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Medicina
Special Issues
Clinical Practice and Future Challenges in Abdominal Surgery
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Clinical Practice and Future Challenges in Abdominal Surgery

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Surgery".

Deadline for manuscript submissions: 20 May 2026 | Viewed by 2152

Special Issue Editors

Dr. Bojan Krebs

E-Mail Website
Guest Editor
1. General and Abdominal Surgery Department, University Medical Center Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia
2. Department of Surgery, Medical Faculty, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
Interests: colorectal surgery; surgical site infection; aparoscopy
Dr. Arpad Ivanecz

E-Mail Website
Guest Editor
1. General and Abdominal Surgery Department, University Medical Center Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia
2. Department of Surgery, Medical Faculty, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
Interests: hepato-pancreato-biliary surgery; colorectal liver metastasis; inflammation in cancer; liver; laparoscopy
Dr. Irena Plahuta

E-Mail Website
Guest Editor Assistant
1. General and Abdominal Surgery Department, University Medical Center Maribor, Ljubljanska ulica 5, 2000 Maribor, Slovenia
2. Department of Surgery, Medical Faculty, University of Maribor, Taborska ulica 8, 2000 Maribor, Slovenia
Interests: gastrointestinal surgery; inflammation; oncogenesis; liver; laparoscopy

Special Issue Information

Dear Colleagues,

In recent years, significant progress has been made in the field of abdominal surgery, driven by technological innovations, advanced surgical methods, and a deeper understanding of disease mechanisms and patient-centered care.

This Special Issue, entitled “Clinical Practice and Future Challenges in Abdominal Surgery”, will examine current practice and future perspectives regarding diagnosis, treatment, and prognosis in abdominal disorders in both elective and emergency settings.

The scope of this Special Issue encompasses benign, inflammatory, and malignant diseases of the gastrointestinal tract, including the hepato-pancreato-biliary system and proctology, as well as various treatment modalities (endoscopic, surgical, interventional, and hybrid procedures). We are interested in papers presenting techniques and treatment scenarios and their short- and long-term outcomes. Submissions on subjects such as the education and training of new surgeons in abdominal surgery are also welcome.

An emphasis will be placed on breakthroughs related to minimally invasive techniques, fresh perspectives on familiar problems, and new strategies for achieving optimal patient outcomes, including the significance of signal molecule pathways, inflammation, and nutrition.

Authors are welcome to submit original articles, clinical outcome studies, comparative studies, narrative reviews, scoping reviews, and systematic reviews and meta-analyses.

Dr. Bojan Krebs
Dr. Arpad Ivanecz
Guest Editors

Dr. Irena Plahuta
Guest Editor Assistant

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. Medicina is an international peer-reviewed open access monthly 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 2200 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

  • abdominal surgery
  • gastrointestinal oncology
  • hernia
  • minimally invasive surgery
  • surgical techniques
  • surgical innovation
  • endoscopy
  • nutrition
  • inflammation
  • outcomes

