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Minimally Invasive Gastrointestinal Surgery: Clinical Updates and Challenges

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

Deadline for manuscript submissions: closed (25 March 2025) | Viewed by 524

Special Issue Editor


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Guest Editor
Department of Surgical Sciences, Sapienza University of Rome, 00162 Rome, Italy
Interests: clinical trials; minimally invasive surgery; laparoscopic surgery; general surgery; gastric surgery; gastrointestinal surgery; colorectal surgery; bariatric surgery; hernia repair; vascular surgery
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Special Issue Information

Dear Colleagues,

Minimally invasive gastrointestinal surgery has become a cornerstone of modern surgical practice, offering substantial benefits over traditional open surgery. Techniques such as laparoscopy, endoscopy, and robotic-assisted surgery have enabled surgeons to perform complex procedures with greater precision and minimal tissue disruption.

Technological advancements have played a significant role in the evolution of minimally invasive gastrointestinal surgery. High-definition imaging, enhanced endoscopic tools, and sophisticated robotic systems have improved the safety and efficacy of these procedures. However, the high cost of these technologies and the need for specialized training can limit their accessibility, particularly in resource-constrained settings.

Advanced endoscopic techniques such as endoscopic submucosal dissection (ESD) and peroral endoscopic myotomy (POEM) are expanding treatment options for neoplasms and motility disorders. In bariatric surgery, novel minimally invasive methods are improving weight and metabolic outcomes. Recent advancements in gastric cancer surgery include the increased use of robotic-assisted and refined laparoscopic techniques, which offer enhanced precision. Sentinel lymph node navigation surgery and personalized neoadjuvant and adjuvant therapies are improving staging accuracy and survival rates.

Future directions for minimally invasive gastrointestinal surgery include the integration of artificial intelligence and machine learning to aid in real-time decision-making, the refinement of robotic systems, and the development of less invasive techniques such as single-port surgery and natural orifice transluminal endoscopic surgery (NOTES). These innovations promise to further enhance surgical precision and patient outcomes.

This Special Issue aims at exploring the current state and future perspectives of minimally invasive gastrointestinal surgery, offering valuable insights into its clinical applications and the obstacles that need to be navigated.

Dr. Lidia Castagneto Gissey
Guest Editor

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Keywords

  • robotic surgery
  • single-incision laparoscopic surgery
  • natural orifice transluminal endoscopic surgery (NOTES)
  • endoscopic submucosal dissection (ESD)
  • peroral endoscopic myotomy (POEM)
  • Heller myotomy
  • bariatric surgery
  • hiatal hernia
  • gastric cancer
  • gastrointestinal surgery

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Published Papers (1 paper)

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Research

9 pages, 7188 KiB  
Article
Comparison of Reduced-Port Totally Robotic Pancreaticoduodenectomy with Conventional Totally Robotic and Laparoscopic Pancreaticoduodenectomy
by Boram Lee, Ho-Seong Han, Yoo-Seok Yoon and Jun Suh Lee
J. Clin. Med. 2025, 14(11), 3960; https://doi.org/10.3390/jcm14113960 - 4 Jun 2025
Viewed by 237
Abstract
Background: Reduced-port totally robotic pancreaticoduodenectomy (rpRPD) has been introduced to address limitations of conventional robotic pancreaticoduodenectomy (cRPD), particularly regarding assistant mobility and visualization. This study aimed to evaluate the clinical feasibility and procedural consistency of rpRPD in comparison with cRPD and laparoscopic pancreaticoduodenectomy [...] Read more.
Background: Reduced-port totally robotic pancreaticoduodenectomy (rpRPD) has been introduced to address limitations of conventional robotic pancreaticoduodenectomy (cRPD), particularly regarding assistant mobility and visualization. This study aimed to evaluate the clinical feasibility and procedural consistency of rpRPD in comparison with cRPD and laparoscopic pancreaticoduodenectomy (LPD). Methods: We conducted a retrospective cohort study of patients who underwent pancreaticoduodenectomy between January 2015 and December 2024. Patients were categorized into rpRPD (n = 40), cRPD (n = 60), and LPD (n = 262) groups. Clinical outcomes and learning curves were compared using regression and cumulative sum (CUSUM) analysis. Results: Baseline characteristics were similar across groups. The rpRPD group demonstrated significantly shorter operative time (p < 0.001) and lower blood loss (p < 0.05) than cRPD, with no significant differences in postoperative complications or hospital stay. The learning curve analysis revealed that rpRPD had lower variance (5839.3 vs. 8919.1) and more stable performance than cRPD despite a slightly longer stabilization point. Lymph node retrieval was comparable across groups, supporting oncological equivalence. Conclusions: rpRPD offers comparable perioperative and oncologic outcomes to cRPD and LPD while improving operative efficiency and procedural predictability. It represents a technically feasible and safe option for minimally invasive pancreatic surgery. Full article
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