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Challenges in Minimally Invasive Colorectal and Abdominal Wall Surgery
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Challenges in Minimally Invasive Colorectal and Abdominal Wall 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: closed (31 March 2026) | Viewed by 5792

Special Issue Editors

Dr. Francesco Ferrara

E-Mail Website
Guest Editor
Department of Precision Medicine in Medical, Surgical, and Critical Care (Me.Pre.C.C.), Unit of General and Oncologic Surgery, “Paolo Giaccone” Hospital, University of Palermo, Palermo, Italy
Interests: colorectal surgery; proctology; laparoscopy; abdominal wall surgery; hernia; diastasis recti; surgical oncology
Dr. Roberto Peltrini

E-Mail Website
Guest Editor
Department of Public Health, School of Medicine and Surgery, University of Naples Federico II, Naples, Italy
Interests: colorectal surgery; laparoscopy; surgical oncology

Special Issue Information

Dear Colleagues,

Progress in minimally invasive colorectal and abdominal wall surgery has been significant over the years, driven by advancements in technology, surgical techniques, and perioperative care. A large number of controlled studies and meta-analyses have shown that laparoscopic colorectal surgery is associated with the same benefits as other minimally invasive procedures, including lesser pain, earlier recovery of bowel transit, and a shorter hospital stay. The use of laparoscopy for the surgical treatment of colorectal cancer is currently widely accepted. Moreover, the introduction of robotic systems has introduced more innovation in this field. These advancements have also been seen in abdominal wall surgery, where new laparoscopic, endoscopic, and robotic techniques have been proposed in the last few years. The aim of this Special Issue is to collect the most recent studies about the treatment of colorectal diseases and abdominal wall defects with the use of minimally invasive approaches.

Dr. Francesco Ferrara
Dr. Roberto Peltrini
Guest Editors

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Keywords

  • colorectal surgery
  • laparoscopy
  • abdominal wall surgery
  • hernia
  • diastasis recti
  • surgical oncology
  • rectal tumor
  • colon tumor
  • colorectal neoplasia

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Published Papers (4 papers)

