Minimally Invasive Surgery: Current Challenges and New Perspectives

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

Deadline for manuscript submissions: 25 July 2024 | Viewed by 1700

Special Issue Editor


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Guest Editor
Department of Digestive and Emergency Surgery, S.Maria Hospital Trust, Terni, Italy
Interests: gastrointestinal surgery; laparoscopic surgery; robotic surgery; HPB surgery; gastric surgery; colorectal surgery

Special Issue Information

Dear Colleagues,

The advent of laparoscopic surgery in the late 1980s completely revolutionized the practice of abdominal and pelvic surgery. We are here to testify the progress from “great cut great surgeon” to “keyhole surgery” to the benefit of our patients, whose clinical courses have been radically changed from the old days of postoperative pain and long postoperative recovery to a new era of no postoperative pain, minimal scarring, and a quick return to normal life. At the same time, we have seen surgical techniques and technology leaping ahead to a new generation of surgical robots. At the core of this progress, there is always the patient and his or her relationship with the surgeon, their expectations, and their choices.

Minimally invasive surgery has received the interest of surgeons and patients, and nowadays more and more advanced operations can be performed through laparoscopic or robotic surgery. From the first laparoscopic cholecystectomy performed by Eric Muhe in 1985 to complex liver resections and duodenopancreatectomies nowadays in the armamentarium of many surgeons, the step forward has been huge.

Minimally invasive surgery has created new challenges for surgeons and new opportunities for everyone. 

Surgical education has changed as well, and a new generation of surgeons will take the scene in the next few years, whose technological skills will merge with their manual dexterity and whose hand–eye coordination will be mediated by a 3D screen.

This upcoming Special Issue of the JCM will cover as much as possible the issues related to the practice of laparoscopic as well as robotic surgery of the gastrointestinal tract, from the esophagus to the rectum, but also of the genitourinary tract and the retroperitoneum.

Meta-analyses, systematic reviews, and original research will be considered for publication.

Dr. Giovanni Domenico Tebala
Guest Editor

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Keywords

  • laparoscopic surgery
  • robotic surgery
  • minimally invasive surgery
  • surgical technology
  • esophagus
  • stomach
  • small bowel
  • colon/rectum
  • liver
  • biliary tract
  • pancreas
  • spleen
  • kidney
  • bladder
  • pelvis
  • uterus
  • adnexa

Published Papers (2 papers)

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13 pages, 963 KiB  
Article
Reducing the Risks of Esophagectomies: A Retrospective Comparison of Hybrid versus Full-Robotic-Assisted Minimally Invasive Esophagectomy (RAMIE) Approaches
by Jens Peter Hoelzen, Brooke E. Frankauer, Carsten Szardenings, Dhruvajyoti Roy, Lukas Pollmann, Lukas Fortmann, Jennifer Merten, Emile Rijcken, Mazen A. Juratli and Andreas Pascher
J. Clin. Med. 2023, 12(18), 5823; https://doi.org/10.3390/jcm12185823 - 07 Sep 2023
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Abstract
This retrospective analysis aimed to assess and compare the short-term perioperative outcomes and morbidity of hybrid and full-Robotic-Assisted Minimally Invasive Esophagectomy (RAMIE) surgical techniques. A total of 168 robotic-assisted Ivor Lewis esophagectomy procedures performed at Muenster University Hospital were included in the study, [...] Read more.
This retrospective analysis aimed to assess and compare the short-term perioperative outcomes and morbidity of hybrid and full-Robotic-Assisted Minimally Invasive Esophagectomy (RAMIE) surgical techniques. A total of 168 robotic-assisted Ivor Lewis esophagectomy procedures performed at Muenster University Hospital were included in the study, with 63 cases in the hybrid group and 105 cases in the full-robotic group. Demographic factors, comorbidities, and tumor stages showed no significant differences between the two groups. However, the full-RAMIE technique demonstrated superiority in terms of overall operative time, postoperative pain levels, and patient morphine consumption. Additionally, the full-RAMIE group exhibited better perioperative outcomes, with significantly shorter ICU stays and fewer occurrences of pneumonias and severe complications. While there was a trend favoring the full-RAMIE technique in terms of severe postoperative complications and anastomotic insufficiencies, further research is required to establish it as the gold standard surgical technique for Ivor Lewis esophagectomy. Full article
(This article belongs to the Special Issue Minimally Invasive Surgery: Current Challenges and New Perspectives)
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11 pages, 1507 KiB  
Case Report
Endoscopic Vacuum-Assisted Closure (E-VAC) in Septic Shock from Perforated Duodenal Ulcers with Abscess Formations
by Bogdan Mihnea Ciuntu, Adelina Tanevski, David Ovidiu Buescu, Valerii Lutenco, Raul Mihailov, Madalina Stefana Ciuntu, Mihai Marius Zuzu, Dan Vintila, Mihai Zabara, Ana Trofin, Ramona Cadar, Alexandru Nastase, Corina Lupascu Ursulescu and Cristian Dumitru Lupascu
J. Clin. Med. 2024, 13(2), 470; https://doi.org/10.3390/jcm13020470 - 15 Jan 2024
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Abstract
This case report underscores the importance of utilizing E-VAC (endoscopic vacuum-assisted closure) in the treatment of a perforated duodenal ulcer complicated by the formation of a subphrenic abscess and septic shock. It showcases how E-VAC can effectively mitigate the risk of further complications, [...] Read more.
This case report underscores the importance of utilizing E-VAC (endoscopic vacuum-assisted closure) in the treatment of a perforated duodenal ulcer complicated by the formation of a subphrenic abscess and septic shock. It showcases how E-VAC can effectively mitigate the risk of further complications, such as leakage, bleeding, or rupture, which are more commonly associated with traditional methods like stents, clips, or sutures. As a result, there is a significant reduction in mortality rates. A perforated duodenal ulcer accompanied by abscess formation represents a critical medical condition that demands prompt surgical intervention. The choice of the method for abscess drainage and perforation closure plays a pivotal role in determining the patient’s chances of survival. Notably, in patients with a high ASA (American Association of Anesthesiologists) score of IV-V, the mortality rate following conventional surgical intervention is considerably elevated. The management of perforated duodenal ulcers has evolved from open abdominal surgical procedures, which were associated with high mortality rates and risk of suture repair leakage, to minimally invasive techniques like laparoscopy and ingestible robots. Previously, complications arising from peptic ulcers, such as perforations, leaks, and fistulas, were primarily addressed through surgical and conservative treatments. However, over the past two decades, the medical community has shifted towards employing endoscopic closure techniques, including stents, clips, and E-VAC. E-VAC, in particular, has shown promising outcomes by promoting rapid and consistent healing. This case report presents the clinical scenario of a patient diagnosed with septic shock due to a perforated duodenal ulcer with abscess formation. Following an exploratory laparotomy that confirmed the presence of a subphrenic abscess, three drainage tubes were utilized to evacuate it. Subsequently, E-VAC therapy was initiated, with the kit being replaced three times during the recovery period. The patient exhibited favorable progress, including weight gain, and was ultimately discharged as fully recovered. In the treatment of patients with duodenal perforated ulcers and associated abscess formation, the successful and comprehensive drainage of the abscess, coupled with the closure of the perforation, emerges as a pivotal factor influencing the patient’s healing process. The positive outcomes observed in these patients underscore the efficacy of employing a negative pressure E-VAC kit, resulting in thorough drainage, rapid patient recovery, and low mortality rates. Full article
(This article belongs to the Special Issue Minimally Invasive Surgery: Current Challenges and New Perspectives)
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