Journal Of Minimal Access Surgery[JOURNAL]
Sun
200 papers
Thoracoscopic repair of Morgagni-Larrey hernia in a child - A case report with surgical video.
Sinha SK, Gupta P, Dey R
J Minim Access Surg · 2026 Feb · PMID 41744278 · Publisher ↗
Morgagni-Larrey hernias are a rare form of diaphragmatic hernia, differentiated from the more common Morgagni hernia by their location in the left retro-costo-xiphoid area. In contrast, Morgagni hernias are typically fou...
Morgagni-Larrey hernias are a rare form of diaphragmatic hernia, differentiated from the more common Morgagni hernia by their location in the left retro-costo-xiphoid area. In contrast, Morgagni hernias are typically found in the right retro-costo-xiphoid region. These hernias usually contain small amounts of abdominal contents, are covered by a hernial sac, present later in life and are most often repaired via a laparoscopic approach. This case report describes an unusual presentation in a 4-year-old child with significant herniated contents - including small intestine, part of the large intestine and omentum - without a hernial sac, a finding rarely seen even in adults. We managed the child using a thoracoscopic approach, anticipating adhesions between the bowel and thoracic structures, which could be addressed under direct vision. The child recovered uneventfully.
Role of platelet-rich plasma in prevention of port site infection, wound healing and post-operative pain after elective laparoscopic cholecystectomy: A randomised controlled trial.
Kumar A, Srivastava V, Verma N … +3 more , Yadav AK, Ansari MA, Pratap A
J Minim Access Surg · 2026 Feb · PMID 41744266 · Publisher ↗
INTRODUCTION: Laparoscopic cholecystectomy (LC) is the preferred treatment for symptomatic gallstone disease because of its minimally invasive technique and associated benefits. Surgical outcomes are influenced by wound...
INTRODUCTION: Laparoscopic cholecystectomy (LC) is the preferred treatment for symptomatic gallstone disease because of its minimally invasive technique and associated benefits. Surgical outcomes are influenced by wound infection, pain and scar quality. Port site infections (PSIs) are a notable issue in laparoscopic procedures, affecting around 1.4% to 6.7% of cases. The use of platelet-rich plasma (PRP) has gained interest for its ability to promote wound healing and antimicrobial property. This study evaluated the role of PRP in improving these outcomes after LC. PATIENTS AND METHODS: In this randomised controlled trial, 190 patients were assigned to either the PRP group (n = 95) or control group (n = 95). Freshly prepared PRP was compared with 0.9% normal saline for port site infiltration. Follow-up was conducted on post-operative days 1, 2, 10, 30 and 90. The primary outcome, PSIs, was assessed using the Southampton Scoring System. Secondary outcomes included pain (Numerical Rating Scale [NRS]), wound healing (redness, oedema, ecchymosis, discharge and approximation [REEDA] scale) and scar quality (Vancouver Scar Scale [VSS]). RESULTS: Mean ages were 35.26 ± 6.40 years (PRP) and 34.84 ± 5.86 years (control) (P = 0.637). PSIs were lower in the PRP group on days 1, 2 and 10. At 1 month, the difference was marginally significant (P = 0.050), and at 3 months, not statistically significant (P = 0.115). Pain scores (NRS) were consistently lower in the PRP group from day 1 to 3 months. Wound healing (REEDA) scores were better in the PRP group at all time points. Scar quality (VSS) at 3 months favored PRP (0.68 ± 0.75) over control (1.51 ± 0.85, P < 0.001). CONCLUSION: PRP use in LC significantly reduced post-operative pain, improved wound healing and enhanced scar quality, with early reductions in infection rates. PRP shows promise as an adjunct to improve post-operative outcomes after LC.
How to train knot-tying in the thoracic cavity for residents: A cost-effective simulator.
Jeong J, Kang MK
J Minim Access Surg · 2026 Feb · PMID 41744254 · Publisher ↗
We present a low-cost, simple simulation model of knot-tying in a thoracic cavity. This model uses a cardboard paper box to reproduce the chest cavity, which is narrow, long and deep. Practising basic skill in the simula...
We present a low-cost, simple simulation model of knot-tying in a thoracic cavity. This model uses a cardboard paper box to reproduce the chest cavity, which is narrow, long and deep. Practising basic skill in the simulation setting will help residents better prepare to use it.
