A right colectomy case study: transitioning to the Hugo RAS system with a novel 3-ports technique in experienced robotic colorectal practice.

Introduction: Advancements in robotic technology have revolutionized general surgery, with new platforms and continuous improvements enhancing surgical procedures. Our unit adopted the Da Vinci Si model in 2012 and later the X model for various abdominal surgeries. In early 2023, we integrated the Hugo RAS system by Medtronic into our practice following comprehensive training.

46-kg abdominal tumor misdiagnosed as obesity: Unveiling healthcare bias due to obesity stigma.

Key Clinical Message: Obesity results in higher risk of some cancers while obesity stigma affect patient's quality of care. In this case report, a 46 kg ovary mass was misdiagnosed as severe obesity. Obesity stigma awareness and a sustained effort from healthcare professionals are required to deliver adequate patient care to patients with obesity.

The impact of colectomy and restorative procedure on pouch function after ileo-pouch-anal anastomosis in ulcerative colitis. The icon fun study on behalf of the Italian Society of Colon and Rectal Surgery (SICCR) Inflammatory Bowel Diseases committee.

Background: Available guidelines lack in indications on surgical standard in Ulcerative Colitis (UC) AIMS: To determine the role of surgical strategies of colectomy and proctectomy with pouch-anal-anastomosis (IPAA) on functional outcomes in a nationwide population multicenter study. The secondary aims consisted of perioperative outcomes and complications.

Methods: Data on 379 patients who underwent total abdominal colectomy and proctectomy with ileo-pouch-anal-anastomosis (IPAA) with or without diverting ileostomy were retrospectively collected in a red cap multicenter-database searching for variables that could impact on pouch outcomes as cuffitis, pouchitis, anastomotic stenosis, pouch stenosis, failure or pathological Low-Anterior-Resection-Syndrome (LARS) score.

Technology availability, sector policies and behavioral change are complementary strategies for achieving net-zero emissions.

In this study, we analyze the effects of technology availability, political coordination, and behavioral change on transformation pathways toward net-zero greenhouse gas emissions in the European Union by 2050. We implemented an iterative stakeholder dialogue to co-design the scenarios that were calculated using a global multi-regional energy-economy-land-climate model. We find that in scenarios without behavioral change and with restriction of technologies, the target of greenhouse gas neutrality in the European Union cannot be reached.

Effect of powered circular stapler in colorectal anastomosis after left-sided colic resection: systematic review and meta-analysis.

Purpose: Anastomotic leak (AL) remains the most important complication after left-sided colic anastomoses and technical complications during anastomotic construction are responsible of higher leakage incidence. Powered circular stapler (PCS) in colorectal surgery has been introduced in order to reduce technical errors and post-operative complications due to the manual circular stapler (MCS).

Methods: A systematic review and meta-analysis were performed.

The Importance of Multiorgan Procurement in the Improvement of Residents' Open Surgical Skills.

Introduction: The multiorgan procurement (MOP) represents a chance for the general surgery resident to learn the fundamental steps of open abdominal surgery. The objective of this study was to evaluate the impact of MOP on the residents' open surgical skills.

Methods: Residents' surgical skills were assessed during a 6-month transplant rotation (October 2020-March 2021) using a modified Objective Structured Assessment of Technical Skills with the global rating scale.

Effect of centre volume on pathological outcomes and postoperative complications after surgery for colorectal cancer: results of a multicentre national study.

Background: The association between volume, complications and pathological outcomes is still under debate regarding colorectal cancer surgery. The aim of the study was to assess the association between centre volume and severe complications, mortality, less-than-radical oncologic surgery, and indications for neoadjuvant therapy.

Methods: Retrospective analysis of 16,883 colorectal cancer cases from 80 centres (2018-2021).

A comparison of surgical techniques for perineal wound closure following perineal excision: a systematic review and network meta-analysis.

Background: To mitigate pelvic wound issues following perineal excision of rectal or anal cancer, a number of techniques have been suggested as an alternative to primary closure. These methods include the use of a biological/dual mesh, omentoplasty, muscle flap, and/or pelvic peritoneum closure. The aim of this network analysis was to compare all the available surgical techniques used in the attempt to mitigate issues associated with an empty pelvis.

