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  • Expanding indications: hybrid surgical-percutaneous coronary intervention (PCI) coronary revascularization of chronic total occlusions in patients with multivessel coronary artery disease (CAD)

    Michael F. Bode, Farouc A. Jaffer
    Mini-invasive Surg 2022;6:52. DOI: 10.20517/2574-1225.2022.45
    Abstract
    Hybrid revascularization of multivessel coronary artery disease by combining coronary artery bypass grafting (CABG) and ... MORE
    Hybrid revascularization of multivessel coronary artery disease by combining coronary artery bypass grafting (CABG) and chronic total occlusion (CTO) percutaneous coronary intervention (PCI) is a relatively novel concept. Hybrid CABG-CTO PCI aims to combine the durable clinical benefits of a left internal mammary artery graft (ideally minimally invasively) with the durability of CTO PCI in non-left anterior descending vessels. This review assesses the current evidence for performing hybrid CTO PCI-CABG and pre-procedural planning considerations. LESS      Full article
    Review|Published on: 13 Sep 2022
    Full-Text | PDF-528K

  • Ureter identification utilizing indocyanine green (ICG) imaging in colorectal surgery: a systematic review of the literature

    Zoe Garoufalia, Steven D. Wexner
    Mini-invasive Surg 2022;6:51. DOI: 10.20517/2574-1225.2022.60
    Abstract
    Aim: To describe the currently available evidence regarding the efficacy and safety of intraureteral indocyanine ... MORE
    Aim: To describe the currently available evidence regarding the efficacy and safety of intraureteral indocyanine green (ICG) instillation for ureteral identification in colorectal surgery. Methods: Systematic search of PubMed and Scopus through May 2022 reported according to PRISMA 2020. Studies reporting treatment of patients < 18 years, with unavailable full-text, reviews, editorials, animal studies, and studies including non-colorectal operations were excluded.Results: Seven retrospective studies, published between 2020 and 2022, were identified, in which 142 patients (43% females) were evaluated, of which three were undertaken in the USA, two in Japan, and two in India. The most common indications for surgery were cancer in 58 patients (41%) and diverticular disease in 52 patients (36.6%). Most patients involved underwent robotic surgery (70%), while the remaining patients had laparoscopic surgery. The intraoperative ureteral injury was reported in one patient, while adverse effects (mainly transient hematuria) were reported in 10% of the study population (14 patients). The use of intrauretal ICG prolonged surgery by a median of 12.8 minutes.Conclusion: Intraoperative visualization of ureters using ICG in colorectal surgery is safe and effective, according to the results of this study. However, this technique still bears the potential disadvantages of ureteral catheterization. Research is focusing on future dyes combining the ICG properties with renal excretion to minimize the need for stents. Further comparative studies are needed to reach safe results. LESS      Full article
    Systematic Review|Published on:  1 Sep 2022
    Full-Text | PDF-465K

  • Endoscopic submucosal dissection for early gastric adenocarcinoma: basic procedures and management of complications

    Takahiko Nakamura, Noriya Uedo
    Mini-invasive Surg 2022;6:50. DOI: 10.20517/2574-1225.2022.38
    Abstract
    Mastery of endoscopic submucosal dissection (ESD) requires a deep understanding of not only the technique ... MORE
    Mastery of endoscopic submucosal dissection (ESD) requires a deep understanding of not only the technique but also the preparation, electrosurgical unit, its peripherals, and probable procedural complications. An endoscope with a water-jet function is suitable for gastric ESD. A transparent attachment on the tip of the endoscope is necessary. The mucosal preparation is important for proper lesion recognition and precise device movement during the procedure and to reduce the risk of complications. A needle-type knife allows accurate tissue dissection and is especially useful for dissecting fibrosis in the submucosa. A partially insulated-type knife prevents current transmission from the tip of the needle to the deep tissues, thus reducing the risk of unintentional perforation or bleeding. When using a scissor-type knife, stable device movement is possible and unintended tissue dissection is minimized. The electrosurgical unit mode must be adjusted according to the different tissue conditions. The basic techniques for ESD incision and dissection should be mastered, and the appropriate knives, accessories, strategy, and traction device should be methodically selected by each operator. The main complications of ESD are bleeding and perforation, which should be treated appropriately when they occur. LESS      Full article
    Review|Published on:  1 Sep 2022
    Full-Text | PDF-1.5M

