Evolving thoracic surgery: from open surgery to single port thoracoscopic surgery and future robotic

Thoracic Surgery is a continuous evolving specialty. In the past, thoracic surgeons had to make large incisions in order to operate any pathology inside the chest. This often meant big, painful and ugly scars and long recovery times after surgery. But he history of thoracic surgery changed since the begining of video-assisted thoracoscoDic surgery （VATg3

Single port laparoscopic right hemicolectomy with D3 dissection for advanced colon cancer

We report the first case of single port laparoscopic right hemicolectomy for advanced colon cancer.An abdominal 3 cm length incision was made via the umbilicus.A small wound retractor and a surgical glove were used as a single port.All soft tissue anterior to the superior mesenteric vein was completely removed and D3 lymph node dissection was achieved.The total operative time was 180 min with minimal blood loss (<50 mL).The size of the tumor was 5 cm×3 cm and its tumor stage was T3N0.Sixty-nine lymph nodes were harvested and none were positive.We believe that single port surgery for colon cancer is a feasible and safe procedure with surgical results comparable to conventional laparoscopic procedures.

Analogies between medusa and single port surgery in gastroenterology and hepatology:A review

Single port surgery(SPS)was introduced as an attractive,minimally invasive surgical technique that ensures esthetic results for many types of visceral surgery.Initially,surgeons immediately set about performing SPS without preliminary knowledge or training,which resulted in higher complication rates.Today,current studies conclusively show that SPS is scientifically rehabilitated and indicated for simple and complex laparoscopic procedures.We here describe the astonishing analogies between Greek mythology and modern surgery.

Single Port Transumbilical Laparoscopic Surgery versus Conventional Laparoscopic Surgery for Benign Adnexal Masses： A Retrospective Study of Feasibility and Safety

Background： Single port laparoscopic surgery （SPLS） is an innovative approach that is rapidly gaining recognition worldwide. The aim of this study was to determine the feasibility and safety of SPLS compared to conventional laparoscopic surgery for the treatment of benign adnexal masses. Methods： In total, 99 patients who underwent SPLS for benign adnexal masses between December 2013 and March 2015 were compared to a nonrandomized control group comprising 104 conventional laparoscopic adnexal surgeries that were performed during the same period. We retrospectively analyzed multiple clinical characteristics and operative outcomes of all the patients, including age, body mass index, size and pathological type of ovarian mass, operative time, estimated blood loss （EBL）, duration of postoperative hospital stay, etc. Results： No significant difference was observed between the the pathological results between the two groups were found to two groups regarding preoperative baseline characteristics. However, be slightly different. The most common pathological type in the SPLS group was mature cystic teratoma, whereas endometrioma was more commonly seen in the control group. Otherwise, the two groups had comparable surgical outcomes, including the median operation time （51 min vs. 52 min, P = 0.909）, the median decreased level of hemoglobin from preoperation to postoperation day 3 （10 g/L vs. 10 g/L, P = 0.795）, and the median duration of postoperative hospital stay （3 days vs. 3 days, P = 0.168）. In SPLS groups, the median EBL and the anal exsufftation time were significantly less than those of the conventional group （5 ml vs. 10 ml, P〈 0.001; 10 h vs. 22 h, P〈 0.001）. Conclusions： SPLS is a feasible and safe approach for the treatment of benign adnexal masses. Further study is required to better determine whether SPLS has significant benefits compared to conventional techniques.

Can a single-port robot be safely used for robotic total gastrectomy for advanced gastric cancer?First experience using the da Vinci SP platform

Background Many studies have shown the operative feasibility and safety of robotic gastrectomy.Surgeons are pursuing single-port(SP)surgery to leverage the advantages of minimally invasive gastrectomy.The purpose of this study was to describe technical considerations and short-term outcomes from the first reported SP robotic total gastrectomy(RTG)using the da Vinci SP platform.Methods A 75-year-old patient with a body-mass index of 19.8 kg/m^(2) and clinical stage III cancer(cT3NtM0)underwent SP RTG on 22 January 2022 at the Department of General Surgery,the Chinese PLA General Hospital.All procedures were performed successfully using the da Vinci SP robotic platform.Results The SP RTG was successfully performed with D2 lymphadenectomy including No.10 lymph-nodes dissection and extracorporeal Roux-en-Y anastomosis.Except for subcutaneous emphysema,no severe adverse events occurred during the operation.According to a visual analogue scale(VAS),the subjective feeling of post-operative pain was given a VAS score of 3 of 10 on Post-Operative Day 1(POD 1),1 of 10 on POD 3,and 1 of 10 on POD 7.We removed the gastric tube on POD 2 and advised sipping water,a liquid diet,and a soft diet on PODs 2,4,and 6,respectively.The patient was discharged without any complications on POD 8.Conclusion RTG is technically feasible and safe using the da Vinci SP robotic platform.To our knowledge,this is the first study using the da Vinci SP platform in RTG for advanced gastric cancer in elderly patients.To verify its superior operative outcomes,further clinical trials are needed.