Publications by authors named "Isamu Koyama"

The Senhance robotic system (Asensus Surgical, Durham, NC, USA) is an innovative platform for minimally invasive surgery. It enables surgeons to perform precise and cost-effective procedures using reusable instruments and has advanced features such as haptic feedback and eye-tracking camera control. Herein, we present the first application of the "double bipolar method" (DBM) in a Senhance-assisted laparoscopic partial cystectomy utilizing 3 mm Maryland bipolar instruments.

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  • The study compared the effectiveness of external and internal pancreatic stents in preventing complications after pancreatoduodenectomy (PD), focusing on a risk-stratified approach based on a preoperative pancreatic fistula score (preFRS).
  • Data from 285 patients showed that external stents significantly reduced the rate of clinically relevant pancreatic fistula and postpancreatectomy hemorrhage in high-risk patients compared to internal stents.
  • The findings suggest that using external stents can improve postoperative outcomes, especially for patients at higher risk, and emphasize the need for better stent management strategies.
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  • Patients with distal cholangiocarcinoma (DCC) often receive chemotherapy, but predicting their survival risk during treatment selection is difficult.
  • This study analyzed 170 DCC patients who underwent pancreatoduodenectomy between 2009 and 2022, using various clinical parameters to identify overall survival (OS) risk factors through Cox regression analysis.
  • Key findings showed that tumor size ≥15 mm and main pancreatic duct dilatation (≥3 mm) significantly impacted OS; patients with two risk factors had a poor 5-year OS of only 8%, suggesting that more aggressive treatment options should be considered for these individuals.
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We report our initial experience and the utility of 3 mm bipolar forceps in laparoscopic renal surgery using the Senhance robotic system. We performed laparoscopic nephroureterectomy for upper tract urothelial carcinoma in two patients: an 80-year-old female with a left renal pelvic tumor and an 80-year-old male with a right ureteral tumor. Both surgeries were successfully completed without conversion to conventional laparoscopic surgery or laparotomy.

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Background: Most adult cases of intussusception are caused by colorectal cancer, and emergency surgery is performed when symptoms such as abdominal pain and vomiting are present. The patient must customarily undergo both bowel decompression and radical surgery for colorectal cancer at the same time, and laparotomy is generally the procedure of choice.

Case Presentation: An 86-year-old woman presented to our hospital with diarrhea and bloody stools.

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Background: An increasing number of patients are achieving long-term survival after pancreatoduodenectomy, meaning that risk assessments of endocrine and exocrine pancreatic insufficiency are needed. Herein, we investigated the risk factors for pancreatic insufficiency after pancreatoduodenectomy by incorporating pancreatic morphologic changes and perioperative factors.

Methods: Patients who underwent pancreatoduodenectomy between January 2015 and December 2020 were enrolled in this single-center retrospective study.

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Background: Laparoscopic liver resection (LLR) is rapidly gaining popularity; however, its efficacy for nonalcoholic fatty liver disease (NAFLD)-associated hepatocellular carcinoma (HCC) (NAFLD-HCC) has been not evaluated. The purpose of this study was to compare short- and long-term outcomes between LLR and open liver resection (OLR) among patients with NAFLD-HCC.

Methods: We used a single-institution database to analyze data for patients who underwent LLR or OLR for NAFLD-HCC from January 2007 to December 2022.

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Background: We compared the recurrence-free survival (RFS), overall survival (OS), and safety of laparoscopic liver resection (LLR) between non-alcoholic fatty liver disease (NAFLD) and non-NAFLD hepatocellular carcinoma (HCC) patients.

Methods: Patients with HCC (n = 349) were divided into four groups based on the HCC etiology (NAFLD [n = 71], hepatitis B [n = 27], hepatitis C [n = 187], alcohol/autoimmune hepatitis [AIH] [n = 64]). RFS and OS were assessed by multivariate analysis after adjustment for clinicopathological variables.

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Background: Laparoscopic liver resection for hepatocellular carcinoma (HCC) in patients with Child-Pugh A cirrhosis has been shown to be beneficial. However, less is known regarding the outcomes of such treatment in patients with Child-Pugh B cirrhosis. We conducted a retrospective study to evaluate the outcomes of laparoscopic liver resection for HCC in patients with Child-Pugh B cirrhosis, focusing on surgical risks, recurrence, and survival.

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  • The study reports on the short-term outcomes of 55 colorectal cancer surgeries using the Senhance Digital Laparoscopy System in Japan, assessing its feasibility and safety.
  • Patients had a median age of 71, with a variety of surgical techniques used, and the procedures showed no intraoperative complications or need for blood transfusion.
  • The results indicated that the system allowed for effective surgeries, with a median postoperative hospital stay of 7 days and only two cases of significant postoperative complications.
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Lymphoid hyperplasia is a type of tumor-like hyperplasia of lymphoid tissue. There have been few reports on lymphoid hyperplasia of the gallbladder. Here, we report a case of lymphoid hyperplasia with a polyp form of the gallbladder macroscopically mimicking carcinoma.

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Background: Covered stent placement (CSP) is gaining popularity for the management of delayed massive hemorrhage (DMH) after pancreatic or biliary surgery. However, early studies have produced conflicting results regarding the potential advantages of the procedure. We aimed to compare the short- and medium-term outcomes of arterial embolization (AE) and CSP for DMH.

