Objective To investigate the effects of laparoscopic sleeve gastrectomy(LSG)on the cardiac structure and function in obese patients with heart failure(HF)and compare the efficacy of LSG across obese patients with different HF types.Methods This study included 33 obese patients with HF who underwent LSG.The clinical indicators were compared between before operation and 12 months after operation.Repeated measures analysis of variance was employed to evaluate the changes in echocardiographic parameters before operation and 3,6,and 12 months after operation.Patients were allocated into a HF with preserved ejection fraction group(n=17),a HF with mildly reduced ejection fraction group(n=5)and a HF with reduced ejection fraction(HFrEF)group(n=11)based on left ventricular ejection fraction(LVEF)before operation for subgroup analyses of the effects of LSG on the cardiac structure and function of obese patients with HF.The paired samples t-test was conducted to assess the degree of cardiac structural and functional alterations after LSG.Results The 33 patients included 69.7% males,with an average age of(35.3±9.9)years,and a body mass index(BMI)of(51.2±9.8)kg/m².The median follow-up was 9.0(5.0,13.3)months.Compared with the preoperative values,the postoperative BMI(P=0.002),body surface area(BSA)(P=0.009),waist circumference(P=0.010),hip circumference(P=0.031),body fat content(P=0.007),and percentage of patients with cardiac function grades Ⅲ-IV(P<0.001)decreased.At the 12-month follow-up left atrial diameter(P=0.006),right atrial long-axis inner diameter(RAD1)(P<0.001),right atrial short-axis inner diameter(RAD2)(P<0.001),right ventricular inner diameter(P=0.002),interventricular septal thickness at end-diastolic(P=0.002),and left ventricular end-diastolic volumes(P=0.004)and left ventricular end-systolic volumes(P=0.003) all significantly reduced compared with preoperative values.Additionally,left ventricular fractional shortening and LVEF improved(both P<0.001).Subgroup analyses revealed that cardiac structural parameters significantly decreased in the HF with preserved ejection fraction,HF with mildly reduced ejection fraction,and HFrEF subgroups compared with preoperative values.Notably,the HFrEF group demonstrated the best performance in terms of left atrial diameter(P=0.003),left ventricular inner diameter at end-diastole(P=0.008),RAD1(P<0.001),RAD2(P=0.004),right ventricular inner diameter(P=0.019),left ventricular end-diastolic volume(P=0.004)and left ventricular end-systolic volume(P=0.001),cardiac output(P=0.006),tricuspid regurgitation velocity(P=0.002),and pulmonary artery systolic pressure(P=0.001) compared to preoperatively.Postoperative left ventricular fractional shortening(P<0.001,P=0.003,P<0.001)and LVEF(P<0.001,P=0.011,P=0.001)became higher in all the three subgroups than the preoperative values.Conclusions LSG decreased the body weight,BMI,and BSA,improved the cardiac function grade,reversed the enlargement of the left atrium and left ventricle,reduced the right atrium and right ventricle,and enhanced the left ventricular systolic function.It was effective across obese patients with different HF types.Particularly,LSG demonstrates the best performance in improving the structures of both atria and ventricles in obese patients with HFrEF.
Humans ; Male ; Female ; Gastrectomy/methods* ; Heart Failure/complications* ; Adult ; Obesity/physiopathology* ; Laparoscopy ; Middle Aged ; Heart/physiopathology* ; Stroke Volume

Parasitic dermoid cysts may form from autoamputation of the ovarian mass secondary to torsion or rupture. It may then reimplant in surrounding structures and undergo subsequent neovascularization and further growth. The true incidence of these cases is unknown, however, a study reported a 0.04% incidence among 1,007 cases of dermoid cysts. This report describes the case of a 30-year-old multigravida who presented with an ultrasound finding of an ovarian dermoid cyst, which, upon laparoscopic surgery, turned out to be a parasitic dermoid cyst adherent to the bladder, with grossly normal bilateral ovaries. Theories on the development of parasitic dermoid cyst are also presented.
Human ; Female ; Adult: 25-44 yrs old ; dermoid cyst ; laparoscopy

