Videosurgery and Other Miniinvasive Techniques

INTRODUCTION: Enhanced recovery after surgery (ERAS) is rarely used in minimally invasive endoscopic surgery, especially in endoscopic retrograde cholangiopancreatography (ERCP). AIM: This study evaluated the safety and efficacy of the ERAS protocol in patients undergoing ERCP for choledocholithiasis. MATERIAL AND METHODS: The study had a retrospective design and included patients with biliary tract stones who underwent ERCP between June 2019 and November 2022...

INTRODUCTION: Anastomotic leakage is one of the most dangerous complications after rectal surgery. It can cause systemic complications, reduce the quality of life and worsen the results of oncological treatment. One of the causes of anastomotic leak is insufficient blood supply to the anastomosis. Intraoperative infrared angiography with indocyanine green (ICG) is expected to improve the assessment of intestinal perfusion and thus prevent anastomotic leakage. AIM: To present the results of the use of ICG intraoperative angiography during rectal surgery in the prevention of anastomotic leakage...

INTRODUCTION: Laparoscopic minimally invasive surgery has been widely used in the diagnosis and treatment of gynaecological diseases. AIM: To investigate the effect of dexmedetomidine on perioperative haemodynamics and cognitive function in elderly gynaecological patients who underwent laparoscopic surgery. MATERIAL AND METHODS: Clinical baseline characteristics, haemodynamic parameters, renin activity, norepinephrine level, cognitive function, pain level, and sedation were compared between the 2 groups...

Awake video-assisted thoracoscopic surgery (A-VATS) enables the surgeon to penetrate the tissue via a small incision and with less contact between the lung and atmospheric pressure; postoperative respiratory functions are also less affected than in open surgery. A-VATS is a safer technique than traditional VATS and non-intubated video-assisted thoracoscopic surgery (NI-VATS) because it does not require muscle relaxants and sedoanalgesics. In particular, diagnostic VATS for pleural effusions can be easily performed over a single port using only local anaesthetic...

INTRODUCTION: Colon cancer is a common malignancy, for which surgery is currently the preferred therapy. AIM: To assess the effect of transversus abdominis plane block (TAPB) combined with low-dose dexmedetomidine on elderly patients undergoing laparoscopic colectomy. MATERIAL AND METHODS: Sixty-two elderly patients undergoing laparoscopic colectomy between March 2021 and March 2022 were randomly selected and equally divided into Group A (low-dose dexmedetomidine) and Group B (TAPB + low-dose dexmedetomidine) by the randomized double-blind method...

INTRODUCTION: To achieve effective weight loss and remission of comorbidities, various surgical methods are used in the treatment of obesity. The most common procedures performed worldwide are followed by the newest ones. AIM: To present the results of the first group of patients from a high-volume bariatric centre in central Europe and to compare single anastomosis sleeve ileal (SASI) as a primary and revisional procedure. MATERIAL AND METHODS: We retrospectively analysed patients who underwent SASI for obesity from December 2018 to June 2022 by the same team of surgeons...

INTRODUCTION: Gallstones are a common digestive system disease. AIM: To assess the effects of laparoscopic and choledochoscopic gallbladder-preserving cholecystolithotomy on the levels of operation indicators, gallbladder function, and cholecystokinin type-A receptor (CCKAR) in patients with gallstones. MATERIAL AND METHODS: The medical records of 100 patients with gallstones receiving operation from July 2019 to August 2022 were collected for retrospective analysis...

Minimally invasive techniques have been widely applied in general thoracic surgery. Compared with video-assisted thoracoscopic surgery (VATS), due to its theoretic superiority, robotic surgery is challenging the traditional position of VATS. With its unique advantages, including 3D vision and a high-freedom endowrist, it leads to easier lymph node dissection, more convenient blood vessel dissection, a shorter learning curve and competence for the completion of complex surgery. However, as a new surgical technology, the safety and efficacy of robotic-assisted thoracoscopic surgery (RATS) still need to be further verified...

INTRODUCTION: Over the past three decades, almost every type of abdominal surgery has been performed and refined using the laparoscopic technique. Surgeons are applying it for more procedures, which not so long ago were performed only in the classical way. The position of laparoscopic surgery is therefore well established, and in many operations it is currently the recommended and dominant method. AIM: The aim of the preparation of these guidelines was to concisely summarize the current knowledge on laparoscopy in acute abdominal diseases for the purposes of the continuous training of surgeons and to create a reference for opinions...

INTRODUCTION: Extensive subcutaneous emphysema may lead to a significantly prolonged hospital stay, cosmetic problems, and even death without timely treatment. However, the risk factors for it have been poorly studied. AIM: To clarify the prevalence and risk factors of extensive subcutaneous emphysema after pulmonary resection by video-assisted thoracoscopic surgery. MATERIAL AND METHODS: This is a retrospective matched case-control study...