  • Antithrombotic therapy in patients undergoing transcatheter aortic valve replacement (TAVR): from current evidence to perspective

    Silvia Mauri, ... Marco Ferlini
    Mini-invasive Surg 2022;6:49. DOI: 10.20517/2574-1225.2022.34
    Abstract
    The use of transcatheter aortic valve replacement (TAVR) for care of symptomatic severe aortic stenosis ... MORE
    The use of transcatheter aortic valve replacement (TAVR) for care of symptomatic severe aortic stenosis has increased over the last years; after initially treating patients at prohibitive or high surgical risk, nowadays the procedure can be considered for intermediate or low surgical risk. Although thrombotic events (ischemic stroke, myocardial infarction, and leaflet thrombosis) decreased in patients at lower risk, antithrombotic therapy after TAVR is still recommended. However, the optimal antithrombotic regimen is a still matter of debate due to the lack of randomized data and the concomitant increased risk of bleeding events. In the present review, we analyze current data, recommendations of international guidelines and consensus documents, and potential future scenarios with a rational approach of separation of patients with or without a pre-procedural indication for long-term oral anticoagulant therapy. LESS      Full article
    Review|Published on:  1 Sep 2022
    Full-Text | PDF-1014K

  • More efficient vaporization by the 200-W Thulium laser system than by the GreenLight high-performance system (HPS) 120-W system

    Masatake Shinohara, ... Toshihisa Saka
    Mini-invasive Surg 2022;6:48. DOI: 10.20517/2574-1225.2022.47
    Abstract
    Aim: We retrospectively compared and evaluated the safety, efficacy, and 1-year outcomes of 200-W Thulium ... MORE
    Aim: We retrospectively compared and evaluated the safety, efficacy, and 1-year outcomes of 200-W Thulium laser vaporization of the prostate (ThuVAP) and the GreenLight high-performance system (HPS) 120-W system for benign prostatic hyperplasia (BPH). Methods: Between February 2019 and December 2021, 137 patients with lower urinary tract symptoms secondary to BPH underwent ThuVAP. Between October 2014 and April 2019, 233 patients underwent GreenLight HPS 120-W vaporization of the prostate (HPS-PVP). Prostate-specific antigen (PSA) levels, International Prostate Symptom Scores (IPSS), quality of life (QOL) scores, overactive bladder symptom scores (OABSS), post-void residual (PVR), and maximum flow rates (Qmax) were evaluated before and 1, 3, 6, and 12 months after surgery.Results: Mean ages in the ThuVAP and HPS-PVP groups were 73.7 and 73.4 years, respectively. Prostate volumes (PV) were 77.0 and 61.4 mL (P < 0.001), respectively. Significant improvements were observed in IPSS, QOL scores, OABSS, Qmax, and PVR in both groups 1 to 12 months after surgery. Laser and hospitalization times were significantly shorter and approximate tissue removal (ΔPV) was significantly larger in the ThuVAP group than in the HPS-PVP group (means, 49.4 min vs. 62.5 min, P < 0.001, means, 4.9 days vs. 5.4 days, P = 0.007, means, 50.4 mLvs. 27.8 mL, P < 0.001, respectively). Vaporization efficiency (ΔPV/laser time) was > 2-fold higher in the ThuVAP group than in the HPS-PVP group (1.1 mL/min vs. 0.5 mL/min). There were significantly fewer postoperative complications in the ThuVAP group than in the HPS-PVP group (13.9% vs. 23.6%, P = 0.030).Conclusion: Both procedures are safe and useful for BPH obstruction. Based on shorter operating and hospitalization times, fewer complications, and more efficient tissue removal, ThuVAP is a more favorable and effective treatment than HPS-PVP. LESS      Full article
    Original Article|Published on:  5 Aug 2022
    Full-Text | PDF-329K

  • Laparoscopic hepaticojejunostomy for the treatment of bile duct injuries in difficult scenarios (with video)

