Ovarian cystadenomas in adolescents are rare neoplastic tumors arising from the ovarian epithelium. These are seen in adult women, posing diagnostic challenges in the pediatric age group. Due to its propensity to become large up to 30cm, its acute presentation and complications necessitate urgent management. We present a case of a 17-year-old female who came in due to increasing abdominal girth of 1-year duration with a CT scan finding of 35 cm hypodense non-enhancing abdominopelvic mass. Tumor markers were requested, leading to non-malignancy, and the patient underwent minimally invasive surgery. This clinical case highlights the importance of a comprehensive approach to the diagnosis of intraabdominal masses in adolescents while providing optimal management and reducing potential complications.

BACKGROUND

Laparoscopic surgery is a widely accepted treatment modality, but with few disadvantages.

To describe the demographic, clinical, tumor, and operative characteristics of patients with colorectal cancer who underwent laparoscopic surgery.

Descriptive study.

47 males and 40 females, aged 19 years and older with colorectal cancer who underwent laparoscopic colorectal surgery.

Surgery Department - Colorectal Surgery section, Southern Philippines Medical Center, Davao City, August 2014 to August 2018.

Demographic and clinical characteristics, tumor profile, and operative outcomes.

This study analyzed 87 patients with colorectal cancer who underwent laparoscopic colorectal surgery. The participants had a mean age of 56.55 ± 11.99 years, with a slight male predominance (54.02%). Most patients resided within Davao Province (72.41%) and commonly presented with comorbidities, particularly hypertension (22.99%). Tumors were mostly located in the rectum (62.07%), and the majority of patients had advanced disease, with 59.77% classified as stage IIIB. Advanced tumor invasion was common, with 60.92% of patients presenting with T3 and 32.18% with T4 disease, while lymph node involvement was observed in 75.86% of cases. Distant metastasis was present in 11.49% of patients, most frequently involving the liver. Low anterior resection was the most commonly performed procedure (39.08%). The mean operative time was 278.89 ± 72.76 minutes, with a mean blood loss of 476.73 ± 341.86 mL and a conversion-to-open rate of 23.26%. Postoperative outcomes showed a morbidity rate of 26.44% and a mortality rate of 3.45%, with patients resuming oral intake after a mean of 4.02 ± 2.17 days and a mean hospital stay of 8.35 ± 6.38 days.

Laparoscopic colorectal surgery at our institution was performed among middle-aged patients, mostly males. Rectal cancer was the most common diagnosis, with most patients presenting with advanced stage IIIB disease, and low anterior resection was the most frequently performed procedure. The mean operative time was 279 minutes, with a conversion-to-open rate of nearly 25%. The mean intraoperative blood loss was 476 mL. Oral intake was resumed after a mean of 4 days. The mean hospital stay was 8 days, with low mortality despite a moderate morbidity rate.

In recent years, minimally invasive technology has been at the forefront of advancing various disciplines due to its unique advantages. With the development of endoscopic techniques, low-temperature plasma technology, and balloon dilation methods, the application of minimally invasive surgery in pediatric otolaryngology has increased significantly in clinical practice. The primary objective of minimally invasive techniques is to preserve normal anatomical structures as much as possible, reduce tissue damage associated with surgery, lower surgical risks, accelerate postoperative recovery, and achieve surgical outcomes that are comparable to or even better than those obtained through conventional procedures. In the future, the development of minimally invasive surgery must be aimed at pursuing the maximum benefit for patients, and operations will be more scientific, functional, comfortable, and diversified. The author believes that the development of minimally invasive surgery is inseparable from multidisciplinary cooperation, including clinicians, engineers, and other professionals in different fields. Only by working together can we jointly promote the development of minimally invasive surgery technology and provide patients with more accurate, efficient, and safe treatment options.
Humans ; Minimally Invasive Surgical Procedures/methods* ; Child ; Otorhinolaryngologic Diseases/surgery* ; Endoscopy ; Otorhinolaryngologic Surgical Procedures/methods*

