Surgical endoscopy
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Robotic surgery for gastric cancer patients has been increasing because of its many advantages over conventional laparoscopic surgery. Despite the suggestion that robotic surgery may lessen the learning curve for complex laparoscopic procedures, little is known about the learning curve for robotic gastrectomy. This study aimed to assess the learning curve of robotic gastrectomy for patients with cancer by analyzing the operation time. ⋯ Surgeons with sufficient experience in laparoscopic gastrectomy can rapidly overcome the learning curve for robotic gastrectomy. In addition, the surgeon's experience with laparoscopic gastrectomy affects the operation time after stabilization and the reduction in operation time.
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The aim of this study was to compare outcome measures between conventional transabdominal laparoscopic adrenalectomy and single-incision laparoscopic adrenalectomy (SILA). ⋯ The findings of the present study suggest that SILA is as safe as conventional transabdominal laparoscopic adrenalectomy. Furthermore, SILA is associated with less pain and better cosmesis than the conventional laparoscopic procedure.
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To improve endoscopic surgical skills, an increasing number of surgical residents practice on box or virtual reality (VR) trainers. Current training is focused mainly on hand-eye coordination. Training methods that focus on applying the right amount of force are not yet available. ⋯ The force-sensing training system provides us with the unique possibility to objectively assess tissue-handling skills in a laboratory setting. The real-time visualization of applied forces during training may facilitate acquisition of tissue-handling skills in complex laparoscopic tasks and could stimulate proficiency gain curves of trainees. However, larger randomized trials that also include other tasks are necessary to determine whether training with visual feedback about forces reduces the interaction force during laparoscopic surgery.
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Comparative Study
Single-incision versus conventional laparoscopic sigmoid colectomy: a case-matched series.
Single-incision laparoscopic surgery is an emerging modality that has proven to be safe and feasible for colon resection in multiple case reports and series. Nonetheless, comparative analyses with established techniques are limited in the published literature. We evaluated the efficacy of single-incision laparoscopic colectomy (SILC) for the treatment of sigmoid disease through a matched-case comparison with conventional laparoscopic colectomy (CLC). ⋯ Compared with conventional laparoscopic technique, single-incision laparoscopic surgery results in similar intraoperative and postoperative outcomes. The technique avoids use of multiple trocar sites and may safely be performed in patients with a history of previous abdominal surgery while maintaining a short length of hospital stay and low complication rate.
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Randomized Controlled Trial Multicenter Study Comparative Study
Bowel obstruction after laparoscopic and open colon resection for cancer: results of 5 years of follow-up in a randomized trial.
Postoperative bowel obstruction caused by intra-abdominal adhesions occurs after all types of abdominal surgery. It has been suggested that the laparoscopic technique should reduce the risk for adhesion formation and thus for postoperative bowel obstruction. This study was designed to compare the incidence of bowel obstruction in a randomized trial where laparoscopic and open resection for colon cancer was compared. ⋯ This analysis does not support the hypothesis that laparoscopy leads to fewer episodes of bowel obstruction compared with open surgery.