Publications by authors named "Marco M Lirici"

Since the early1990s, laparoscopic right colon resections have been the most performed advanced laparoscopic procedures just after laparoscopic left colectomies and sigmoid resections. Indications for laparoscopic right colectomies are either benign or malignant diseases. Despite its many indications, a laparoscopic right or extended right colectomy is mostly performed for cancer of the caecum, the ascending colon, the hepatic flexure or the proximal transverse colon.

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Introduction: Bile duct injuries avoidance is a key goal of biliary surgery. In this prospective study we evaluate the safety and feasibility of ICG fluorescent cholangiography during laparoscopic cholecystectomy (LC) focusing on the optimization of timing and dose administration.

Material And Methods: From February to December 2022 fifty-four LC were performed with fluorescence imaging in our surgical department.

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Introduction: Indocyanine green fluorescence angiography (ICG-FA) is commonly used in general surgery, but its use in bariatric surgery is still marginal. Moreover, post-operative leaks remain a dramatic complication after this surgery and the leak tests available have poor performance preventing them. The aim of the present paper is to assess the use and utility of a new innovative technology based on quantitative measures of fluorescence signal intensity.

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Article Synopsis
  • The study aimed to share experiences treating elastofibroma, a rare and usually benign lesion that commonly appears in the subscapular region, by analyzing surgical outcomes over three years.
  • Fourteen procedures were performed on 11 patients, with a notable percentage showing bilateral cases, and results showed that surgery was generally successful but some patients faced postoperative complications like seromas.
  • The findings suggest that patients with symptomatic elastofibromas larger than 5 cm should have surgery, and using ultrasound energy devices may help minimize bleeding during the procedure.
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Background: We analyzed the evolution of genitourinary dysfunctions in patients undergoing surgical treatment for rectal cancer, and compared open surgery, laparoscopy, robotic and TaTME.

Methods: Functional outcomes were evaluate using standardized questionnaires, compiled at the start of treatment, after the end of Radiotherapy, at 1 and 6 months after surgery.

Results: In 72 patients 37.

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Rectovaginal fistulas (RVFs) represent the majority of all symptomatic leakages after anterior and low anterior resection in women. Conservative management is useful in paucisymptomatic patients with small fistulas but is usually unsuccessful in all other cases. The surgical strategies are various and heavily dependent on the type and extent of anatomic involvement.

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Bochdaleck hernia (BH) is a congenital diaphragmatic hernia that presents after birth with respiratory symptoms and needs surgical treatment in the neonatal period. However, there are some rare cases of adult presentation, which require surgery to avoid complications. BHs can be treated through several approaches, including laparoscopy.

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Secondary aorto-enteric fistulae (SAEF) are rare life-threatening complications that occur after abdominal aortic graft implant to treat aortic aneurysm or occlusive disease. Conventional treatments such as extra-anatomic bypass grafting with aortic ligation and subsequent graft removal with bowel repair are associated with a 25% to 90% operative mortality rate. In the emergency setting, patients unsuitable for major arterial surgery may benefit from a staged, less invasive approach.

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Introduction: Laparoscopic total mesorectal excision is effective and safe but often technically challenging because of inadequate exposure. Transanal total mesorectal excision was introduced to mitigate this limitation and improve the quality of mesorectal dissection in even the most challenging cases. Currently, the technique for transanal total mesorectal excision dissection is not standardized.

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Background: Natural orifice specimen extraction - NOSE laparoscopy is a promising technique that avoids mini-laparotomy, possibly reducing postoperative pain, wound infections and hospital stay. Recent systematic reviews have shown that postoperative morbidity associated with laparoscopically assisted gastrectomies is similar to that after open gastrectomies. More specifically, there is no difference in wound infection rate.