Objective:Analyze the clinical features in children with pharyngeal neoplasm, and explore the clinical efficacy of low-temperature plasma minimally invasive treatment in children with pharyngeal neoplasm. Methods:A total of 46 pediatric cases of pharyngeal neoplasms admitted to the Otolaryngology Department of Wuhan Children's Hospital from January 2016 to December 2023 were included. There were 23 males and 23 females, with admission ages ranging from 5 days to 9 years and 4 months, and a median age of 2 years and 2 months. The clinical manifestations, examinations, treatments, and outcomes were evaluated. Results:Among the 46 pediatric patients, 21 were admitted with throat wheezing, 7 with masses in the oropharynx or head and neck, 5 with dyspnea, 4 with snoring during sleep as the main symptom, 3 with hoarseness, 2 with sore throat, 2 with swallowing discomfort, and 2 with difficulty feeding as the first symptom. Comorbidities included 5 cases of combined laryngomalacia, 4 of snoring, 4 of congenital heart disease, 4 of severe pneumonia, 3 of myocardial damage, 1 of multiple deformities, and 1 after hematopoietic stem cell transplantation. All patients underwent CT or MRI examination, with 26 cases undergoing local ultrasound examination and 39 undergoing electronic laryngoscopy examination. A total of 19 patients were transferred to the ICU after surgery, all of whom were patients with pharyngeal cysts. All patients underwent low-temperature plasma minimally invasive surgery, and all patients were diagnosed through pathological examination, including 1 case of nasopharyngeal teratoma, 5 of pharyngeal non-Hodgkin's lymphoma, 1 of oropharyngeal rhabdomyosarcoma, 1 of laryngeal perivascular epithelioid cell tumor （PEComa）, and 38 of pharyngeal cysts （2 cases of uvula, 2 of oropharynx, 7 of epiglottic valley, 19 of tongue base, 2 of branchial cleft cyst, and 6 of throat）. Conclusion:Pharyngeal neoplasms in children are prone to upper airway obstruction, including some rare or malignant tumors. Imaging and pathological diagnosis can assist in early diagnosis. Depending on the nature of the tumor, early detection and treatment can improve the quality of life and survival rate of children. Low-temperature plasma radiofrequency ablation is safe, minimally invasive, precise, and provides a clear field of vision, making it a valuable treatment option for children with pharyngeal neoplasms.
Humans ; Male ; Female ; Child, Preschool ; Child ; Infant ; Pharyngeal Neoplasms/therapy* ; Minimally Invasive Surgical Procedures/methods* ; Cold Temperature ; Treatment Outcome

Objective:Over the past decades, minimally invasive cochlear implantation（CI） have achieved significant advancements, evolving from initial emphasis on incision miniaturization to comprehensive strategies for preserving intracochlear structures and functions, as well as optimizing overall minimally invasive surgical procedure. However, current academic debates persist regarding standardized definitions and consensus on technical protocols. Future research should prioritize innovations in surgical-assistive robots, refinement of hidden cochlear implant, and exploration of drug deliver electrodes. These efforts aim to advance surgical methodologies toward enhanced minimally invasive approaches, functional preservation, and personalized therapeutic interventions.
Humans ; Cochlear Implantation/trends* ; Minimally Invasive Surgical Procedures/trends* ; Cochlear Implants

