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  • EditorialSeptember 15, 2016

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  • Review ArticleSeptember 15, 2016

    3 196 944

    Minimal invasive surgery (MIS) has rapidly gained acceptance for the management of a wide variety of pediatric diseases. The evolution of minimally invasive surgery (MIS) in children, especially newborns, has been delayed because of the limited working space and unique physiology. With the development of smaller instruments and advanced surgical skills, many of the initial obstacles have been overcome. MIS in children has been used in specialized centers with excellent results, and its application in Korea has been increasing recently. Obvious advantages include better cosmoses, less trauma, and better postoperative musculoskeletal function, especially after thoracic procedures. However, prospective randomized trials and high-level evidence of the benefits of MIS are still scarce. Questions to be answered in the upcoming years will therefore include identify both advantages and potential disadvantages of MIS, especially in neonates. In this review, recent surveys regarding use of MIS by the Korean Association of Pediatric Surgeons were also discussed.

  • Original ArticleSeptember 15, 2016

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    Safety and Feasibility of Single Incision Laparoscopic Spleen Preserving Distal Pancreatectomy

    Huisong Lee, Jin Seok Heo, Seong Ho Choi, and Dong Wook Choi

    J Minim Invasive Surg 2016; 19(3): 89-96

    Purpose: Single-incision laparoscopic distal pancreatectomy (SIL-DP) has recently been attempted in the treatment of left-sided benign neoplasms of the pancreas. This study was conducted to evaluate the perioperative outcomes of SIL-DP compared with conventional laparoscopic DP (CL-DP).
    Methods: Patients who received laparoscopic DP from a single surgeon for benign pancreatic neoplasm from January 2012 to January 2014 were included. The patients were divided into two groups, SIL-DP and CL-DP. We used four trocars for CL-DP and a custom-made glove port for SIL-DP and analyzed the conversion cases separately. Perioperative outcomes were compared between types of surgery.
    Results: SIL-DP was attempted in 13 patients, five of whom required conversion to CL-DP or dual-incision surgery. CL-DP was attempted in 27 patients and all were successful without open conversion. The spleen was preserved in all patients who underwent SIL-DP without conversion, in four of five (80%) in the conversion group, and 21 (78%) of those who underwent CL-DP. The complication rate was 13% in the SIL-DP-only group, 60% in the conversion group, and 19% in the CL-DP group. The operation time, estimated blood loss, numeric pain intensity score, and hospital duration were similar in the SIL-DP and CL-DP groups.
    Conclusion: SIL-DP was associated with a moderate need for an additional port, and the complication rate was high in the conversion group. Our findings indicate that SIL-DP should be attempted carefully. Further studies are needed to evaluate the long term follow-up outcomes of SIL-DP.

  • Original ArticleSeptember 15, 2016

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    Evaluation of P-POSSUM as a Risk Prediction Model in Laparoscopic Gastrectomy of Elderly Patients with Gastric Cancer

    Hyo Jung, Ki Hyun Kim, Si Hak Lee, Cheol Woong Choi, Su Jin Kim, Chang In Choi, Dae Hwan Kim, Tae Yong Jeon, Dong Heon Kim, and Sun Hwi Hwang

    J Minim Invasive Surg 2016; 19(3): 97-101

    Purpose: The physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) is a validated scoring system for auditing surgical outcomes. However, evaluation of this system has primarily been applied to open surgical techniques. The present study demonstrates the validity of P-POSSUM in predicting morbidity and mortality in the treatment of elderly patients with gastric cancer who underwent curative laparoscopic gastrectomy.
    Methods: All patients aged 70 years or over, who underwent curative laparoscopic gastrectomy between January 2014 and January 2015, were collected from our hospital database. A case-note review was used to collate data in terms of clinical and operative factors as described in P-POSSUM. Observed/Estimated ratio of morbidity and 30-day mortality were calculated.
    Results: Laparoscopic gastrectomy was performed in 101 patients. The mean age was 74.9 years (70~83 years). A significant postoperative morbidity was observed in 20 (19.8%) of 101 patients. There was no 30-day mortality. Using exponential analysis, P-POSSUM predicted morbidity in 22 patients. Thus, O/E ratios for morbidity and mortality were 0.9 and 0, respectively.
    Conclusion: P-POSSUM scoring slightly overestimated predictions of morbidity and mortality. An assessment of its application to laparoscopic gastrectomy of elderly patients with gastric cancer merits further evaluation. Also, laparoscopic gastrectomy was a feasible and safe treatment for elderly patients in terms of P-POSSUM.