    Agustin Pinsak, ... Fernando A. Alvarez
    Mini-invasive Surg 2022;6:47. DOI: 10.20517/2574-1225.2022.50
    Abstract
    Open Roux-en-Y hepaticojejunostomy (RYHJ) is the treatment of choice for bile duct injuries (BDI) sustained ... MORE
    Open Roux-en-Y hepaticojejunostomy (RYHJ) is the treatment of choice for bile duct injuries (BDI) sustained during laparoscopic cholecystectomy. Although in recent years the mini-invasive approach has been explored at expert centers, laparoscopic RYHJ for challenging surgical scenarios has rarely been attempted. We herein report two cases of RYHJ for BDI in highly complex surgical scenarios, such as right posterior BDI or failure of previous repairs, with special emphasis on the technical aspects through the embedded videos. The first was an intraoperative repair in a 55-year-old female who suffered a Strasberg type C (transection of the aberrant right hepatic duct) thermal lesion. The second was an iterative repair in a 54-year-old female with a history of a Strasberg type E1 lesion (injury of the main hepatic duct more than 2 cm from the confluence) that had been repaired intraoperatively with an end-to-end anastomosis over a T-tube nine months before referral. Both patients had an uneventful recovery and were discharged four and five days after surgery. After 2.5 and 4 years of follow-up, both patients are asymptomatic and have normal imaging and laboratory tests. To our knowledge, there is no other report in the literature regarding intraoperative laparoscopic right posterior RYHJ for BDI. Laparoscopic RYHJ for BDI repair in the hands of expert laparoscopic biliary surgeons is feasible and safe, even in very challenging surgical scenarios, as herein reported, offering the benefits of mini-invasive surgery. Future high-quality and long-term comparative studies are necessary to elucidate its potential superiority against the standard open approach. LESS      Full article
    Technical Note|Published on:  1 Aug 2022
    Full-Text | PDF-4.6M
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Most Cited Papers In Last Two Years

  • Searching for a better definition of robotic surgery: is it really different from laparoscopy?

    Andrew A. Gumbs, ... Elie Chouillard
    Mini-invasive Surg 2020;4:90. DOI: 10.20517/2574-1225.2020.110
    Editorial|Published on: 10 Dec 2020
    Full-Text | PDF-971K

  • Gender disparities in weight loss surgery

    Sherif Aly, ... Luise I. M. Pernar
    Mini-invasive Surg 2020;4:21. DOI: 10.20517/2574-1225.2019.57
    Abstract
    Obesity is a growing epidemic affecting more than one third of the United States’ population. ... MORE
    Obesity is a growing epidemic affecting more than one third of the United States’ population. It has detrimental effects on an individual’s health and is associated with myriad negative outcomes including increased mortality. It also poses a substantial financial burden on the healthcare system. Weight loss surgery is an effective way of treating obesity with tremendous positive outcomes. Most patients who undergo bariatric surgery lose a significant amount of weight, reverse most of their comorbidities, and enjoy an improved quality of life. However, fewer than one percent of patients eligible for bariatric surgery actually undergo treatment. Furthermore, there exists a considerable gender disparity, with women comprising 80% of those patients who undergo bariatric surgery, despite equal obesity rates across genders. Many barriers exist between obese patients and weight loss surgery including misconceptions among patients and primary care providers regarding the perceived risk of surgery. This is in addition to numerous other psychosocial and cultural factors that may have contributed to and precipitated the existing gender imbalance. This review aims to highlight barriers to patients undergoing bariatric surgery and examine factors leading to the gender disparity that exists. LESS      Full article
    Review|Published on: 10 Apr 2020
    Full-Text | PDF-334K

  • Laparoscopic Roux-en-Y gastric bypass for excess weight and diabetes: a multicenter retrospective cohort study in China

