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Surgical Endoscopy

Sudeep Hegde, Mark A Gromski, Tansel Halic, Melih Turkseven, Zhaohui Xia, Berk Çetinsaya, Mandeep S Sawhney, Daniel B Jones, Suvranu De, Cullen D Jackson
BACKGROUND: One of the major impediments to the proliferation of endoscopic submucosal dissection (ESD) training in Western countries is the lack of sufficient experts as instructors. One way to address this gap is to develop didactic systems, such as surgical simulators, to support the role of trainers. Cognitive task analysis (CTA) has been used in healthcare for the design and improvement of surgical training programs, and therefore can potentially be used for design of similar systems for ESD...
May 17, 2019: Surgical Endoscopy
Tomoko Mizota, Nicholas E Anton, Elizabeth M Huffman, Michael J Guzman, Frederick Lane, Jennifer N Choi, Dimitrios Stefanidis
BACKGROUND: Fundamentals of Endoscopic Surgery (FES) has become a board certification requirement for general surgery residents. While the FES program provides a robust didactic curriculum, an endoscopic skills curriculum is lacking for this high stakes assessment. The aims of this study were to develop a proficiency-based endoscopic skills curriculum and assess its effectiveness on success in the FES exam. METHODS: Endoscopy experts developed a multiple-choice questionnaire based on the FES online didactics...
May 17, 2019: Surgical Endoscopy
Samantha L Margulies, Maria V Vargas, Denny Kathryn, D Sparks Andrew, Q Marfori Cherie, Moawad Gaby, L Amdur Richard
BACKGROUND: While laparoscopic hysterectomy has benefits compared to abdominal hysterectomy, the operative times are longer. Longer operative times have been associated with negative outcomes. This study's purpose was to elucidate if there is an operative time at which 30-day outcomes for laparoscopic hysterectomy become inferior to a more expeditiously completed abdominal hysterectomy. METHODS: This was a retrospective cohort study (Canadian Task Force classification II-2) using the American College of Surgeons National Surgical Quality Improvement Program database to identify women undergoing hysterectomy for benign indications from 2010 to 2016 by current procedural terminology code...
May 16, 2019: Surgical Endoscopy
Takeo Nomi, Fumitoshi Hirokawa, Masaki Kaibori, Masaki Ueno, Shogo Tanaka, Daisuke Hokuto, Takehiro Noda, Takuya Nakai, Hisashi Ikoma, Hiroya Iida, Koji Komeda, Morihiko Ishizaki, Shinya Hayami, Hidetoshi Eguchi, Masataka Matsumoto, Ryo Morimura, Hiromitsu Maehira, Masayuki Sho, Shoji Kubo
BACKGROUND: The frequency of liver resection in elderly patients has been increasing. However, data are limited regarding the safety of laparoscopic liver resection (LLR) compared with that of open liver resection (OLR) for hepatocellular carcinoma (HCC) in elderly patients. The present study aimed to compare short-term outcomes between LLR and OLR in elderly patients with HCC using propensity score matching. METHODS: The study included 630 patients (age, ≥ 75 years) who underwent liver resection for HCC at nine liver centres between April 2010 and December 2017...
May 15, 2019: Surgical Endoscopy
David Wei, Stephen Johnston, Laura Goldstein, Deborah Nagle
BACKGROUND: We used a population-based database to: (1) compare clinical and economic outcomes between minimally invasive surgery (MIS) and open surgery (OS) for colectomy; and (2) evaluate contemporary trends in MIS rates. METHODS: Retrospective Premier Healthcare Database review of patients undergoing elective inpatient colectomy between January 1, 2010 and September 30, 2017 (first = index admission). Patients were classified into MIS (laparoscopic/robotic) or OS groups, and by left or right colectomy...
May 14, 2019: Surgical Endoscopy
Elif Bilgic, Motaz Alyafi, Tomonori Hada, Tara Landry, Gerald M Fried, Melina C Vassiliou
BACKGROUND: Laparoscopic suturing (LS) has become a common technique used in a variety of advanced laparoscopic procedures. However, LS is a challenging skill to master, and many trainees may not be competent in performing LS at the end of their training. The purpose of this review is to identify simulation platforms available for assessment of LS skills, and determine the characteristics of the platforms and the LS skills that are targeted. METHODS: A scoping review was conducted between January 1997 and October 2018 for full-text articles...
May 14, 2019: Surgical Endoscopy
Juan Mata, Nicolò Pecorelli, Pepa Kaneva, Dan Moldoveanu, Alexandre Gosselin-Tardiff, Mohsen Alhashemi, Stephan Robitaille, Saba Balvardi, Lawrence Lee, Barry L Stein, Sender Liberman, Patrick Charlebois, Julio F Fiore, Liane S Feldman
BACKGROUND: Increased adherence with enhanced recovery pathways (ERP) is associated with improved outcomes. However, adherence to postoperative elements that rely on patient participation remains suboptimal. Mobile device apps may improve delivery of health education material and have the potential to foster behavior change and improve patient compliance. The objective of this study was to estimate the extent to which a novel mobile device app affects adherence to an ERP for colorectal surgery in comparison to standard written education...
