Robotic Assistance in Percutaneous Liver Ablation Therapies: A Systematic Review and Meta-Analysis.

Objective: The aim of this systematic review and meta-analysis is to identify current robotic assistance systems for percutaneous liver ablations, compare approaches, and determine how to achieve standardization of procedural concepts for optimized ablation outcomes.

Background: Image-guided surgical approaches are increasingly common. Assistance by navigation and robotic systems allows to optimize procedural accuracy, with the aim to consistently obtain adequate ablation volumes.

Educational Scoring System in Laparoscopic Cholecystectomy: Is It the Right Time to Standardize?

: Laparoscopic cholecystectomy (LC) is one of the most performed surgeries worldwide. Procedure difficulty and patient outcomes depend on several factors which are not considered in the current literature, including the learning curve, generating confusing and subjective results. This study aims to create a scoring system to calculate the learning curve of LC based on hepatobiliopancreatic (HPB) experts' opinions during an educational course.

Risk Factors for Hemorrhagic Adverse Events in Percutaneous Transhepatic Biliary Drainage: A Prospective Multicenter Study.

Purpose: To determine risk factors (RFs) for hemorrhagic adverse events (AEs) associated with percutaneous transhepatic biliary drainage (PTBD) and to develop a risk assessment model.

Materials And Methods: This was a multicenter, prospective, case control study between 2015 and 2020. Adults with an indication for PTBD were included.

Sleeve Gastrectomy and Cholecystectomy are Safe in Obese Patients with Asymptomatic Cholelithiasis. A Multicenter Randomized Trial.

Background: Obesity is a severe health problem. Gallstones may symptomatize after sleeve gastrectomy (SG). Concomitant laparoscopic cholecystectomy (LC) with SG is controversial.

Online Education, Was It Here but We Did Not Know?

Online education is not new. Their main options are talks, videos, and virtual courses. The quality and quantity of talks, together with the level of the speakers, is variable and heterogeneous.

Laparoscopic-Percutaneous Combined Gastrostomy: Initial Experience and Description of a Technique.

Gastrostomy is a widely used procedure that aims to obtain access to the stomach. Its purpose may be feeding or gastric decompression. Currently, the most common techniques are endoscopic and radiologic.

Toward a Change in Our Work in Surgery: Collaborative Work, Coaching, and Teamwork.

Until now, working with others has been shaped by a style where 1 person made the main decisions at the top of the hierarchical pyramid. These days this one-directional model no longer makes sense. That is why we need to change to a collaborative style.

Image-Guided Surgical Simulation in Minimally Invasive Liver Procedures: Development of a Liver Tumor Porcine Model Using a Multimodality Imaging Assessment.

Image-guided liver surgery and interventions are growing as part of the current trend to translate liver procedures into minimally invasive approaches. Hands-on surgical training in such techniques is required. Consequently, a meaningful and realistic liver tumor model using multi-imaging modalities, such as ultrasound (US), computed tomography (CT), magnetic resonance (MR), cone beam-CT (CBCT), is mandatory.

Fluoroless intravascular ultrasound image-guided liver navigation in porcine models.

Background: An intravascular ultrasound catheter (IVUSc) was developed for intracardiac ultrasound to assess interventions with compelling results. However, intrahepatic vascular exploration was rarely tested and was always associated with X-ray techniques. The aim of this study was to demonstrate the feasibility to navigate through the whole liver using an IVUSc, providing high-quality images and making it unnecessary to use ionizing radiation.

Percutaneous transhepatic cholangioscopy using a single-operator cholangioscope (pSOC), a retrospective, observational, multicenter study.

Background And Aims: Percutaneous cholangioscopy (PC) is more complex and invasive than a transpapillary approach, with the need for a large percutaneous tract of 16 French (Fr) on average in order to advance standard percutaneous cholangioscopes. The aim of this study was to investigate whether percutaneous single-operator cholangioscopy (pSOC) using the SpyGlass DS system is feasible, safe, and effective in PC for diagnostic and therapeutic indications.

Materials And Methods: The data of 28 patients who underwent pSOC in 4 tertiary referral centers were retrospectively analyzed.

Image-Guided Surgery for Common Bile Duct Stones After Roux-en-Y Gastric Bypass.

