Feasibility and safety of single-incision laparoscopic surgery in gastric benign and malignant diseases

Development and future perspectives of natural orifice specimen extraction surgery for gastric cancer

In recent years, natural orifice specimen extraction surgery (NOSES), a novel minimally invasive surgical technique, has become a focus in the surgical field, and has been initially applied in gastric surgery in many national medical centers worldwide. In addition, this new surgical technique was launched in major hospitals in China. With an increasing number of patients who have accepted this new surgical technique, NOSES has provided new prospects for the treatment of gastric cancer (GC), which may achieve a better outcome for both patients and surgeons. More and more experts and scholars from different countries and regions are currently paying close attention to NOSES for the treatment of GC. However, there are only a few reports of its use in GC. This review focuses on the research progress in NOSES for radical gastrectomy in recent years. We also discuss the challenges and prospects of NOSES in clinical practice.

Novel surgical approach for gastric gastrointestinal stromal tumor (GIST): Robotic single port partial gastrectomy

BACKGROUND

Minimally invasive resection of gastrointestinal stromal tumors (GIST) results in faster recovery and similar oncological safety when compared to conventional approach [1-3]. The new robotic Single Port platform (Da Vinci SP) could help decreasing invasiveness while overcoming technical limitations of previous single incision surgical approaches [4].

METHODS

A 69-year-old male was treated for a 3 cm non-ulcerated GIST in the anterior wall of the proximal gastric body.

RESULTS

A robotic partial gastric resection was performed. The Da Vinci SP platform, which hosts three multi jointed, wristed instruments and a 3D HD articulating scope was used. The camera and instruments were introduced in the abdominal cavity through a 25 mm multichannel port. The lesion was identified in the lesser curvature at the level of the body, approximately 3 cm above the incisura. The gastric wall was resected en-bloc with the tumor using a combination of monopolar hook and bipolar forceps. The lesion was lifted using the third robotic arm and was not manipulated during the dissection. The gastric defect was closed with two running sutures of polydioxanone 3/0. Operative time was 82 minutes. Postoperative course was uneventful, and the patient was discharged home on postoperative day 2 with adequate pain control. Histopathology analysis found a 2.3 × 2 cm low grade GIST.

CONCLUSIONS

Robotic SP partial gastrectomy is safe and feasible in patients with gastric GIST. The robotic SP approach might help expanding the indications of previous single incision techniques.

Analogies between medusa and single port surgery in gastroenterology and hepatology: A review

Single port surgery (SPS) was introduced as an attractive, minimally invasive surgical technique that ensures esthetic results for many types of visceral surgery. Initially, surgeons immediately set about performing SPS without preliminary knowledge or training, which resulted in higher complication rates. Today, current studies conclusively show that SPS is scientifically rehabilitated and indicated for simple and complex laparoscopic procedures. We here describe the astonishing analogies between Greek mythology and modern surgery.