Usefulness of participation of endoscopic surgical skill qualification system-qualified surgeons in laparoscopic high anterior resection.

Introduction: A technical qualification system was established by the Japanese Society of Endoscopic Surgery in 2004, and its effectiveness in low anterior resection (LAR) has been reported. We herein performed a subgroup analysis of the effectiveness of the participation of technically qualified surgeons in laparoscopy-assisted high anterior resection (HAR), a procedure used for the technical qualification of surgeons.

Methods: The EnSSURE study enrolled 3188 patients who underwent laparoscopic rectal resection for rectal cancer between January 2014 and December 2016 at 56 Japanese hospitals.

Formation of a Colo-colonic Fistula Communicating with the Transverse Colon in Cecal Cancer: A Case Report.

Although colorectal cancer frequently invades adjacent organs, colon-to-colon invasion is rarely observed, and colo-colonic fistula formation due to colorectal cancer is uncommon. Here we report a case of preoperative diagnosis of cecal cancer that has invaded the transverse colon. A 69-year-old woman presented with diarrhea and a palpable mass in the lower right abdomen.

Automatic Surgical Skill Assessment System Based on Concordance of Standardized Surgical Field Development Using Artificial Intelligence.

Importance: Automatic surgical skill assessment with artificial intelligence (AI) is more objective than manual video review-based skill assessment and can reduce human burden. Standardization of surgical field development is an important aspect of this skill assessment.

Objective: To develop a deep learning model that can recognize the standardized surgical fields in laparoscopic sigmoid colon resection and to evaluate the feasibility of automatic surgical skill assessment based on the concordance of the standardized surgical field development using the proposed deep learning model.

Deep-learning-based semantic segmentation of autonomic nerves from laparoscopic images of colorectal surgery: an experimental pilot study.

Background: The preservation of autonomic nerves is the most important factor in maintaining genitourinary function in colorectal surgery; however, these nerves are not clearly recognisable, and their identification is strongly affected by the surgical ability. Therefore, this study aimed to develop a deep learning model for the semantic segmentation of autonomic nerves during laparoscopic colorectal surgery and to experimentally verify the model through intraoperative use and pathological examination.

Materials And Methods: The annotation data set comprised videos of laparoscopic colorectal surgery.

Universal meta-competencies of operative performances: a literature review and qualitative synthesis.

Background: Prioritizing patient health is essential, and given the risk of mortality, surgical techniques should be objectively evaluated. However, there is no comprehensive cross-disciplinary system that evaluates skills across all aspects among surgeons of varying levels. Therefore, this study aimed to uncover universal surgical competencies by decomposing and reconstructing specific descriptions in operative performance assessment tools, as the basis of building automated evaluation system using computer vision and machine learning-based analysis.

Development and Validation of a Model for Laparoscopic Colorectal Surgical Instrument Recognition Using Convolutional Neural Network-Based Instance Segmentation and Videos of Laparoscopic Procedures.

Importance: Deep learning-based automatic surgical instrument recognition is an indispensable technology for surgical research and development. However, pixel-level recognition with high accuracy is required to make it suitable for surgical automation.

Objective: To develop a deep learning model that can simultaneously recognize 8 types of surgical instruments frequently used in laparoscopic colorectal operations and evaluate its recognition performance.

Real-time vascular anatomical image navigation for laparoscopic surgery: experimental study.

Background: Recognition of the inferior mesenteric artery (IMA) during colorectal cancer surgery is crucial to avoid intraoperative hemorrhage and define the appropriate lymph node dissection line. This retrospective feasibility study aimed to develop an IMA anatomical recognition model for laparoscopic colorectal resection using deep learning, and to evaluate its recognition accuracy and real-time performance.

Methods: A complete multi-institutional surgical video database, LapSig300 was used for this study.

Artificial Intelligence-Based Total Mesorectal Excision Plane Navigation in Laparoscopic Colorectal Surgery.

Background: Total mesorectal excision is the standard surgical procedure for rectal cancer because it is associated with low local recurrence rates. To the best of our knowledge, this is the first study to use an image-guided navigation system with total mesorectal excision.

Impact Of Innovation: The impact of innovation is the development of a deep learning-based image-guided navigation system for areolar tissue in the total mesorectal excision plane.

Technical Report and Surgical Outcomes of Needlescopic Totally Extraperitoneal Inguinal Hernia Repair: A Single-center, Retrospective Cohort Study.

Background: Technical difficulties in totally extraperitoneal inguinal hernia repair (TEP) may be strongly associated with poor operability in a limited operative field. Needlescopic instruments could be helpful in a limited space, and the aim of this study was to evaluate the clinical efficacy of needlescopic TEP.

Materials And Methods: The study population constituted 150 consecutive patients undergoing needlescopic TEP, and we compared these patients with 151 consecutive patients who underwent conventional TEP regarding patients' demographic features and operative outcomes.

