The purpose of this study was to investigate the safety and feasibility of da Vinci robotic transanal full-thickness local excision for rectal cancer with complete clinical remission after neoadjuvant chemoradiotherapy.

A patient with rectal cancer who had complete clinical remission after neoadjuvant chemoradiotherapy underwent transanal full-thickness local excision using the da Vinci Si surgical system.

The operation was successful with a duration of about 180 min and an intraoperative bleeding of about 10 ml. The patient was discharged 3 days later. The postoperative pathological stage was ypT0N0M0.

It is safe and feasible to treat rectal cancer with complete clinical remission after neoadjuvant chemoradiotherapy by transanal full-thickness local excision using the da Vinci Si surgical system. More evidence is needed in large-scale clinical studies.

To explore the safety and feasibly of staple-free hand-sewn laparoscopic colonic anastomosis in the totally laparoscopic left hemicolectomy.

From Apr. 2020 to Apr. 2022, in the Department of Gastrointestinal Surgery, Inner Mongolia Autonomous Region People's Hospital, patients who underwent total laparoscopic left colectomy with staple-free hand-sewn and total laparoscopic or laparoscopic-assisted left colectomy with stapler were retrospectively analyzed. According to the method of digestive reconstruction , a total of 77 patients with left colon cancer who met the inclusion criteria were divided into two groups: staple-free hand-sewn laparoscopic colonic anastomosis group (35 cases) and staple anastomosis (Overlap, end-to-end anastomosis) group (42 cases). The operation time, anastomotic complications, abdominal infection and postoperative recovery of the two types of digestive reconstruction were statistically analyzed.

No significant differences were founded in gender, age, BMI, ASA grade, tumor location, TNM stage, preoperative diabetes mellitus and preoperative imcomplete colon obstruction between the two groups (P>0.05). R0 resection was performed in both groups, none required conversion to open surgery. Moreover, there were statistically significant differences in digestive reconstruction time and auxiliary incision between the two groups.The reconstruction time of staple-free hand-sewn group was remarkably longer than staple anastomosis group[(33.7±5.0)min vs(27.1±4.9)min, P<0.001], The length of auxiliary incision of staple-free hand-sewn group was shorter than that of staple anastomosis group[(5.6±0.84)cm vs(7.7±1.11)cm, P<0.001]. In addition, there were no statistically significant differences in the incidence of overall complications, anastomotic bleeding, anastomotic leakage, anastomotic stenosis, and abdominal infection between the two groups(P>0.05). There was also no significant difference in the first flatus time and hospital stay(P>0.05). The complications of the two groups were cured by non-operative treatment. No reoperation and death cases occurred.

The technique of staple-free hand-sewn anastomosis is simple, safe and feasible in total laparoscopic left colectomy , it can be used as a supplement to staple anastomosis, but it needs to be performed by experienced laparoscopic surgeons.

To investigate the feasibility and safety of using robot in gastric cancer NOSES surgery.

A case of gastric cancer in the Department of General Surgery of the First Affiliated Hospital of Nanchang University was selected and successfully performed robotic radical total gastrectomy with vaginal specimen removal without abdominal incision.

The operation was smooth without transit, the operation time was 190 min, the blood loss was about 50 ml, and the hospital was discharged smoothly after the operation.

Robotic radical total gastrectomy without an auxiliary abdominal incision for transvaginal sampling is safe and feasible, and has a greater advantage when applied to Noses compared to laparoscopy.

To investigate the feasibility, safety and effect of natural orifice transumbilical three-dimensional laparoscopic single-port hepojejunostomy for congenital choledochal cyst in children.

Seven children with congenital choledochal cyst were treated by the same surgeon with transumbilical three-dimensional laparoscopic single-port Roux-en-Y hepojejunostomy. Preoperative, intraoperative and postoperative clinical data of the children were collected for retrospective analysis and followed up for 3 months.

