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Clinical Advances and Challenges in Laparoscopic Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: 25 March 2026 | Viewed by 813

Special Issue Editor


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Guest Editor
Department of Gastrointestinal Surgery, Haukeland University Hospital, Bergen, Norway
Interests: HPB-surgery; gastrointestinal surgery; laparoscopic surgery; robotic surgery; clinical trials

Special Issue Information

Dear Colleagues,

The laparoscopic approach has been increasingly used over the past few decades across various surgical fields. It is now widely accepted as a method of choice for many minor surgeries, as it significantly reduces postoperative complications compared to traditional open surgery. However, the role of laparoscopy in major surgical procedures and its impact on oncological radicality remain topics of debate. This Special Issue aims to provide updated research on the surgical outcomes of laparoscopic and minimally invasive techniques. We invite researchers to submit their findings as original articles or review papers.

Dr. Leonid Barkhatov
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

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Keywords

  • laparoscopic surgery
  • minimally invasive surgery
  • surgical outcomes
  • oncologic surgery
  • general surgery
  • learning curve

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Published Papers (1 paper)

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Research

21 pages, 7927 KB  
Article
Topographic and Anatomical Landmarks of Key Points in Embryologically Guided Surgery for Locally Advanced Gastric Cancer Using Computer-Assisted 3D Navigation
by Tatiana Khorobrykh, Vadim Agadzhanov, Anton Grachalov, Ivan Ivashov, Alexey Spartak, Artem Romanovskii, Yaroslav Drach and Daniil Kharkov
J. Clin. Med. 2025, 14(17), 6282; https://doi.org/10.3390/jcm14176282 - 5 Sep 2025
Viewed by 578
Abstract
Background/Objectives: Gastric cancer remains a leading cause of cancer-related mortality, with over 50% of cases diagnosed at a locally advanced or metastatic stage. High-quality surgical resection within the embryological mesogastric layer is critical for achieving optimal oncological outcomes but is often complicated by [...] Read more.
Background/Objectives: Gastric cancer remains a leading cause of cancer-related mortality, with over 50% of cases diagnosed at a locally advanced or metastatic stage. High-quality surgical resection within the embryological mesogastric layer is critical for achieving optimal oncological outcomes but is often complicated by anatomical distortion in advanced tumors. This study aimed to develop and validate a system of topographic and anatomical navigation landmarks for embryologically guided laparoscopic gastrectomy, leveraging 3D modeling to enhance precision and safety. Methods: A single-center study was conducted, analyzing 78 patients undergoing emergency laparoscopic gastrectomy for locally advanced gastric cancer. Preoperative 3D models were generated from CT data annotations to map the stomach, tumor, vascular structures, and mesogastric adipose tissue. Thirty biomodels were used to refine dissection techniques. Surgical procedures adhered to embryological principles, with lymphadenectomy guided by predefined landmarks. Histopathological validation assessed resection margins and tumor infiltration in resected specimens. Statistical analysis compared outcomes between patients with and without 3D planning. Results: The 3D models demonstrated 100% concordance with intraoperative vascular anatomy. Radiologically dense adipose tissue, resected as potentially tumor-infiltrated, showed histopathological invasion in 74% of cases. R0 resection was achieved in 74.4% of patients. Operative time decreased from 300 to 250 min after technical optimization, with a 7.7% conversion rate (primarily due to vascular injury or tumor fixation). Postoperative mortality was 5.1%, attributed to comorbidities. Patients with 3D planning had significantly higher lymph node yields (p < 0.00001) and R0 rates (p = 0.045). Conclusions: The integration of embryologically based topographic landmarks and 3D navigation improves the safety and standardization of laparoscopic gastrectomy for locally advanced gastric cancer. This approach enhances oncological radicality, reduces operative time, and mitigates risks in anatomically distorted fields. Further validation in larger cohorts is warranted. Full article
(This article belongs to the Special Issue Clinical Advances and Challenges in Laparoscopic Surgery)
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