Is the bipolar vessel sealer device an effective tool in robotic surgery? A retrospective analysis of our experience and a meta-analysis of the literature about different robotic procedures by investigating operative data and post-operative course.

Background: The latest robotic bipolar vessel sealing tools have been described to be effective allowing to perform procedures with reduced blood loss and shorter operative times. The aim of this study was to assess the efficacy and reliability of these devices applied in different robotic procedures.

Material And Methods: All robotic operations, between 2014 and 2016, were performed using the EndoWrist One VesselSealer (EWO, Intuitive Surgical, Sunnyvale, CA), a bipolar fully wristed device.

Two Decades of Laparoscopic Adrenalectomy: 326 Procedures in a Single-Center Experience.

Aim: Aim of this study is to evaluate the results of 20-year single-center laparoscopic adrenalectomy (LA), with different transperitoneal techniques.

Materials And Methods: Three hundred twenty-six adrenalectomies were performed from 1993 to 2013 using a transperitoneal approach through anterior access, flank access, and anterior submesocolic access (adopted by the author for left LA since 2004).

Results: Overall 142 men and 184 women (mean age 59.

Treatment of rectal cancer by transanal endoscopic microsurgery: experience with 425 patients.

Aim: To describe our experience in treating rectal cancer by transanal endoscopic microsurgery (TEM), report morbidity and mortality and oncological outcome.

Methods: A total of 425 patients with rectal cancer (120 T1, 185 T2, 120 T3 lesions) were staged by digital rectal examination, rectoscopy, transanal endosonography, magnetic resonance imaging and/or computed tomography. Patients with T1-N0 lesions and favourable histological features underwent TEM immediately.

Laparoscopic adrenalectomy for Cushing's syndrome: a 12-year experience.

Aim: The outcome after laparoscopic adrenalectomy in 51 patients with pre-Cushing's and Cushing's syndrome was evaluated at six months and one year of follow-up.

Methods: In this retrospective analysis of 51 patients (35 females and 16 males) selected for laparoscopic adrenalectomy (28 left and 23 right adrenal glands), clinical presentation, endocrine and blood chemistry and hemodynamics, and pre- and postsurgical management were analyzed. Evaluations included, blood pressure, body-mass index (BMI), lipid profile, blood glucose (fasting insulin and oral glucose tolerance test [OGTT]), liver function and hormonal profile (17-hydroxyprogesterone, dehydroepiandrosterone sulfate and cortisol), and perioperative complications.

Transanal endoscopic microsurgery for rectal tumors: an option to radical surgery?

Aim: We present our experience in the treatment of rectal adenomas and selected cases of distal rectal cancer without evidence of nodal or distant metastasis (N0-M0) managed by transanal endoscopic microsurgery (TEM). This study examines our experience evaluating surgical morbidity, mortality and oncological outcome.

Methods: Eight hundred ten patients with rectal lesions (462 adenomas, 115 T1, 130 T2 and 103 T3) were enrolled.

Randomized clinical trial of endoluminal locoregional resection versus laparoscopic total mesorectal excision for T2 rectal cancer after neoadjuvant therapy.

Background: In selected patients with early low rectal cancer, locoregional excision combined with neoadjuvant therapy may be an alternative treatment option to total mesorectal excision (TME).

Methods: This prospective randomized trial compared endoluminal locoregional resection (ELRR) by transanal endoscopic microsurgery versus laparoscopic TME in the treatment of patients with small non-advanced low rectal cancer. Patients with rectal cancer staged clinically as cT2 N0 M0, histological grade G1-2, with a tumour less than 3 cm in diameter, within 6 cm of the anal verge, were randomized to ELRR or TME.

Laparoscopic colectomy is a reliable option for colon cancer treatment.

Aims: To report oncological results in a remarkable single institution series of laparoscopic colectomy for cancer.

Methods: 340 not selected patients with adenocarcinoma of colon underwent laparoscopic colonic resection in a five years period (2004-2008). Of the 340 patients, there were 185 male and 155 female.

[Laparoscopic surgery of rectal cancer: state of art and long-term results].

