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  • Review|Open Access

    The role of splenic flexure mobilization in laparoscopic rectal surgery for rectal cancer

    Tao-Wei Ke, Christian Ross Geniales, William Tzu-Liang Chen
    Laparoscopic surgery for the treatment of colorectal cancer has gained an enormous advantage as compared to the traditional approach in terms of patient benefits. Although it has gained popularity among surgeons, there are still some contentious issues especially in laparoscopic rectal surgery. Splenic flexure mobilization (SFM) is a crucial aspect of the procedure with complex technical details thereby establishing a learning curve that cannot be easily overcome. A team of colorectal surgeons at China Medical University Hospital (CMUH) adopted a standardized approach to laparoscopic rectal... Read more
    This article belongs to the Special Issue A bespoke approach to rectal cancer resection and management
    Mini-invasive Surg 2018;2:35. | doi:10.20517/2574-1225.2018.46
    Published on: 9 Oct 2018  | Viewed:233  | Downloaded:19
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  • Review|Open Access

    Minimally invasive contact X-ray brachytherapy as an alternative option in patients with rectal cancer not suitable for bespoke surgical resection

    Arthur Sun Myint, Jean Pierre Gerard
    Surgery remains the gold standard treatment for rectal cancer. All published guidelines and most protocols recommend surgery as the standard of care. However, non-surgical management of rectal cancer is increasingly gaining acceptance as it avoids extirpative surgery and a stoma. In patients who are not suitable for surgery because of advancing age or medical comorbidities, and also in a small number of patients who are stoma phobic and refuse surgery, we need to consider an alternative treatment option to bespoke surgery. External beam radiotherapy is usually offered as an alternative.... Read more
    This article belongs to the Special Issue A bespoke approach to rectal cancer resection and management
    Mini-invasive Surg 2018;2:34. | doi:10.20517/2574-1225.2018.52
    Published on: 7 Oct 2018  | Viewed:234  | Downloaded:9
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  • Original Article|Open Access

    Laparoscopic hepatectomy for benign hepatic lesions: short and long-term outcomes including quality-of-life evaluation

    Sergio Renato Pais-Costa, Olímpia Alves Teixeira Lima, Guilherme Crispim Costa, Sandro José Martins
    Aim: Even though laparoscopic hepatectomy (LH) has proved to be both safe and effective in specialized centers; the restricted indications for resection in the case of benign liver lesions has resulted in poorly reported outcomes. Our aim was to describe the short and long-term results of LH to treat benign hepatic lesions, including quality of life (QoL) evaluation. Methods: Thirty-one LHs were performed between 2007 and 2018 in 30 patients. We evaluated QoL with the SF-36 test and a body image satisfaction questionnaire by personal interview before surgical treatment and at 1 month, 3... Read more
    This article belongs to the Special Issue New trends in minimally invasive management of liver tumors
    Mini-invasive Surg 2018;2:33. | doi:10.20517/2574-1225.2018.33
    Published on: 29 Sep 2018  | Viewed:127  | Downloaded:6
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  • Review|Open Access

    Enhanced recovery after rectal surgery: what we have learned so far

    Giovanni D. Tebala, Ayeshah Gordon-Dixon, Mohammad Imtiaz, Ashish Shrestha, Mohamed Toeima
    Enhanced recovery after surgery (ERAS) protocols are gradually becoming the gold standard in the perioperative management of rectal patients. It is a multimodal and multidisciplinary approach that has the great merit to involve and empower the patient and bring him or her back to the centre of the strategy of care. If applied correctly, ERAS can improve the postoperative recovery, reduce the rate of complications and reduce the postoperative length of stay, in patients who had extensive pelvic dissection. The factors within ERAS and their application do not represent rigid schematizations... Read more
    This article belongs to the Special Issue A bespoke approach to rectal cancer resection and management
    Mini-invasive Surg 2018;2:32. | doi:10.20517/2574-1225.2018.37
    Published on: 28 Sep 2018  | Viewed:240  | Downloaded:17
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  • Review|Open Access

    Reduced-port surgery for rectal cancer

    Takashi Ishida, Kohei Shigeta, Koji Okabayashi, Masashi Tsuruta, Hirotoshi Hasegawa, Yuko Kitagawa
    Laparoscopic surgery for rectal cancer has short-term and long-term oncological outcomes similar to those of open surgery. Conventional multiport laparoscopic surgery (CMLS) for rectal cancer requires four or five abdominal incisions for trocars, each of which could lead to complications and/or pain. Single-incision laparoscopic surgery (SILS) would reduce the incidence of such wound-related complications and achieve better cosmetic outcomes relative to CMLS. The potential advantages of SILS are less pain and more rapid recovery than achieved with CMLS. However, SILS is rarely used for... Read more
    This article belongs to the Special Issue A bespoke approach to rectal cancer resection and management
    Mini-invasive Surg 2018;2:31. | doi:10.20517/2574-1225.2018.53
    Published on: 28 Sep 2018  | Viewed:110  | Downloaded:4
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  • Review|Open Access