All patients successfully completed operation, without transfer to open surgery or additional Trocar cases, none of 7 cases need blood transfusion and postoperative ICU treatment. The average operative time was 331 min, the intraoperative blood loss was 5-22 ml, and the postoperative hospital stay was 5-7 d. There were no anastomotic leakage, anastomotic stenosis, hemorrhage, acute intestinal obstruction, incision infection, cholangitis, acute pancreatitis or other complications. The appearance of the umbilical region was satisfactory and no visible postoperative scar was found in all patients.

Natural orifice transumbilical three-dimensional laparoscopic single-port hepojejunostomy for congenital choledochal cyst in children is safe and feasible, with good short-term results and satisfactory postoperative cosmetic results, but the procedure is difficult.

To summarize the experience and technical points of the robotic target-territory resection techniques for liver tumors target resection technology under the guided by the watershed theory.

A retrospective analysis was performed for the data of 62 patients in the author′s team who underwent robotic target-territory resection of liver tumors from Oct. 2021 to Dec. 2022. target-territory analysis was carried out before surgery, the target-territory resection extent based on the biological characteristics of the tumor, and the resection was performed according to individual anatomical markers during surgery.

All 62 patients successfully completed the operation, including 3 cases of left hemiliver plus caudate lobectomy, 1 case of right liver plus caudate lobec, 12 cases of left liver tumor resection, 7 cases of middle liver tumor resection, 35 cases of right liver tumor resection, 4 cases of caudate lobe tumor resection, and no laparotomy. The duration of surgery and the median intraoperative bleeding were 188 min(70-510 min) and 50 mL(5-1 100 mL), Intraoperative hemorrhage (≥800 mL) was 2 cases. There were 2 cases of bile duct leakage after surgery, both of which were cured without surgical treatment. The median length of hospital stay after surgery was 7 d(3-28 d). There were no secondary surgeries or deaths.

Target-territory resection technology of liver tumor is safe and feasible. It is based on the biological characteristics of tumor, and individualized anatomic landmarks play an important role. The comprehensive application of surgical robots and various technologies will help the implementation of target-territory resection.

To the feasibility and safety of "chopsticks technique" for the laparoendoscopic single-site surgery total hysterectomy were confirmed by peroperative outcome was compared with traditional laparoscopic total hysterectomy.

A retrospective cohort study was used in this study. Patients who were included in the laparoendoscopic single-site surgery total hysterectomy and the traditional laparoscopic total hysterectomy of the First Affiliated Hospital of the Army Military Medical University from Dec. 2016 to Jun. 2019. The operation time, intraoperative bleeding amount, postoperative exhaust time, VAS score after surgery (12 h, 24 h), postoperative hospitalization time and postoperative complications of the two groups were compared.

A total of 297 patients were included in the study, including 107 laparoendoscopic single-site surgery (LESS group) and 190 traditional laparoscopic(TL group). Both groups successfully completed the operation, no case was transferred to laparotomy. Baseline values of patients were balanced in both groups. The operation time of the LESS and TL groups were 131 min(102, 155)min and 125.5 min (92.8, 155) min with no statistical difference (P> 0.05); intraoperative bleeding was 100 ml(100, 200)ml and 100 ml(100, 150)ml, no statistical difference (P> 0.05); there were no statistical differences in postoperative exhaust time, VAS score after surgery (12 h, 24 h), postoperative complications (P> 0.05); both groups vaginal stump healed well. The LESS group was shorter postoperative hospital stay than the TL group and was statistically significant (P<0.05). For patients at uterine size≥12 weeks gestation and uterine size<12 weeks gestation were compared, there was no statistical difference between LESS group and TL groups in the operation time, postoperative bleeding time, postoperative exhaust time, VAS score after surgery (12 h, 24 h), perioperative complications (P> 0.05). Among them, for the uterine <12 gestational weeks, The LESS group was shorter postoperative hospital stay than the TL group and was statistically significant (P<0.05).

The perioperative outcome of the "chopstick technique" for laparoendoscopic single-site surgery total hysterectomy was similar to that of traditional laparoscopic total hysterectomy. The feasibility and safety in the laparoendoscopic single-site surgery were preliminarily demonstrated.