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Research

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12 pages, 991 KB  
Article
Open vs. Laparoscopic Surgery for Rectal Cancer: Impact on Identification and Preservation of Pelvic Autonomic Nerves and Effects on Urinary and Sexual Function and Quality of Life
by Ivan Dimitrijevic, Marko Miladinov, Jelenko Jelenkovic, Predrag Gavrilovic, Aleksandar Sekulic, Goran Barisic and Jovana Rosic Stojkovic
J. Clin. Med. 2026, 15(6), 2421; https://doi.org/10.3390/jcm15062421 - 21 Mar 2026
Viewed by 386
Abstract
Background/Objectives: With advances in surgical techniques for rectal cancer—particularly laparoscopic and robotic-assisted approaches—the choice of operative method may influence not only oncological but also functional outcomes. This study aimed to compare open and laparoscopic rectal cancer surgery regarding pelvic autonomic nerve identification, [...] Read more.
Background/Objectives: With advances in surgical techniques for rectal cancer—particularly laparoscopic and robotic-assisted approaches—the choice of operative method may influence not only oncological but also functional outcomes. This study aimed to compare open and laparoscopic rectal cancer surgery regarding pelvic autonomic nerve identification, preservation and its impact on postoperative urinary, sexual, and quality-of-life outcomes. Methods: A total of 181 patients who underwent curative rectal cancer surgery at the Clinic for Digestive Surgery, University Clinical Center of Serbia, were included. Six types of procedures were performed using both open and laparoscopic approaches. Intraoperative identification and preservation of pelvic autonomic nerves were assessed and verified postoperatively through evaluation of urinary, sexual, and quality-of-life parameters. Urinary function and related life quality were assessed using the International Prostate Symptom Score (IPSS and IPSS-QoL), while sexual function was evaluated using gender-specific validated questionnaires (IIEF-15 and FSFI) preoperatively and at 2, 4, and 6 months postoperatively. Results: Nerve non-visualization and/or injuries were significantly more frequent in the open surgery group. The laparoscopic approach was associated with better preservation of urinary function, particularly among male patients, better sexual function in both sexes, and a transient advantage in quality of life. Conclusions: Laparoscopic rectal cancer surgery demonstrated superior pelvic autonomic nerve visualization and preservation and better short-term urinary and sexual function. Nonetheless, quality-of-life outcomes were comparable by 6 months of follow-up, underscoring the importance of meticulous nerve-preserving technique regardless of surgical approach. Full article
(This article belongs to the Special Issue Challenges in Minimally Invasive Colorectal and Abdominal Wall Surgery)
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9 pages, 229 KB  
Article
Evaluation of Short-Term Effects on Colorectal Surgery Elective Patients after Implementing a Patient Blood Management Program: A Multicenter Retrospective Analysis
by Filippo Carannante, Gabriella Teresa Capolupo, Manuel Barberio, Amedeo Altamura, Valentina Miacci, Martina Zenobia Scopigno, Erika Circhetta, Gianluca Costa, Marco Caricato and Massimo Giuseppe Viola
J. Clin. Med. 2024, 13(15), 4447; https://doi.org/10.3390/jcm13154447 - 29 Jul 2024
Cited by 1 | Viewed by 1990
Abstract
Introduction: Patients who undergo surgery may require a blood transfusion and patients undergoing major colorectal surgery are more prone to preoperative and perioperative anemia. Blood transfusions have, however, long been associated with inflammatory and oncological complications. We aim to investigate the effects [...] Read more.
Introduction: Patients who undergo surgery may require a blood transfusion and patients undergoing major colorectal surgery are more prone to preoperative and perioperative anemia. Blood transfusions have, however, long been associated with inflammatory and oncological complications. We aim to investigate the effects of an optimal implementation of a patient blood management (PBM) program in our hospital. Methods: This study retrospectively reviewed data from two different prospectively maintained databases of all patients undergoing elective major colorectal surgery with either a laparoscopic, open, or robotic approach from January 2017 to December 2022 at two different high-volume colorectal surgery Italian centers: the Colorectal Surgery Unit of Fondazione Policlinico Campus Bio-Medico in Rome and the Colorectal Surgery Unit of Fondazione Cardinale Panico in Tricase (Lecce). Our study compares the first group, also known as pre-PBM (January 2017–December 2018) and the second group, known as post-PBM (January 2021–December 2022). Results: A total of 2495 patients, who satisfied the inclusion and exclusion criteria, were included in this study, with, respectively, 1197 patients in the pre-PBM group and 1298 in the post- PBM group. The surgical approach was similar amongst the two groups, while the operative time was longer in the pre-PBM group than in the post-PBM group (273.0 ± 87 vs. 215.0 ± 124 min; p < 0.001). There was no significant difference in preparatory Hb levels (p = 0.486), while anemia detection was significantly higher post-PBM (p = 0.007). However, the rate of transfusion was drastically reduced since the implementation of PBM, with p = 0.032 for preoperative, p = 0.025 for intraoperative, and p < 0.001 for postoperative. Conclusions: We confirmed the need to reduce blood transfusions and optimize transfusion procedures to improve short-term clinical outcomes of patients. The implementation of the PBM program was associated with a significant reduction in the rate of perioperative transfusions and an increase in only appropriate transfusions. Full article
(This article belongs to the Special Issue Challenges in Minimally Invasive Colorectal and Abdominal Wall Surgery)