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History of rectal cancer surgery has shown a continuous evolution of techniques and technologies over the years, with the aim of improving both oncological outcomes and patient's quality of life. Progress in rectal cancer surgery depended on a better comprehension of the disease and its behavior, and also, it was strictly linked to advances in technologies and amazing surgical intuitions by some surgeons who pioneered in rectal surgery, and this marked a breakthrough in the surgical treatment of rectal cancer. Rectal surgery with radical intent was first performed by Miles in 1907 and the procedure he developed, abdomino-perineal resection, became a gold standard for many years.

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Introduction: First described in 1982, TME overcomes most of the concerns regarding adequate local control after anterior rectal resection. TME requires close sharp dissection along the so-called Heald's plane down to the levators, with distal dissection often cumbersome. In recent years, Transanal TME was introduced with the aim to improve distal rectal dissection and quality of mesorectal excision.

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Background: Single-incision laparoscopic cholecystectomy (SILC) has been widely introduced into the clinical practice, but the real clinical benefits for patients still remain a matter of debate. We conducted a systematic review, according to the PRISMA guidelines comparing clinical and peri-operative outcomes of SILC and conventional laparoscopic cholecystectomy (CLC).

Method: A literature search, including only randomised controlled trials (RCTs), was performed via PubMed, Google Scholar, Cochrane Library and Embase database.

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Background: Laparoscopic sleeve gastrectomy has become a popular stand-alone procedure among bariatric surgeons. Recently, Natural Orifice Specimen Extraction laparoscopic surgery has been introduced to avoid minilaparotomy, possibly reducing postoperative pain, hospital stay, and improving QoL and cosmetics. Operative steps and preliminary results of NOSE sleeve gastrectomy are described and reported.

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Background And Aim: The literature continues to emphasize the advantages of treating patients in "high volume" units by "expert" surgeons, but there is no agreed definition of what is meant by either term. In September 2012, a Consensus Conference on Clinical Competence was organized in Rome as part of the meeting of the National Congress of Italian Surgery (I Congresso Nazionale della Chirurgia Italiana: Unità e valore della chirurgia italiana). The aims were to provide a definition of "expert surgeon" and "high-volume facility" in rectal cancer surgery and to assess their influence on patient outcome.

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A quarter of a century has passed since the Society of Minimally Invasive Therapy (SMIT) was founded in 1989 with the aim to provide a platform to promote the development of minimally invasive therapy and the new instruments and devices needed to carry out the new surgical techniques. Both the founder of the society, British urologist John EA Wickham, and the German surgeon Gerhard F Buess, who was one of the leading members from the beginning, conceived SMIT as an interdisciplinary forum to promote the cooperation between physicians from various surgical specialties, but also medical engineers, resp. medical device manufacturers, whose expertise was needed to build the instruments that had to be developed to carry out the new concept of surgery.

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Guidelines for laparoscopy and cancer of stomach have been outlined by several scientific societies: The main recommendation being that laparoscopy should be used only by surgeons already highly skilled in gastric surgery. The laparoscopic approach to gastric cancer surgery has become more and more frequent in most Italian centers. On behalf of the Guideline Committee of the Italian Society of Hospital Surgeons and the Italian Hi-Tech Surgical Club, a panel of experts analyzed the highest evidence of all scientific papers focusing on laparoscopic gastrectomies for cancer and published from 2003 to 2011, and drew these national guidelines.

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Laparoscopic sleeve gastrectomy (LSG) has received recognition in the treatment of patients with morbid obesity and BMI <40 kg/m2 and high-risk patients with BMI >50 kg/m2. Conventional LSG usually requires the placement of four or more trocars. Recently, newly designed access devices have allowed a single-incision laparoscopic approach; however, the clinical application of this method is still limited.

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Background: In recent years, new devices providing multiple channels have made the performance of laparoscopic cholecystectomy through a single access site not only feasible but much easier. The potential benefits of laparoendoscopic single-site (LESS) cholecystectomy may include scarless surgery, reduced postoperative pain, reduced postoperative length of stay, and improved postoperative quality of life. There are no comparative data between LESS cholecystectomy and standard laparoscopic cholecystectomy (LC) available at present with which to quantify these benefits.

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