    Current state of transanal minimally invasive surgery in the management of rectal cancer

    Arman Erkan, Justin J. Kelly, John R. T. Monson
    Rectal cancer surgery has undergone a rapid change over the last few decades. We have come a long way from abdominoperineal resection to minimally invasive sphincter preserving techniques. Colorectal cancer screening programs made it possible to diagnose patients at earlier stages and this has led to question the necessity of radical surgery and the possibility of organ preservation. The platform most recently added to the surgical armamentarium is transanal minimally invasive surgery (TAMIS). It utilizes conventional laparoscopic tools to perform endoluminal surgery in rectum. Along with... Read more
    This article belongs to the Special Issue A bespoke approach to rectal cancer resection and management
    Mini-invasive Surg 2018;2:30. | doi:10.20517/2574-1225.2018.51
    Published on: 26 Sep 2018  | Viewed:219  | Downloaded:16
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  • Review|Open Access

    Open or laparoscopic resection: does approach matter?

    Ebru Esen, Cihangir Akyol
    In colon cancer surgery, laparoscopic resection is a safer and more feasible method than open resection; however, despite its increasing popularity in recent years, laparoscopic approaches for the treatment of rectal cancer have not become a standard therapy option, due to the technical difficulties in gaining access to the deep and narrow pelvis and the steep learning curve. Multiple randomized trials found that short-term oncological outcomes and perioperative mortality and morbidity were comparable between laparoscopic and open rectal surgery, whereas comparative data between the two... Read more
    This article belongs to the Special Issue A bespoke approach to rectal cancer resection and management
    Mini-invasive Surg 2018;2:29. | doi:10.20517/2574-1225.2018.32
    Published on: 26 Sep 2018  | Viewed:282  | Downloaded:17
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  • Original Article|Open Access

    Effect of mental training on short-term psychomotor skill acquisition in laparoscopic surgery - a pilot study

    Mohammad K Riaz, Abdul Muiz Shariffuddin, Benjie Tang, Afshin Alijani
    Aim: The mental demands of laparoscopic surgery create a steep learning curve for surgical trainees. Experienced surgeons informally conduct mental training prior to starting a complex laparoscopic procedure. Reconstructing haptic feedback to mentally observe surgeon-instrument-tissue interaction is considered to be acquired only with experience. An experiment was devised to implement mental training for the haptic feedback reconstruction and its effect on laparoscopic task performance was observed. Methods: Twenty laparoscopy novice medical students with normal/corrected visual acuity and... Read more
    Mini-invasive Surg 2018;2:28. | doi:10.20517/2574-1225.2018.41
    Published on: 15 Sep 2018  | Viewed:811  | Downloaded:11
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  • Original Article|Open Access

    Clinical feasibility of sphincter-preserving resection with transanal rectal dissection for low-lying rectal cancer in Japanese patients: a single-center cohort study

    Kimihiko Funahashi, Junichi Koike, Hiroyuki Shiokawa, Mitsunori Ushigome, Tomoaki Kaneko, Satoru Kagami, Takamaru Koda, Tatsuo Teramoto
    Aim: Recently, the transanal down-to-up rectal dissection, a new approach to improve the difficult total mesorectal excision (TME) for low-lying rectal cancer, has been popularized. This study assessed the long-term oncologic and functional outcomes after sphincter-preserving resection combined with transanal rectal dissection (TARD) under direct vision for both complete TME and preservation of the internal anal sphincter (IAS) as much as possible to clarify the clinical feasibility of this approach. Methods: A prospective cohort study was conducted in 90 Japanese patients between April... Read more
    This article belongs to the Special Issue A bespoke approach to rectal cancer resection and management
    Mini-invasive Surg 2018;2:27. | doi:10.20517/2574-1225.2018.28
    Published on: 28 Aug 2018  | Viewed:422  | Downloaded:19
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  • Original Article|Open Access

    Repeat thermal ablation for local progression of lung tumours: how safe and efficacious is it?

