Gastrocolic trunk of Henle (GCT) is considered as an important anatomical landmark in the gastrointestinal surgery. Small venous tributaries of GCT and its tributaries can be occasionally observed. In this study, we counted the probability of the appearance of small venous tributaries on the surface of GCT and its tributaries.

Data of 37 patients who underwent radical surgery for right hemicolonic cancer from Jan. 2017 to Oct. 2022 were collected in this study. The videos of the 37 surgical procedures were collected. Small veins appearing on the surface of GCT and its tributaries were recorded and counted by reviewing the surgical videos.

Among the 31 patients with GCT, thicker tributaries (type Ⅰ) presented in 7 patients, all of which were located on the surface of GCT (22.6%). Thinner tributaries (type Ⅱ) presented on the surface of GCT in 3 patients, while on the surface of right gastroepiploic vein (RGEV) in 1 patient. In addition, there was 1 case with two type Ⅱ small tributaries on the surface of both RGEV and superior right colic vein (SRCV). Among the 6 patients without GCT, 1 patient had type Ⅰ tributaries on the surface of RGEV, while another patient had type Ⅱ tributaries located on the surface of RGEV.

Type Ⅰ tributaries were mainly distributed on the surface of GCT which were easy to detect and not easily damaged. On the other hand, type Ⅱ tributaries can be found on the surface of both GCT and its tributaries. Type Ⅱ tributaries are relatively thinner, which makes it difficult to identify during operation, and prone to injury leading to bleeding.

To proove the advantage of Laennec membrane-based guidance in the separation of perihepatic adhesions after multiple liver operation.

The adhesions were isolated from the subphrenic, subhepatic and naked areas through Laennec approach in patients with multiple liver surgery.

The adhesions were separated by Laennec membrane after several liver operations. The layers of adhesions were clear, the bleeding was less and the side injury was less.

Laennec membrane is a safe and feasible approach for the separation of perihepatic adhesions after multiple liver operations.

To summarize the clinical efficacy and advantages of laparoscopic hepatectomy for solitary liver metastases after radical esophageal cancer resection.

A retrospective analysis was performed for a patient with isolated liver metastases in the Department of Hepatobiliary Surgery, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing University, in Feb. 2023. Whose right liver lesion was slowly enlarged during 4 cycles of chemotherapy by DCF (docetaxel, cisplatin and 5-fluorouracil) regimen, and then the anatomical laparoscopic right posterior lobectomy were performed.

The patient successfully underwent laparoscopic anatomical right posterior lobe resection of the liver, with less intraoperative bleeding, no postoperative complications such as infection, bleeding, and biliary fistula, and recovered smoothly. The postoperative pathological examination was consistent with the liver metastasis of esophageal cancer. The patient recovered well 6 months after surgery, no recurrence or progression, and continued systematic chemotherapy in the local hospital for 3 cycles.

The laparoscopic minimally invasive resection of solitary liver metastases after oesophageal cancer resection, combined with systemic chemotherapy, improves prognosis and progression-free survival.

The creation method of the gastric conduit holds paramount significance in esophagectomy procedures. This study aims to investigate the safety and feasibility of a novel improved technique, the Tension Gastroplasty Approach (TGA), for constructing a gastric conduit.

A retrospective analysis of data from patients who underwent surgical resection for esophageal cancer at Sichuan Cancer Hospital in Jul. 2021 was conducted. The Tension Gastroplasty Approach and its key aspects were presented. Additionally, a technical assessment was performed comparing the integrity of staple lines at the cut edge of tension-free and tension gastroplasty of gastric conduit, the integrity of mucosal surface stapling, and the presence of exposed metal staples.

The surgical procedures proceeded smoothly, and clinical practice revealed that the TGA technique achieved superior outcomes in terms of complete staple line integrity, full mucosal surface stapling, and absence of exposed metal staples.

The TGA technique enhances the more complete apposition of the gastric mucosal surface, thereby achieving a superior "two-sided" molding effect of the serosal and mucosal surfaces of the gastric conduit. It holds the potential to offer a safer and more dependable approach for the construction of a gastric conduit and surgery-related treatments in esophageal cancer patients. Moreover, it lays the technical foundation for further refining and optimizing clinical research on the TGA approach.

To investigate the feasibility and safety of robotic-assisted radical cholecystectomy for the stage Ⅳ gallbladder cancer after adjuvant chemotherapy.

