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Life
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State of the Art in Laparoscopic Surgery
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State of the Art in Laparoscopic Surgery

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 10023

Special Issue Editors

Dr. Alin Mihai Vasilescu

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Guest Editor
Department of Surgery, St. Spiridon Emergency University Hospital, Grigore T. Popa University of Medicine and Pharmacy, 16 University Street, 700115 Iassy, Romania
Interests: laparoscopic surgery; general surgery; hepato-biliary surgery; endocrine surgery; oncologic surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Costel Bradea

E-Mail Website
Guest Editor
Department of Surgery, St. Spiridon Emergency University Hospital, Grigore T. Popa University of Medicine and Pharmacy, 16 University Street, 700115 Iassy, Romania
Interests: laparoscopic surgery; general surgery; hepato-biliary surgery; endocrine surgery; oncologic surgery
Prof. Dr. Eugen Tãrcoveanu

E-Mail Website
Guest Editor
Department of Surgery, St. Spiridon Emergency University Hospital, Grigore T. Popa University of Medicine and Pharmacy, 16 University Street, 700115 Iassy, Romania
Interests: laparoscopic surgery; general surgery; hepato-biliary surgery; endocrine surgery; oncologic surgery

Special Issue Information

Dear Colleagues,

Laparoscopic surgery is the latest revolution in surgery, it has conquered the present and dominated the future, but it requires a greater mastery than in open surgery. Robotic surgery is the latest frontier in surgery. Most surgeries can be performed laparoscopically, and the benefits of this approach are incontestable: decreased surgical aggression ("velvet surgery" through a keyhole), shorter operating time, more and rapid achievement of normal bowel function, postoperative pain, decreased morbidity (surgical site infection), mortality, reduced duration of postoperative hospitalization and the costs, short postoperative socio-professional reintegration, excellent aesthetic results. Also, laparoscopic procedure is feasible, safe for selected cases in emergency operation. Conversion is not a complication but a good judgement.

Robotic devices were developed to overcome the disadvantages of conventional laparoscopic surgery. Moreover, the robotic system provides excellent ergonomics, tremor stabilization, enhanced ambidextrous capability, motion scaling, and instruments capable of moving with multiple degrees of freedom. Robotic surgery has the drawbacks of diminished haptic feedback, increased operative times, and increased procedural cost

Careful patient selection, accurate lesion localization, an experienced surgeon and working with an experienced operating room staff all contribute to maximizing patient benefit and minimizing conversion to open resection.

We invite you and your colleagues to submit your articles reporting om this topic. Original research articles, reviews or rare case reports focusing on the minimally invasive video-assisted approach, innovative procedures, individualized therapy are invited.

Dr. Alin Mihai Vasilescu
Dr. Costel Bradea
Prof. Dr. Eugen Tãrcoveanu
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at mdpi.longhoe.net 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. Life is an international peer-reviewed open access monthly 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

  • recent advances in laparoscopic surgery
  • surgical training in laparoscopy
  • endoscopic surgery
  • robotic surgery
  • laparoscopy in abdominal emergency
  • laparoscopic pancreatic surgery
  • laparoscopic liver surgery
  • laparoscopic management of gastroesophageal disorders
  • laparoscopic small bowel resection
  • laparoscopic colo-rectal resection
  • laparoscopic appendectomy
  • laparoscopic cholecystectomy
  • laparoscopic surgery for hernia repair
  • laparoscopic management of adrenal tumors
  • laparoscopic management of endocrine digestive tumors
  • the feasibility and safety of laparoscopic and endoscopic cooperative surgery (LECS) for the treatment of digestive pathology

Published Papers (5 papers)

