Early Experience with the Senhance Surgical System in Bariatric Surgery
Robotic-assisted surgery advancements have paralleled growing bariatric surgery demands. The Senhance robotic platform offers an alternative to the da Vinci surgical system but there are limited studies evaluating the Senhance system in bariatric surgery. This study aims to review a single surgeon's experience comparing outcomes between traditional laparoscopic and Senhance-assisted sleeve gastrectomy.
Exploring Bariatric Surgery's Impact on Weight Loss and Diabetes: Sodium and Glucose Receptor Modulation
Sodium-glucose cotransporters (SGLT) and glucose transporters (GLUT) have been shown to influence diabetes management by modulating glucose uptake by the intestine. Therefore, alterations in gastrointestinal anatomy during bariatric surgery can change SGLT and GLUT receptor activity. These changes offer an additional mechanism for weight loss and may explain the differential impact of the various bariatric surgical procedures. This review examines the current literature on SGLT and GLUT receptors and their effects on weight loss through genetic studies, pharmacologic inhibition, and how SGLT/GLUT receptors impact surgical physiologic modulation. A better understanding of Type I sodium-glucose cotransport receptors (SGLT-1), GLUT-2, and GLUT-5 could provide insight for improved procedures and allow us to determine the best method to tailor operations to a patient's individual needs.
"Slim-Mesh" Technique for Diastasis Recti Abdominis, Including Obesity-Related Cases
We operated on a series of mostly obese patients with diastasis recti abdominis using the "Slim-Mesh" technique to repair/reinforce the diastasis and linea alba/recti muscles without plicating and traumatizing them. Additional objectives were to decrease operation time and intra- and postoperative complications.
Modified Open Anterior Preperitoneal Repair
Modified anterior preperitoneal (mAPP) repair for inguinal hernia (IH) was compared with Lichtenstein repair (LR) and laparoscopic transabdominal preperitoneal (TAPP) repairs.
Inferior-Medial Approach to Laparoscopic Splenic Vessel-Preserving Distal Pancreatectomy
Complete preservation of the splenic vessels is ideal during laparoscopic spleen-preserving distal pancreatectomy (LSPDP). However, this remains challenging and time-consuming because the vessels are often deeply embedded in the pancreatic parenchyma. Herein, we introduce our inferior-medial approach to laparoscopic splenic vessel-preserving distal pancreatectomy (lap-SVPDP) and evaluate its safety and feasibility.
Comparative Analysis of Hemostasis and Staple-Line Integrity between Medtronic Tri-Staple with Preloaded Buttress Material and the AEON Stapler in Bariatric Surgery
Haemostasis-related complications associated with Medtronic Tri-staple with preloaded buttress material and the novel, naked AEON gastrointestinal staplers have not been extensively studied in bariatric surgery. The study aimed to assess and compare the 30-day haemostasis-related complications between Medtronic Tri-staple and AEON GIA staplers.
Propensity Score Matched Comparison of Robotic Single-Site and Laparoscopic Cholecystectomy
To demonstrate the feasibility and potential of robotic single-site cholecystectomy, the study aimed to compare it with conventional laparoscopic cholecystectomy.
Factors Influencing CRP levels in Laparoscopic and Robotic Total Hysterectomy
Patients with high postoperative C-reactive protein levels are known to have a high risk of complications such as intestinal injuries than those with low levels. However, the factors that influence postoperative C-reactive protein levels in patients without complications are unknown. In this study, we aimed to determine the factors affecting postoperative C-reactive protein levels in patients undergoing laparoscopic and robotic total hysterectomy.
Current Status and Role of Artificial Intelligence in Anorectal Diseases and Pelvic Floor Disorders
Anorectal diseases and pelvic floor disorders are prevalent among the general population. Patients may present with overlapping symptoms, delaying diagnosis, and lowering quality of life. Treating physicians encounter numerous challenges attributed to the complex nature of pelvic anatomy, limitations of diagnostic techniques, and lack of available resources. This article is an overview of the current state of artificial intelligence (AI) in tackling the difficulties of managing benign anorectal disorders and pelvic floor disorders.
A Pain Desensitization Algorithm for Phenotyping and Treating Chronic Pelvic Pain
Chronic pelvic pain remains challenging for physicians to manage due to central and peripheral sensitization and multiple pain generators including the bladder, pelvic floor, and pudendal nerve. Pain management providers have used nerve blocks for years for diagnosis and treatment. We developed a desensitization algorithm that provides a stepwise approach to improve patients pain scores.