Laparoscopy-assisted percutaneous nephrolithotomy in a pelvic ectopic kidney: A minimally invasive approach.
Özen M, Uğur M
J Minim Access Surg · 2026 Feb · PMID 41744252 · Publisher ↗
Ectopic pelvic kidneys present unique anatomical challenges in the management of nephrolithiasis due to their abnormal position and proximity to surrounding structures. This case report describes a 58-year-old male patie...
Ectopic pelvic kidneys present unique anatomical challenges in the management of nephrolithiasis due to their abnormal position and proximity to surrounding structures. This case report describes a 58-year-old male patient with a 26-mm renal stone in a left pelvic ectopic kidney, successfully treated using a laparoscopy-assisted percutaneous nephrolithotomy (PCNL) approach. The procedure involved initial ureteral catheter placement, laparoscopic mobilisation of the kidney and fluoroscopic-guided percutaneous access for stone fragmentation and removal. Laparoscopic assistance improved visualisation, facilitated safe access to the renal collecting system and minimised the risk of injury to adjacent organs. The patient had an uneventful recovery, with no residual stone burden. This case highlights laparoscopy-assisted PCNL as an effective and minimally invasive alternative for treating nephrolithiasis in pelvic ectopic kidneys, offering advantages in terms of safety and precision. Further studies are needed to establish standardised protocols for this technique.
Importance of simulation-based endoscopy training for surgeons to achieve competence.
Sundaram E
J Minim Access Surg · 2026 Feb · PMID 41744237 · Publisher ↗
The endoscopy training path has become a less-travelled road by surgeons due to their interest in the vast arena of laparoscopic surgery. There is a lack of skilled trainers and training opportunities. A short-structured...
The endoscopy training path has become a less-travelled road by surgeons due to their interest in the vast arena of laparoscopic surgery. There is a lack of skilled trainers and training opportunities. A short-structured endoscopy training course is the commonly preferred option by surgeons. Endoscopy simulators are an attractive proposition to fast-track the training of budding surgeons toward achieving competence without compromising on the safety of patients. Innovative teaching modules incorporating the vast array of low and high-fidelity endoscopy simulators are the need of the hour.
Assessment of the efficacy and safety of enhanced recovery after surgery in the thoracoscopic adjuvant treatment of radical surgery for oesophageal carcinoma: A systematic review and meta-analysis.
Song Y, Xi X, Li N … +4 more , Wang H, Wang G, Tian L, Niu Y
J Minim Access Surg · 2026 Feb · PMID 41744139 · Publisher ↗
OBJECTIVE: To investigate the efficacy and safety assessment of intensive post-operative recovery during thoracoscopic-assisted radical oesophageal carcinoma (OC) treatment. PATIENTS AND METHODS: The meta-analysis was co...
OBJECTIVE: To investigate the efficacy and safety assessment of intensive post-operative recovery during thoracoscopic-assisted radical oesophageal carcinoma (OC) treatment. PATIENTS AND METHODS: The meta-analysis was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and English terms were searched in PubMed, Embase, Cochrane Library (2020, Issue 1) and Web of Science, and the same Chinese terms were searched in China National Knowledge Internet and Wanfang Data, with the date range set from January 2010 to January 2020. Search engines, including Google Scholar and Baidu Library, were also applied for manual searches of relevant literature. The final number of articles included was 12, 11 of which were in Chinese and one in English. The basic data of the two groups were statistically analysed. Among 1049 OC patients, 527 were treated with enhanced recovery after surgery (ERAS) and 522 were treated with conventional perioperative management (control group), comparing the operative time, intraoperative blood loss, self-rating anxiety scale (SAS), visual analog scale (VAS), post-operative first venting time, chest tube removal time, post-operative hospitalisation time, post-operative hospitalisation cost, combined complication rate, lung infection rate, anastomotic leak rate and gastric emptying disorder rate. RESULTS: There were statistically significant differences between the ERAS group and the control group in terms of operative day anxiety score, post-operative Visual Analogue Scale, time to first post-operative anal vent, time to chest tube removal, post-operative hospital stay, hospitalisation cost and overall complication rate (weighted mean difference [WMD] = -5.61, 95% confidence interval [CI]: -7.95 to -3.28, P < 0.00001; WMD = -1.58, 95% CI: -1.58, -1.94 to -1.22, P < 0.00001; standardized mean difference [SMD] = -1.86, 95% CI: -2.53 to -1.18, P < 0.00001; SMD = -4.97, 95% CI: -6:73 to -3.21, P < 0.00001; WMD = -3.93, 95% CI: -4.80 to -3.07, P < 0.00001; WMD = -0.65, 95% CI: -0.74~-0.55, P < 0.00001 and relative risk [RR] =0.41, 95% CI: 0.33-0.51, P < 0.00001). ERAS reduced the incidence of pulmonary infection, anastomotic leak and impaired gastric emptying with a statistically significant difference (RR =0.45, 95% CI: 0.31-0.65, P < 0.0001; RR =0.34, 95% CI: 0.16-0.74, P < 0.05; RR =0.34, 95% CI: 0.16-0.73, P < 0.05). CONCLUSION: ERAS is effective in patients with OC undergoing thoracoscopic-assisted radical OC treatment to improve patients' clinical symptoms and reduce the incidence of adverse effects.