INTRODUCTION: Although introduction of the laparoscopic approach for adrenal gland surgery revolutionized the strategy in management of adrenal gland tumors, open surgery is still a method of choice in some clinical scenarios. Moreover, laparoscopy may have limitations resulting in conversion. AIM: To assess risk factors predisposing for conversion based on our own material, including 256 laparoscopic adrenalectomies performed in 2009-2016. MATERIAL AND METHODS: A retrospective analysis of patients who underwent adrenalectomies between 2009 and 2016 was conducted...

INTRODUCTION: Despite improvements in patient selection, operative technique, and postoperative care, oesophagectomy remains one of the most morbid oncologic resection types. Introduction of minimally invasive practice has been shown to have a greater marginal benefit for oesophagectomy than most of the other types of procedures. AIM: To evaluate early surgical outcomes through the adoption of totally minimally invasive oesophagectomy and accumulating experience in perioperative management...

INTRODUCTION: Liver cirrhosis is a common diffuse and persistent liver disease in the gastroenterology department. AIM: To assess the effects of gastrointestinal endoscopy at different time points on the diagnosis and treatment of upper gastrointestinal bleeding (UGIB) in patients with liver cirrhosis. MATERIAL AND METHODS: The clinical data of 102 liver cirrhosis patients with UGIB admitted from July 2020 to May 2022 were retrospectively analysed...

INTRODUCTION: Laparoscopic sleeve gastrectomy (SG) is currently the most commonly performed bariatric operation, but re-do surgery may be necessary in up to half of the patients. Single anastomosis duodeno-ileal bypass (SADI-S) is quickly gaining recognition as a revisional procedure after failed SG. AIM: To discuss the surgical technique and analyze initial outcomes after introduction of SADI-S after SG with 1-year follow-up. MATERIAL AND METHODS: This is a retrospective cohort study of consecutive patients who underwent re-do bariatric surgery - revisional SADI-S - in 2021 at a secondary referral public hospital...

INTRODUCTION: Upper urinary tract epithelial carcinoma (UTUC) and bladder cancer are both sources of urinary epithelial cell. In our previous study of asymptomatic bladder tumors, we found that most of these tumors could be resected through the urethra without radical surgery. This study analyzed the treatment strategies for asymptomatic UTUC. AIM: To investigate the clinicopathological features and surgical methods of these patients, thus choosing appropriate surgical treatment...

Laparoscopic liver resection has become a standard practice in many surgical wards in elective liver surgery, due to its positive impact on reducing hospital stay and postoperative complications, including lower blood loss and transfusion rate. However, achieving proper hemostasis in liver surgery, due to its vast blood supply, still remains a main concern to surgeons. Therefore, numerous techniques were and are still being developed to further reduce blood loss and transfusion rate. The aim of this literature review was to summarize the best available methods for achieving the minimal blood loss and transfusion rate in laparoscopic liver surgery, according to the newest data...

INTRODUCTION: Both the trans-radial approach (TRA) and the trans-femoral approach (TFA) have been employed for cerebral angiography, but the relative advantages of these two techniques remain uncertain. AIM: To compare the relative safety and efficacy of the TRA and TFA when conducting cerebral angiography. MATERIAL AND METHODS: Relevant studies published up to August 2022 were identified in the PubMed, Embase, and Wanfang databases. The rate of successful cerebral angiography was the primary study endpoint, while secondary endpoints included successful puncture rates, operative duration, puncture time, fluoroscopic duration, complication rates, and duration of postoperative recovery...

INTRODUCTION: In laparoscopic surgery, it is the assistant who manipulates the laparoscope and manages the field of view. AIM: To develop an endoscopic image processing system that can adjust laparoscopic images as intended by the surgeon without interrupting the surgical procedure. MATERIAL AND METHODS: We developed a touchless user interface that displays a magnified image of the endoscope using information of the surgeon's gaze point acquired by an eye-tracking device and the surgeon's voice commands, and evaluated its usefulness during laparoscopic percutaneous extraperitoneal closure (LPEC) of pediatric inguinal hernia...

INTRODUCTION: Negative pressure wound therapy (NPWT) has been used in reducing the incidence of surgical site infections (SSIs) and wound complications across various surgical categories. SSIs are a common post-surgical complication following caesarean section (CS) births, making it necessary to use prophylactic interventions to reduce SSI and wound complication incidences. AIM: To conduct an updated meta-analysis on randomized controlled trials (RCTs) comparing SSI incidence and wound complications in women undergoing C-sections receiving NPWT or standard dressings after wound closure...

INTRODUCTION: Prediction models are increasingly being used to predict outcomes after surgery, and such a model would be a precious tool for patients with clear cell renal cell carcinoma (ccRCC) after surgery. AIM: To develop a comprehensive model for predicting disease-free survival (DFS) in patients with localized ccRCC. MATERIAL AND METHODS: In a retrospective analysis of 612 patients, least absolute shrinkage and selection operator (LASSO) Cox regression analysis was performed to identify significant predictors, and then risk factors were used to construct a prognostic model...