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JCM
Special Issues
Clinical Advances in Minimally Invasive Surgery
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Clinical Advances in Minimally Invasive Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: closed (28 November 2023) | Viewed by 6037

Special Issue Editors

Prof. Dr. Giovanni Conzo

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Guest Editor
Department of Traslational Medical Sciences, Division of General, Mininvasive, Oncologic and Bariatric Surgery University of Campania "Luigi Vanvitelli", 80131 Naples, Italy
Interests: thyroid cancer; thyroidectomy; complications; neck dissection; local relapse; differentiated; neuromonitoring vocal folds; palsy
Special Issues, Collections and Topics in MDPI journals
Dr. Renato Patrone

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Guest Editor
1. PhD ICTH, University of Federico II of Naples, 80131 Napoli, Italy
2. Hepatobiliary Surgical Oncology Division, Istituto Nazionale Tumori-IRCCS-Fondazione G. Pascale, Via Mariano Semmola, 80131 Naples, Italy
Interests: thyroid cancer; endocrine surgery; thyroid surgery; oncological surgery; pancreatic surgery; pancreatic cancer, HPB surgery
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Ludovico Docimo

E-Mail Website
Guest Editor
Division of General, Mininvasive, Oncologic and Bariatric Surgery, Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Via Pansini 5, 80131 Naples, Italy
Interests: bariatric surgery; general surgery; colorectal surgery; oncological surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is for us a great honor to present this Special Issue of JCM: “Clinical Advances in Minimally Invasive Surgery”.

This monograph is meant to provide an overview of current principles and future directions in minimally invasive surgery (MIS) in general, gastrointestinal (GI) and endocrine surgery.

More and more papers in the literature have considered the issue and investigated novel technologies, but the debate is still open.

This Special Issue will publish articles written by expert Italian surgeons, members of the Italian Society of Digestive System Pathologies (SIPAD), the Neapolitan Society of Surgery (SnAC) and the United Italian Society of Endocrine Surgery (SIUEC) with a deep knowledge in this field.

Their work will be an inspiration for future research.

This Special Issue will be published on behalf of these three important Italian scientific societies (SIPAD, SnAC and SIUEC), and we wish to thank their boards.

Special thanks go to Dr. Emmanuel Andrès and Prof. Dr. Michael G. Hennerici, Editors-in-Chief of JCM, for allowing the publication of this Special Issue, and to Amy Lu for the editorial assistance.

In recent years, MIS reached a large diffusion worldwide for the treatment of benign and malignant diseases, especially in GI and endocrine pathologies, demonstrating safety and feasibility.

MIS has provided indisputable benefits over traditional approaches in a large number of surgical operations, with similar operative time and cost. Rapid recovery is very useful for patients in comparison to the large skin incisions with a long hospital stay and complex post-operative mobilization that are typical of open surgery.

The incidence of gastrointestinal and endocrine neoplasms remains high, and the scientific literature shows an increasing interest in this topic, with a mounting article production.

Evolutions of surgical technique, the growth of team expertise, the support of data from the literature, and necessity for hospitals to increase patient turnover have allowed minimally invasive approaches to have an increasingly predominant role in general, GI and endocrine surgery.

The ERAS program and its diffusion have given a further boost.

In this Special Issue, we aim to deepen and explore new surgical techniques to improve minimally invasive surgery, its applications in the treatment of gastrointestinal and endocrine cancers, investigate the outcomes and hospital implications, the role of robotic surgery, future perspectives, and finally cost analysis.

We will also evaluate MIS oncological outcomes.

Limitations of MIS, such as reduced maneuverability, loss of depth perception and sometimes longer operative time are also considered.

Finally, an accurate literature review will offer readers the more recent international trends and evidence in general gastrointestinal and endocrine surgery, current limitations and future directions.

Thanks to expert opinions, we have summarized more common MIS operative techniques and evaluated the evidenced advances.

Special thanks go to the authors who collaborated to drafting this Special Issue, and to the Board Members of SIPAD, SIUEC, and SnAC who accepted our invitation.

In conclusion, we wish to express our gratitude to the reviewers that allowed the publication of this Issue with their support.

