The continuous refinement and enhancement of laparoscopic (robotic) techniques have facilitated the widespread implementation of minimally invasive resection for malignant liver tumor in clinical settings. Nevertheless, the difficulty in accurate detection of deep-seated malignant liver tumor and the reliable identification of operative biliary leakage remain significant constraints on its utilization. The introduction of indocyanine green (ICG) presents a promising strategy to address these particular challenges. Laparoscopic (robotic) surgical platforms incorporating ICG fluorescence imaging technology provide optimal operative results in terms of anatomical accuracy, oncologic radicality, and procedural safety for the surgeon and patient alike. Through a synthesis of clinical expertise and extant literature, specialists within China′s hepatobiliary surgery community have engaged in thorough deliberations to formulate the "Expert Consensus on the Application of ICG Fluorescence Imaging Technology in Laparoscopic (Robotic) Malignant Liver Tumor Resection." This consensus is intended to broaden comprehension of the clinical attributes and contemporary progress associated with ICG application in laparoscopic (robotic) malignant liver tumor resection, thereby establishing directives for its standardized implementation.

To explore the influencing factors for achieving textbook outcome (TO) after laparoscopic pancreaticoduodenectomy (LPD) in elderly patients with malignant tumors, and the relationship between TO and long-term prognosis.

A retrospective analysis was conducted on the clinicopathological data of elderly patients with malignant tumors who underwent LPD at our center between Mar. 2017 and Mar. 2025. Variables with a significance level of P<0.05 in the univariate analysis were included in a multivariate logistic regression analysis to identify independent risk factors for failure to achieve a TO postoperatively.

This study included a total of 351 patients, among whom 215 achieved a TO, while 136 did not. The long-term prognosis of patients in the TO group was significantly better than that of the non-TO group(P<0.05). The multivariate logistic regression analysis revealed that preoperative BMI (OR 1.095; 95%CI: 1.016-1.180; P=0.018), firm pancreatic texture (OR 0.568; 95%CI: 0.367-0.934; P=0.025), main pancreatic duct diameter (OR 0.748; 95%CI: 0.616-0.909; P=0.003), and postoperative delayed gastric emptying (OR 5.036; 95%CI: 2.354-10.770; P<0.001) were independent risk factors for failure to achieve a TO.

High preoperative body mass index(BMI), soft pancreatic texture, narrow main pancreatic duct diameter, and postoperative delayed gastric emptying are independent risk factors for failure to achieve TO in elderly malignant tumor patients after LPD. TO is associated with long-term survival in these patients.

To investigate the effect of laparoscopic resection for giant hepatic hemangiomas.

Clinical data of 136 patients with giant hepatic hemangiomas admitted to the second affiliated hospital of Air Force Medical University from Jan. 2020 to Jun. 2025 were retrospectively analyzed. According to surgical procedure, the patients were divided into laparoscopic resection group (LR group, n=66)and open resection group(OR group, n=70). The perioperative conditions, postoperative laboratory indicators and complications of the two groups were compared.

The operation time, intraoperative blood loss, intraoperative blood infusion, time of gastrointestinal function recovery, time of urinary catheter removal, time of abdominal drainage-tube removal and postoperative hospital stay in the LR group were significantly shorter than those in the OR group, with statistically significant differences between groups (P<0.05). There were no significant differences in surgical procedures (hepatectomy and hemangioma enucleation) and hepatic portal occlusion time between the two groups (P>0.05). On the first day postoperative, PT in LR group was significantly lower than that in OR group (P<0.05), and ALB was significantly higher in LR group than that in OR group (P<0.05). There were no significant differences in WBC, PLT, HGB, ALT, AST and TBIL between the two groups on the first day postoperative (P>0.05). On the third day postoperative, WBC and PT in LR group was significantly lower than that in OR group (P<0.05), and HGB was significantly higher in LR group than that in OR group (P<0.05). There were no significant differences in PLT, ALT, AST and TBIL between the two groups on the first day postoperative (P>0.05). The main complications included biliary leakage, abdominal infection, abdominal bleeding, abdominal effusion, pleural effusion and lower extremity intermuscular venous thrombosis between the two groups showed no significant difference (P>0.05). However, the number of complications in the LR group was significantly lower than that in the OR group(P<0.05).