Impact of structured robotic simulation workshop on knowledge and attitude of medical undergraduates: A scoping view through student's eye.
Paruchuri A, Gajula A, Goyal R … +4 more , Khan MA, Fahad PT, Roy A, Suhani S
J Minim Access Surg · 2026 Feb · PMID 41744138 · Publisher ↗
INTRODUCTION: Robotic-assisted surgery is transforming surgical practice, necessitating early exposure for medical students. Its representation in undergraduate curriculum is limited. This study was conducted with the ob...
INTRODUCTION: Robotic-assisted surgery is transforming surgical practice, necessitating early exposure for medical students. Its representation in undergraduate curriculum is limited. This study was conducted with the objective to assess if a structured simulation-based demonstrative workshop impacted any change in knowledge and attitude of medical undergraduates towards robot-assisted surgery. PATIENTS AND METHODS: A cross-sectional study was conducted at a robotic training facility on undergraduates. Baseline and post-session questionnaire-based survey using a validated self-developed questionnaire was done for knowledge and attitude domains. The workshop included 15-min didactic lecture and live demonstration of simulation tasks. Statistical analysis was performed using STATA 18.0. RESULTS: Fifty undergraduates were enrolled. Median knowledge scores increased from 2 (interquartile range [IQR]: 1-4) to 7 (IQR: 4-9) (P < 0.0001). The majority believed robotic surgery should be integrated into medical curriculum. Median attitude score increased from 2 (IQR: 2-3) to 3 (IQR: 3-5) (P < 0.0001). CONCLUSION: Structured robotic simulation workshop significantly enhanced medical students' knowledge and attitudes towards robotic surgery.
Early outcomes of robotic Heller's cardiomyotomy: First report from central India.
Gajbhiye R, Tirpude B, Deshpande GA … +3 more , Bhanarkar H, Akulwar V, Kodape G
J Minim Access Surg · 2026 Feb · PMID 41744127 · Publisher ↗
INTRODUCTION: Achalasia cardia is a rare oesophageal motility disorder characterised by the inability of the lower oesophageal sphincter to relax. The gold standard of care being surgical cardiomyotomy, the robotic appro...
INTRODUCTION: Achalasia cardia is a rare oesophageal motility disorder characterised by the inability of the lower oesophageal sphincter to relax. The gold standard of care being surgical cardiomyotomy, the robotic approach is becoming more popular, over the last decade. This study evaluates the early outcomes of robotic Heller's cardiomyotomy performed at a single centre in central India. PATIENTS AND METHODS: A retrospective data analysis of all the patients of achalasia cardia who underwent robotic cardiomyotomy from March 2024 to June 2025 was done. All the patients were operated using the SSi Mantra™ surgical robotic system (SSI Innovations International Inc., Gurugram). Patient demographics, high-resolution manometry findings, pre-operative Eckardt scores, docking and total console times were noted. RESULTS: Eleven patients were included in the study. Median age was 36 years (range 20-63 years), with males comprising 54.5%. Mean body mass index was 21.4 ± 2.2. Type 2 achalasia was found in 63.6% of patients. The median pre-operative integrated relaxation pressure was 28 mmHg. Mean docking and console time were 12.5 ± 7.4 min and 130.7 ± 34.2 min, respectively. The improvement of the Eckhardt score was from median score of 8 to 1 (P < 0.05). CONCLUSION: The magnified vision, precision and improved instrument manoeuvrability provided by the robotic platform help in improved patient outcomes. The modular design of the SSi Mantra™ surgical robotic system allows for better ergonomics, making it a viable platform for performing robotic Heller's cardiomyotomy. The initial outcomes appear comparable to those achieved with other robotic systems. Larger studies are needed to further evaluate these potential benefits.