The relationship between obesity with common bile duct stone (CBDS) is close and increases after a Roux-en-Y gastric bypass (RYGB). Due to the anatomical modification, direct endoscopic access is not always possible. For this reason, image-guided surgery (IGS) by percutaneous transhepatic biliary drainage (PTBD) of the common bile duct (CBD) could be a first-line approach for the treatment of post-RYGB choledocholithiasis.

Clinical practice guidelines for the management of liver metastases from extrahepatic primary cancers 2021.

Background: Hepatectomy is standard treatment for colorectal liver metastases; however, it is unclear whether liver metastases from other primary cancers should be resected or not. The Japanese Society of Hepato-Biliary-Pancreatic Surgery therefore created clinical practice guidelines for the management of metastatic liver tumors.

Methods: Eight primary diseases were selected based on the number of hepatectomies performed for each malignancy per year.

Image-Guided Surgical Training in Percutaneous Hepatobiliary Procedures: Development of a Realistic and Meaningful Bile Duct Dilatation Porcine Model.

Malignant or benign biliary obstructions can be successfully managed with minimally invasive percutaneous interventions. Since percutaneous approaches are challenging, extensive training using relevant models is fundamental to improve the proficiency of percutaneous physicians. The aim of this experimental study was to develop an training model in pigs to simulate bile duct dilatation to be used during percutaneous biliary interventions.

Acute Gastric Dilation of the Post-Roux-en-Y Gastric Bypass Remnant Stomach: Image-Guided Surgery Approach.

Bariatric surgery is an effective treatment for obesity and its associated morbidities. They are safe surgeries, their general complication rate is 0%-10%. However, acute gastric dilation is an unusual complication.

What is the Role of Image-Guided Endovascular Surgery in Postbariatric Surgery Bleeding Complications?

Obesity treatment requires surgical procedures included in bariatric surgery. Bleeding complications are reported in 1%-4%. Image-guided surgery (IGS) includes minimally invasive procedures that have the advantage of less aggression to the patient, fewer complications, and a quick recovery.

Laparoscopic Common Bile Duct Exploration Using a Single-Operator Cholangioscope.

Gallbladder stones are a very common disease, with a prevalence of 21.9% in Argentina. The incidence of common bile duct stones (CBDS) varies with age and with the clinical presentation; ∼3%-10% of patients with gallbladder lithiasis have concomitant choledocholithiasis.

Transhepatic Percutaneous Sustained Dilation with Multiple Catheters for the Management of Hepaticojejunostomy Benign Stricture.

Benign biliary strictures (BBS) befall in ∼7%-23% after hepaticojejunostomy and in 0.3%-0.6% after cholecystectomies.

Applications of Elastography in Ablation Therapies: An Animal Model Study.

Ablation therapies are one of the main local treatments for solid organ tumors. After applying any ablation therapy, few days should be waited to perform an imaging study and analyze the result. In this work, we analyzed the correlation between elastography monitoring after procedure and the result of ablation.

Image-Guided Surgical e-Learning in the Post-COVID-19 Pandemic Era: What Is Next?

The current unprecedented coronavirus 2019 (COVID-19) crisis has accelerated and enhanced e-learning solutions. During the so-called transition phase, efforts were made to reorganize surgical services, reschedule elective surgical procedures, surgical research, academic education, and careers to optimize results. The intention to switch to e-learning medical education is not a new concern.

Percutaneous Image-Guided Surgery in Complications After Bariatric Surgery.

Although bariatric surgery is a standardized procedure, it is not without complications. Image-guided surgery allows minimally invasive resolution of complications, making it ideal for bariatric patients. The objective of this work was to analyze the image-guided surgery approach to postoperative complications of bariatric surgery.

RISK OF BLEEDING COMPLICATIONS IN PERCUTANEOUS BILIARY DRAINAGE: THE PARADOX OF THE NORMAL HEMOSTASIS.

Background: Percutaneous biliary drainage is a safe procedure. The risk of bleeding complications is acceptable. Frequently, patients with biliary obstructions usually have coagulation disorders thus increasing risk of bleeding.

Percutaneous Image-Guided Abdominal Interventions for Leaks and Fistulas Following Sleeve Gastrectomy and Roux-en-Y Gastric Bypass.

Background: Bariatric surgery offers the only effective long-term weight loss therapy for morbidly obese patients. Numerous studies have demonstrated a mortality and morbidity reduction associated with weight loss surgery, but these interventions also have significant rates of complications. It is important for the bariatric surgeons to recognize these complications and acknowledge which of them can be solved in a minimally invasive manner in order to offer to patients the best treatment.