Laparoscopic resection for giant hepatic hemangiomas is safe, feasible and effective, with the advantage of minimally invasive, and the choice of surgical procedure should follow individualization.

To preliminarily investigate the technical feasibility, safety, and short-term clinical outcomes of total laparoscopic stomach-partitioning gastrojejunostomy (TLSPGJ) for treating outlet obstruction in upper gastrointestinal Crohn′s disease.

Clinical data were retrospectively analyzed for six patients with upper gastrointestinal Crohn′s disease outlet obstruction treated by the same surgical team between Jan. 2024 and Aug. 2025. All patients underwent TLSPGJ. The following parameters were recorded and analyzed for each case: operative time, intraoperative blood loss, time to postoperative gastrointestinal function recovery, postoperative hospital stay, perioperative complication rate, and short-term postoperative quality of life improvement.

All six procedures were successfully completed laparoscopically without conversion to open surgery. Mean operative time was 90.8±22.0 minutes, with mean intraoperative blood loss of 28.3±13.3 ml. Mean time to gastrointestinal recovery was 2.0±0.9 days, and mean postoperative hospital stay was 6.8±1.7 days. One Clavien-Dindo Grade I complication (incisional fat liquefaction) occurred postoperatively, resolving after wound dressing changes. No severe complications such as anastomotic leakage or intra-abdominal infection were observed. All patients experienced resolution of obstructive symptoms at three months postoperatively, with marked improvement in nutritional status and quality of life. No disease recurrence or progression was noted during follow-up period.

These findings demonstrate that TLSPGJ is technically safe and feasible for treating outlet obstruction in upper gastrointestinal Crohn′s disease. This approach offers advantages of minimal trauma and rapid recovery, with satisfactory short-term clinical outcomes. It may serve as a minimally invasive treatment option for carefully selected patients, though long-term efficacy requires further validation through larger sample sizes and extended follow-up periods.

To retrospectively analyzed the therapeutic efficacy and perioperative safety of single-port laparoscopic myomectomy (SPLM) versus multiport laparoscopic myomectomy (MPLM) for large uterine fibroids.

A retrospective analysis was conducted on the clinical data of 482 patients who underwent SPLM or MPLM at the General Gynecology Center of Peking Union Medical College Hospital between Aug. 2022 and Sep. 2024. Patients with a single uterine fibroid of maximum diameter ≥10 cm were selected, including 24 cases in the SPLM group and 64 cases in the MPLM group. Surgical outcomes were evaluated based on three main aspects: 1) surgical parameters (operative time, additional trocar use, postoperative hemoglobin decrease, frequency of blood transfusion, adjacent organ injury); 2) perioperative recovery and safety indicators (pain scores at 6 h, 24 h, and 48 h postoperatively, postoperative fever, hospital stay, hospitalization costs, perioperative complications); and 3) scar cosmesis assessed using a scar evaluation and rating scale. Statistical analysis was performed using SPSS 27.0 software, with a P-value<0.05 considered statistically significant.

The operative time was 136.81±56.82 min for the SPLM group and 119.85±42.07 min for the MPLM group, with a significant difference between groups (P=0.025). The postoperative hemoglobin decrease was 18.26±8.01 g/L in the SPLM group and 17.04±7.70 g/L in the MPLM group (P=0.480). Postoperative VAS scores at 6 h, 24 h, and 48 h were significantly lower in the SPLM group compared to the MPLM group (3.88±1.14 vs. 4.51±1.15, 2.83±0.96 vs. 3.18±1.03, 1.57±0.83 vs. 1.83±0.90, respectively; all P<0.05). No statistically significant differences were found between the two groups regarding hospital stay or hospitalization costs. The total scar score was significantly lower in the SPLM group (1.21±1.18) compared to the MPLM group (5.36±2.45, P<0.001). Specifically, the SPLM group demonstrated superior outcomes in scar spread, erythema, pigmentation abnormality, suture marks, and hypertrophy/atrophy compared to the MPLM group (0.29±0.56 vs. 1.56±0.82, 0.04±0.20 vs. 0.89±0.69, 0.33±0.48 vs. 0.73±0.45, 0.21±0.41 vs. 0.98±0.13, 0.25±0.44 vs. 0.80±0.68, respectively; all P<0.001).