Video-assisted thoracic surgery management of giant pulmonary bullae: Insights from a single-centre series of 53 patients.
Bangeria S, Puri HV, Bishnoi S … +4 more , Pulle MV, Asaf MBB, Bhardwaj D, Kumar A
J Minim Access Surg · 2026 Feb · PMID 41744122 · Publisher ↗
INTRODUCTION: Giant bullae (GB) of the lung are emphysematous air spaces occupying at least one-third of the hemithorax. GB may lead to progressive dyspnoea, compression of adjacent lung and pneumothorax, necessitating s...
INTRODUCTION: Giant bullae (GB) of the lung are emphysematous air spaces occupying at least one-third of the hemithorax. GB may lead to progressive dyspnoea, compression of adjacent lung and pneumothorax, necessitating surgery as the definitive management in symptomatic patients. PATIENTS AND METHODS: We conducted a retrospective analysis of 53 cases of GB operated at a tertiary care centre in India from December 2020 to December 2024. RESULTS: The study cohort included 42 males and 11 females, with a mean age of 49.8 years (range: 12-74). GB occurred unilaterally in 38 patients (right lung - 20, left - 18), bilateral in 15 patients and 6 patients had extensive emphysematous changes also. The primary procedures performed to take care of the bulla included video-assisted thoracic surgery (VATS) bullectomy (30 patients), VATS bullectomy with wedge resection of additional bullae (8 patients) and lobectomy (15 patients). The adjunct procedures performed included talc pleurodesis (24 patients), pleurectomy (13 patients) and decortication in one patient. Median chest drain duration was 6-7 days with an average hospital stay of 6.4 days. Post-operative complications occurred in 12 patients, including prolonged air leak (8), atrial fibrillation (2), ileus (1) and urinary retention (1). No wound infections or deaths were reported, and there were no recurrences of GB during the follow-up period of 48 months. CONCLUSIONS: VATS is a safe and effective surgical approach for treating symptomatic GB. It has minimal complications, leads to a quick recovery and has very low chances of recurrence.
Is laparoscopic total extraperitoneal mesh repair gold standard approach to inguinal hernia? A large case series with operative complications, post-operative outcome and recurrence rate after laparoscopic TEP mesh repair for inguinal hernias.
Harsha MP, Panda SN, Das S
J Minim Access Surg · 2026 Feb · PMID 41744119 · Publisher ↗
INTRODUCTION: Laparoscopic extraperitoneal mesh hernia repair is better approach for inguinal hernia with its low complication rate, early recovery and negligible recurrence rate. The aim of this case series is to study...