May 13, 2019: Surgical Endoscopy
Yasushi Hasegawa, Hiroyuki Nitta, Takeshi Takahara, Hirokatsu Katagiri, Shoji Kanno, Akira Sasaki
BACKGROUND: The use of pure laparoscopic donor hepatectomy has been increasing, with various advantages reported. However, the Glissonean approach has not been adopted despite its usefulness. The aim of this study was to introduce the Glissonean pedicle approach for laparoscopic living donor hepatectomy. METHODS: We retrospectively reviewed data from 11 patients who underwent pure laparoscopic donor hepatectomy for adult living donor liver transplantation. In this novel operative procedure, after mobilization of the liver, the right or left Glissonean pedicle was encircled, and then the liver parenchymal transection was completed...
May 13, 2019: Surgical Endoscopy
Jun-Ook Park, Yeong Jun Park, Mi Ra Kim, Dong-Il Sun, Min-Sik Kim, Yoon Woo Koh
BACKGROUND: The transoral endoscopic thyroidectomy vestibular approach (TOETVA) has been the subject of increasing interest from several institutions around the world over the last 2 years. Recently, we successfully performed TOETVA in live human patients without CO2 gas using our newly designed retractable blade. METHODS: We reviewed the medical records of 15 consecutive patients who underwent gasless TOETVA using a self-retaining retractor. RESULTS: We successfully performed 13 thyroid lobectomies and 2 total thyroidectomies in 15 patients...
May 13, 2019: Surgical Endoscopy
Kamleshsingh Shadhu, Dadhija Ramlagun, Yao Wang, Xiaochun Ping, Tao Chen, Yanhui Zhu, Zekuan Xu
PURPOSE: The aim of this study was to compare the outcomes of laparoscopic appendectomy (LA) using purse string invaginating sutures (PS) with those using intracorporeal knotting (IK) or Hem-o-lock polymeric clips (HL). METHODS: A total of 882 patients who underwent laparoscopic appendectomy from January 2015 to December 2017 were studied retrospectively. Of these, 538 patients used PS, 229 patients used IK and 115 patients used HL to close the appendiceal stump...
May 13, 2019: Surgical Endoscopy
Hisanori Miki, Yosuke Fukunaga, Toshiya Nagasaki, Takashi Akiyoshi, Tsuyoshi Konishi, Yoshiya Fujimoto, Satoshi Nagayama, Masashi Ueno
BACKGROUND: Needlescopic surgery (NS) is a minimally invasive technique for colorectal cancer. NS may be easier to perform than other minimally invasive surgery such as single-incision laparoscopic surgery and natural orifice transluminal endoscopic surgery because the port setting is the same while the shafts are thinner than in conventional laparoscopic surgery. We evaluated the capability of introducing this surgery for sigmoid and rectosigmoid colon cancer by assessing the learning curve in Japanese Endoscopic Surgical Skill Qualification System (JESSQS)-unqualified surgeons...
May 13, 2019: Surgical Endoscopy
Saurabh Chandan, Babu Pappu Mohan, Ojasvini Choudhry Chandan, Lokesh Kumar Jha, Harmeet Singh Mashiana, Alexander Todd Hewlett, Mouen A Khashab
BACKGROUND: POEM has been successfully performed in patients with spastic esophageal disorders (SED), such as diffuse esophageal spasm, jackhammer esophagus, and type 3 achalasia. We performed a systematic review and meta-analysis to evaluate its efficacy in these patients and if total average myotomy length and prior medical or endoscopic treatments affected clinical success. METHODS: PubMed, EMBASE, Google-Scholar, Scopus, and Cochrane Review were searched for studies on POEM in SED from 2008 to September 2018...
May 9, 2019: Surgical Endoscopy
Akira Dobashi, Andrew C Storm, Louis M Wong Kee Song, Jodie L Deters, Charles A Miller, Crystal J Tholen, Christopher J Gostout, Elizabeth Rajan
BACKGROUND: Efficacy of an internal magnet traction device (MTD) for gastric endoscopic submucosal dissection (ESD) by an expert endoscopist has been reported. We hypothesized that use of the MTD would enhance the performance of colorectal ESD in a non-expert endoscopist in ESD compared to the conventional technique. Primary aim of this study was to compare procedure times between conventional ESD (C-ESD) and MTD-assisted ESD (MTD-ESD) by expert and non-expert endoscopists in ESD. Secondary aims included rate of en bloc resection, iatrogenic injury, visualization score of the submucosal layer, and endoscopist satisfaction score...
May 8, 2019: Surgical Endoscopy
Amir Ben Yehuda, Abraham Nyska, Amir Szold
BACKGROUND: Mesh fixation in hernia repair is currently based on penetrating sutures or anchors, with proven early and late complications such as pain, adhesions, erosions, and anchor migration. In an attempt to reduce these complications, a bio-adhesive-based self-fixation system was developed. The purpose of this study was to assess the performance and safety of this novel self-adhesive mesh (LifeMesh™) by comparing it with standard tack fixation. METHODS: A full-thickness abdominal wall defect was created bilaterally in 24 pigs...
