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Approaches to Prevention and Management of Postoperative Complications in Minimally Invasive 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: 15 July 2026 | Viewed by 1113

Special Issue Editor

Dr. Shingo Tsujinaka

E-Mail Website
Guest Editor
Division of Gastroenterological Surgery, Department of Surgery, Tohoku Medical and Pharmaceutical University, Sendai 983-8536, Japan
Interests: colorectal cancer; minimally invasive surgery; colorectal surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The aim of this Special Issue, “Approaches to Prevention and Management of Postoperative Complications in Minimally Invasive Surgery”, is to highlight recent advances in minimizing and managing early and late postoperative complications following minimally invasive surgical procedures. We invite submissions from diverse specialties, including thoracic, gastrointestinal, hepatobiliary–pancreatic surgery, gynecology, and urology, to foster a multidisciplinary discussion. Topics of interest include preoperative risk assessment, intraoperative techniques, and postoperative care strategies aimed at preventing and managing issues such as bleeding, organ injury, bowel obstruction, surgical site occurrence, incisional hernia, and anesthetic-related events. This Special Issue will also explore the role of technology, patient optimization, and multidisciplinary approaches in improving postoperative outcomes. Furthermore, it will emphasize how minimally invasive surgery affects patient care and patient satisfaction, with a focus on patient-reported outcomes and their impact on overall quality of care.

Dr. Shingo Tsujinaka
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 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • minimally invasive surgery
  • postoperative complications
  • preventive measures
  • risk assessment
  • surgical techniques
  • patient optimization
  • complication management
  • surgical outcomes
  • patient satisfaction
  • patient-reported outcomes

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Published Papers (2 papers)

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Research

10 pages, 325 KB  
Article
Mid-Term Oncological Outcomes of Vaginal Natural Orifice Transluminal Endoscopic Surgery Compared with Total Laparoscopic Hysterectomy for Early-Stage Endometrial Cancer: A Single-Center Retrospective Study
by Ken Imai, Junya Abe, Kenro Chikazawa, Mina Hasegawa, Nanami Suzuki, Miyuki Taniguchi and Tomoyuki Kuwata
J. Clin. Med. 2026, 15(9), 3350; https://doi.org/10.3390/jcm15093350 - 28 Apr 2026
Viewed by 367
Abstract
Background/Objectives: Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is increasingly being used to avoid abdominal incisions; however, its mid-term oncological safety in endometrial cancer remains unclear. Methods: This single-center retrospective cohort study included patients with International Federation of Gynecology and Obstetrics [...] Read more.
Background/Objectives: Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is increasingly being used to avoid abdominal incisions; however, its mid-term oncological safety in endometrial cancer remains unclear. Methods: This single-center retrospective cohort study included patients with International Federation of Gynecology and Obstetrics (FIGO) clinical stage IA endometrioid endometrial carcinoma undergoing simple hysterectomy between January 2014 and December 2023. Patients were treated with either total laparoscopic hysterectomy (TLH) or vNOTES. Patients who underwent lymph node assessment were excluded. Follow-up assessed mid-term oncological outcomes. Recurrence-free survival (RFS) was evaluated using the Kaplan–Meier method and compared between the groups, and Cox proportional hazards models were used to identify prognostic factors for RFS. Results: In total, 130 patients were included: 109 underwent TLH and 21 vNOTES. The median follow-up period was 48 and 33 months in the TLH and vNOTES groups, respectively. Postoperative adjuvant therapy was more frequent in the vNOTES group. The operative time was significantly shorter with vNOTES. Postoperative complications were low and similar between the groups. The 3-year RFS was 92.8% and 94.4% in the TLH and vNOTES groups, respectively, without a significant difference (p = 0.874). Lymphovascular space invasion was significantly associated with worse RFS, whereas surgical approach was not significantly associated with RFS. Conclusions: No statistically significant difference in mid-term RFS was observed between vNOTES hysterectomy and conventional TLH in this highly selected low-risk cohort. However, the study was underpowered and subject to residual confounding; therefore, these findings should be considered preliminary and hypothesis-generating. Full article
(This article belongs to the Special Issue Approaches to Prevention and Management of Postoperative Complications in Minimally Invasive Surgery)
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14 pages, 262 KB  
Article
Long-Term Safety and Efficacy of Alginate-Based Serosal Reinforcement (SEAL-G/SEAL-G MIST) Following Colorectal Anastomosis: A Multicenter, Comparative and Retrospective Cohort Study
by Fahim Kanani, Antonino Spinelli, Mordechai Shimonov, Husam Zbede, Nouha Hinnawi, Ron Lavy, Oded Zmora and Moshe Kamar
J. Clin. Med. 2026, 15(4), 1448; https://doi.org/10.3390/jcm15041448 - 12 Feb 2026
Viewed by 436
Abstract
Background: Anastomotic leakage (AL) remains a major complication following colorectal surgery (3–19% incidence, 6–39% mortality). SEAL-G/SEAL-G MIST are alginate-based sealants for anastomotic reinforcement. While short-term safety and efficacy feasibility have been established in a previous study, this study reports long-term results. Methods: A [...] Read more.
Background: Anastomotic leakage (AL) remains a major complication following colorectal surgery (3–19% incidence, 6–39% mortality). SEAL-G/SEAL-G MIST are alginate-based sealants for anastomotic reinforcement. While short-term safety and efficacy feasibility have been established in a previous study, this study reports long-term results. Methods: A multicenter, retrospective and comparative study at three centers (Israel, Italy). Retrospective Treatment group: 79 patients from the original study treated with SEAL-G/SEAL-G MIST during elective colon cancer resection (2021–2023). Retrospective Control group: 86 comparative patients with standard technique. Primary endpoint: Incidence of long-term complications (adhesions, stenosis, stricture, obstruction) at 1 year. Secondary endpoints: Complications at 1–4 years and 30-day AL rate. Non-inferiority assessed via Farrington–Manning method (margin 0.10). Results: Mean follow-up: 3.3 ± 0.63 years (treatment) vs. 3.4 ± 1.10 years (control). Groups were comparable for demographics and surgical characteristics. Long-term complications at 1 year: 1.27% (1/79) vs. 2.33% (2/86); 90% CI for difference: −0.067 to 0.046, p = 0.0048 (non-inferiority confirmed). No stenosis or stricture occurred in either group. No additional complications emerged at 1–4 years in the treatment group. Thirty-day AL rate: 1.27% (1/79) vs. 5.68% (5/88); all subclinical leaks (Grade B, n = 4) occurred in controls. Conclusions: Serosal reinforcement with alginate-based sealants does not introduce device-related long-term complications following colorectal anastomosis. The favorable short-term safety profile extends to 2–4 years. These findings support the safety of alginate-based sealants as anastomotic adjuncts, consistent with the paradigm of leak containment and severity reduction. Full article
(This article belongs to the Special Issue Approaches to Prevention and Management of Postoperative Complications in Minimally Invasive Surgery)
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