A patient with the stage Ⅳ gallbladder cancer was retrospectively analyzed. After adjuvant chemotherapy with gemcitabine+ oxaliplatin+ carrilizumab, the stage of the gallbladder cancer was significantly reduced, and the robotic-assisted radical cholecystectomy was performed, and the relevant literature was reviewed.

The patients with the stage Ⅳ gallbladder cancer, after adjuvant chemotherapy, the robotic surgery was successfully performed. The operation time was 265 min, the intraoperative blood loss was 50 ml, the postoperative hospital stay was 6 days, and there were no related complications such as bile leakage, bleeding, abdominal infection. Postoperative pathology confirmed a gallbladder adenocarcinoma with negative margins and 17 lymph nodes were removed.

The Ⅳ stage gallbladder cancer, with effective adjuvant chemotherapy, was resected with a small rang specimen and obtained R0. Robotic-assisted radical cholecystectomy has the characteristics of safe and effective surgery, less trauma and quick recovery, etc., and has clinical application prospects.

This study aimed to assess perioperative and survival outcomes of minimally invasive surgery(MIS) compared to standard laparotomy interval debulking surgery(IDS) for stage IV ovarian cancer.

A retrospective study was applied in this study. All patients diagnosed with stage IV ovarian cancer who underwent IDS at the People′s Liberation Army General Hospital from Jan. 2017 to Dec. 2021 were included. According to surgical approaches, patients were divided into laparotomy(n=74) and MIS(n=24) cohorts. We collected perioperative indicators and follow-up information and then made statistical analyses to compare clinical efficacy and survival outcome.

The clinical baseline of IDS patients in the MIS cohort was comparable to that the open cohort. No statistical differences were observed for surgical procedures, operation time and residual diseases. Compared with the laparotomy group, the MIS group had more favorable estimated blood loss, transfusion rate, duration of postoperative recovery and adjuvant chemotherapy(above P<0.001) as well as fewer intraoperative complications (P<0.05). 82.7% of the whole were optimally cytoreductive and there was no significant difference in residual diseases(P<0.05). Nevertheless, MI-IDS patients afforded higher medical expense(P<0.001). Besides, progression-free survival and overall survival had no statistical difference(P=0.998 and 0.592, respectively).

For stage IV ovarian cancer patients after NACT, minimally invasive IDS could represent a technically feasible alternative surgical choice with optimal cytoreduction. It could reduce intraoperative bleeding and injury, shorten postoperative recovery duration and time to chemotherapy, which benefit patients to some extent.

To summarize the preliminary experience and key points of the application of completely visualized cavity construction technique in the posterior sheath approach single incision laparoscopic totally extraperitoneal hernia repair (SIL-TEP).

Retrospective analysis of the clinical data of 30 cases of posterior sheath approach SIL-TEP from Jan. 2023 to Apr. 2023.

The peritoneum injury occurred in 1 patient (3.3%) when establishing the cavity. The bleeding volume was (9.50±2.40) ml. The operation time was (61.04±15.11) min on one side and (80.83±16.25) min on two sides. The time from skin cutting to device insertion was (120.77 ± 17.16) sec. The time to enter the space behind the posterior sheath was (249.67 ± 66.71) sec. The postoperative pain visual analogue score was (2.57 ± 0.73) at 24 hours and (1.97 ± 0.56) at 48 hours. Postoperative umbilical incision infection occurred in 1 patient (3.3%), Urinary retention in 1 patient (3.3%), seroma in 3 patients (10%), and ecchymosis in 1 patient (3.3%). No Chronic pain, patch infection, or recurrence was found in the follow-up.

The completely visualized cavity construction technology has a clear field of vision, clear anatomical hierarchy, low peritoneum injury rate, and effectively reduces surgical difficulty. It can be routinely applied to the posterior sheath SIL-TEP.

To explore the advantages of single-direction three-port thoracoscopic surgery(ST-VATS)lobectomy in the treatment of early-stage lung cancer.

Clinical data of consecutive VATS lobectomy and systematic lymph nodes dissection with lung malignant tumor confirmed in the First Medical Center, Chinese PLA General Hospital between Jul. 2020 and May 2022. The data of 200 patients were selected for analysis and were divided into a ST-VATS group with 100 patients and a conventional T-VATS (CT-VATS) group; The operation time, intraoperative blood loss, number of dissected lymph nodes, 3d postoperative drainage volume, postoperative chest drainage time and postoperative complications were compared respectively between the groups.