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*

BACKGROUND: Telesurgery has the potential to overcome spatial limitations for surgeons, which depends on surgical robot and the quality of network communication. However, the influence of network latency and bandwidth on telesurgery is not well understood. METHODS: A telesurgery system capable of dynamically adjusting image compression ratios in response to bandwidth changes was established between Beijing and Sanya (Hainan province), covering a distance of 3000 km. In total, 108 animal operations, including 12 surgical procedures, were performed. Total latency ranging from 170 ms to 320 ms and bandwidth from 15-20 Mbps to less than 1 Mbps were explored using designed surgical tasks and hemostasis models for renal vein and internal iliac artery rupture bleeding. Network latency, jitter, frame loss, and bit rate code were systemically measured during these operations. National Aeronautics and Space Administration Task Load Index (NASA-TLX) and a self-designed scale measured the workload and subjective perception of surgeons. RESULTS: All 108 animal telesurgeries, conducted from January 2023 to June 2023, were performed effectively over a total duration of 3866 min. The operations were completed with latency up to 320 ms and bandwidths as low as 1-5 Mbps. Hemostasis for vein and artery rupture bleeding models was effectively achieved under these low bandwidth conditions. The NASA-TLX results indicated that latency significantly impacted surgical performance more than bandwidth and image clarity reductions. CONCLUSIONS This telesurgery system demonstrated safety and reliability. A total of 320 ms latency is acceptable for telesurgery operations. Reducing image clarity can effectively mitigate the potential latency increase caused by decreased bandwidth, offering a new method to reduce the impact of latency on telesurgery.
Animals ; Robotic Surgical Procedures/methods* ; Laparoscopy/methods*

Humans ; Laparoscopy/education* ; Female ; Gynecologic Surgical Procedures/education* ; Consensus ; Genital Diseases, Female/surgery* ; China ; Robotic Surgical Procedures/methods*

Pancreatoduodenectomy with portal-superior mesenteric vein resection and reconstruction can provide radical surgical opportunities for patients with venous invasion and enable them to benefit from the surgery. With the development of minimally invasive concepts and surgical techniques, laparoscopic and robot-assisted pancreatoduodenectomy with portal-superior mesenteric vein resection and reconstruction is being increasingly widely carried out. This surgical procedure is highly technically demanding, and the perioperative management of patients is complex. However, there is a lack of high-quality and high-level evidence-based clinical studies in this regard. In order to better standardize the clinical application of laparoscopic or robot-assisted pancreatoduodenectomy with portal-superior mesenteric vein resection and reconstruction in China, the Study Group of Minimally Invasive Treatment for Pancreatic Cancer in China Anti-Cancer Association, guided by problems and based on evidence, formed 17 recommendations through full discussions among experts. The recommendations involve the safety, oncological benefits, and perioperative patient management of the minimally invasive approach to pancreatoduodenectomy with portal-superior mesenteric vein resection and reconstruction.
Humans ; Pancreaticoduodenectomy/methods* ; Mesenteric Veins/surgery* ; Laparoscopy ; Portal Vein/surgery* ; Robotic Surgical Procedures ; Pancreatic Neoplasms/surgery* ; Consensus

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

Compared with traditional laparotomy,laparoscopy is restricted to the location and number of trocars,making it still faces many problems such as "chopstick effect", insufficient exposure of viscera and tissues,and limited surgical field. Magnetic-anchoring technology,as an innovative method specifically designed to assist tissue retraction and broaden surgical field in laparoscopy,has been applied in a variety of surgical procedures,including hepatobiliary surgery,thoracic surgery,gastrointestinal surgery,weight loss and metabolic surgery,gynecology,urology and other departments. Thus,it is of great significance to standardize the clinical application of magnetic-anchoring technology in assisting tissue retraction and broaden surgical field in laparoscopic surgery. This consensus was built according to evidence from published clinical researches and relative experiences,and was shaped based on key literature collection and discussion about practicing magnetic anchoring technology assisted laparoscopic tissue retraction and surgical field exposure. Further,this consensus was drafted by experts from related field,and was revised by 38 invited units and 68 invited professionals across China,from which the suggestions were collected and verified by the corresponding authors to officially establish this consensus.
Laparoscopy/methods* ; Humans ; Consensus ; Magnetics