    Wah Yang, ... Cunchuan Wang
    Mini-invasive Surg 2021;5:11. DOI: 10.20517/2574-1225.2021.06
    Abstract
    Aim: The aims of this study were to better understand the outcomes of Roux-en-Y gastric ... MORE
    Aim: The aims of this study were to better understand the outcomes of Roux-en-Y gastric bypass (RYGB) surgery in patients across multiple hospitals in China along with patients with type 2 diabetes mellitus (T2DM) and to explore the potential preoperative predictors of diabetes outcomes after RYGB.Methods: This was a retrospective cohort study in Chinese patients who underwent laparoscopic RYGB at five Chinese hospitals from April 2009 to December 2014 and returned for follow-up approximately one-year post-surgery. The STROCSS guideline checklist was applied.Results: In total, 130 patients underwent RYGB: 85 males and 45 females; age, 43.4 ± 11.3 years; and preoperative body mass index (BMI), 33.1 ± 9.0 kg/m2. Of those, 103 (79.2%) had T2DM duration of 6.6 ± 4.7 years and pre-RYGB HbA1c of 8.1 ± 1.9%. Among the patients with T2DM, glycemic control (HbA1c < 7.0%) increased from 28.7% before surgery to 79.3% at 12 months post-procedure, with a concurrent reduction in the use of anti-hyperglycemic agents, including a reduction in insulin requirement from 55.4% to 27.0%. The percentage of excess weight loss was -42.8 ± 44.2%. Among 71 patients with T2DM and data about remission status, 14 (19.7%) achieved T2DM remission at 12 months post-surgery. Age and duration of T2DM were lower in the remission group, while baseline BMI and weight were higher compared with the non-remission group.Conclusion: RYGB may be effective for weight loss and T2DM control in Chinese patients, and outcomes are consistent with the literature in Western populations. Younger patients with T2DM and with a higher BMI pre-surgery and shorter duration of T2DM were more likely to achieve T2DM remission. LESS      Full article
    Original Article|Published on:  9 Mar 2021
    Full-Text | PDF-884K

  • Large hiatal hernia: minimizing early and long-term complications after minimally invasive repair

    Elettra Ugliono, ... Mario Morino
    Mini-invasive Surg 2021;5:2. DOI: 10.20517/2574-1225.2020.93
    Abstract
    Paraesophageal Hernia (PEH) is the protrusion of the stomach and/or other abdominal viscera into the ... MORE
    Paraesophageal Hernia (PEH) is the protrusion of the stomach and/or other abdominal viscera into the mediastinum due to an enlargement of the diaphragmatic hiatus. The treatment of PEH is challenging: On the one hand, watchful waiting carries the risk of developing acute life-threatening complications requiring an emergency operation. On the other hand, elective repair of PEH has non-negligible morbidity and mortality rates, also due to the characteristics of PEH affected patients, who are generally elder and frail. A review of the literature is presented to highlight strategies that can be adopted to minimize early and long-term complications after PEH surgical repair. The laparoscopic approach has been shown to provide reduced hospital stay, postoperative morbidity and mortality, and overall costs compared to traditional open surgery, and it is currently considered the standard approach both to elective and emergency operations. The evidence suggests that strict adherence to surgical principles, such as hernia sac excision, extended mediastinal dissection of the esophagus, and tension-free crural repair with or without mesh are mandatory to achieve optimal surgical outcomes and reduce PEH recurrence rate. Different shapes, materials, and techniques of prosthetic repair and the use of relaxing incisions have been proposed, but long-term data are lacking, and no conclusions can be drawn regarding the ideal method of crural closure. When a short esophagus is recognized despite extensive mediastinal dissection, esophageal lengthening procedures are indicated. Systematic addition of a fundoplication is strongly encouraged, for either treating gastroesophageal reflux or reducing recurrence rate. LESS      Full article
    Review|Published on:  7 Jan 2021
    Full-Text | PDF-1.4M
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About The Journal

  • ISSN

    2574-1225 (Online)

    Publisher

    OAE Publishing Inc.

    Article Processing Charges

    $600

  • Editor-in-Chief

    Giulio Belli

    Publishing Model

    Gold Open Access

    Copyright

    Copyright is retained by author(s)

  • Publication Frequency

    Continuously

    Indexing

    Scopus (Accepted for inclusion on Aug 15, 2022)

    Google Scholar

    CNKI

    Dimensions

Open Archives
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