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  • System for the safe deployment of minimally invasive pancreaticobiliary surgery in Japan

    Akio Saiura
    Mini-invasive Surg 2023;7:2. DOI: 10.20517/2574-1225.2022.119
    Abstract
    The Japanese healthcare system is characterized by universal coverage and free access. It is an ... MORE
    The Japanese healthcare system is characterized by universal coverage and free access. It is an excellent social system that allows everyone to receive advanced medical care at a low cost. Minimally invasive hepato-pancreato-biliary (HPB) surgery in Japan is now covered by insurance. However, after experiencing a series of serious medical accidents, Japan’s government requested a more advanced system to safely promote highly advanced surgery including laparoscopic HBP surgery. As a practical measure, the academic societies of HPB surgery established a new prospective registration system for all cases of minimally invasive HPB for highly advanced hepatobiliary and pancreatic surgery while utilizing the existing technical certification system. Under these systems, hepatobiliary and pancreatic surgeries in Japan are now being undertaken gradually but safely. LESS      Full article
    Editorial|Published on: 17 Jan 2023
    Full-Text | PDF-266K

  • Minimally invasive transthoracic resection of a segment eight liver tumor

    Elena Panettieri, ... Claudius Conrad
    Mini-invasive Surg 2023;7:1. DOI: 10.20517/2574-1225.2022.79
    Abstract
    Despite advances in technology and technique of minimally invasive liver surgery, resection of lesions in ... MORE
    Despite advances in technology and technique of minimally invasive liver surgery, resection of lesions in the posterosuperior segments such as segment 8 (S8) remains challenging. Compared to open surgery, there are specific differences that make minimally invasive access to S8 challenging. These include the caudal view along the axis of the hepatoduodenal ligament, increased distance between trocars and the operative field, and the liver fulcrum created by the anterolateral segments limiting the view. However, several advancements have helped to overcome these challenges, such as the use of intercostal trocars (combined lateral-abdominal approach) and a flexible tip camera. Consequently, a total thoracoscopic (transthoracic) approach was developed to resect subdiaphragmatic tumors, which may particularly benefit patients with a hostile abdomen. This article summarizes the anatomic, technical, and technological considerations for safe resection of lesions in S8. LESS      Full article
    Review|Published on:  4 Jan 2023
    Full-Text | PDF-622K

  • Robotic resection of hilar cholangiocarcinoma: a single institution experience

    Harel Jacoby, ... Iswanto Sucandy
    Mini-invasive Surg 2022;6:58. DOI: 10.20517/2574-1225.2022.58
    Abstract
    Aim: Hilar cholangiocarcinoma is an aggressive malignancy with a poor prognosis, for which only surgical ... MORE
    Aim: Hilar cholangiocarcinoma is an aggressive malignancy with a poor prognosis, for which only surgical resection offers potential cure. Because of its complex location in the porta hepatis, the standard surgical approach has been open surgery. With the gradual increase in the use of minimally invasive surgery, we aimed to describe our single institutional experience of robotic resection of hilar cholangiocarcinoma. To the best of our knowledge, this is the largest published series in North America.Methods: Between 2016-2022, we prospectively followed all patients who underwent robotic extrahepatic biliary resection for hilar cholangiocarcinoma.Results: Robotic resection of hilar cholangiocarcinoma was performed on 21 patients of median age 72 years, 16 (76%) of whom underwent concomitant hepatectomy. All patients initially presented with jaundice and underwent preoperative drainage. Median operative time was 458 minutes and the estimated blood loss was 150 mL. There were no intraoperative complications or conversions to open surgery. The length of stay was five days, with one readmission at 30 days. There were three postoperative complications and one postoperative mortality (at 90 days). R0 was attained in 90% (19/21) of cases and R1 in 10% (2/21). Our median follow-up time was 21 months. At the final follow-up, 15 patients were alive with no evidence of disease and six died.Conclusion: Robotic resection of hilar cholangiocarcinoma is safe and feasible and achieves excellent outcomes. We believe that robotic surgery will soon be an accepted approach for complex hepatobiliary resections, such as for hilar cholangiocarcinoma. LESS      Full article
    Original Article|Published on: 21 Dec 2022
    Full-Text | PDF-612K

  • Expanding the therapeutic options for Zenker’s diverticulum: from open diverticulectomy to transoral septoplasty

    Andrea Scardino, ... Luigi Bonavina
    Mini-invasive Surg 2022;6:57. DOI: 10.20517/2574-1225.2022.55
    Abstract
    Significant technical changes and a shift toward a transoral approach have occurred in the management ... MORE
    Significant technical changes and a shift toward a transoral approach have occurred in the management of Zenker’s diverticulum over the past three decades. Transoral stapling is already an established and commonly performed procedure. Zenker peroral endoscopic myotomy (Z-POEM) and Zenker peroral endoscopy septotomy (Z-POES) are innovative techniques that are rapidly spreading and replacing more traditional therapeutic options. This review provides an overview of the current status of minimally invasive transoral management to assess whether a tailored approach is feasible and safe and may improve quality of life and reduce recurrence rates. LESS      Full article
    Review|Published on: 14 Nov 2022
    Full-Text | PDF-423K