OBJECTIVE: To investigate the effect of laparoscopic high ligation of spermatic cord vein in patients with chronic prostatitis and varicocele prostatitis. METHODS: A total of 90 varicocele patients were selected from January 2016 to December 2020, including 33 patients with chronic prostatitis. Changes of white blood cell count, National Institutes of Health chronic prostatitis symptom index (NIH-CPSI) score and serum testosterone level in the expressed prostate secretion (EPS) were observed before and after the operation of laparoscopic high ligation of spermatic vein. RESULTS: All patients were followed up three months after the surgery. There was no significant difference in the white blood cell counts in EPS, NIH-CPSI score, and serum testosterone level in patients with varicocele-only who underwent high ligation surgery after the operation. However, the white blood cell count in the EPS of patients with chronic prostatitis was lower than that before 3 months of operation ( ［12.39±4.23］×109/L vs ［21.36±5.05］×109/L). The NIH-CPSI score was significantly lower than that before operation ( ［12.71±6.21］ vs ［26.76±8.43］). And the serum testosterone level was higher than that before operation (［4.34±1.77］ng/ml vs ［2.36±1.05］ng/ml). CONCLUSION Laparoscopic high ligation of the spermatic vein in patients with chronic prostatitis and varicocele could effectively reduce the number of white blood cells in the EPS, boost the level of serum testosterone and improves symptoms of chronic prostatitis.
Male ; Humans ; Varicocele/surgery* ; Prostatitis/blood* ; Ligation ; Spermatic Cord/blood supply* ; Testosterone/blood* ; Chronic Disease ; Prostate/metabolism* ; Veins/surgery* ; Leukocyte Count ; Leukocytes ; Laparoscopy ; Adult

OBJECTIVE: To compare the clinical efficacy between microscopic varicocelectomy and laparoscopic varicocelectomy in the treatment of varicocele（VC）with male infertility. METHODS: A total of 307 patients who were diagnosed with VC complicated with male infertility and admitted to the Affiliated Hospital of Qingdao University from October 2018 to October 2022 were recruited for retrospective analysis. The patients were divided into the microscopic group (180 cases) and laparoscopic group (127 cases) according to the surgery method. The pre- and postoperative clinical data of these two groups were analyzed, including the degree of dilatation and reflux time of internal spermatic vein，hemodynamic parameters of testicular capsular artery，proportion of progressive motility spermatozoa (PR), concentration of spermatozoa, proportion of normal morphology sperm，the pregnancy outcome of spouses and the incidence of complications related with surgery within 2 years postoperatively. RESULTS: All the surgeries for the 307 patients in this study were successful. There was no significant difference in operation time, hospitalization time and management expenses between the microscopic group and the laparoscopic group (P>0.05). Compared to the patients in laparoscopic group, the patients in the microscopic group received a better improvement in venous diameter, reflux time of spermatic veins and hemodynamic parameters of testicular capsular artery (P<0.05). Moreover, the semen analysis showed that the PR, spermatozoa concentration and proportion of normal morphology sperm in the microscopic group were also obviously increased than those in the laparoscopic group (P<0.05). During the 2-year follow-up period, the conception rate of spouses in the microscopic group was 67.2%, while only 47.2% in the laparoscopic group, in which the difference was statistically significant (P<0.05). Besides, the time-to-pregnancy ( TTP ) within 2 years postoperatively in the microscopic group was significantly shorter than that in the laparoscopic group（P<0.05). Meanwhile, the incidence of adverse pregnancy outcomes in the microscopic group was also significantly lower than that in the laparoscopic group (P<0.05). It is worth mentioned that the spontaneous conception rate of spouses with successful pregnancy in the microscopic group was also significantly higher than that in the laparoscopic group (P<0.05). Severe complication such as testicular atrophy, bleeding and infection did not appear in both of two groups. However, the incidences of testicular hydrocele and recurrence of VC postoperatively in the laparoscopic group were significantly higher than those in the microscopic group (P<0.05). CONCLUSION Both microscopic varicocelectomy and laparoscopic varicocelectomy can be applied to the management of VC combined with male infertility. But microscopic varicocelectomy showed better clinical efficacy in improving the testicular hemodynamic parameters, semen quality, pregnancy outcome and postoperative complications, which is worthy of further clinical applications.
Humans ; Male ; Varicocele/complications* ; Laparoscopy ; Infertility, Male/etiology* ; Retrospective Studies ; Adult ; Microsurgery ; Treatment Outcome ; Pregnancy ; Female