There was no perioperative mortality and tumor-negative surgical margin in groups. The two groups were no statistically difference in intraoperative blood loss, number of dissected lymph nodes and 3 d postoperative drainage volume. As compared with the CT-VATS group, patients in the ST-VATS group demonstrated shorter operation time [(56.29±13.35) min vs. (63.78±14.91) min, P=0.001] and shorter postoperative chest drainage time [3(3) d vs. 5(4) d, P<0.0001], with statistical differences (P<0.05).

Compared with CT-VATS lobectomy, the ST-VATS lobectomy has the advantages of shorter operation time and postoperative chest drainage time. Additionally, it achieves the same surgical outcomes, making it a safe, effective, and promotable surgical approach.

To compare the application of in-bag integrated power morcellation and contained manual scalpel morcellation in transumbilical single-port laparoscopic myomectomy.

The medical records of patients who underwent transumbilical single-port laparoscopic myomectomy at the Department of Gynecology, Zhongnan Hospital of Wuhan University from Jul. 2021 to Jun. 2023 were retrospectively analyzed. There were 52 patients who underwent in-bag integrated power morcellation and 61 patients who underwent contained manual scalpel morcellation. Compare and analyze the hospitalization time, operation time, intraoperative blood loss, intraoperative blood transfusion rate, postoperative complications, visual analogue scale (VAS) pain score of 24 h after surgery, the rate of bag breakage, postoperative drainage tube removal time, postoperative urinary catheter removal time, postoperative intestinal ventilation time, hemoglobin difference between preoperative and postoperative (1 d and 3 d) and postoperative pathology.

Compared with the contained manual scalpel morcellation group, the in-bag integrated power morcellation group had shorter operation time [(152.88±43.37)min vs. (176.23±59.45)min, P=0.021] and lower rate of bag breakage [0 (0.0%) vs. 8 (13.1%), P=0.019]. The difference was statistically significant (P<0.05). Compared the in-bag integrated power morcellation group with the contained manual scalpel morcellation group, there was no significantly statistical difference (P>0.05) in the hospitalization time, intraoperative blood loss, intraoperative blood transfusion rate, postoperative complications rate, VAS pain score of 24 h after surgery, postoperative drainage tube removal time, postoperative catheter removal time, postoperative intestinal ventilation time, hemoglobin difference between preoperative and postoperative (1 d and 3 d), and postoperative pathology.

In transumbilical single-port laparoscopic myomectomy, in-bag integrated power morcellation is a safe and feasible solution. It can be used with single-port laparoscope and electric rotator. Compared with contained manual scalpel morcellation, in-bag integrated power morcellation has shorter operation time and lower bag breakage rate, but it still needs further verification in large-sample prospective studies.

To investigate the diagnosis and management of middle arch ligament syndrome (MALS).

We retrospectively analyzed the clinical data of a patient with MALS admitted to The Fourth Affiliated Hospital of Soochow University (Suzhou Dushu Lake Hospital) in May 2023. The patient was a 60-year-old woman who was admitted to the hospital with "intermittent vague abdominal pain for 1 year and sudden severe pain in the upper abdomen for 16 hours" . No positive signs were found on physical examination, and the routine blood test showed a slightly high percentage of neutrophils, while the rest of the blood test results showed no obvious abnormality. Examination of the heart and abdominal organs showed no specific abnormality, and computed tomography angiography (CTA) of thoracic and abdominal vessels showed severe stenosis of the lumen at the beginning of the celiac artery, with a stenosis rate of 85%. Laparoscopic middle arch ligament release and celiac ganglionectomy were performed in May 2023 under general anesthesia. The patient was observed for surgery and postoperative symptom relief.

Five-hole laparoscopy was used to incise the hepatogastric ligament and explore the peritoneal artery, and after incision of the retroperitoneum, the mid-arch ligament was seen to compress the peritoneal artery, so the mid-arch ligament was cut off and the periportal ganglion of the peritoneal artery was peeled off. After surgery, the patient recovered well, and the symptoms were significantly relieved compared with the preoperative period. CTA of the thoracic and abdominal vessels was repeated 4 d after surgery, which showed that the stenosis of the celiac artery had significantly improved compared with the previous period, and the patient was discharged from the hospital. The patient was discharged from the hospital. At the 20-d postoperative outpatient follow-up, the symptoms were completely relieved, and no restenosis of the celiac artery or recurrence of symptoms was observed until the date of manuscript submission.

