and workflow implications for colorectal surgery. Modular architectures offer individualised docking, greater port-placement flexibility and improved team integration through open-console design. However, established systems maintain advantages in master-control ergonomics, camera responsiveness and integrated energy and stapling ecosystems. Emerging comparative studies demonstrate that modular platforms achieve perioperative outcomes comparable to traditional systems, though setup times may be longer during early adoption. Understanding these complementary strengths is essential for selecting and optimising robotic platforms in colorectal practice.
Comparison of ultrasound-guided TAPB and rectus sheath block combined with dexmedetomidine in patients undergoing transumbilical single-port laparoscopic surgery.
Ma Y, Zhong Q, Qiu J … +3 more , Huang H, Li G, Yang S
J Minim Access Surg · 2026 Feb · PMID 41744294 · Publisher ↗
INTRODUCTION: To evaluate the efficacy of ultrasound-guided transversus abdominis plane block (TAPB) and rectus sheath block (RSB) combined with dexmedetomidine in patients undergoing transumbilical single-port laparosco...
INTRODUCTION: To evaluate the efficacy of ultrasound-guided transversus abdominis plane block (TAPB) and rectus sheath block (RSB) combined with dexmedetomidine in patients undergoing transumbilical single-port laparoscopic surgery (TSLS). PATIENTS AND METHODS: A total of 120 patients scheduled for TSLS at Shenzhen Hospital (Futian) of Guangzhou University of TCM from October 2023 to October 2024 were randomly allocated into three groups: Group A (n = 40) received general anaesthesia, Group B (n = 40) received general anaesthesia plus TAPB and Group C (n = 40) received general anaesthesia plus RSB. We assessed intraoperative sufentanil dosage, Visual Analogue Scale (VAS) scores at 6 and 24 h post-surgery, the requirement for rescue analgesia within 24 h, sleep disturbance scores, Ramsay sedation scores at 6 and 24 h post-surgery and the incidence of adverse reactions. RESULTS: There was no significant difference in intraoperative sufentanil dosage amongst the groups (P > 0.05). VAS scores at 6 h and 24 h post-surgery and the rate of rescue analgesia within 24 h were significantly lower in Group C compared to Group B and Group A (P < 0.05). Sleep disturbance scores in Group C were also significantly lower than those in Group B and Group A at 6 h (P < 0.05). The incidence of adverse reactions was significantly lower in Group C compared to Group B and Group A (P < 0.05). CONCLUSIONS: Ultrasound-guided RSB combined with dexmedetomidine is superior to TAPB in reducing post-operative pain, decreasing the need for remedial analgesia, minimally impacting post-operative sleep and reducing the incidence of adverse reactions.
Evaluation of 1-year follow-up data of reoperative sleeve gastrectomy and one-anastomosis gastric bypass after laparoscopic gastric plication.
Toprak ŞS, Pekin C
J Minim Access Surg · 2026 Feb · PMID 41744289 · Publisher ↗
INTRODUCTION: Laparoscopic gastric plication (LGP) technique requires a high rate of reoperative bariatric surgery (RBS) because of failure to lose weight, regaining weight, inadequate remission of comorbidities and comp...
INTRODUCTION: Laparoscopic gastric plication (LGP) technique requires a high rate of reoperative bariatric surgery (RBS) because of failure to lose weight, regaining weight, inadequate remission of comorbidities and complications. RBSs have higher perioperative complication and mortality rates when compared to primary bariatric procedures. The present study aimed to compare post-operative complications and body mass index (BMI) changes in one-anastomosis gastric bypass (OAGB) and sleeve gastrectomy (SG) operations following LGP. PATIENTS AND METHODS: The study had a retrospective, single-centre and cohort design. Group OAGB (n = 12) and Group SG (n = 16) were compared for post-operative 1st-month complications, operation times, discharge times, time from primary surgery to RBS and post-operative 1, 3, 6 and 12th-month BMI changes. Post-operative complications were evaluated using the Comprehensive Complication Index (CCI). RESULTS: The mean operation times in OAGB and SG were 77.50 ± 9.77 and 53.75 ± 8.08 min, discharge times were 3.83 ± 0.72 and 2.38 ± 0.62 days and the time from primary surgery to RBS was found to be 26.17 ± 7.96 and 36.44 ± 14.69 months, respectively. These differences were statistically significant. No statistically significant differences were detected between the CCI values at the end of the 1st post-operative month and the BMI changes at the 1st, 3rd, 6th and 12th months of post-operative surgery in both groups. CONCLUSIONS: OAGB had similar outcomes for post-operative 1st-month CCI values and post-operative 1st-month, 3rd-month, 6th-month and 12th-month BMI changes when compared with SG. According to our findings, OAGB can be considered a clinically effective and safe surgical procedure for RBS after LGP compared to SG.
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