INTRODUCTION: Laparoscopic extraperitoneal mesh hernia repair is better approach for inguinal hernia with its low complication rate, early recovery and negligible recurrence rate. The aim of this case series is to study intraoperative complications, post-operative outcome and recurrence rate after laparoscopic total extraperitoneal mesh repair for inguinal hernias. PATIENTS AND METHODS: This is a retrospective observational data. We have performed laparoscopic total extra peritoneal repair (TEP) for 152 consecutive patients presented with inguinal hernia at Surgical Outpatient Department, Command Hospital (Eastern Command), Kolkata, using 10-mm infraumbilical midline port and two 5-mm working lateral ports inserted lateral to the inferior epigastric artery. None of them required eTEP. All the hernias are repaired with flat, light-weight, macroporous polypropylene mesh 15 cm × 15 cm for unilateral hernias and 30 cm × 15 cm mesh for bilateral hernia covering myopectineal orifice and anchored with single absorbable tacker to lacunar ligament to each side. All patients were assessed for intraoperative complications such as bleeding, peritoneal breach, injury to vessels, vas deferens and bowel, total operative time and post-operative complications such as chronic pain, seroma, surgical site infection (SSI) and recurrence. Follow-up was done after 10 days, 1 month and 6 months. RESULTS: There were one hundred and fifty-two patients with a mean age of 47.8 years, oldest 78 and youngest 20 years; among them, 141 were males and 11 were females; 125 had unilateral and 27 had bilateral hernia. Four had minor intraoperative bleeding, 5 had intraoperative peritoneal breach and required accessor intra-abdominal port and required peritoneal repair. None of them had any chronic pain. Seven had seroma which is managed with serial aspirations. Seven patients developed SSI, of which 4 underwent mesh explanation and 3 resolved with ultrasonography-guided aspiration and pre-peritoneal amikacin infiltration. None of the patients had recurrence even after mesh explanation. CONCLUSIONS: The laparoscopic total extraperitoneal mesh repair for inguinal hernia is minimal invasive approach. With same port placement, bilateral inguinal hernias can be repaired with ease. Laparoscopic TEP repairs inguinal hernia with less post-operative complications, no pain and nil recurrence, less hospital stay and patients can get back to their routine activities since the next day. It can be considered as gold standard laparoscopic approach for inguinal hernia.
Initial experience with robotic-assisted kidney transplantation: A single-centre descriptive, retrospective study with technical modifications.
Gravetz A, Kanani F, Bielopolski D … +3 more , Tennak V, Nado A, Nesher E
J Minim Access Surg · 2026 Jan · PMID 41556629 · Full text
INTRODUCTION: Robot-assisted kidney transplantation (RAKT) has demonstrated non-inferiority to open kidney transplantation (OKT), with particular benefits for obese patients. We report our single-centre initial experienc...
INTRODUCTION: Robot-assisted kidney transplantation (RAKT) has demonstrated non-inferiority to open kidney transplantation (OKT), with particular benefits for obese patients. We report our single-centre initial experience implementing RAKT with technical modifications. PATIENTS AND METHODS: This retrospective descriptive study analysed consecutive living donor kidney transplants performed between September 2020 and March 2021. From 75 potential candidates, patients were selected for RAKT based on exclusion criteria, including obesity (body mass index [BMI] >35 kg/m²), severe atherosclerosis and previous complex abdominal surgery. Ten patients underwent RAKT and were matched 1:3 with OKT controls using propensity score matching based on age, sex, BMI and diabetes status. Technical modifications included polyglactin mesh wrapping for graft stabilisation and continuous cooling and a custom robotic arterial punch device. The primary surgeon completed 35 RAKT procedures at a high-volume centre before initiating this programme. RESULTS: Ten RAKT patients (90% male, mean age 41.5 ± 10.2 years, mean BMI 27.0 ± 3.2 kg/m²) were compared to 30 matched OKT controls. Mean operative time was 263 ± 29 min for RAKT versus 185 ± 22 min for OKT (P < 0.001). Warm ischaemia time averaged 52.2 ± 16.8 min for RAKT versus 3.2 ± 1.1 min for OKT (P < 0.001). All grafts functioned immediately except one delayed graft function in each group. Hospital stay averaged 8.0 ± 1.5 days for RAKT versus 7.2 ± 1.8 days for OKT (P = 0.21). At median follow-up of 60 months, graft survival was 100% in both groups. No incisional hernias occurred in RAKT patients versus 2 (6.7%) in OKT. Overall, 30-day complications were 10% for RAKT versus 20% for OKT (P = 0.66). CONCLUSIONS: This small descriptive study demonstrates RAKT feasibility with technical modifications at an experienced centre. While no definitive conclusions can be drawn from this limited experience, our results align with larger studies supporting RAKT safety. The polyglactin mesh technique for continuous cooling and manipulation, along with the absence of incisional hernias, warrants further investigation in larger cohorts.
De novo inguinal hernia after radical prostatectomy: Does the access make some difference? - A systematic review and meta-analysis.
Galdino MM, Hidaka AK, Morrone MC … +5 more , Oliveira CHF, Glina S, Dell'Oglio P, Galfano A, Machado MT
J Minim Access Surg · 2026 Jan · PMID 41556628 · Full text
Prostate cancer is one of the most prevalent neoplasms among men, and radical prostatectomy is a common treatment. While urinary incontinence and erectile dysfunction are frequently discussed postoperative complications,...
