This study aims to present the surgical technique and clinical outcomes of reduced-port robotic extended cholecystectomy using the da Vinci Single Port (SP) system (Intuitive Surgical) in a patient diagnosed with gallbladder cancer. The da Vinci SP surgical system was employed to perform a reduced-port robotic extended cholecystectomy in a patient with gallbladder cancer. Procedural details, operative time, estimated blood loss, and postoperative outcomes were documented and analyzed. The total operative time was 210 minutes, with an estimated blood loss of less than 400 mL. No intraoperative complications were reported. The patient had an uneventful recovery and was discharged on postoperative day 8. The da Vinci SP system appears to be a safe and feasible platform for performing reduced-port robotic extended cholecystectomy, with acceptable perioperative outcomes in appropriately selected patients.

In liver transplantation, the primary concern is to ensure an adequate future liver remnant (FLR) volume for the donor, while selecting a graft of sufficient size for the recipient. The living donor–resection and partial liver segment 2−3 transplantation with delayed total hepatectomy (LD−RAPID) procedure offers a potential solution to expand the donor pool for living donor liver transplantation (LDLT).We report the first case involving a cirrhotic patient with autoimmune hepatitis and hepatocellular carcinoma, who underwent left lobe LDLT using the LD−RAPID procedure. The living liver donor (LLD) underwent a laparoscopic left hepatectomy, including middle hepatic vein. The resection on the recipient side was an extended left hepatectomy, including the middle hepatic vein orifice and caudate lobe. At postoperative day 7, a computed tomography scan showed hypertrophy of the left graft from 320 g to 465 mL (i.e., a 45.3% increase in graft volume body weight ratio from 0.60% to 0.77%). After a 7-day interval, the diseased right lobe was removed in the second stage surgery. The LD−RAPID procedure using left lobe graft allows for the use of a small liver graft or small FLR volume in LLD in LDLT, which expands the donor pool to minimize the risk to LLD by enabling the donation of a smaller liver portion.

Purpose: The purpose of this study is to build a prediction model for estimating graft weight about different graft volumetry methods combined with other variables. Methods: Donors who underwent living-donor right hepatectomy from March 2021 to March 2023 were included. Estimated graft volume measured by conventional method and 3-dimensional (3D) software were collected as well as the actual graft weight. Linear regression was used to build a prediction model. Donor groups were divided according to the 3D volumetry of <700 cm3 , 700–899 cm3 , and ≥900 cm3 to compare the performance of different models. Results: A total of 119 donors were included. Conventional volumetry showed R2 of 0.656 (P < 0.001) while 3D software showed R2 of 0.776 (P < 0.001). The R2 of the multivariable model was 0.842 (P < 0.001) including for 3D volume (β = 0.623, P < 0.001), body mass index (β = 7.648, P < 0.001), and amount of weight loss (β = –7.252, P < 0.001). The median errors between different models and actual graft weight did not differ in donor groups (<700 and 700–899 cm3 ), while the median error of univariable linear model using 3D software (122.5; interquartile range [IQR], 61.5–179.8) was significantly higher than multivariable-adjusted linear model (41.5; IQR, 24.8–69.8; P = 0.003) in donors with estimated graft weight ≥900 cm3 . Conclusion The univariable 3D volumetry model showed an acceptable outcome for donors with an estimated graft volume <900 cm3 . For donors with an estimated graft volume ≥900 cm3 , the multivariable-adjusted linear model showed higher accuracy.

OBJECTIVES: To analyze the treatment results of combined treatment with percutaneous vertebroplasty and adhesiolysis in the patients who happened the osteoporotic compression fractures during the conservative treatment of pre-existing degenerative spinal stenosis. MATERIALS AND METHODS: A retrospective review was carried out on 38 patients who happened the osteoporotic compression fractures during the conservative treatment of pre-existing degenerative spinal stenosis. We performed percutaneous vertebroplasty for osteoporotic compression fractures and adhesiolysis for degenerative spinal stenosis after 4 weeks after vertebroplasty. Radiologic results were evaluated by progression of compression rate, fractures in adjacent segment and change of the BMD. Clinical results were evaluated with Denis pain scale for osteoporotic compression fractures and Katz satisfaction scale for degenerative spinal stenosis. RESULTS: The compression rate was 30.2% preoperatively, 21.4% postoperatively, and 24.6% at 12 months postoperatively. There was no fracture in adjacent segment. Clinically, the Denis score were P3 in 13 and P4 in 25, preoperatively, P1 in 11 and P2 in 26, P3 in 1, postoperatively (P=0.03). In regard to degenerative diseases, the Kats scale were 38 to 5, 86.8% in low back pain (P=0.017) and 38 to 4, 89.4% in claudication (P=0.006). The overall Katz satisfaction scale was 81.5% at 12 months postoperatively. The BMD changes in patients who treated neuroplasty was not significant (P=0.175). CONCLUSIONS: The combined treatment with percutaneous vertebroplasty and adhesiolysis may be an effective treatment strategy for the osteoporotic compression fracture and spinal stenosis without surgical intervention in old age patients.
Fractures, Compression ; Humans ; Low Back Pain ; Retrospective Studies ; Spinal Stenosis ; Vertebroplasty