Single-port laparoscopic surgery is a safe and feasible treatment option for large uterine fibroids. It is superior to multiport laparoscopic surgery, particularly in terms of postoperative pain control and cosmetic outcomes.

To investigate the feasibility, safety, and clinical efficacy of transcervical resection of myoma (TCRM) in the management of International Federation of Gynecology and Obstetrics(FIGO) type 3 uterine fibroids.

A retrospective analysis was conducted on the clinical data of 42 patients with solitary FIGO type 3 uterine fibroids treated at XiJing Hospital, Air Force Medical University between Feb. 2021 and Feb. 2024. Perioperative parameters, surgical complications, improvement in menstrual symptoms, and postoperative reproductive outcomes were recorded and analyzed.

The mean age of the 42 patients was 34.3±5.1 years, with a mean fibroid diameter of 4.6±1.8 cm. The primary procedure success rate was 85.7%(36/42). The mean operative time was 43±18 minutes, and the mean intraoperative blood loss was 26±16 ml. The shortest distance from the tumor cavity to the uterine serosa significantly increased from 3.1±1.3 mm preoperatively to 8.4±1.5 mm postoperatively. No severe complications, such as uterine perforation or major hemorrhage, occurred. Among the 35 patients with preoperative menorrhagia, the cure rate was 80.0%(28/35), resulting in a total effective rate of 97.1%(34/35). Among the 28 patients with fertility desires, the average follow-up duration was 16.2±7.3 months. The pregnancy rate within one year postoperatively was 78.5%(22/28). Seventeen patients have delivered (11 vaginal deliveries and 6 cesarean sections), with no cases of uterine rupture reported.

For FIGO type 3 uterine fibroids, hysteroscopic resection performed by experienced surgeons under ultrasonographic guidance is a safe and effective minimally invasive treatment. It significantly ameliorates menstrual symptoms and is associated with favorable reproductive outcomes.

To evaluate the clinical efficacy, oncologic safety, and aesthetic outcomes of axillary single-port endoscopic subcutaneous glandular resection combined with immediate implant reconstruction in patients with breast cancer, and to provide evidence for optimizing surgical approach selection.

This retrospective comparative study included 129 female breast cancer patients who underwent subcutaneous glandular resection with immediate implant-based reconstruction at the 960th Hospital of the Joint Logistics Support Force from Jan. 2023 to May 2025. Patients were allocated to an endoscopic group (n=67) or an open surgery group (n=62) according to surgical approach. Baseline characteristics, perioperative parameters, postoperative complications, oncologic outcomes, and aesthetic satisfaction were systematically compared between groups.

No significant differences were found between the two groups in baseline characteristics, including age, body mass index, smoking history, diabetes, tumor T/N stage, ER/PR/HER2 status, and perioperative treatments (all P>0.05). Intraoperative blood loss was significantly lower in the endoscopic group than in the open group (40.9±27.6 ml vs. 71.5±66.3 ml, P=0.001). The overall postoperative complication rates were 11.3% and 7.5% in the open and endoscopic groups, respectively, with no significant difference (P=0.550). The incidence of nipple-areolar complex (NAC) ischemia/necrosis was 3.2% versus 4.5%, also without a significant difference (P>0.05). Aesthetic evaluation showed higher BREAST-Q scores in the endoscopic group at 1 month and 3 months postoperatively (67.96±5.33 vs. 64.11±6.38, P=0.019; 76.19±4.47 vs. 67.46±6.41, P<0.001). The proportion of "excellent" Harris ratings was also higher in the endoscopic group (79.1% vs. 61.3%, P=0.034). During follow-up, one case of nipple Paget′s disease recurrence occurred in the endoscopic group, whereas no local recurrence was observed in the open group; no distant metastasis or death occurred in either group, and the between-group differences were not statistically significant.