Review

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14 pages, 817 KB  
Review
Technical Principles in Elective Surgical Treatment of Left Colon Diverticular Disease: A Scoping Review
by Luca Emanuele Amodio, Gianluca Rizzo, Federica Marzi, Camilla Marandola, Francesco Ferrara and Vincenzo Tondolo
J. Clin. Med. 2025, 14(24), 8645; https://doi.org/10.3390/jcm14248645 - 5 Dec 2025
Viewed by 670
Abstract
Left colon diverticular disease (LCDD) is prevalent in the aging populations of industrialized countries, with many patients requiring surgery. Elective surgery decisions should consider individual health conditions and quality of life. Typically, surgery is recommended six weeks after an acute episode. This scoping [...] Read more.
Left colon diverticular disease (LCDD) is prevalent in the aging populations of industrialized countries, with many patients requiring surgery. Elective surgery decisions should consider individual health conditions and quality of life. Typically, surgery is recommended six weeks after an acute episode. This scoping review, following PRISMA-ScR guidelines, analyzed the literature on elective LCDD surgery, focusing on inferior mesenteric artery (IMA) ligation, splenic flexure mobilization (SFM), surgical approach, and extent of resection. The databases searched included PubMed, Embase, and Cochrane Library up to May 2025. Twenty studies met the inclusion criteria: 2 randomized trials (RCTs), 6 systematic reviews, 3 prospective studies, and 9 retrospective cohorts. The findings suggest preserving the IMA and selectively omitting SFM may reduce minor complications without compromising safety. Resection should reach the rectosigmoid junction and include only the affected colon segment. Minimally invasive techniques, especially laparoscopic surgery improve outcomes, reduce morbidity, and are more cost-effective than open surgery. Robotic approaches offer new options for complex cases. Surgical strategies must be tailored to disease severity, patient comorbidities, and anatomy. Further prospective studies are needed to refine guidelines and support personalized surgical decisions in LCDD management. Full article
(This article belongs to the Special Issue Challenges in Minimally Invasive Colorectal and Abdominal Wall Surgery)
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Other

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10 pages, 5172 KB  
Case Report
Successful Laparoscopy-Assisted Extirpation of Burkitt’s Lymphoma Causing Intestinal Obstruction in a 17-Year-Old Boy
by Zoltán Derzsi, Zsolt Bara, Emőke Horváth, Gabriel Serac, Răzvan Mărginean, Réka Sólyom, Evelyn Kovács and Horea Gozar
J. Clin. Med. 2024, 13(24), 7834; https://doi.org/10.3390/jcm13247834 - 22 Dec 2024
Cited by 2 | Viewed by 2036
Abstract
Background: Childhood extranodal B-cell non-Hodgkin’s lymphomas are often caused by Burkitt’s lymphoma (BL). Treatment usually involves intensive polychemotherapy, and recent prospective trials show significantly improved outcomes. Surgery primarily involves conducting biopsies; ablative interventions are not recommended. However, in cases of severe presentation, such [...] Read more.
Background: Childhood extranodal B-cell non-Hodgkin’s lymphomas are often caused by Burkitt’s lymphoma (BL). Treatment usually involves intensive polychemotherapy, and recent prospective trials show significantly improved outcomes. Surgery primarily involves conducting biopsies; ablative interventions are not recommended. However, in cases of severe presentation, such as an acute abdomen, emergency surgery may be necessary. Methods: We present the case of a 17-year-old boy who underwent emergency surgery due to intestinal obstruction caused by a tumor mass. An exploratory laparoscopy was performed due to abdominal wall infiltrates, and a large intraabdominal mass was discovered in the ileocaecal region. The tumor and tumor infiltrates were successfully removed en bloc in a minimally invasive laparoscopy-assisted fashion. Results: The postoperative course was favorable, and chemotherapy was started. Histopathology confirmed the diagnosis of BL. Follow-up examinations, including a positron emission tomography (PET) scan, showed no tumor recurrence. More than two years later, the patient remains asymptomatic with negative PET scans. Conclusions: Laparoscopy-assisted removal can be useful for pediatric solid abdominal tumors with abdominal wall infiltrates that cause obstruction. Surgeons must assess indications and procedures based on imaging and findings during emergency interventions. The role of ablative MIS in pediatric BL is limited. Full article
(This article belongs to the Special Issue Challenges in Minimally Invasive Colorectal and Abdominal Wall Surgery)
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