    Henry Zhao, Satomi Okano, Anita Pelecanos, Karin Steinke
    Aim: To retrospectively evaluate the safety and efficacy of repeat thermal ablation for local progression of lung tumours after prior ablation(s). Methods: From December 2009 to March 2017, 13 patients underwent repeat ablation [11 repeat microwave ablations and 2 repeat radiofrequency ablations] of a lung tumour [9 non-small cell lung carcinomas, 3 metastatic colorectal adenocarcinomas, 1 metastatic pelvic sarcoma] for local progression after prior ablation(s). Safety of the procedure was assessed by presence or absence of adverse events. Efficacy of the procedure was assessed by local... Read more
    Mini-invasive Surg 2018;2:26. | doi:10.20517/2574-1225.2018.27
    Published on: 28 Aug 2018  | Viewed:360  | Downloaded:9
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  • Review|Open Access

    Completion proctectomy following transanal endoscopic microsurgery for early rectal cancer

    Katarina Levic-Souzani, Orhan Bulut
    Transanal endoscopic microsurgery (TEM) has proven to be a safe and effective procedure in removal of rectal lesions and may be used in treatment of early rectal cancer in selected patients. In cases when the TEM specimen shows non-radical resection, or histological high-risk factors, completion proctectomy (CP) is warranted. It is debated when it is the best time to perform CP following TEM. It is furthermore uncertain whether CP leads to an increased risk of abdominoperineal excision. Herein, we review the available literature regarding controversial issues with early completion... Read more
    This article belongs to the Special Issue A bespoke approach to rectal cancer resection and management
    Mini-invasive Surg 2018;2:25. | doi:10.20517/2574-1225.2018.35
    Published on: 16 Aug 2018  | Viewed:334  | Downloaded:14
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  • Review|Open Access

    Is laparoscopic rectal surgery really not non-inferior?

    Peter F. O’Donohue, Conor D. Warren, Carina F. K. Chow
    Laparoscopic rectal surgery has gained popularity over the last 20 years. Currently there are still questions surrounding the safety and efficacy of this technique as compared to the traditional open modalities. To date, despite the initial enthusiasm for laparoscopic rectal surgery this technique is yet to reach non-inferiority in trials when compared to open resection. This review article discusses the current evidence exploring the value of laparoscopic rectal surgery. It will discuss its evolution over the last 20 years, exploring all the major randomised control trials and their... Read more
    This article belongs to the Special Issue A bespoke approach to rectal cancer resection and management
    Mini-invasive Surg 2018;2:24. | doi:10.20517/2574-1225.2018.34
    Published on: 14 Aug 2018  | Viewed:386  | Downloaded:23
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  • Case Report|Open Access

    Endoscopic ultrasound-guided drainage of the biliary tree in malignant obstruction

    Elia Armellini, Fabrizio Mazza, Marco Ballarè, Giulio Donato, Marco Orsello, Pietro Occhipinti
    Endoscopic retrograde cholangiopancreatography (ERCP) with stenosis stenting is the procedure of choice for treatment of malignant biliary obstruction. It has a low failure rate (< 5%-10% in cases of normal anatomy). The traditional alternative is radiological percutaneous drainage with a variable and non-negligible burden of adverse events. Interventional endoscopic ultrasound offers real-time imaging of the bilio-pancreatic district with the possibility of accessing the main biliary duct and the left hepatic duct from the duodenum or stomach. Consequently, endoscopic ultrasound-guided... Read more
    This article belongs to the Special Issue New trends in minimally invasive management of liver tumors
    Mini-invasive Surg 2018;2:23. | doi:10.20517/2574-1225.2018.07
    Published on: 10 Aug 2018  | Viewed:446  | Downloaded:20
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  • Review|Open Access

    The role of transanal total mesorectal excision in rectal surgery

    Shlomo Yellinek, Steven D. Wexner
    Transanal total mesorectal excision (TaTME) is the newest approach for the resection of rectal cancer, according to the principles of TME. The evolution of TaTME started almost 40 years ago and is a combination of several important developments in both micro-endoscopic surgery and transanal surgery. The preliminary clinical data have revealed acceptable TME quality. Clinical trials to determine the long-term oncological results are still in process. In order to master TaTME, the surgeon should be an expert in laparoscopic rectal surgery as well as transanal microsurgery and follow a... Read more
    This article belongs to the Special Issue A bespoke approach to rectal cancer resection and management
    Mini-invasive Surg 2018;2:22. | doi:10.20517/2574-1225.2018.17
    Published on: 2 Aug 2018  | Viewed:1589  | Downloaded:85
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  • Original Article|Open Access

    Laparoscopic and endoscopic cooperative surgery for non-ampullary duodenal epithelial neoplasms

    Hiroki Toma, Kazuhiro Haraguchi, Kei Fujii, Tomonari Kobarai, Ichio Hirota, Toru Eguchi
    Aim: We herein describe our initial experience of laparoscopic and endoscopic cooperative surgery (LECS) for non-ampullary duodenal epithelial neoplasms (NADENs) and reveal its clinical significance. Methods: This study included 5 consecutive patients treated by LECS for NADENs between April 2015 and January 2016 in our hospital. For surgery, R0-resection of NADENs was accomplished by endoscopic submucosal dissection (ESD), and the mucosal defect resulting from ESD was subsequently repaired by laparoscopic seromuscular suture and endoscopic clipping. Clinical records were reviewed... Read more
    Mini-invasive Surg 2018;2:21. | doi:10.20517/2574-1225.2018.24
    Published on: 31 Jul 2018  | Viewed:884  | Downloaded:17
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  • Review|Open Access