May 8, 2019: Surgical Endoscopy
Se Hyun Paek, Hye Ah Lee, Hyungju Kwon, Kyung Ho Kang, Sung Jun Park
BACKGROUND: There is ongoing debate about whether or not robot-assisted thyroidectomy is appropriate for modified radical neck dissection (MRND). The purpose of this study was to compare the surgical outcomes of robot-assisted MRND with those of a conventional open procedure. METHODS: One hundred and forty-five patients who underwent total thyroidectomy, bilateral central neck dissection, and MRND (robotic, n = 28; open, n = 117) at our institution from June 2011 to June 2015 were enrolled in the study...
May 7, 2019: Surgical Endoscopy
Zachary Sanford, Shyam Jayaraman, Adam S Weltz, H Reza Zahiri, Adrian Park
BACKGROUND: Current literature is conflicted regarding the efficacy of laparoscopic anti-reflux surgery (LARS) among obese patients complaining of pathologic reflux or otherwise symptomatic hiatal hernias. Controlling for other factors, this study examined the influence of preoperative body mass index (BMI) on clinical and subjective quality of life (QOL) outcomes following LARS. METHODS: Patients who underwent LARS between February 2012 and April 2018 were subdivided into four BMI stratified categories according to CDC definitions: normal (18...
May 6, 2019: Surgical Endoscopy
Gyu Young Pih, Sung Jin Jeon, Ji Yong Ahn, Hee Kyong Na, Jeong Hoon Lee, Kee Wook Jung, Do Hoon Kim, Kee Don Choi, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung, Seon-Ok Kim
BACKGROUND: Upper gastrointestinal bleeding (UGIB) is one of the major manifestations of gastrointestinal stromal tumor (GIST) of the stomach. Several studies have reported that GIST bleeding is associated with poor prognosis. However, only case reports have reported hemostasis modalities for treating hemorrhagic gastric GIST. To identify clinical outcome of gastric GIST bleeding, we analyzed risk factors and prognosis of hemorrhagic GIST evaluating hemostasis methods. METHODS: Total 697 patients histopathologically diagnosed with primary gastric GIST between January 1998 and May 2015 were enrolled to the study, retrospectively...
May 6, 2019: Surgical Endoscopy
Shin Miura, Atsushi Kanno, Koji Fukase, Yu Tanaka, Ryotaro Matsumoto, Tatsuhide Nabeshima, Seiji Hongou, Tetsuya Takikawa, Shin Hamada, Kiyoshi Kume, Kazuhiro Kikuta, Kei Nakagawa, Michiaki Unno, Atsushi Masamune
BACKGROUND: In patients with malignant perihilar biliary strictures, preoperative biliary drainage (PBD) of the hepatic lobe to be resected may decrease the liver volume of the future liver remnant (FLR) after percutaneous transhepatic portal vein embolization (PVE). However, evidence of its application is insufficient. This study aimed to clarify the effects of PBD on liver hypertrophy after PVE. METHODS: Between January 2008 and December 2017, 169 patients with malignant perihilar biliary strictures underwent major hepatectomy or palliative surgery at our hospital...
May 6, 2019: Surgical Endoscopy
Fernando Dip, Luis Sarotto, Mayank Roy, Aaron Lee, Emanuelle LoMenzo, Matthew Walsh, Thomas Carus, Sylke Schneider, Luigi Boni, Takeaki Ishizawa, Nohiro Kokudo, Kevin White, Raul J Rosenthal
BACKGROUND: Incisionless fluorescent cholangiography (IFC) has recently been proven feasible, safe, and efficacious as an intraoperative procedure to help identify extrahepatic bile ducts during laparoscopic cholecystectomies (LC). We conducted a pilot survey of 51 surgeons attending an international conference who perform endoscopic cholecystectomies to identify their typical LC practices, and perceptions of IFC. METHODS: An international panel of ten IFC experts, all with > 500 prior IFC procedures and related research publications, convened during the 4th International Congress of Fluorescence-Guided Surgery in Boca Raton, Florida in February 2017...
May 6, 2019: Surgical Endoscopy
Christopher G Yheulon, Fadi M Balla, Edward Lin, S Scott Davis
INTRODUCTION: Percutaneous Endoscopic Gastrostomy (PEG) is an infrequent adjunct in elective paraesophageal hernia repair (PEHR). Guidelines denote that PEG "may facilitate postoperative care in selected patients." Though there is sparse literature defining which patients may benefit. The purpose of this study is to determine factors associated with simultaneous PEG placement during PEHR and their subsequent outcomes. METHODS: The NSQIP database was queried from 2011 to 2016 for patients undergoing elective laparoscopic PEHR...
May 6, 2019: Surgical Endoscopy
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