Endoscopic nipple-sparing mastectomy with immediate implant reconstruction achieves comparable short-term oncologic safety and surgical efficacy to open surgery while reducing intraoperative trauma and significantly improving early aesthetic outcomes and patient satisfaction. Longer follow-up is warranted to confirm long-term efficacy and safety.

To investigate the diagnostic value of laparoscopy combined with ultrasound technology in idiopathic retroperitoneal fibrosis(IRF) and summarize the clinical diagnostic and therapeutic characteristics of this disease.

Clinical data from 11 patients with pathologically confirmed IRF were collected. A retrospective analysis was conducted on their clinical manifestations, laboratory tests, and imaging features, with a detailed description of the method for obtaining pathological diagnosis using laparoscopy combined with ultrasound technology.

The 11 patients had a mean age of 53.3±7.6 years, comprising 7 males and 4 females. The predominant clinical symptoms were abdominal and lumbar pain(8/11). The median disease duration was 5(3, 11) months. CT or MRI revealed a retroperitoneal soft tissue density, yet the diagnosis remained indeterminate (0/11). All 11 patients underwent laparoscopy combined with ultrasound-guided biopsy of retroperitoneal masses, which confirmed IRF. The treatment regimen included prednisone + tamoxifen + mycophenolate mofetil. All patients were followed up for a median duration of 21(13.5, 27) months, showing significant reduction in lesion size and effective treatment outcomes.

IRF presents with non-specific clinical manifestations and blood test results, and has a low diagnostic confirmation rate by imaging, making differential diagnosis from retroperitoneal tumors challenging. Laparoscopy combined with ultrasound-guided technology enables the acquisition of pathological tissue for definitive diagnosis, effectively avoiding missed or misdiagnoses, with minimal surgical trauma and proven safety and efficacy.

By reviewing the diagnosis and treatment process of a pediatric patient with primary fibrolamellar hepatocellular carcinoma (FLC) who underwent laparoscopic surgery at our center, we summarize and discuss the technical experience of combining Laennec approach with dorsal approach in minimally invasive management of FLC.

Based on a 12-year-old pediatric patient with a hepatic space-occupying lesion admitted to the Department of Hepatobiliary Surgery at Wuxi Xishan People′s Hospital in Mar. 2025, who was clinically diagnosed with FLC, a laparoscopic surgical strategy was formulated after thorough preoperative evaluation.

The patient successfully underwent laparoscopic left hemihepatectomy via the Laennec approach (intracapsular dissection) combined with a dorsal approach, along with hilar lymph node dissection and cholecystectomy. The procedure was associated with minimal intraoperative blood loss. Postoperatively, there were no complications such as infection, hemorrhage, bile leakage, or portal vein thrombosis. The patient recovered smoothly. Pathological examination confirmed the diagnosis of FLC.

Surgery remains the only effective strategy for treating FLC. For tumors adjacent to the sagittal portion of the hepatic hilum, a laparoscopic hepatectomy utilizing the Laennec approach (intracapsular dissection) combined with a dorsal approach could be adopted after systematic and comprehensive preoperative evaluation. This strategy ensures adequate surgical margins, reduces intraoperative bleeding, enhances procedural safety, and ultimately benefits the patient.

Esophageal cancer is a highly prevalent and specific malignant tumor of the digestive tract in China, and surgery is an important treatment for esophageal cancer. However, anastomotic leakage is a high incidence and serious postoperative complication, which adversely affects perioperative mortality and long-term survival. This article summarizes the clinical characteristics, high-risk factors, and progress of prevention and treatment of anastomotic leakage after radical surgery for esophageal cancer, with a view to providing future references for reducing the incidence of this complication and improving its treatment prognosis.