Objective:To investigate the application value of intraoperative electrocochleography（ECochG） monitoring technique and insertion techniques in cochlear implant（CI） and analyze its relationship with postoperative residual hearing（RH） preservation. Methods:Thirty-one patients（35 ears） who received CI in our hospital from June 2022 to July 2024 were enrolled. The Advanced Bionics Active Insertion Monitoring（AIM） system was used for real-time ECochG monitoring during surgery. Intraoperative cochlear microphonics （CM） waveform changes were recorded and analyzed in relation to postoperative RH preservation. Results:①ECochG recordings were successfully obtained in 34 of 35 ears （97.1%）. ②According to Harris classification, there were 7 ears（20.6%） of Type A（rising）, 7 ears（20.6%） of Type C（declining）, 8 ears（23.5%） of Type CC（fluctuating）, and 12 ears（35.3%） of Type D（no response）. ③The total CM amplitude decrease was significantly moderately correlated with postoperative low-mid frequency hearing loss（r=0.67, P=0.017）. The total CM amplitude decrease was significantly moderately correlated with postoperative low frequency hearing loss（r=0.65, P=0.023）. ④For the mean amplitude variation, the Amax was 30.70 μV, the Amin was 8.64 μV, and the Aend was 18.27 μV. ⑤Sixteen cases completed postoperative follow-up, with an average low-mid frequency（125-1 000 Hz） residual hearing loss of 15.25 dB HL and a RH preservation rate of 87.5%. Conclusion:Intraoperative ECochG monitoring can effectively predict postoperative residual hearing changes, effectively guide surgical manipulation, and improve residual hearing preservation rate.
Humans ; Cochlear Implantation/methods* ; Audiometry, Evoked Response ; Cochlear Implants ; Male ; Female ; Adult ; Middle Aged ; Monitoring, Intraoperative ; Adolescent ; Young Adult ; Minimally Invasive Surgical Procedures ; Child ; Aged ; Postoperative Period

The clinical burden of colorectal cancer (CRC) is high. Population-based screening and early detection are essential to improve the long-term clinical outcome. Nonetheless, a significant proportion of patients still present at an advanced stage, including with acute large bowel obstruction. Image-enhanced endoscopy and artificial intelligence can improve the detection and diagnosis of colonic adenomas and early cancer. Endoscopic resection is regarded as the preferred curative treatment option for colonic adenoma and T0 and T1 CRC limited to the superficial submucosa. Emergency colonic stenting as bridge to interval curative surgery is increasingly accepted as a first-line option when technically feasible. Minimally invasive resection techniques such as laparoscopic colectomy and robot-assisted colorectal surgery have also come of age. These techniques reduce post-treatment morbidity, shorten the recovery process and can be cost-effective while maintaining long-term oncological cure. These outcome measures are relevant to our patients; therefore, minimally invasive approaches to curative resection should be embraced.
Humans ; Colorectal Neoplasms/surgery* ; Minimally Invasive Surgical Procedures/methods* ; Laparoscopy/methods* ; Colectomy/methods* ; Robotic Surgical Procedures/methods* ; Treatment Outcome ; Colonoscopy/methods*

Visual minimally invasive acupotomy is applicable for the diseases with the pathological characteristics of soft tissue injury, including disorders of spine, four limbs and joints, peripheral nerve compression and chronic soft tissues. The diseases with superior effect obtained are cervicogenic headache, lumbar disc herniation, carpal tunnel syndrome and flexor tendon stenosing tenosynovitis. Under the guidance with ultrasound, visual minimally invasive acupotomy is advantaged at preoperative diagnosis, intraoperative guidance and postoperative evaluation in clinical practice so that it is precise, safe and reliable in clinical treatment. Visual minimally invasive acupotomy is essentially a kind of "ultra-minimally invasive" technique in treatment, focusing on the self-rehabilitation of the body induced by external treatment measures. It is highly complementary to the repair and reconstruction of minimally invasive surgery of modern medicine in clinical application.
Humans ; Acupuncture Therapy/methods* ; Minimally Invasive Surgical Procedures