Prostate cancer is one of the most prevalent neoplasms among men, and radical prostatectomy is a common treatment. While urinary incontinence and erectile dysfunction are frequently discussed postoperative complications, the incidence of inguinal hernias (IHs) has received less attention. Retzius-sparing robot-assisted radical prostatectomy (RS-RALP) has emerged as a technique that may reduce the risk of IH compared to conventional approaches (C-RALP). We conducted a systematic review and meta-analysis following PRISMA guidelines to evaluate whether different surgical approaches influence the incidence of IHs. From 670 initially identified studies, four met the inclusion criteria. The meta-analysis showed that RS-RALP was associated with a significantly lower incidence of IH compared to C-RALP (odds ratio = 0.31; confidence interval = 0.18-0.55; P < 0.001). Preservation of the Retzius space appears to reduce the risk of postoperative IH, whereas reconstructive measures within this space do not seem to offer additional protection.
Does training on robotic virtual reality simulators improve the post-training robotic surgical skills of surgeons? A systematic review and meta-analysis.
Singh L, Rodrigues AP, Jenkins J
J Minim Access Surg · 2026 Apr · PMID 41467453 · Full text
BACKGROUND: The effectiveness of virtual reality (VR) simulation training for improving robotic surgical skills is not firmly established. This systematic review and meta-analysis aimed to evaluate the impact of VR simul...
BACKGROUND: The effectiveness of virtual reality (VR) simulation training for improving robotic surgical skills is not firmly established. This systematic review and meta-analysis aimed to evaluate the impact of VR simulator training on surgeons' robotic surgical performance in the operating room (OR). AIM: To synthesize evidence regarding the association between VR-based robotic surgery training and subsequent technical performance inside the OR. DATA SOURCES: A comprehensive literature search was conducted in PubMed, Scopus, Embase, and CINAHL databases, adhering to PRISMA 2020 guidelines. ELIGIBILITY CRITERIA AND STUDY SELECTION: Studies evaluating VR simulator training for robotic surgeons with subsequent performance assessment in the OR were included. Risk of bias assessment was performed using the Medical Education Research Study Quality Instrument and the modified Newcastle-Ottawa Scale for Education (NOS-E), along with funding source appraisal. DATA SYNTHESIS: A total of 294 records were screened, resulting in 13 studies (281 participants) included in the systematic review, and 4 studies (72 participants) suitable for meta-analysis. Metaanalysis was conducted using a random-effects model to pool correlation coefficients between preand post-training performance. RESULTS: Of the included studies, nine reported positive evidence, three found no evidence, and one found negative evidence regarding VR training's role. The meta-analysis of before-after studies revealed a significant positive correlation ( r = 0.717, P < 0.05) between simulation performance and intraoperative outcomes. LIMITATIONS: The small number of studies included in the meta-analysis and methodological heterogeneity may limit generalisability of results. CONCLUSIONS: VR simulator training is associated with improved robotic surgical performance in the OR. Incorporation of VR simulation into robotic surgical curricula is likely beneficial for skill acquisition and operative readiness.
Faster bowel recovery with superior haemorrhoidal artery preservation in patients undergoing sigmoidectomy for diverticular disease: A retrospective cohort study from the diverticular disease registry trial.
Crippa J, Achilli P, Origi M … +14 more , Roufael F, Sassun R, Re LD, Montroni I, Belotti D, Sivieri F, Magistro C, Bertoglio CL, Borroni G, Cocozza E, Spinelli A, Maggioni D, Mari GM, AIMS Academy Clinical Research Network
J Minim Access Surg · 2026 Jan · PMID 41351583 · Full text
INTRODUCTION: The pathogenesis of diverticular disease varies significantly and so does its clinical presentation. The procedure for left-sided diverticular disease is standardised, but there is still no consensus on the...