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Research

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18 pages, 1906 KiB  
Article
Influence of Intraoperative Active and Passive Breaks in Simulated Minimally Invasive Procedures on Surgeons’ Perceived Discomfort, Performance, and Workload
by Rosina Bonsch, Robert Seibt, Bernhard Krämer, Monika A. Rieger, Benjamin Steinhilber and Tessy Luger
Life 2024, 14(4), 426; https://doi.org/10.3390/life14040426 - 22 Mar 2024
Viewed by 816
Abstract
Laparoscopic surgeons are at high risk of experiencing musculoskeletal discomfort, which is considered the result of long-lasting static and awkward body postures. We primarily aimed to evaluate whether passive and active work breaks can reduce ratings of perceived discomfort among laparoscopic surgeons compared [...] Read more.
Laparoscopic surgeons are at high risk of experiencing musculoskeletal discomfort, which is considered the result of long-lasting static and awkward body postures. We primarily aimed to evaluate whether passive and active work breaks can reduce ratings of perceived discomfort among laparoscopic surgeons compared with no work breaks. We secondarily aimed to examine potential differences in performance and workload across work break conditions and requested the surgeons evaluate working with passive or active work breaks. Following a balanced, randomized cross-over design, laparoscopic surgeons performed three 90 min laparoscopic simulations without and with 2.5 min passive or active work breaks after 30 min work blocks on separate days. The simulation included the following tasks: a hot wire, peg transfer, pick-and-place, pick-and-tighten, pick-and-thread, and pull-and-stick tasks. Ratings of perceived discomfort (CR10 Borg Scale), performance per subtask, and perceived workload (NASA-TLX) were recorded, and the break interventions were evaluated (self-developed questionnaire). Statistical analyses were performed on the rating of perceived discomfort and a selection of the performance outcomes. Twenty-one participants (9F) were included, with a mean age of 36.6 years (SD 9.7) and an average experience in laparoscopies of 8.5 years (SD 5.6). Ratings of perceived musculoskeletal discomfort slightly increased over time from a mean level of 0.1 to 0.9 but did not statistically significantly differ between conditions (p = 0.439). Performance outcomes of the hot wire and peg transfer tasks did not statistically significantly differ between conditions. The overall evaluation by the participants was slightly in favor regarding the duration and content of active breaks and showed a 65% likelihood of implementing them on their own initiative in ≥90 min-lasting laparoscopic surgeries, compared with passive breaks. Both passive and active breaks did not statistically significantly influence ratings of perceived discomfort or perceived workload in a 90 min simulation of laparoscopic surgery, with an overall low mean level of perceived discomfort of 0.9 (SD 1.4). As work breaks do not lead to performance losses, rest breaks should be tested in real-life situations across a complete working shift, where perceived discomfort may differ from this laboratory situation. However, in this respect, it is crucial to investigate the acceptance and practicality of intraoperative work breaks in feasibility studies in advance of assessing their effectiveness in follow-up longitudinal trials. Full article
(This article belongs to the Special Issue State of the Art in Laparoscopic Surgery)
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19 pages, 5959 KiB  
Article
Laparoscopic Hartmann Procedure—A Surgery That Still Saves Lives
by Costel Bradea, Eugen Tarcoveanu, Valentina Munteanu, Cristian Dumitru Lupascu, Florina Delia Andriesi-Rusu, Delia Gabriela Ciobanu and Alin Mihai Vasilescu
Life 2023, 13(4), 914; https://doi.org/10.3390/life13040914 - 31 Mar 2023
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Abstract
Background: A Hartmann operation, which is the intervention by which the lower part of the sigmoid and the upper part of the rectum are resected with the closing of the rectal stump and end colostomy, has as its indications: advanced or complicated rectosigmoid [...] Read more.
Background: A Hartmann operation, which is the intervention by which the lower part of the sigmoid and the upper part of the rectum are resected with the closing of the rectal stump and end colostomy, has as its indications: advanced or complicated rectosigmoid neoplasm, moderate biological condition of the patient, peritoneal sepsis, intestinal occlusion and fragile colonic wall, especially in the context of inflammatory changes. The Hartmann procedure can save lives even at the cost of a stoma reversal failure. Methods: The cases operated with the Hartmann procedure by an open approach or laparoscopic approach in our clinic, between 1 January 2016 and 31 December 2020, were admitted in this study and their medical records were reviewed, also making a comparison between the two types of approach. Univariate statistical comparisons but also a multivariate analysis was performed. Results: We performed 985 operations for intestinal and colonic occlusion (7.15% of the total operations in the clinic), 531 (54%) were non-tumor occlusions and 454 (46%) were occlusive tumors (88 Hartmann operations). Of these, 7.3% were laparoscopically performed (7 laparoscopic Hartmann operations and 23 diagnostic laparoscopies). A total of 11 cases (18%) also had colonic perforation. We compared laparoscopic Hartmann with open Hartmann and observed the benefits of laparoscopy for postoperative morbidity and mortality. The presence of pulmonary and cardiac morbidities is associated with the occurrence of general postoperative morbidities, while peritonitis is statistically significantly associated with the occurrence of local complications that are absent after the laparoscopic approach. Conclusions: The Hartmann procedure is still nowadays an operation widely used in emergency situations. Laparoscopy may become standard for the Hartmann procedure and reversal of the Hartmann procedure, but the percentage of laparoscopy remains low due to advanced or complicated colorectal cancer, poor general condition both at the first and second intervention, and the difficulties of reversal of the Hartmann procedure. Full article
(This article belongs to the Special Issue State of the Art in Laparoscopic Surgery)
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16 pages, 1022 KiB  
Article
Laparoscopic Esocardiomyotomy—Risk Factors and Implications of Intraoperative Mucosal Perforation
by Abdullah Alkadour, Eugenia Panaitescu, Petre Hoară, Silviu Constantinoiu, Madalina Mitrea-Tocitu, Diana Ciuc, Valeriu-Gabi Dinca and Rodica Bîrla
Life 2023, 13(2), 340; https://doi.org/10.3390/life13020340 - 27 Jan 2023
Viewed by 1243
Abstract
Background: Mucosal perforation during laparoscopic esocardiomyotomy is quite frequent, and its consequences cannot always be neglected. The purpose of the study is to investigate the risk factors for intraoperative mucosal perforation and its implications on the postoperative outcomes and the functional results three [...] Read more.
Background: Mucosal perforation during laparoscopic esocardiomyotomy is quite frequent, and its consequences cannot always be neglected. The purpose of the study is to investigate the risk factors for intraoperative mucosal perforation and its implications on the postoperative outcomes and the functional results three months postoperatively. Material and methods: We retrospectively identified the patients with laparoscopic esocardiomyotomy performed at Sf. Maria Hospital Bucharest, in the period between January 2017–January 2022 and collected the data (preoperative—clinic, manometric and imaging, intra-and postoperative). To identify the risk factors for mucosal perforations, we used logistic regression analysis. Results: We included 60 patients; intraoperative mucosal perforation occurred in 8.33% of patients. The risk factors were: the presence of tertiary contractions (OR = 14.00, 95%CI = [1.23, 158.84], p = 0.033206), the number of propagated waves ≤6 (OR = 14.50), 95%CI = [1.18, 153.33], p < 0.05), the length of esophageal myotomy (OR = 1.74, 95%CI = [1.04, 2.89] p < 0.05), the length of esocardiomyotomy (OR = 1.74, 95%CI = [1.04, 2.89] p < 0.05), and a protective factor—the intraoperative upper endoscopy (OR = 0.037, 95%CI = [0.003, 0.382] p < 0.05). Conclusions: Identifying risk factors for this adverse intraoperative event may decrease the incidence and make this surgery safer. Although mucosal perforation resulted in prolonged hospital stays, it did not lead to significant differences in functional outcomes. Full article
(This article belongs to the Special Issue State of the Art in Laparoscopic Surgery)
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Review