MALS is a rare syndrome that currently relies on a diagnosis of exclusion, and large-vessel CTA provides a better indication of compression of the celiac artery. Laparoscopic middle arch ligament release and abdominal ganglionectomy are the mainstay of treatment for MALS, and endovascular treatment or revascularization is chosen to fundamentally eliminate the stenosis of the celiac artery according to arterial morphology and disease regression.

To summarize the clinical effect and advantage of single-port laparoscopic UGF two-wings para-aortic lymphadenectomy on the treatment of endometrial carcinoma.

A retrospective analysis was conducted of 1 patients with endometrial carcinoma in stage IB (G3) from the Zhongnan Hospital of Wuhan University on Jul. 2023.The patient was diagnosed as endometrioid adenocarcinoma stage IB (G3), uterine fibroids, type 2 diabetes mellitus and anemia (mild). Single-port laparoscopic para-aortic lymphadenectomy, pelvic lymphadenectomy, epifascial hysterectomy, and bilateral salpingo-oophorectomy were performed.

The surgery went well. Intraoperative bleeding was low during surgery and no postoperative complications such as infection, bleeding, and celiac leakage. Patient recovering well after surgery.

For the reason that good surgical field exposure, single-port laparoscopic UGF two-wings para-aortic lymphadenectomy can not only greatly reduce the difficulty of para-aortic lymphadenectomy, but also reduce both the collateral damage to peripheral organs during surgery and reduce postoperative complications.

To investigate the clinical effect of pre-pregnancy transumbilical single-port laparoscopic simplified cervical cerclage in the treatment of cervical incompetence, and discuss the safety and feasibility of the operation.

Medical records of 3 patients who underwent transumbilical single-port laparoscopic simplified cervical cerclage between Mar. 2022 and Nov. 2022 at Wuhai Maternal and Child Health Hospital were reviewed. Preoperative, intraoperative, and postoperative clinical data were analyzed.

All patients underwent a thorough pre-operative evaluation, showed clear indications for surgery and had a successful transumbilical single-port laparoscopic simplified cervical cerclage. The operation time of 3 patients was 68, 55 and 42 minutes respectively. The amount of bleeding in operation was less than 10 milliliters. Postoperative exhaust time were 15, 11 and 12 hours respectively. The visual analog scale pain score within 24 hours after surgery were 2, 1 and 1 respectively. The postoperative maximum body temperature was 36.6-36.8 ℃. No perioperative complications occurred in 3 patients. All were discharged successfully on the second day after surgery. The position of the cervical suture was located in the isthmus of the uterus according to transvaginal ultrasonography 1 week after the operation, and the cervical suture did not shift or fall off during the follow-up period. No poor wound healing or umbilical hernia occurred at the 3-month follow-up, and the cosmetic effect of umbilical suture was good. Patients were satisfied with the efficacy. Embryo transfer was performed postoperatively in 3 patients, all of whom were clinically pregnant. The current gestational weeks of the three pregnant women are all longer than the gestational weeks of the previous miscarriage.

For patients with cervical incompetence, transumbilical single-port laparoscopic simplified cervical cerclage surgery is feasible, but large-sample studies are still needed to verify.

To compare the clinical effects of transvaginal natural endoscopic surgery (vNOTES), transumbilical single-site laparoscopic surgery (TU-LESS) and traditional laparoscopic surgery (MPLS) in large hysterectomy.

A total of 138 patients with large uterus who underwent total uterine + salpinx ± oophorectomy in The First Affiliated Hospital of Shandong First Medical University &Shandong Provincial Qianfoshan Hospital from Jan. 2018 to Dec. 2020 were selected and divided into MPLS group (n=40), TU-LESS group (n=37) and vNOTES group (n=61) according to different surgical approaches, and the clinical application effects of the three groups were compared and analyzed.

All operations in the three groups were successfully completed without transferring to other surgical methods. vNOTES group had the shortest operation time, the shortest time of first postoperative anal exhaust, the lowest score of 0 h and 24 h VAS, the lowest score of BIS and the highest score of CS. There was no significant difference in postoperative hospital stay among the three groups (P>0.05). There were no significant differences in the amount of intraoperative blood loss, total hospitalization cost, postoperative hospital stay, surgical complications and postoperative follow-up, the healing of the broken end of the vagina and the satisfaction of the operation among the three groups (P>0.05).

vNOTES, TU-LESS and MPLS can successfully complete large hysterectomy plus tubal ± ovariectomy. Compared with TU-LESS and MPLS, vNOTES has the advantages of shorter operation time, faster recovery of gastrointestinal function after surgery, less postoperative pain, and no scar in the abdomen during large hysterectomy.