European association for endoscopic surgery (EAES) consensus statement on single-incision endoscopic surgery

Laparoscopic surgery changed the management of numerous surgical conditions. It was associated with many advantages over open surgery, such as decreased postoperative pain, faster recovery, shorter hospital stay and excellent cosmesis. Since two decades single-incision endoscopic surgery (SIES) was introduced to the surgical community. SIES could possibly result in even better postoperative outcomes than multi-port laparoscopic surgery, especially concerning cosmetic outcomes and pain. However, the single-incision surgical procedure is associated with quite some challenges.This article is freely available via Open Access, click on the Publisher's URL to access the full-text.Publishe

Post-Operative Functional Outcomes in Early Age Onset Rectal Cancer

Background: Impairment of bowel, urogenital and fertility-related function in patients treated for rectal cancer is common. While the rate of rectal cancer in the young (<50 years) is rising, there is little data on functional outcomes in this group. Methods: The REACCT international collaborative database was reviewed and data on eligible patients analysed. Inclusion criteria comprised patients with a histologically confirmed rectal cancer, <50 years of age at time of diagnosis and with documented follow-up including functional outcomes. Results: A total of 1428 (n=1428) patients met the eligibility criteria and were included in the final analysis. Metastatic disease was present at diagnosis in 13%. Of these, 40% received neoadjuvant therapy and 50% adjuvant chemotherapy. The incidence of post-operative major morbidity was 10%. A defunctioning stoma was placed for 621 patients (43%); 534 of these proceeded to elective restoration of bowel continuity. The median follow-up time was 42 months. Of this cohort, a total of 415 (29%) reported persistent impairment of functional outcomes, the most frequent of which was bowel dysfunction (16%), followed by bladder dysfunction (7%), sexual dysfunction (4.5%) and infertility (1%). Conclusion: A substantial proportion of patients with early-onset rectal cancer who undergo surgery report persistent impairment of functional status. Patients should be involved in the discussion regarding their treatment options and potential impact on quality of life. Functional outcomes should be routinely recorded as part of follow up alongside oncological parameters

Transanal TME - Really needed?

In the last decade, thanks to natural orifice translumenal endoscopic surgery, the application of laparoscopy through the anus has gained interest from both research and clinical point of views. Therefore, an increased number of transanal procedures have been reported, from the resection of a large rectal polyp to total mesorectal excision, and for controlling perioperative complications like leak, bleeding, and stenosis. Currently, the most popular surgical trend remains transanal total mesorectal excision. In this article, the technique, advantages, and disadvantages are discussed.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Single-incision laparoscopy: a review of the indications, techniques and results after more than 700 procedures

Single-incision laparoscopy (SIL) gained in popularity in the last 5-7 years, as a new philosophy has emerged to reduce the invasiveness of minimally invasive surgery. Various abdominal procedures using fewer and smaller trocars in order to obtain pure SIL have been described. To overcome some known problems of SIL, such as establishing the conventional multiport laparoscopic working triangulation, the non-ergonomic positioning of the surgeon, and the increased cost of each procedure, a particular SIL technique has been developed. The technique involves reusable trocars along with specially designed DAPRI curved reusable instruments introduced through the same incision but laterally to the optical system. Hence, the main principle of conventional multiport laparoscopy--working in an appropriate triangulation while maintaining the scope in the center--is respected. The final scar is 15 mm and the cost of the procedure remains unchanged because reusable materials are used. All the abdominal procedures, including upper and lower gastrointestinal, colorectal, hepatobiliopancreatic, solid organs, gynecologic and abdominal wall hernia repair, are here reported, as are the indications for and the results after 740 procedures. In conclusion, SIL has to be considered as one of the most attractive techniques of the new minimally invasive era.SCOPUS: ar.jFLWINinfo:eu-repo/semantics/publishe

Laparoscopic hand sewn regastrojejunostomy for complicated Roux-en-Y gastric bypass

SCOPUS: no.jinfo:eu-repo/semantics/publishe

Transanal TME – really needed?

In the last decade, thanks to natural orifice translumenal endoscopic surgery, the application of laparoscopy through the anus has gained interest from both research and clinical point of views. Therefore, an increased number of transanal procedures have been reported, from the resection of a large rectal polyp to total mesorectal excision, and for controlling perioperative complications like leak, bleeding, and stenosis. Currently, the most popular surgical trend remains transanal total mesorectal excision. In this article, the technique, advantages, and disadvantages are discussed

Single-port laparoscopic abdominoperineal resection

Single-port laparoscopy (SPL) gained interest in the last decade, thanks to the attraction of performing minimally invasive surgery through natural orifices. In front of diseases where a tumor has to be removed, frequently the access site has to be enlarged at the end of SPL. Hence, the rationale of performing SPL in the suprapubic area and under the bikini line is for the resulting scar to be easily covered by the bikini and cosmetically acceptable. In this chapter, the SPL abdominoperineal resection, through a suprapubic access, is described.SCOPUS: ch.binfo:eu-repo/semantics/publishe

Suprapubic single-incision laparoscopic left hemicolectomy: An alternative non-visible scar

SCOPUS: no.jSCOPUS: no.jinfo:eu-repo/semantics/publishe

Specially designed curved reusable instruments for single-access laparoscopy: 2.5-year experience in 265 patients

Minimally invasive surgery has been expanded recently by an increasing interest in single-incision, single-port, single-access laparoscopy (SAL). The main drawbacks of this laparoscopic approach include the clashing of the instruments and/or the crossing of the surgeon's hands due to the single-access site and an increase in the cost of the procedures due to the use of disposable materials. Furthermore, one of the rules of laparoscopy, which is to maintain the surgeon's two effectors at the right angle using the optical system as the bisector of this angle, is frequently lost during SAL. To solve these problems, curved reusable instruments for basic and advanced procedures in SAL have been developed based on this laparoscopic principle. The technique consists of the placement of a standard 11-mm reusable trocar, a 10-mm standard rigid scope, and the insertion of curved reusable instruments transabdominally without trocars. The 2.5-year experience in 265 patients is reported here. © 2012 Informa Healthcare.SCOPUS: ar.jinfo:eu-repo/semantics/publishe