    Functional results and quality of life after transanal total mesorectal excision

    Paola De Nardi
    This is a narrative review on ano-rectal, sexual, urinary, and quality of life outcomes after transanal total mesorectal excision (TME). Little is known on this topic as only a few studies are currently available in the literature. According to these, it appears that the functional results and quality of life are not substantially impaired compared with standard TME. However more data are needed to precisely assess the outcomes of this technique. Read more
    This article belongs to the Special Issue A bespoke approach to rectal cancer resection and management
    Mini-invasive Surg 2018;2:20. | doi:10.20517/2574-1225.2018.30
    Published on: 24 Jul 2018  | Viewed:768  | Downloaded:42
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  • Review|Open Access

    Minimal invasive approach for beyond total mesorectal excision/extended resections in rectal cancer

    Naveena A. N. Kumar, Praveen Kammar, Avanish Saklani
    Minimal invasive surgery (MIS) is an accepted modality of treatment for rectal cancer. The indications for MIS have gradually been extended to locally advanced and locally recurrent rectal cancer as a result of technological advances in instrumentation, advances in surgical techniques, increased surgeon experience, and high volume center. However, safety and feasibility of laparoscopic surgery and robotic surgery in beyond total mesorectal excision (b-TME) and extended TME (e-TME) are not well established. This review summarizes the current evidence for MIS approach for b-TME/extended... Read more
    This article belongs to the Special Issue A bespoke approach to rectal cancer resection and management
    Mini-invasive Surg 2018;2:19. | doi:10.20517/2574-1225.2018.26
    Published on: 23 Jul 2018  | Viewed:764  | Downloaded:20
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  • Review|Open Access

    Is robotic rectal resection the preferred option for resectable cancer?

    Hanumant Chouhan, James Shin, Seon-Hahn Kim
    The ultimate goal of rectal cancer surgery is to achieve a negative circumferential, distal resection margin and intact mesorectal excision; however, controversy remains as to what is the best approach. Based on the current evidence, open surgery remains the “gold standard”, however recent improvements in minimally invasive surgery (MIS) techniques with the introduction of robotic surgery and transanal total mesorectal excision have questioned the historical approach of open rectal dissection. A robotic system (da Vinci) overcomes many of the limitations of laparoscopic surgery. A robotic... Read more
    This article belongs to the Special Issue A bespoke approach to rectal cancer resection and management
    Mini-invasive Surg 2018;2:18. | doi:10.20517/2574-1225.2018.40
    Published on: 20 Jul 2018  | Viewed:512  | Downloaded:22
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  • Review|Open Access

    The treatment of early rectal cancer in the era of adjuvant and neo-adjuvant therapy

    Michael G. Thomas, David E. Messenger, Katherine Gash
    The accurate staging of rectal cancer improves the stratification of patients for adjuvant therapy. Staging of tumor with endoluminal ultrasonography (EUS) shows a good correlation with histology (κ = 0.85; 95% confidence interval 0.76-0.95). Overall pT and pN stage accuracy of EUS was 92% and 65% respectively. The staging of local disease can be further augmented by EUS guided fine needle aspiration of extra rectal lesions lying within or outside of the mesorectum. In a systematic review of local excision after neoadjuvant therapy a total of 22 unique studies reporting on 1068 patients... Read more
    This article belongs to the Special Issue A bespoke approach to rectal cancer resection and management
    Mini-invasive Surg 2018;2:17. | doi:10.20517/2574-1225.2018.25
    Published on: 18 Jul 2018  | Viewed:393  | Downloaded:19
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  • Meta-Analysis|Open Access

    Maternal and fetal delivery outcomes in pregnancies following bariatric surgery: a meta-analysis of the literature

    Brittanie Young, Samantha Drew, Christopher Ibikunle, Aliu Sanni
    Aim: The objective of this study is to evaluate maternal and fetal outcomes following pregnancies after bariatric surgery as compared to the general population affected by obesity. Methods: A systematic review was conducted through MEDLINE, Cochrane, and EMBASE to identify relevant studies from 2007 to 2016 with comparative data on the maternal and fetal delivery outcomes following bariatric surgery as compared to the population affected by obesity. The primary outcome analyzed was the rate of cesarean deliveries. Other outcomes included intrauterine growth restriction, small for... Read more
    Mini-invasive Surg 2018;2:16. | doi:10.20517/2574-1225.2017.50
    Published on: 28 Jun 2018  | Viewed:1572  | Downloaded:56
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