The Sling Technique for Laparoscopic Liver Mobilization
As liver surgery continues to evolve, be it open, laparoscopic or robotic, it remains a procedure that can deteriorate in the blink of an eye. Liver surgery in patients with hepatoma is further complicated, as the vast majority have significant fibrosis, if not cirrhosis. Thus, parenchymal sparing resection is increasingly necessary. Effective and safe intracorporeal mobilization of the liver is essential for minimal access parenchymal-sparing and conventional resection.
Hysterectomy for Large Uterus by Minimally Invasive Surgery (MIS)
When the uterus is or more than 18 to 20 weeks in size, laparotomy but not minimally invasive surgery (MIS) is commonly performed for hysterectomy. It is, however, acknowledged that MIS carries numerous benefits to patients compared to laparotomy. The uterine size should therefore not be an excluding factor for MIS. This study aims to demonstrate the feasibility and benefits of MIS for hysterectomy for large uterus and explain specific techniques employed.
Limitations in Medical Research: Recognition, Influence, and Warning
As the number of limitations increases in a medical research article, their consequences multiply and the validity of findings decreases. How often do limitations occur in a medical article? What are the implications of limitation interaction? How often are the conclusions hedged in their explanation?
Bilateral Spigelian Hernias Robotic Repair: A Novel Approach to a Rare Surgical Entity
Spigelian hernias are an uncommon protrusion defect noted between the rectus abdominis and the transversus abdominis muscles, at the semilunar line, with a low incidence of approximately 0.12% to 2% of all ventral hernias. Furthermore, the incidence of bilateral cases is noted to be even lower in the general population. They are associated with bowel incarceration and strangulation; hence surgical repair is indicated. Therapeutic alternatives for Spigelian hernias include open repair, however laparoscopic repair stands as the standard of care in these cases. Feasible and successful robotic repair has been reported, with associated advantages in terms of visualization and surgical instrument dexterity. We present the first ever reported cases of bilateral Spigelian hernias repaired using robotic approach. Two female Puerto Rican patients referred to our institution complaining of abdominal pain, where imaging studies found bilateral Spigelian hernias. In both cases, a transabdominal preperitoneal repair was performed using the Da Vinci Surgical System. Both patients were discharged home tolerating oral intake with adequate wound healing. On follow up visits, patients denied abdominal discomfort and had adequate wound healing. Robotic surgery for Spigelian hernias poses an advantage over laparoscopic repair as improved visualization, mobility, and precision in movements allow for more gentle tissue manipulation. Furthermore, this is the first evidence of safe and effective repair in the uncommon entity of bilateral cases, providing a newer alternative in the setting of such presentation.
Spinal Anesthesia Prior to Laparoscopic Hysterectomy Resulted in Decreased Postoperative Pain and Opioid Use
To determine if a pre-operative morphine/bupivacaine spinal injection prior to laparoscopic hysterectomy reduced postoperative pain and resulted in less opioid consumption during the hospital stay.
Ovarian Loss in Laparoscopic and Robotic Cystectomy Compared Using Artificial Intelligence Pathology
A Comparison of Ovarian Loss Following Laparoscopic versus Robotic Cystectomy As Analyzed by Artificial Intelligence-Powered Pathology Software.
Energy Device Preferences Among Gynecologic Surgeons
Multiple vessel-sealing devices are available for use during laparoscopy. The objective of this study is to determine what surgeon-level and device characteristics influence the choice of advanced energy device during gynecologic laparoscopy.
Laparoscopic-Assisted Transvaginal Cholecystectomy - the US Military Experience With Long-Term Follow Up
We present our initial clinical experience applying Natural Orifice Transluminal Endoscopic Surgical (NOTES) technique to perform cholecystectomy in ten patients at a military institution.
Uterine Weight and Perioperative Morbidity in Robotic-Assisted versus Conventional Laparoscopic Hysterectomy
Minimally invasive approaches to benign hysterectomy are the current standard of care when feasible. Use of robotic-assisted laparoscopic hysterectomy (RA-LH) has been increasing; however, direct comparative data that accounts for uterine weight in conventional laparoscopic hysterectomy (CLH) and RA-LH is limited. We sought to examine the impact of uterine weight on immediate perioperative morbidity in CLH versus RA-LH. The primary outcome was a composite of complications including visceral injuries, conversions to abdominal procedures, and transfusions.
Surgeons' Approach to Intraoperative Complications in Total Extraperitoneal (TEP) Hernia Repair
This study aimed to determine the frequency of laparoscopic inguinal hernia repair (LIHR) and how surgeons managed complications such as intraoperative bleeding, organ damage, and peritoneal injury that may develop during this procedure.