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  • The study examined the impact of the COVID-19 pandemic on the diagnosis and treatment of oesophageal cancer in Japan, using data from 546 patients over three years.
  • During the early pandemic phase (April to June), fewer cancer diagnoses occurred, and significantly more patients presented with distant metastases, suggesting delays in seeking consultations.
  • There was a notable decrease in radical treatments and definitive chemoradiotherapy during the pandemic, emphasizing the importance of maintaining healthcare access and encouraging timely medical consultations.
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Unlabelled: The Senhance robotic system (TransEnterix, Morrisville, NC, USA), previously called the TELELAP Alf-X system, is a novel robotic system with a telesurgical concept. We herein describe our initial experience of Senhance assisted laparoscopic radical nephrectomy (LRN) for renal cell carcinoma (RCC) with detailed figures and videos. Case 1: A left renal tumor was incidentally detected in a 52-year-old female on ultrasonography.

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  • Surgery remains the primary treatment for resectable esophageal cancer (EC), and lymph node metastasis (LNM) significantly impacts patient prognosis.
  • A study of 157 patients found that the presence of abdominal LNM (cALNM) greatly predicted lower cause-specific survival (CSS) and systemic recurrence-free survival, highlighting its clinical importance.
  • The findings suggest that patients with cALNM may need more aggressive treatment beyond standard chemotherapy due to their increased risk of systemic metastases.
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  • The study aimed to assess the effectiveness of two stapler types (circular and linear) used in esophagogastrostomy (EG) for laparoscopic proximal gastrectomy (LPG) from 2013 to 2019.
  • After analyzing data from 84 patients and matching them by propensity scores, the outcomes of 30 patients using each type of stapler were compared.
  • Results indicated that while the overall outcomes were similar, the linear stapler group had a significantly lower rate of severe reflux esophagitis compared to the circular stapler group, suggesting it may be the safer option for patients.
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Background: The effectiveness of prophylactic lateral lymph node dissection (LLND) in treating patients with lower rectal cancer remains controversial and has not been clearly established. Therefore, we aimed to retrospectively analyze the survival impact of prophylactic LLND in patients with lower rectal cancer.

Methods: Data of 301 patients with lower rectal cancer (tumor's lower edge on the anal side of the peritoneal reflexion) with clinical T3 disease and negative preoperative lateral lymph node metastasis, who underwent radical resection (R0) at our hospital between April 2007 and March 2017, were included in this study.

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Background: We have introduced the Senhance Digital Laparoscopy System and actively use for colorectal cancer surgery. Recently, we also try to perform surgery by reduce port as less invasive method. For the first time, we report a case of single-incision plus one-port transverse colectomy using Senhance system.

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Purpose: Bleeding from unresectable gastric cancer is a localized condition that adversely affects quality of life. Radiotherapy can be used to treat gastric cancer bleeding when surgery, endoscopic treatment, and intravascular embolization are ineffective. This study evaluated the utility of radiotherapy for unresectable hemorrhagic gastric cancer.

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Various innovative robotic systems have been developed to improve surgery precision. The Senhance Surgical System (SSS) is a digital laparoscopic system offering eye tracking and haptic feedback. Several reports have described application of the SSS to general surgeries, including cholecystectomy and colectomy.

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  • This study evaluates the oncological safety of hand-assisted laparoscopic surgery (HALS) compared to conventional open laparotomy (OL) in radical esophageal cancer surgeries, focusing on both thoracic and abdominal procedures.
  • A retrospective analysis of 142 patients showed that before adjusting for differences, HALS had better overall survival (OS) rates than OL, but this difference was not significant after matching.
  • The findings suggest that HALS is a safe and effective option for radical esophagectomy, providing comparable local control and recurrence-free survival to traditional open surgery.
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Portal vein aneurysms are rare vascular findings for which there are no optimal treatment guidelines. The scarce knowledge about their etiology, natural history, and management mean that there are limited treatment options. Here, we describe the case of a 69-year-old woman who presented with a 35-mm hypoechoic area in the hilar region of the liver that was accidentally detected by ultrasonography.

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We report the case of a 68-year-old male with EGJ cancer, who was treated with palliative radiotherapy for persistent bleeding, and for whom, pCR was ultimately obtained by chemotherapy. Chemotherapy was planned to treat the EGJ cancer with intramural metastasis of the esophagus, but anemia due to persistent bleeding from the tumor was noted. Even with frequent blood transfusions, the anemia was difficult to control.

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Background: Several manufacturers are in the process of developing various innovative systems and expect more options in the robot market. One of the latest systems, the Senhance® platform (TransEnterix Surgical Inc, Morrisville, NC, USA), has already been introduced in Europe and has also been approved for clinical use in Japan. We report the first case of colorectal resection using Senhance in Japan.

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A 72-year-old woman who underwent colorectal endoscopy because of positive fecal occult blood test results was diagnosed with ascending colon cancer.Preoperative CT revealed advanced ascending colon cancer and portosystemic shunt between the ileocecal vein and inferior vena cava.It was necessary to cut the shunt when ileocecal resection was performed.

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