Open mesh removal combined with laparoscopic totally extraperitoneal inguinal hernia repair: A case report of a novel surgical technique for chronic postoperative inguinal pain.

A 74-year-old man presented for surgical treatment to alleviate chronic post-herniorrhaphy inguinal pain. Physical and imaging examinations suggested that his pain was due to his ilioinguinal nerve being entrapped by a meshoma composed of bilayer mesh and plug mesh. The patient strongly desired mesh removal, although it appeared challenging because of adhesion of the meshes from the previous herniorrhaphies.

Laparoscopic total extraperitoneal treatment for a hydrocele of the canal of Nuck located entirely within the inguinal canal: A case report.

A 43-year-old woman was diagnosed with a hydrocele of the canal of Nuck, for which laparoscopic total extraperitoneal excision was successfully undertaken. The hydrocele was located entirely within the inguinal canal and was barely visible at the internal inguinal ring, even with strong retraction. The inferior epigastric vessels were at risk of injury secondary to excessive tension when retracting the round ligament.

Clinical efficacy of bowel perfusion assessment during laparoscopic colorectal resection using laser speckle contrast imaging: A matched case-control study.

Introduction: Disadvantages of bowel perfusion assessment with indocyanine green fluorescence angiography include the need for a fluorophore and the subjective nature of the assessment. This study was performed to evaluate the clinical efficacy of bowel perfusion assessment using laser speckle contrast imaging (LSCI) during laparoscopic colorectal surgery.

Methods: The study population comprised the first 27 consecutive patients who underwent laparoscopic left-sided colorectal resection with intraoperative perfusion assessment using LSCI.

Scleroderma renal crisis with coexisting segmental arterial mediolysis presenting as intraperitoneal bleeding: a case report.

Background: Segmental arterial mediolysis is a rare nonarteriosclerotic and noninflammatory vascular disease that may cause intraperitoneal bleeding. Scleroderma renal crisis is a rare complication of systemic sclerosis, leading to severe hypertension and renal dysfunction. To the best of our knowledge, this is the first reported case of a patient with concurrent systemic sclerosis with scleroderma renal crisis and pathologically confirmed segmental arterial mediolysis.

Aortoenteric fistula following overlap esophagojejunal anastomosis using linear staplers for cancer of the esophagogastric junction: a case report.

Background: Aortoenteric fistula (AEF), occasionally reported as a fatal complication after aortic or other vascular procedures, is a communication between the aorta and the digestive tract. AEF as a fatal complication of overlap esophagojejunostomy after esophagogastrectomy has not been reported previously. Herein, we report a case of AEF after laparoscopic proximal gastrectomy and transhiatal lower esophagectomy for cancer of the esophagogastric junction, in which linear staplers were used for overlap esophagojejunostomy.

Laser Speckle Contrast Imaging for Intraoperative Quantitative Assessment of Intestinal Blood Perfusion During Colorectal Surgery: A Prospective Pilot Study.

Background: The main limitation of perfusion assessment with indocyanine green fluorescence angiography during colorectal surgery is that the surgeon assesses the quality of perfusion subjectively. The ideal intestinal viability test must be minimally invasive, objective, and reproducible. We evaluated the quantitativity and reproducibility of laser speckle contrast imaging for perfusion assessment during colorectal surgery.

Metachronous rectal metastasis from primary transverse colon cancer: a case report.

Background: Colorectal metastases from primary colorectal cancers are very rare, and little is known about their epidemiological aspects or the best diagnostic and therapeutic strategies. Herein, we report a case of a 65-year-old woman with suspected metachronous metastasis to the rectum from primary transverse colon cancer.

Case Presentation: The patient underwent a laparoscopic extended right hemicolectomy for primary transverse colon cancer.

Oral nutrition for left-sided malignant colonic obstruction after decompression with a transanal drainage tube: A case series of 6 patients.

Oral nutrition with a low-residue diet for left-sided malignant colonic obstruction after decompression with a transanal drainage tube is safe and can be considered a viable preoperative management option for appropriate patients.

Rare complication after totally extraperitoneal endoscopic inguinal hernia repair: Small bowel perforation without peritoneal disruption.

We report a rare case of visceral injury after totally extraperitoneal endoscopic inguinal hernia repair. A 48-year-old man underwent needlescopic totally extraperitoneal repair of a direct inguinal hernia. Bleeding from a branch of the inferior epigastric vessels occurred at the beginning of the extraperitoneal dissection with a monopolar electrosurgical device.

Strangulated transmesosigmoid hernia as a late complication of a fall from a height: A case report.

Introduction: A transmesosigmoid hernia is defined as small bowel herniation through a complete defect involving both layers of the sigmoid mesentery. Blunt trauma injury to the sigmoid mesocolon has been reported only rarely. We herein report a case of a strangulated transmesosigmoid hernia associated with a history of a fall from a height.