Prof. Dr. Giovanni Conzo
Dr. Renato Patrone
Prof. Dr. Ludovico Docimo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • MIS
  • laparoscopic surgery
  • advanced surgical technique
  • oncological surgery
  • general surgery
  • endocrine surgery
  • gastrointestinal surgery

Published Papers (3 papers)

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Research

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13 pages, 5160 KiB  
Article
Tentacle Mesh for Fixation-Free Spigelian Hernia Repair: Mini-Invasive Approach Granting Broad Defect Overlap
by Giuseppe Amato, Antonino Agrusa, Salvatore Buscemi, Giuseppe Di Buono, Pietro Giorgio Calò, Roberta Vella, Giorgio Romano, Gabriele Barletta, Giovanni Cassata, Luca Cicero and Giorgio Romano
J. Clin. Med. 2023, 12(12), 3866; https://doi.org/10.3390/jcm12123866 - 06 Jun 2023
Cited by 2 | Viewed by 2528
Abstract
Background: Compared to other types of abdominal protrusions, Spigelian hernias are not very common. In prosthetic repair of abdominal protrusions, mesh fixation and defect overlap are an open issue, as they are a source of complications. A newly developed tentacle-shaped mesh has been [...] Read more.
Background: Compared to other types of abdominal protrusions, Spigelian hernias are not very common. In prosthetic repair of abdominal protrusions, mesh fixation and defect overlap are an open issue, as they are a source of complications. A newly developed tentacle-shaped mesh has been used to ensure a fixation-free repair with a broader defect overlap in the repair of abdominal hernias. This study describes the long-term results of a fixation-free repair of Spigelian hernias carried out with a tentacle mesh. Methods: A proprietary mesh composed of a central body with integrated radiating arms was used for repairing Spigelian hernias in 54 patients. The implant was positioned in preperitoneal sublay, and the straps were delivered across the abdominal musculature with a needle passer, and then, after fascia closure, cut short in the subcutaneous layer. Results: The friction of the straps passing through the abdominal wall served to hold the mesh in place, guaranteeing a wide overlap over the defect without fixation. In a long-term follow-up of 6 to 84 months (mean 64 months), a very low rate of complications occurred, but no recurrence was reported. Conclusions: The tentacle strap system of the prosthesis allowed for an easy, fast and safe fixation-free placement granting a wide overlap, avoiding intraoperative complications. Greatly reduced pain and a negligible amount of postoperative complications characterized the postoperative outcome. Full article
(This article belongs to the Special Issue Clinical Advances in Minimally Invasive Surgery)
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Review

