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Minimally Invasive Surgical Procedures: Challenges, Advancements and New Directions
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Minimally Invasive Surgical Procedures: Challenges, Advancements and New Directions

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

Deadline for manuscript submissions: closed (29 September 2024) | Viewed by 2470

Special Issue Editors

Dr. Michail Pitiakoudis

E-Mail Website
Guest Editor
Second Department of Surgery, University General Hospital of Alexandroupolis, Democritus University of Thrace Medical School, 68100 Alexandroupolis, Greece
Interests: minimally invasive surgery; laparoscopic surgery; colorectal surgery; gastrointestinal surgery; hernia surgery; surgical oncology; colorectal cancer; metastasis; abdominal surgery; endocrine surgery; thyroid diseases; biopsy
Dr. Konstantinos Romanidis

E-Mail Website
Guest Editor
Second Department of Surgery, University General Hospital of Alexandroupolis, Democritus University of Thrace Medical School, 68100 Alexandroupolis, Greece
Interests: surgical oncology; colorectal cancer surgery; colorectal surgery; laparoscopic surgery; artificial intelligence in surgery; minimally invasive surgery; cellular metabolism in colorectal cancer; metastasis; gastrointestinal surgery; abdominal surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Minimally invasive surgery represents an approach that has revolutionized healthcare by promoting a new era of surgery. Such procedures provide several benefits over traditional open surgery in many aspects. In addition, technological advancements have played a vital role in the evolution of minimally invasive surgery. Laparoscopic, robot-assisted, endoscopic, and thoracoscopic surgery constitute procedures that have gained more ground and acceptance due to their significant advantages. To date, minimally invasive surgery is steadily becoming the preferred approach for treating patients with several diseases, including upper and lower gastrointestinal malignancies. This Special Issue aims to seek articles that emphasize the value of minimally invasive surgery through its widespread use in a plethora of diseases. It will also highlight novel techniques and procedures that can contribute to and transform the future of surgery.

Dr. Michail Pitiakoudis
Dr. Konstantinos Romanidis
Guest Editors

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.

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
  • laparoscopic surgery
  • robot-assisted surgery, endoscopic surgery
  • thoracoscopic surgery
  • upper and lower gastrointestinal surgery
  • lymphadenectomy

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Published Papers (2 papers)