  • Original ArticleSeptember 15, 2016

    0 182 944

    The Role of Laparoscopic Necrosectomy in the Era of Minimally Invasive Treatment for Necrotizing Pancreatitis: A Case Series and Review of the Literature

    Chul Kyu Roh, Yoo-Seok Yoon, Ho-Seong Han, Jai Young Cho, Young Rok Choi, Jae Seong Jang, Seonguk Kwon, Sung Ho Kim, and Jang Kyu Choi

    J Minim Invasive Surg 2016; 19(3): 102-107

    Purpose: Despite the recent increasing application of minimally invasive techniques to treat necrotizing pancreatitis, few reports on laparoscopic necrosectomy have appeared. The aim of the present study was to evaluate the role played by laparoscopic necrosectomy in treatment of necrotizing pancreatitis. We review our own experience and the relevant literature.
    Methods: All patients undergoing laparoscopic necrosectomy at Seoul National University Bundang Hospital from March 2005 to January 2016 were included in the study. Data on patient demographics, CT severity index score, American Society of Anesthesiologists’ score, preoperative procedures, operative methods, operation time, estimated blood loss, postoperative complications, and length of hospital stay were retrospectively analyzed. We also performed an up-to-date review of the relevant literature.
    Results: Laparoscopic necrosectomy was performed on four patients with infective pancreatic necrosis that was inadequately treated by percutaneous drainage. A transgastrocolic, transmesocolic, or retrocolic approach was used. The median time from diagnosis to operation was 57 days (range, 34~109 days) and the median operation time 203 min (range, 180~255 min). There was no operative mortality. The necrotic tissue was successfully removed in a single operation in three of the four patients. Three patients experienced postoperative complications, including pleural effusion and recurrence of necrosis. The median postoperative hospital stay was 39 days (range, 16~99 days).
    Conclusion: Laparoscopic necrosectomy is safe and effective when used to treat necrotizing pancreatitis. Such treatment is especially useful for patients with solid, necrotic pancreatic components that are not removed by percutaneous or endoscopic drainage.

  • Case ReportSeptember 15, 2016

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    Laparoscopic Excision of a Retroperitoneal Solitary Fibrous Tumor: A Case Report

    Eun-Ki Min, Younghae Song, Jae Uk Chong, and Chang Moo Kang

    J Minim Invasive Surg 2016; 19(3): 108-112

    Solitary fibrous tumors (SFTs) are rare mesenchymal tumors mainly originating in the pleura. Since complete resection is the most important prognostic factor, typical surgical approach has been open laparotomy. In this report, we present a unusual case of large retropancreatic SFT that was successfully treated via laparoscopic resection. A 22-year-old female was diagnosed with a 8×7 cm-sized well-demarcated mass with multiple loculating and enhancing solid portions on the left adrenal fossa. The mass showed no definite invasion of adjacent organs and laparoscopic resection was planned. Using blunt dissection and individual vessel ligation, the operation was successful. The operative time was 220 minutes, and the amount of intraoperative blood loss was estimated to be within 100 ml. The patient recovered without complications. Laparoscopic excision of large retroperitoneal SFTs can be safe and feasible if there is no evidence of local invasion or malignancy on preoperative radiologic images.

  • Video/Multimedia ArticleSeptember 15, 2016

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    Reduced Port Laparoscopic Reversal of Hartmann’s Procedure Using the Colostomy Site

    Min-Hyun Kim, Heung-Kwon Oh, Il-Tae Son, Sung-Il Kang, Myung Jo Kim, Duck-Woo Kim, and Sung-Bum Kang

    J Minim Invasive Surg 2016; 19(3): 113-114

    Utilization of the colostomy site for laparoscopic reversal of Hartmann’s procedure was recently introduced, and several studies have shown the feasibility of the procedure, which allows the colostomy site to serve as an access port for the operation. We demonstrate a method utilizing an accessory 5 mm trocar to assist in the operation while employing a colostomy-deepened glove port.

  • Video/Multimedia ArticleSeptember 15, 2016

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    Technical Compensation for Hepatic Vein Injury during Robotic Single Site Cholecystectomy

    Jae Uk Chong, Myung Jae Jung, and Chang Moo Kang

    J Minim Invasive Surg 2016; 19(3): 115-116

    This video describes an event that could occur during any cholecystectomy. To the best of our knowledge, this video is the first description of the technical compensation for hepatic vein injury during robotic single-site cholecystectomy (RSSC). A 61-year-old male with a 1.6 cm gallbladder stone sought to go through with RSSC. During dissection of gallbladder from the liver bed, the hepatic vein was unexpectedly exposed and injured. Using the angulated robotic needle holder, the injured hepatic vein was repaired with 5-0 prolene monofilament suture. Although there is a lack of EndoWrist movement in RSSC, suturing was feasible. The patient was discharged on the second postoperative day without complications. Incidental hepatic vein injury could be safely managed using RSSC and prevent the need for conversion to a conventional laparoscopic or open approach.

Jun 15, 2024 Vol.27 No.2
pp. 55~127


Journal of Minimally Invasive Surgery

pISSN 2234-778X
eISSN 2234-5248