INTRODUCTION: The pathogenesis of diverticular disease varies significantly and so does its clinical presentation. The procedure for left-sided diverticular disease is standardised, but there is still no consensus on the level of arterial ligation. In 2021, our group initiated the Diverticular Disease Registry (DDR) Trial, a multi-institutional registry on diverticular disease. The aim of this study is to analyse patients enrolled in the DDR who underwent elective laparoscopic sigmoidectomy to determine if different arterial ligations result in differences in bowel function. PATIENTS AND METHODS: Patients enrolled in the DDR from June 2021 to January 2024 were reviewed. Inclusion criteria included elective sigmoidectomy for diverticular disease, reported pre-operative bowel preparation and availability of data on the level of the arterial section. Patients were grouped according to the level of artery ligation: the superior haemorrhoidal artery transection (SHA-T) group and the superior haemorrhoidal artery preservation (SHA-P) group. RESULTS: A total of 242 patients were enrolled at 8 hospitals. One hundred and ten patients were included in the analysis. Hospital stay was shorter although not significantly in the SHA-P group compared to the SHA-T group (5 ± 2 vs. 6 ± 1.5; P = 0.062). The first flatus occurred earlier in the SHA-P group, approaching the level of significance (1 ± 0.5 vs. 2 ± 0.8; P = 0.057). Bowel function restored significantly earlier in the SHA-P group (2 ± 0.4 vs. 3 ± 2.1; P = 0.041). CONCLUSIONS: Our study reported improved bowel function in patients undergoing SHA preservation during elective sigmoidectomy for diverticular disease.
Uniportal video-assisted thoracoscopic surgery diverticulectomy of oesophagus: Two cases.
Jeong J, Kang MK
J Minim Access Surg · 2026 Apr · PMID 41351273 · Full text
We report two cases of successful oesophageal diverticulectomy through uniportal video-assisted thoracoscopic surgery (VATS). In both cases, a chest computed tomography showed huge mid-oesophageal diverticulum. Gastroint...
We report two cases of successful oesophageal diverticulectomy through uniportal video-assisted thoracoscopic surgery (VATS). In both cases, a chest computed tomography showed huge mid-oesophageal diverticulum. Gastrointestinal endoscopy confirmed a diverticulum on the right wall. Surgical treatment through uniportal VATS was planned and performed successfully. We recommend that uniportal VATS could be a feasible method for oesophageal diverticulectomy.
Modified transabdominal pre-peritoneal technique in post-appendectomy scarred peritoneum: A case report on surgical challenges and adaptations.
Kalyanam R, Sultana R, Potru P … +4 more , Doodipala VR, Uppaluri J, Kumar S, Ramavath K
J Minim Access Surg · 2025 Dec · PMID 41351271 · Publisher ↗
Laparoscopic transabdominal pre-peritoneal (TAPP) inguinal hernia repair in patients with post-appendectomy scarring presents unique technical challenges due to adhesions, fibrosis and altered anatomy. Conventional surgi...
Laparoscopic transabdominal pre-peritoneal (TAPP) inguinal hernia repair in patients with post-appendectomy scarring presents unique technical challenges due to adhesions, fibrosis and altered anatomy. Conventional surgical approaches require adaptation to mitigate risks such as bowel or bladder injury. Initiating dissection in unaffected medial peritoneal areas before progressing laterally allows for safer navigation. Precise, sharp dissection, complemented by controlled energy device utilisation, is essential for separating fibrotic peritoneum from underlying structures while preserving anatomical integrity. Avoiding dissection below the scar level optimises mesh placement and prevents compromise on repair. Pre-operative computed tomography imaging aids in assessing the severity of adhesion and helps in individualised surgical planning. Surgeon expertise is paramount in modifying techniques to accommodate complex anatomical variations. Literature underscores the heightened intraoperative risks associated with prior abdominal surgery, reinforcing the necessity for meticulous planning and skilful execution. With appropriate technique modifications, TAPP remains a viable and effective approach in patients with post-appendectomy scarring, ensuring safe and durable repair.
Comparison of laparoscopic and open stand-alone feeding jejunostomy in patients with proximal gastrointestinal tract malignancies: An open-label randomised controlled trial.
Rajasekar S, Kumbhar US, Vijayakumar C … +3 more , Reddy PA, Kalayarasan R, Raja K
J Minim Access Surg · 2025 Dec · PMID 41351262 · Publisher ↗
INTRODUCTION: Patients with obstructive upper gastrointestinal malignancies often suffer from severe dysphagia and cachexia, necessitating enteral feeding. While open feeding jejunostomy (OFJ) is the traditional approach...