Surgery of the alimentary tract for benign and malignant disease with the novel robotic platform HUGO RAS. A first world report of safety and feasibility.

Introduction: As robotic surgery increases its reach, novel platforms are being released. We present the first 17 consecutive cases of alimentary tract surgery performed with the Hugo RAS (Medtronic).

Methods: patients were selected to undergo surgery from February through April 2023.

Symptomatic Uncomplicated Diverticular Disease (SUDD): Practical Guidance and Challenges for Clinical Management.

Symptomatic Uncomplicated Diverticular Disease (SUDD) is a syndrome within the diverticular disease spectrum, characterized by local abdominal pain with bowel movement changes but without systemic inflammation. This narrative review reports current knowledge, delivers practical guidance, and reveals challenges for the clinical management of SUDD. A broad and common consensus on the definition of SUDD is still needed.

Percutaneous Drainage vs. Surgery as Definitive Treatment for Anastomotic Leak after Intestinal Resection in Patients with Crohn's Disease.

Background: Anastomotic leak (AL) remains one of the most relevant complications after intestinal resection for Crohn's disease (CD). While surgery has always been considered the standard treatment for perianastomotic collection, percutaneous drainage (PD) has been proposed as a potential alternative.

Methods: Retrospective study in consecutive patients treated with either PD or surgery for AL after intestinal resection for CD between 2004 and 2022.

Efficacy of laparoscopic Toupet fundoplication compared to endoscopic and surgical procedures for GERD treatment: a randomized trials network meta-analysis.

Purpose: We aim to review and quantitatively compare laparoscopic Toupet fundoplication (LTF), Nissen fundoplication (LNF), anterior partial fundoplication (APF), magnetic augmentation sphincter (MSA), radiofrequency ablation (RFA), transoral incisionless fundoplication (TIF), proton pump inhibitor (PPI), and placebo for the treatment of GERD. A number of meta-analyses compared the efficacy of surgical and endoscopic procedures for recalcitrant GERD, but considerable debate on the effectiveness of operative strategies remains.

Methods: A systematic review of MEDLINE databases, EMBASE, and Web of Science for randomized controlled trials (RCTs) comparing the aforementioned surgical and endoscopic GERD treatments was performed.

A Planned Multidisciplinary Surgical Approach to Treat Primary Pelvic Malignancies.

The pelvic anatomy poses great challenges to orthopedic surgeons. Sarcomas are often large in size and typically enclosed in the narrow confines of the pelvis with the close proximity of vital structures. The aim of this study is to report a systematic planned multidisciplinary surgical approach to treat pelvic sarcomas.

The impact of psychological distress on weight regain in post-bariatric patients during the COVID-19 pandemic: A latent profile analysis.

Objective: The COVID-19 pandemic has caused a global health crisis disrupting healthcare delivery for people with severe obesity who have undergone bariatric surgery. This study examined the role of psychological distress during the first Italian COVID-19 lockdown in predicting post-operative outcomes in post-bariatric patients reaching the end of the 12-18 months follow-up during the lockdown. By using a person-centered approach, groups of patients with different psychological distress profiles were identified.

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy.

Importance: Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis.

Objective: To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer.

Design, Setting, And Participants: This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals.

Influence of diabetes mellitus on inflammatory bowel disease course and treatment outcomes. A systematic review with meta-analysis.

Background: Diabetes Mellitus (DM) may occur in IBD and influence the disease progression.

Aim: To compare disease course and treatment outcomes in IBD patients with and without DM.

Methods: This is a systematic review with meta-analysis comparing patients with IBD plus DM with patients with IBD only.

Multiproxy study of 7500-year-old wooden sickles from the Lakeshore Village of La Marmotta, Italy.

The lakeshore site of La Marmotta is one of the most important Early Neolithic sites of Mediterranean Europe. The site is famous for the exceptional preservation of organic materials, including numerous wooden artefacts related to navigation, agriculture, textile production, and basketry. This article presents interdisciplinary research on three of the most complete and well-preserved sickles recovered from the site, yet unpublished.