Background: From the first laparoscopic colectomy that we performed 18 years ago, several studies showed equivalent oncologic results of this technique compared to open surgery Despite this evidence traditional surgeons remain skeptical in the use of this technique, although it may favor an early return of bowel function and therefore a shorter hospitalization, as reported in recent comparative studies. Many colorectal surgeons, who have appreciated the advantages of laparoscopic colectomy, extended this approach also in rectal cancer, finding a better view in the pelvis during dissection.

Method: From 1992 to july 2009 we performed more than 400 laparoscopic resection and amputation for rectal cancer.

Laparoscopic adrenalectomy approaches: a 15-year experience in the search for a tailored procedure.

Aim: This study reports single-institution experience with anterior, flank lateral and submesocolic approaches in laparoscopic adrenalectomy (LA).

Methods: The study population was 267 patients who underwent LA from 1994 to 2008 at our institution. The choice of surgical route (anterior, anterior submesocolic or flank lateral) was based on patient characteristics (body-mass index, previous abdominal surgery) and lesion features (size, side, secreting mass, pheochromocytoma, suspected malignancy).

Transanal endoscopic microsurgery for 135 patients with small nonadvanced low rectal cancer (iT1-iT2, iN0): short- and long-term results.

Background: Local excision of rectal cancer as an alternative to radical resection for patients with small nonadvanced low rectal cancer (SNALRC) (iT1-iT2, iN0) is debated. This study aimed to analyze the short- and long-term results for a series of 135 patients with SNALRC who underwent local excision by transanal endoscopic microsurgery (TEM).

Methods: According to the study protocol, 135 patients classified by endorectal ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) imaging as having iT1 iN0 iM0 (n = 51) or iT2 iN0 iM0 (n = 84) low rectal cancer were enrolled in the study.

Is laparoscopic fiberoptic choledochoscopy for common bile duct stones a fine option or a mandatory step?

Background: Because choledochoscopy often is a challenging maneuver, it would be advantageous to define the real utility of its use. This study aimed to compare blind exploration of the common bile duct (CBD) with choledochoscopy-assisted CBD stone removal in terms of patient outcome and complication rate.

Methods: Two groups of patients were prospectively evaluated in a 4-year period.

Treatment of rectal adenomas by transanal endoscopic microsurgery: 15 years' experience.

Background: The authors present their experience with rectal adenomas managed by transanal endoscopic microsurgery (TEM). The goals of this study were to examine our institution's experience by evaluating surgical morbidity, mortality, and local recurrence rate.

Methods: This retrospective study investigated 402 patients who underwent TEM a for preoperative diagnosis of adenoma from January 1993 to October 2008.

Long-term results of laparoscopic adrenalectomy for primary aldosteronism.

Background: The management of primary aldosteronism is currently achieved by both medical and surgical treatment. Laparoscopy has in recent years unquestionably become the gold standard in adrenal surgery for benign lesions. This study aims to evaluate our clinical results among patients who underwent laparoscopic adrenalectomy (LA) for primary aldosteronism.

Electrothermal bipolar energy-based device in laparoscopic right colectomy: our experience.

Aim: Aim of the present study was to evaluate effectiveness of bipolar electrothermal energy in laparoscopic right colectomy, both for vascular pedicle ligature and dissecting manoeuvres.

Methods: Eighty-nine consecutive unselected patients underwent laparoscopic right colectomy between 2003 and 2006. All procedures were performed or supervised by the same surgical team (two staff of surgeons).

The learning curve in laparoscopic adrenalectomy.

Background: Laparoscopic adrenalectomy (LA) is the procedure of choice for surgical management of most adrenal tumors. LA learning curve (LC) varies among surgeons and may be influenced by factors depending on surgeon, patient, and lesion peculiarities. The aim of this study was to evaluate the LC by multi-dimensional analysis.

Transanal endoscopic microsurgery for the treatment of selected patients with distal rectal cancer: 15 years experience.

Background: Local therapy for early rectal cancer is a valid alternative to the classical radical operation, which has a higher morbidity and mortality rate. The use of high-dose preoperative radiation appears to enhance the options for sphincter-saving surgery even for T2-T3 rectal cancer patients with effective local control. The authors report their experience with transanal endoscopic microsurgery (TEM) used to manage selected cases of distal rectal cancer without evidence of nodal or distant metastasis (N0-M0).