INTRODUCTION: Patients with obstructive upper gastrointestinal malignancies often suffer from severe dysphagia and cachexia, necessitating enteral feeding. While open feeding jejunostomy (OFJ) is the traditional approach, laparoscopic feeding jejunostomy (LFJ) offers a minimally invasive alternative. This study aimed to compare the safety and outcomes of LFJ versus OFJ. PATIENTS AND METHODS: A prospective, randomised controlled trial was conducted at a tertiary care centre in South India from April 2022 to June 2023. Patients with obstructive upper gastrointestinal cancers were randomised to undergo LFJ or OFJ. The primary endpoint was the incidence of early major complications (Clavien-Dindo grade ≥3). The secondary endpoints included operative time, intraoperative complications, post-operative pain, time to initiate and reach full-strength jejunal feeding, hospital stay and minor complications (Clavien-Dindo grade ≤2). Patients were followed for 30 days postoperatively. RESULTS: Fifty-nine patients met the inclusion criteria (30 LFJ, 29 OFJ). Baseline characteristics were similar, except for a higher rate of comorbidities in the OFJ group. The incidence of major complications was not significantly different (LFJ 10% vs. OFJ 17%, P = 0.472). LFJ was associated with significantly fewer minor complications (26.6% vs. 89.6%, P < 0.001), reduced post-operative pain, earlier initiation of feeds and shorter hospital stay. Operative time was longer in the LFJ group (100.4 ± 12.5 vs. 59.2 ± 6.9 min, P < 0.001). CONCLUSIONS: LFJ is a safe and effective alternative to OFJ, offering better post-operative recovery despite a longer operative time and is recommended in appropriate candidates.
Caecal volvulus following extended view totally extraperitoneal repair for complex ventral hernia.
Pai A, Dasgupta P
J Minim Access Surg · 2026 Jan · PMID 41351258 · Full text
Caecal volvulus is a rare complication in the post-operative period which if missed can result in fatal complications. We present our experience with a 50-year-old female with complex ventral hernia (L3L4 W2 as per Europ...
Caecal volvulus is a rare complication in the post-operative period which if missed can result in fatal complications. We present our experience with a 50-year-old female with complex ventral hernia (L3L4 W2 as per European Hernia Society Classification) who underwent extended view totally extraperitoneal repair with unilateral transversus abdominis release and developed post-operative caecal volvulus with acute small intestinal obstruction. She was taken up for emergency surgery and underwent diagnostic laparoscopy with open right hemicolectomy and mesh explantation. Surgeons must be aware of the possibility of such a rare complication, the means of diagnosis and modalities of treatment available for the treatment of caecal volvulus.
Closure of peritoneal rents during total extraperitoneal inguinal hernia repair using nonabsorbable polymer ligating clips "Hem-o-Lok®".
Ahuja A, Dey A, Manglik S … +2 more , Malik VK, Mittal T
J Minim Access Surg · 2025 Dec · PMID 41351249 · Publisher ↗
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Complete transabdominal and transgastric resection of gastric masses using ordinary laparoscopic instruments.
Zhong K, Ding S, Fu Y … +3 more , Li F, Chen Z, Fang B
J Minim Access Surg · 2026 Jan · PMID 41351233 · Full text
OBJECTIVE: The objective of the study was to explore the feasibility of ordinary laparoscopic instruments for completing laparoscopic intragastric resection of mass near the cardia and pylorus without endoscopic assistan...
OBJECTIVE: The objective of the study was to explore the feasibility of ordinary laparoscopic instruments for completing laparoscopic intragastric resection of mass near the cardia and pylorus without endoscopic assistance. PATIENTS AND METHODS: From March 2018 to October 2022, laparoscopic intragastric resection was performed to remove submucosal masses near the cardia (7 cases) and antrum (3 cases) that were difficult to remove under gastroscopy. The diameter of the tumour is 1.0-4.0 cm, with an average of 2.75 cm. The results showed that all 10 cases underwent surgery smoothly, with a surgical time of 66-134 min, an average of 97.6 min, intraoperative bleeding of 10-30 mL, an average of 18 mL and post-operative hospitalisation of 3-7 days, an average of 4.3 days. No complications were occurred. CONCLUSION: It is safe and feasible to complete transabdominal and transgastric resection of gastric masses using ordinary laparoscopic instruments without the assistance of endoscopy.
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