  • Magnetic-assisted surgery: the road from laparoscopy to robotics

    Gustavo Romero-Velez, ... Matthew D. Kroh
    Mini-invasive Surg 2022;6:56. DOI: 10.20517/2574-1225.2022.51
    Abstract
    The incorporation of magnetic fields into surgery to reduce the invasiveness of minimally invasive surgery ... MORE
    The incorporation of magnetic fields into surgery to reduce the invasiveness of minimally invasive surgery led to the creation of magnetic-assisted surgery. External magnets coupled with their internal counterparts assist during surgical procedures, avoiding the need for additional trocars. Multiple advances have been made in this field in the past 15 years, with new promising technologies being developed. This review centers on the history of magnetic-assisted surgery and the available evidence of its safety, benefits and discusses the very promising combination of this new paradigm-shift technology with robotics. LESS      Full article
    Review|Published on:  2 Nov 2022
    Full-Text | PDF-487K

  • Advanced mucosal imaging in colonoscopy: technical details and clinical applications

    Enrik John Aguila, ... Rajvinder Singh
    Mini-invasive Surg 2022;6:55. DOI: 10.20517/2574-1225.2022.35
    Abstract
    Over the past decades, the significant development in endoscopic imaging has revolutionized digestive endoscopy. Real-time ... MORE
    Over the past decades, the significant development in endoscopic imaging has revolutionized digestive endoscopy. Real-time optical diagnosis has become possible using different tools and techniques (dye-based and virtual chromoendoscopy) such as narrow band imaging, flexible spectral imaging color enhancement, i-Scan, blue-laser imaging and linked-color imaging. Polyp detection and characterization, and prediction of depth of invasion of colorectal cancers have improved remarkably. Confocal laser endomicroscopy and endocytoscopy have allowed the evaluation of lesions on a cellular level. Not far from the horizon are newer technological innovations such as artificial intelligence and texture and color enhancement imaging that are now being studied for their potential to further improve mucosal visualization, optical diagnosis and virtual histology. This review gives an overview of image-enhanced endoscopy (IEE) and discusses its clinical applications and future directions in the lower gastrointestinal (GI) tract. LESS      Full article
    Review|Published on: 27 Oct 2022
    Full-Text | PDF-1M
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Most Cited Papers In Last Two Years

  • 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

  • Urinary diversions for radical cystectomy: a review of complications and their management

    Catarina Laranjo Tinoco, Estevão Lima
    Mini-invasive Surg 2021;5:28. DOI: 10.20517/2574-1225.2021.35
    Abstract
    Radical cystectomy involves a urinary diversion, the most used being the ileal conduit and the ... MORE
    Radical cystectomy involves a urinary diversion, the most used being the ileal conduit and the orthotopic neobladder. This review focuses on the complications associated with these procedures, dividing them into general and diversion related complications, as well as their management. We conducted a search on PubMed and Scopus to identify eligible articles on complications of urinary diversions. Randomized controlled trials and systematic reviews with meta-analysis were preferred when available. Early complications occur in the first 90 days after surgery. The most common is post-operative ileus, followed by urinary tract infections and urinary leakage. Most complications occur in the late post-operative setting, being related to the type of urinary diversion. Some of these complications are renal failure, metabolic abnormalities, infections, urolithiasis, and ureteroenteric strictures, each with particular management options. Specific ileal conduit complications are conduit deformities and parastomal hernias. Neobladder patients can have continence problems, like incontinence or urinary retention, but also fistulas and dehiscence. Standardization of complications’ definitions and time-dependent reporting are crucial to better understand and manage these complications. Complication rates are similar between open and robot-assisted procedures and between intracorporeal and extracorporeal diversion. Radical cystectomy with urinary diversion is the most difficult surgical procedure in urology with high early and late complication rates. There is an urgent need of standardizing complication reporting to better compare different procedures. LESS      Full article
    Review|Published on:  6 Jun 2021
    Full-Text | PDF-387K

  • Computer-aided quality assessment (CAQ): the next step for artificial intelligence in colonoscopy?

    Ishita Barua, ... Yuichi Mori
    Mini-invasive Surg 2022;6:28. DOI: 10.20517/2574-1225.2022.05
    Abstract
    Recent developments and breakthroughs in artificial intelligence (AI) for colonoscopy have the potential to improve ... MORE
    Recent developments and breakthroughs in artificial intelligence (AI) for colonoscopy have the potential to improve the quality of colonoscopy. Computer-aided detection for colorectal polyps has been shown to increase the adenoma detection rate by more than 10%. Furthermore, recently developed computer-aided quality assessment (CAQ) systems, such as real-time withdrawal speed monitoring, are expected to provide additional gain in colonoscopy practice. However, the added clinical value of combining AI techniques is uncertain. This paper provides an overview of the latest evidence on CAQ systems and identifies knowledge gaps that need to be filled before widespread implementation. LESS      Full article
    Review|Published on: 16 May 2022
    Full-Text | PDF-393K
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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

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