Liver transplantation is an effective treatment for end-stage liver disease. Liver transplantation is technically complex and associated with significant trauma. In recent years,minimally invasive surgical techniques,such as laparoscopy and robotic surgery,have rapidly developed and been widely applied across various surgical fields. Minimally invasive surgery offers advantages including reduced trauma,less bleeding,and faster postoperative recovery,and has become a mainstream trend in surgical development. In the field of liver transplantation,laparoscopic and robotic donor hepatectomy techniques for living donor liver transplantation have made significant progress. However, due to difficulties in exposing the anastomotic sites of the donor liver and challenges in vascular anastomosis,the application of minimally invasive techniques in donor liver implantation has progressed relatively slowly. With advancements in laparoscopic and robotic surgical techniques and related instruments,laparoscopic donor liver implantation has gradually become feasible. Currently,multiple liver transplant centers worldwide have begun to progressively perform laparoscopic or robot-assisted liver transplantation in recipients,demonstrating potential advantages in reducing surgical trauma and accelerating postoperative recovery. However,there is currently a lack of guidelines or consensus on the application of minimally invasive surgery in liver transplant recipients. Therefore,Branch of Organ Transplantation of Chinese Medical Association,Surgery Group of Chinese Society of Surgery of Chinese Medical Association,and Branch of Organ Transplant Physicians of Chinese Medical Doctor Association invited experts in the field to discuss clinical issues. Combining published guidelines,consensus statements,and research advancements,they formulated the "Technical guidelines for minimally invasive surgery in liver transplant recipients（2025）", aiming to provide reasonable guidance and references for clinical practitioners in the field of liver transplantation.
Humans ; Liver Transplantation/methods* ; Minimally Invasive Surgical Procedures/methods* ; Laparoscopy ; Robotic Surgical Procedures ; Practice Guidelines as Topic

OBJECTIVE: To explore effectiveness of TiRobot-assisted screw implantation in the treatment of coracoid process fractures of the scapula. METHODS: A retrospective analysis was conducted on the clinical data from 24 patients with coracoid process fractures of the scapula admitted between September 2019 and January 2024 and met selection criteria. Among them, 12 patients underwent TiRobot-assisted screw implantation (robot group) and 12 underwent manual screw implantation (control group) during internal fixation. There was no significant difference ( P>0.05) in baseline data such as gender, age, body mass index, disease duration, cause of injury, coracoid process fracture classification, and proportion of patients with associated injuries between the two groups. The incision length, operation time, intraoperative blood loss, hospital stay, accuracy of screw placement, coracoid process fracture healing time, and complications were recorded and compared, as well as pain visual analogue scale (VAS) score, and Constant-Murley score at last follow-up. RESULTS: The intraoperative blood loss and incision length in the robot group were significantly lower than those in the control group ( P<0.05); however, there was no significant difference in operation time and hospital stay between the two groups ( P>0.05). All patients were followed up 8-27 months (mean, 17.5 months), and the difference in follow-up time between the two groups was not significant ( P>0.05). At last follow-up, the VAS score for shoulder pain in the robot group was signifncatly lower compared to the control group, and the Constant-Murley score was significantly higher ( P<0.05). In the robot group, 16 screws were implanted intraoperatively, while 13 screws were implanted in the control group. Radiographic re-evaluation showed that the excellent and good rate of screw implantation was higher in the robot group (93.8%, 15/16) than in the control group (61.5%, 8/13), but the difference in the precision of screw implantation between the two groups was not significant ( P>0.05). Four patients in the robot group and 1 in the control group achieved double screws fixation; however, the difference in achieving double screws fixation between the two groups was not significant ( P>0.05). All fractures healed in both groups with 1 case of malunion in the control group. There was no significant difference in healing time between the two groups ( P>0.05). During follow-up, 1 patient in the control group experienced screw loosening and displacement. There was no significant difference in the incidence of screw loosening and fracture malunion between the two groups ( P>0.05). CONCLUSION Compared with manual screw implantation, TiRobot-assisted minimally invasive treatment of coracoid process fractures of the scapula can reduce intraoperative blood loss, shorten incision length, alleviate pain, and obtain better promote shoulder joint functional recovery.
Humans ; Male ; Female ; Retrospective Studies ; Fracture Fixation, Internal/instrumentation* ; Minimally Invasive Surgical Procedures/instrumentation* ; Adult ; Middle Aged ; Fractures, Bone/surgery* ; Bone Screws ; Coracoid Process/surgery* ; Robotic Surgical Procedures/methods* ; Scapula/surgery* ; Treatment Outcome ; Operative Time ; Young Adult ; Length of Stay ; Blood Loss, Surgical