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

14 pages, 1968 KB  
Article
Lichtenstein Repair and Intersurgeon Variations: A Textbook Review and Multicenter Surgeon Survey
by Jurij Gorjanc, David C. Chen, Andrew Kingsnorth and Reinhard Mittermair
Medicina 2026, 62(1), 79; https://doi.org/10.3390/medicina62010079 - 30 Dec 2025
Viewed by 972
Abstract
Background and Objectives: A surgical method is rarely very effective and simple to perform. A Lichtenstein Repair (LR) is one such exception. Because of the very high incidence of inguinal hernia, LR has become the global gold standard in inguinal hernia repair—not [...] Read more.
Background and Objectives: A surgical method is rarely very effective and simple to perform. A Lichtenstein Repair (LR) is one such exception. Because of the very high incidence of inguinal hernia, LR has become the global gold standard in inguinal hernia repair—not only due to its relative simplicity and reproducibility but also because it can be performed under local anesthesia. These attributes facilitated its worldwide adoption, including in underdeveloped and resource limited settings. Today, many variations are performed under the common name “Lichtenstein Repair”. The extent to which these modifications influence outcomes—particularly recurrence and chronic pain—remains unclear. Materials and Methods: To evaluate reasons for variation in the LR technique, a literature review of seven major surgery textbooks was performed. In addition, a questionnaire comprising 17 questions addressing the key steps of the LR was sent to 90 surgeons across 19 different hospitals in Austria (6) and Slovenia (13). The questionnaire focused on core principles described by Lichtenstein and later refined by his successors. The overall response rate was 78%. Results: Descriptions of the LR in major hernia textbooks vary substantially, partly due to the evolution of the technique over time and partly because any subaponeurotic anterior-canal mesh repair is often labeled as “Lichtenstein”. Survey responses demonstrated considerable variation and lack of standardization or uniformity in several critical steps of the LR. More than 50% of respondents reported using pre-formed meshes that they excessively trim, limiting adequate coverage of the inguinal region. Furthermore, routine patient follow-up is lacking in the majority of cases. Conclusions: The contemporary umbrella term “Lichtenstein Repair” encompasses many different anterior mesh techniques. While some surgeon-specific preferences may not compromise integrity, strict adherence to the evidence-based key principles of the original repair remains essential to minimize recurrences and chronic inguinal pain. Standardization with meticulous adherence to the key principles of the LR is critical to ensure the data submitted into registries, RCTs, and meta-analyses are accurate, comparable, and meaningful. Full article
(This article belongs to the Special Issue Clinical Practice and Future Challenges in Abdominal Surgery)
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12 pages, 420 KB  
Article
Establishing a Robot-Assisted Liver Surgery Program: Early Experience from University Medical Center Ljubljana
by Miha Petrič, Živa Nardin, Jan Grosek, Aleš Tomažič, Boštjan Plešnik and Blaž Trotovšek
Medicina 2026, 62(1), 18; https://doi.org/10.3390/medicina62010018 - 22 Dec 2025
Viewed by 797
Abstract
Background and Objectives: Robot-assisted procedures represent a significant advancement in minimally invasive liver resection techniques. Nonetheless, the introduction of a novel surgical technique in a new environment necessitates meticulous planning and a gradual, stepwise approach. This study describes the adoption of a [...] Read more.
Background and Objectives: Robot-assisted procedures represent a significant advancement in minimally invasive liver resection techniques. Nonetheless, the introduction of a novel surgical technique in a new environment necessitates meticulous planning and a gradual, stepwise approach. This study describes the adoption of a robotic surgical platform for liver resection at a high-volume tertiary care center. Materials and Methods: We retrospectively analyzed data that had been prospectively collected from fifty robot-assisted liver resections. Descriptive statistics, including frequencies, percentages, means/medians, and standard deviations, were employed for description and summary. Results: The median operative duration was 166 min (range: 85–400 min), with an average intraoperative blood loss of 200 mL (range: 50–1000 milliliters). Intraoperative or postoperative blood transfusion was required in 8% of patients. Conversion to open resection was necessary in one patient (2%). The mean duration of hospitalization was 5 days (range: 3–20 days), with a 30-day readmission rate of 6% and no mortality within 90 days. Postoperative complications classified as Clavien-Dindo grade 3 or higher were observed in five patients (10%). The mean tumor size varied according to pathology: 58.5 mm (range: 30–120 mm) in the hepatocellular carcinoma group; 27.4 mm (range: 10–32 mm) in the secondary malignancy group; and 42.6 mm (range: 24–60 mm) in the intrahepatic cholangiocarcinoma group. The median number of lymph nodes harvested during lymphadenectomy (IHHCA/GBCA) was 5.4, ranging from 1 to 11. The R0 resection rate for malignant tumors was 88.2% (of 30/34). Conclusions: This study validates the safe integration of robot-assisted surgery into liver disease treatment, supported by our initial experience. Despite its technical advantages, robotic-assisted liver surgery remains complex and demanding. Structured robotic training within established programs, meticulous patient selection, and a stepwise implementation approach are critical during the early phases to optimize the outcomes. Full article
(This article belongs to the Special Issue Clinical Practice and Future Challenges in Abdominal Surgery)
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