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15 pages, 2029 KiB  
Review
The Use of Esophageal Stents in the Management of Postoperative Fistulas—Current Status, Clinical Outcomes and Perspectives—Review
by Cristian Gelu Rosianu, Petre Hoara, Florin Achim, Rodica Birla, Alexandra Bolocan, Ahmed Mohssen, Narcis Copca and Silviu Constantinoiu
Life 2023, 13(4), 966; https://doi.org/10.3390/life13040966 - 7 Apr 2023
Viewed by 1873
Abstract
Esophageal fistula remains one of the main postoperative complications, with the treatment often requiring the use of stents. This article reviews the updates on the use of endoscopic stents for the treatment of postoperative esophageal leakage in terms of indications, types of stents [...] Read more.
Esophageal fistula remains one of the main postoperative complications, with the treatment often requiring the use of stents. This article reviews the updates on the use of endoscopic stents for the treatment of postoperative esophageal leakage in terms of indications, types of stents used, efficiency, specific complications and perspectives. Materials and Methods: We searched the PubMed and MEDLINE databases for the keywords postoperative esophageal anastomotic leak and postoperative esophageal anastomotic leak stent, and retrieved relevant papers published until December 2022. Results: The endoscopic discovery of the fistula is usually followed by the insertion of a fully covered esophageal stent. It has an efficiency of more than 60% in closing the fistula, and the failure is related to the delayed application of the method, a situation more suitable for endo vac therapy. The most common complication is migration, but life-threatening complications have also been described. The combination of the advantages of endoscopic stents and vacuum therapy is probably found in the emerging VACstent procedure. Conclusions: Although the competing approaches give promising results, this method has a well-defined place in the treatment of esophageal fistulas, and it is probably necessary to refine the indications for each individual procedure. Full article
(This article belongs to the Special Issue State of the Art in Laparoscopic Surgery)
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Other