Flank approach versus anterior sub-mesocolic access in left laparoscopic adrenalectomy: a prospective randomized study.

Background: Laparoscopy is commonly recognized as the gold standard in adrenal surgery. The most used surgical access is at present the so-called flank approach. The aim of this study was to compare the flank approach and the anterior sub-mesocolic access carrying out left laparoscopic adrenalectomy (LA).

A prospective randomized study with a 5-year minimum follow-up evaluation of transanal endoscopic microsurgery versus laparoscopic total mesorectal excision after neoadjuvant therapy.

Background: This study aimed to compare the oncologic results for local excision via transanal endoscopic microsurgery (TEM) and those for laparoscopic resection (LR) via total mesorectal excision in the treatment of T(2) N(0), G(1-2 )rectal cancer after neoadjuvant therapy with both treatments, incorporating a 5-year minimum follow-up period.

Methods: The study enrolled 70 patients whose malignancy was staged at admission as T(2) N(0), G(1-2 )rectal cancer located within 6 cm of the anal verge with a tumor diameter less than 3 cm. Of these patients, 35 were randomized to TEM and 35 to LR.

Laparoscopic cecopexy for cecal volvulus after laparoscopy. Case report and a review of the literature.

Cecal volvulus is a rare cause of large bowel obstruction. Surgical therapy depends on visceral circulatory conditions at diagnosis. Possible options include endoscopic decompression, detorsion, cecopexy with or without cecostomy, right colectomy with immediate or delayed anastomosis.

Hepatic resections by means of electrothermal bipolar vessel device (EBVS) LigaSure V: early experience.

Background: Many techniques and devices are available for performing liver resection, such as clamp crushing, Cavitron Ultrasonic Surgical Aspirator (CUSA), Hydrojet and dissecting sealer, ultrasonic shears, and, more recently, electrothermal bipolar vessel sealing system (EBVS). In this prospective trial we sought to evaluate the impact of EBVS on hepatic resections.

Methods: From March 2004 to December 2005, 24 patients from our consecutive liver resection series were enrolled in the present study.

Use of the electrothermal bipolar vessel system (EBVS) in laparoscopic adrenalectomy: a prospective study.

Background: Since laparoscopic adrenalectomy (LA) has been adopted as the gold standard for the treatment of adrenal diseases, the development of technology for vascular control and dissection manoeuvres, amongst other things, may play a pivotal role in its further improvement. We report our experience with the electrothermal bipolar vessel sealing (EBVS) device for LA.

Methods: From January 2004 to January 2006, 50 patients (pts) undergoing LA were selected and randomized for use of the EBVS (25 pts, group A) versus the UltraSonic Shears (USS) device (25 pts, group B).

Early rectal cancer: definition and management.

Background: Local excision of rectal cancer is an alternative to radical resection but today its role surrounding the management of patients with early stage rectal cancer (T1-T2-N0) represents an important surgical issue.

Aim: To analyze the results of 135 patients with early stage low rectal cancer treated with local excision by transanal endoscopic microsurgery and in the case of T2 also by neoadjuvant therapy.

Study Design: 135 patients with T1-T2-N0-M0 rectal cancer were enrolled in the study.

Electrothermal bipolar vessel sealing device vs. ultrasonic coagulating shears in laparoscopic colectomies: a comparative study.

Background: Many devices are available for vascular control during laparoscopic colorectal procedures. Ultrasonic coagulating shears (UCS), vascular staplers, titanium or plastic clips, and electrothermal bipolar vessel sealing (EBVS) are currently used according to the surgeon's preference. This study aimed to compare EBVS Ligasure with UCS.

Long-term results of laparoscopic versus open colorectal resections for cancer in 235 patients with a minimum follow-up of 5 years.

Background: Laparoscopic resection for cure of colorectal cancer is controversial. More investigations on long-term results are required. This study aimed to compare the long-term outcome with a minimum follow-up of 5 years between laparoscopic or open approach for the treatment of colo-rectal cancer.