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11 pages, 264 KiB  
Review
Impact of Current Technology in Laparoscopic Adrenalectomy: 20 Years of Experience in the Treatment of 254 Consecutive Clinical Cases
by Giovanni Conzo, Renato Patrone, Luigi Flagiello, Antonio Catauro, Alessandra Conzo, Chiara Cacciatore, Federico Maria Mongardini, Giovanni Cozzolino, Rosetta Esposito, Daniela Pasquali, Giuseppe Bellastella, Katherine Esposito and Ludovico Docimo
J. Clin. Med. 2023, 12(13), 4384; https://doi.org/10.3390/jcm12134384 - 29 Jun 2023
Cited by 2 | Viewed by 1006
Abstract
Background: Laparoscopic adrenalectomy (LA), which avoids large abdomen incisions, is considered the gold standard technique for the treatment of benign small- and medium-size adrenal masses (<6 cm) and weighing < 100 g. A trascurable mortality and morbidity rate, short hospitalization and patient rapid [...] Read more.
Background: Laparoscopic adrenalectomy (LA), which avoids large abdomen incisions, is considered the gold standard technique for the treatment of benign small- and medium-size adrenal masses (<6 cm) and weighing < 100 g. A trascurable mortality and morbidity rate, short hospitalization and patient rapid recovery are the main advantages compared to traditional surgery. During the past decade, a new surgical technology has been developed that expedites a “clipless” adrenalectomy. Here, the authors analyze a clinical series of 254 consecutive patients who were affected by adrenal gland neoplasms and underwent LA by the transabdominal lateral approach over the two last decades. A literature review is also presented. Methods: Preoperative, intraoperative and postoperative data from 254 patients who underwent LA between January 2003 and December 2022 were retrospectively collected and reviewed. Diagnosis was obtained on the basis of clinical examination, laboratory values and imaging techniques. Doxazosin was preoperatively administered in the case of pheochromocytoma (PCC) while spironolactone and potassium were employed to treat Conn’s disease. The same surgeon (CG) performed all the LA and utilized the same laparoscopic transabdominal lateral approach. Different dissection tools—ultrasonic, bipolar or mixed scissors—and hemostatic agents were used during this period. The following results were obtained: 254 patients were included in the study; functioning tumors were diagnosed in 155 patients, 52 patients were affected by PCCs, 55 by Conn’s disease, 48 by Cushing’s disease. Surgery mean operative time was 137.33 min (range 100–180 min) during the learning curve adrenalectomies and 98.5 min (range 70–180) in subsequent procedures. Mean blood loss was respectively 160.2 mL (range 60–280) and 96.98 mL (range 50–280) in the first 30 procedures and the subsequent ones. Only three conversions (1.18%) to open surgery occurred. No mortality or postoperative major complications were observed, while minor complications occurred in 19 patients (3.54%). In 153 out of 155 functioning neoplasms, LA was effective in the normalization of the endocrine profile. According to our experience, a learning curve consisting of 30 cases was identified. In fact, a lower operative time and a lower complication rate was reported following 30 LA. Conclusions: LA is a safe procedure, even for masses larger than 6 cm and PCCs. Undoubtedly, the development of surgical technology has made it possible reducing operative times, performing a “clipless” adrenalectomy and extending the indications in the treatment of more complex patients. A multidisciplinary team, in referral high-volume centers, is recommended in the management of adrenal pathology. A 30-procedure learning curve is necessary to improve surgical outcomes. Full article
(This article belongs to the Special Issue Clinical Advances in Minimally Invasive Surgery)

Other

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13 pages, 556 KiB  
Systematic Review
Predictive Factors for Anastomotic Leakage after Laparoscopic and Open Total Gastrectomy: A Systematic Review
by Umberto Bracale, Roberto Peltrini, Marcello De Luca, Mariangela Ilardi, Maria Michela Di Nuzzo, Alberto Sartori, Maurizio Sodo, Michele Danzi, Francesco Corcione and Carlo De Werra
J. Clin. Med. 2022, 11(17), 5022; https://doi.org/10.3390/jcm11175022 - 26 Aug 2022
Cited by 8 | Viewed by 1673
Abstract
The aim of this systematic review is to identify patient-related, perioperative and technical risk factors for esophago-jejunal anastomotic leakage (EJAL) in patients undergoing total gastrectomy for gastric cancer (GC). A comprehensive literature search of PubMed/MEDLINE, Embase and Scopus databases was performed. Studies providing [...] Read more.
The aim of this systematic review is to identify patient-related, perioperative and technical risk factors for esophago-jejunal anastomotic leakage (EJAL) in patients undergoing total gastrectomy for gastric cancer (GC). A comprehensive literature search of PubMed/MEDLINE, Embase and Scopus databases was performed. Studies providing factors predictive of EJAL by uni- and multivariate analysis or an estimate of association between EJAL and related risk factors were included. All studies were assessed for methodological quality, and a narrative synthesis of the results was performed. A total of 16 studies were included in the systematic review, with a total of 42,489 patients who underwent gastrectomy with esophago-jejunal anastomosis. Age, BMI, impaired respiratory function, prognostic nutritional index (PNI), alcohol consumption, chronic renal failure, diabetes and mixed-type histology were identified as patient-related risk factors for EJAL at multivariate analysis. Likewise, among operative factors, laparoscopic approach, anastomosis type, additional organ resection, blood loss, intraoperative time and surgeon experience were found to be predictive factors for the development of EJAL. In clinical setting, we are able to identify several risk factors for EJAL. This can improve the recognition of higher-risk patients and their outcomes. Full article
(This article belongs to the Special Issue Clinical Advances in Minimally Invasive Surgery)
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