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15 pages, 9244 KiB  
Systematic Review
Laparoscopic Pancreatoduodenectomy in Elderly Patients: A Systematic Review and Meta-Analysis
by Adrian Bartos, Simona Mărgărit, Horea Bocse, Iulia Krisboi, Ioana Iancu, Caius Breazu, Patricia Plesa-Furda, Sandu Brînzilă, Daniel Leucuta, Cornel Iancu, Cosmin Puia, Nadim Al Hajjar and Lidia Ciobanu
Life 2022, 12(11), 1810; https://doi.org/10.3390/life12111810 - 7 Nov 2022
Cited by 1 | Viewed by 1244
Abstract
Background and Aims: Recent single-center retrospective studies have focused on laparoscopic pancreatoduodenectomy (LPD) in elderly patients, and compared the outcomes between the laparoscopic and open approaches. Our study aimed to determine the outcomes of LPD in the elderly patients, by performing a systematic [...] Read more.
Background and Aims: Recent single-center retrospective studies have focused on laparoscopic pancreatoduodenectomy (LPD) in elderly patients, and compared the outcomes between the laparoscopic and open approaches. Our study aimed to determine the outcomes of LPD in the elderly patients, by performing a systematic review and a meta-analysis of relevant studies. Methods: A comprehensive literature review was conducted utilizing the Embase, Medline, PubMed, Scopus and Cochrane databases to identify all studies that compared laparoscopic vs. open approach for pancreatoduodenectomy (PD). Results: Five retrospective studies were included in the final analysis. Overall, 90-day mortality rates were significantly decreased after LPD in elderly patients compared with open approaches (RR = 0.56; 95%CI: 0.32–0.96; p = 0.037, I2 = 0%). The laparoscopic approach had similar mortality rate at 30-day, readmission rate in hospital, Clavien–Dindo complications, pancreatic fistula grade B/C, complete resection rate, reoperation for complications and blood loss as the open approach. Additionally, comparing with younger patients (<70 years old), no significant differences were seen in elderly cohort patients regarding mortality rate at 90 days, readmission rate to hospital, and complication rate. Conclusions: Based on our meta-analysis, we identify that LPD in elderly is a safe procedure, with significantly lower 90-day mortality rates when compared with the open approach. Our results should be considered with caution, considering the retrospective analyses of the included studies; larger prospective studies are required. Full article
(This article belongs to the Special Issue State of the Art in Laparoscopic Surgery)
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