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10 pages, 3879 KiB  
Article
Upper Mediastinal Lymphadenectomy Utilizing Prone-Position Thoracoscopy for Esophageal and Gastroesophageal Junction Cancers
by Spyridon Davakis, Dimitrios Ziogas, Pavlos Papadakis, Stratigoula Sakellariou, Athanasia Mitsala, Christos Tsalikidis and Alexandros Charalabopoulos
J. Clin. Med. 2024, 13(22), 6896; https://doi.org/10.3390/jcm13226896 - 16 Nov 2024
Viewed by 856
Abstract
Background/Objectives: Esophagectomy is the mainstay of treatment in esophageal cancer. Minimally invasive esophagectomy (MIE) remains a challenging procedure and has been associated with a high rate of complications and mortality. Routine lymphadenectomy includes two-field lymphadenectomy for distal-esophageal or gastroesophageal junction Siewert I–II tumors. [...] Read more.
Background/Objectives: Esophagectomy is the mainstay of treatment in esophageal cancer. Minimally invasive esophagectomy (MIE) remains a challenging procedure and has been associated with a high rate of complications and mortality. Routine lymphadenectomy includes two-field lymphadenectomy for distal-esophageal or gastroesophageal junction Siewert I–II tumors. Superior mediastinal lymphadenectomy (SML) refers to an extended two-field lymphadenectomy or total mediastinal lymphadenectomy during MIE for cancer. The exact benefits of SML have been the subject of prolonged debate, with no conclusive evidence indicating improved clinical and oncological results. Herein, we aim to present our surgical technique of thoracoscopic SML during MIE in the prone position, with short-term clinical and oncological outcomes. Methods: About 150 consecutive patients underwent totally MIE within 3 years period (2016–2019). SML included right-paratracheal nodes and nodes along the right-recurrent laryngeal nerve throughout its mediastinal route in cases of extended two-field lymphadenectomy, as well as left-paratracheal nodes and nodes along the left recurrent laryngeal nerve during total mediastinal lymphadenectomy. Eligible patients underwent SML during two-stage or three-stage MIE. Results: Twenty consecutive patients underwent SML during the study period. The 30- and 90-day mortality rates were 0. Pulmonary complications were observed in 16.5% of the patients. There was 1 right recurrent laryngeal nerve palsy noted. The median length of stay was 9 days. The median number of resected lymph nodes was 45, with the median SML nodes count being 8. The median follow-up was 24 months. Conclusions: SML during prone position thoracoscopy for esophageal cancer is safe and feasible, although technically demanding. Minimally invasive esophagectomy with SML may offer meaningful benefits in oncological outcomes without introducing additional significant morbidity. Further comparative studies are needed to better elucidate our results. Full article
(This article belongs to the Special Issue Minimally Invasive Surgical Procedures: Challenges, Advancements and New Directions)
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24 pages, 4647 KiB  
Systematic Review
Ultrasound-Guided Intranodal Lipiodol Lymphangiography for the Assessment and Treatment of Chylous Leaks: A Retrospective Case Series from a Single Center in Switzerland and a Systematic Review of the Literature
by Stephanie Nicole Schulz, Almir Miftaroski, Benoit Rouiller, Bernard Egger, Jon A. Lutz and Lucien Widmer
J. Clin. Med. 2024, 13(21), 6432; https://doi.org/10.3390/jcm13216432 - 27 Oct 2024
Viewed by 1155
Abstract
Background: Lymphatic leaks are well-known complications of major thoracic or abdominal surgeries, which significantly heighten morbidity and mortality rates. While the existing literature provides insights into managing these post-operative leaks, with a step-up approach from conservative measures (CMs) to surgical intervention, there are [...] Read more.
Background: Lymphatic leaks are well-known complications of major thoracic or abdominal surgeries, which significantly heighten morbidity and mortality rates. While the existing literature provides insights into managing these post-operative leaks, with a step-up approach from conservative measures (CMs) to surgical intervention, there are no standardized treatment guidelines. The purpose of this paper is to offer a management algorithm of post-operative lymphatic leaks based on a systematic literature review (SLR) of the therapeutic effect of Lipiodol lymphangiography (LL), completed by a case series of five patients who underwent LL in our department. Methods: In this IRB-approved study, we conducted an SLR following the PRISMA guidelines, using a PICOS. A quality assessment was performed for each study. The case series consisted of consecutive patients who underwent LL for diagnostic and therapeutic purposes at our institution between September 2018 and December 2020. Results: A total of 39 observational studies were included in the SLR comprising 11 retrospective case reviews (Group 1), and 3 case series as well as 25 case reports (Group 2). In total, these studies report cases of 557 patients (51.52% presenting oncological diagnoses; 43.98% having benefited from lymphadenectomy). Lymphatic or chylous fistulas were the most encountered complication, followed by chylothorax. The median volume of Lipiodol injected during lymphography was 11.7 mL (range: 9.8–75 mL). Overall, LL was technically successful in 77.7% (366/471) of patients. The clinical success of all technically successful LLs was 80.6% (295/366). Time-to-leak resolution after lymphography varied between 1 and 31 days. The factors associated with treatment failure were a high leak output (>500 mL/day) and Lipiodol extravasation on post-LL imaging. Our case series consisted of five patients (mean age: 62 ± 9.24 years; 20% female; 100% oncological diagnoses; 60% having beneficiated from lymphadenectomy). Technical and clinical successes were 80% (4/5) and 75% (3/4), respectively. Time-to-leak resolution varied between 1 and 4 days. The volume and technique of LL was not different from that identified in the SLR. Conclusions: LL is a safe procedure with high technical and clinical success rates that could be proposed as both a diagnostic and therapeutic solution for patients with post-operative central lymphatic lesions. Full article
(This article belongs to the Special Issue Minimally Invasive Surgical Procedures: Challenges, Advancements and New Directions)
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