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Journal: Surgical laparoscopy, endoscopy & percutaneous techniques


The advent of laparoscopy has significantly improved postoperative outcomes in patients undergoing surgical repair of a paraesophageal hernia. Although this minimally invasive approach considerably reduces postoperative pain and recovery times, and may improve physiologic outcomes, laparoscopic paraesophageal hernia repair remains a complex operation requiring advanced laparoscopic skills and experience with the anatomy of the gastroesophageal junction and diaphragmatic hiatus. In this article, we describe our approach to patient selection, preoperative evaluation, operative technique, and postoperative management. Specific attention is paid to performing an adequate hiatal dissection and esophageal mobilization, the decision of whether to use a mesh to reinforce the crural repair, and construction of an adequate antireflux barrier (ie, fundoplication).

Concepts: Surgery, Hernia, Minimally invasive, Anatomy, Gastroesophageal reflux disease, Laparoscopic surgery, Laparoscopy, Achalasia


Laparoscopic intracorporeal colorectal anastomosis with double stapling technique is difficult because of unsuitable cutting angle in narrow pelvic cavity. For reasons of tilted and long linear staple line of rectal stump, circular anastomotic plane can make multiple intersections. The present study was designed to assess whether multiple intersections after double stapling technique is the risk factor of anastomotic complication in laparoscopic colorectal surgery.

Concepts: Present, Surgery, Digestive system, Rectum, Anastomosis, Line, Staple, Surgical staple


Undertake a comparison between laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP) for the management of benign and malignant lesions.


With the increase in sphincter preserving rate of rectal cancer (RC) cancer, postoperative quality-of-life, such as genital dysfunction, has become a major issue in the patient management. In this study, we proposed a measurement, namely, the sphincter preserving length (SPL), and investigated the relationship between SPL and postoperative genital function and survival in RC patients.

Concepts: Cancer, Patient, Patience


Transoral thyroidectomy is a kind of “natural orifice transluminal endoscopic surgery (NOTES)” which is now being performed in increasing frequency. However, the safety and feasibility have not been concluded yet.

Concepts: Endoscopy


Among the various types of biliary tract cancer, patients with single, small (<5 cm), peripheral intrahepatic cholangiocarcinoma (ICC), or small (<2 cm) gallbladder tumors (GBTs) rarely develop lymph node (LN) metastasis. We investigated a laparoscopic approach for hilar LN sampling in such cases.

Concepts: Cancer, Breast cancer, Metastasis, Oncology, Lung cancer, Lymph node, Liver, Cholangiocarcinoma


The aim of this study was to evaluate the impact of surgical experience on laparoscopic distal gastrectomy in high body mass index (BMI) patients. Retrospective data were collected on patients who underwent laparoscopic distal gastrectomy for early gastric cancer from July 2002 to December 2014. Patients were divided into a high BMI group (BMI≥25 kg/m) and a low BMI group (BMI<25 kg/m) and classified into subgroups by surgeon experience. Patient characteristics and surgical outcomes between groups were analyzed and compared. Mean operation time in the high BMI group was longer than the low BMI group (173.0±52.5 vs. 164.2±48.0 min; P=0.009). Subgroup analysis showed longer operation time in the high BMI group than the low BMI group (200.8±49.3 vs. 187.9±45.2 min; P<0.001) and fewer retrieved lymph nodes (36.3±11.7 vs. 33.0±13.1; P=0.004) in the early surgeon experience period. Patients in the late experience period showed no significant differences in surgical outcomes between the high BMI and low BMI group. High BMI did not influence surgical outcomes of laparoscopic distal gastrectomy after accumulation of surgical experience.

Concepts: Hospital, Surgery, Physician, Body mass index, Group, Group theory, Subgroup, Normal subgroup


Total laparoscopic right hemicolectomy is a procedure that involves an intracorporeal anastomosis. This approach may reduce tissue injury resulting in a significant lower surgical stress response (SSR) compared with the same procedure performed with an extracorporeal anastomosis. The purpose of this study was to compare the SSR level between 2 groups of patients undergoing laparoscopic right hemicolectomy with intracorporeal or extracorporeal anastomosis. From June 2015 to December 2016, 60 patients were enrolled and randomized. Interleukin-6, C-reactive protein, procalcitonin, white blood cell count, cortisol, prolactin, prealbumin, albumin, triglycerides, and transferrin were analyzed preoperatively and at 1, 3, and 5 days postoperatively. Interleukin-6 and C-reactive protein levels were significantly lower in the intracorporeal group on days 1, 3, and 5 postoperatively compared with the extracorporeal group. Gastrointestinal recovery was significantly earlier in the intracorporeal group. The intracorporeal anastomosis in laparoscopic right hemicolectomy reduces SSR, which may play a role in bowel recovery.

Concepts: Blood, Randomized controlled trial, Surgery, C-reactive protein, 2016, 2015


The aim of this study was to evaluate the safety and feasibility of single-port laparoscopic multivisceral resection (SLMVR) for locally advanced colon cancer invading or adhering to neighboring organs.

Concepts: Cancer, Colorectal cancer, Hereditary nonpolyposis colorectal cancer