Education and training of surgical residents in upper gastrointestinal surgery: a European survey.

Educating and training young surgeons is a complex challenge that requires a structured pathway. Upper gastrointestinal (UGI) surgery is becoming a highly attractive subspecialty, yet it is not universally recognized. Currently, there are no standardized guidelines or curricula for UGI surgical training across Europe and a wide disparity among countries remains.

Can 3D Imaging Improve Results in Colorectal Cancer Laparoscopic Surgery?

The aim of this prospective comparative study is to report our experience with 3D laparoscopy in terms of surgeon's discomfort with 3D vision, and to compare clinical outcomes with 2D laparoscopy in oncological colorectal surgery. From 2016 to 2017, all consecutive patients who underwent elective colorectal surgery for malignancy were enrolled. Based on surgery, patients were grouped as follows: group A, right hemicolectomy; group B, left hemicolectomy; group C, sigmoidectomy; and group D, anterior resection of the rectum.

Minimally invasive approach for inguinoscrotal hernia repair. A systematic literature review.

Background: This systematic review reports the presently available evidence regarding the results of the minimally invasive surgery (MIS) approach for the treatment of inguinoscrotal hernias (ISHs).

Methods: After PROSPERO registration (CRD-42023493129), a search was performed in the MEDLINE, Embase, and Web of Science databases.

Results: One-thousand-fifty-two patients were included (78.

The Italian national consensus conference on the diagnosis and treatment of Rectus Abdominis diastasis in Post-gravidic Women.

Purpose: Rectus Abdominis diastasis (RAD) is a prevalent condition, particularly in post-gravidic women, with functional and esthetic impact. This Delphi consensus, led by general surgeons, aimed to establish evidence-based recommendations for the diagnosis and management of RAD in post-gravidic women.

Methods: A Delphi process was conducted under the auspices of the Italian Society of Hernia and Abdominal Wall Surgery (ISHAWS), the national chapter of the European Hernia Society (EHS).

Robotic Submesocolic Left Adrenalectomy: The Evolution of Delbet Approach.

Introduction: The left adrenal gland is prone to being approached with several access points. This study presents a series of robotic submesocolic left adrenalectomies.

Materials And Methods: Intraoperative and post-operative outcomes of robotic (RB) and laparoscopic (LP) submesocolic (SM) access to the adrenal gland were compared.

Robotic vs. Laparoscopic Adrenalectomy for Pheochromocytoma-A Systematic Review and Meta-Analysis.

The application of robotic adrenalectomy (RA) has been increasing. However, there is still controversy about whether RA is more feasible than laparoscopic adrenalectomy (LA) for pheochromocytoma (PHEO). We conducted a systematic review of published articles between 2013 and 2025 according to the PRISMA statement and the Cochrane Handbook for systematic reviews of interventions.

Current evidence and new trends in anal fissure treatment.

An anal fissure is a benign and painful ulcer extending from the pectinate line to the anal margin. It leads to an increase in the resting pressure of the internal anal sphincter and the pressure within the anal canal, resulting in local ischemia and impaired wound healing. Anal fissures are mostly located in the posterior midline.

Artificial intelligence-enhanced video-based assessment of surgical quality for training in laparoscopic right hemicolectomy: The "Marginal Gains" pilot study.

Introduction: The study aims to propose a standardised workflow with critical views for surgical quality assessment (SQA) in laparoscopic right hemicolectomy (LRH), to disseminate it through a "Marginal Gains" course, and to evaluate its impact through artificial intelligence (AI) enhanced video-based assessment (VBA).

Materials And Methods: Expert colorectal surgeons proposed a protocol for SQA in LRH based on evidence and consensus. A course ("Marginal Gains") comprising remote e-learning and on-site clinical immersion was organised to disseminate the proposed approach to LRH.

Minimally invasive approach in emergency for the treatment of acute incarcerated/strangulated ventral hernias. A systematic review and meta-analysis.

Background: This study aims to report the currently available evidence on minimally invasive surgery (MIS) in emergency settings for treating acute incarcerated/strangulated ventral, primary, or incisional hernias and compare it with the open approach.

Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement.

Results: Six articles were included.

Endoscopic pilonidal sinus treatment versus excision with wound closure: a systematic review of the literature.

Introduction: The aim of this systematic review was to compare minimally invasive procedures versus excision and wound closure for the treatment of pilonidal disease (PD) in terms of perioperative outcomes.

Evidence Acquisition: Search was performed in PubMed, Embase and Web of Science, founding 581 articles.

Evidence Synthesis: Six articles published between 2018 and 2023, including 595 patients were included in the present systematic review.

Protective ileostomy creation after anterior resection of the rectum (PICARR): a decision-making exploring international survey.

In our previous survey of experts, surgeon's decision-making process (DMP) about protective ileostomy (PI) creation after anterior resection was investigated. Based on our previous data, a multiple choice questionnaire has been developed. The aim is to perform a quantitative analysis of the results obtained from an international survey and to describe the clinical practice worldwide.

Systematic review on the use of artificial intelligence to identify anatomical structures during laparoscopic cholecystectomy: a tool towards the future.

Purpose: Bile duct injury (BDI) during laparoscopic cholecystectomy (LC) is a dreaded complication. Artificial intelligence (AI) has recently been introduced in surgery. This systematic review aims to investigate whether AI can guide surgeons in identifying anatomical structures to facilitate safer dissection during LC.

Implementation of intraoperative procedures to prevent anastomotic leak in low anterior rectal resections: a pilot study for a novel technique to evaluate anastomotic vascularization.

Introduction: Altered vascular microcirculation is recognized as a risk factor for anastomotic leakage (AL) in colorectal surgery. However, few studies evaluated its impact on AL using different devices, with heterogeneous results. The present study reported the initial experience measuring gut microcirculatory density and flow with the aid of incidence dark-field (IDF) videomicroscopy (Cytocam, Braedius, Amsterdam, The Netherlands) comparing its operative outcome using a propensity score matching (PSM) model based on age, gender, and Charlson Comorbidity Index (CCI).

Fluorescence-guided identification and dissection of retroperitoneal lymphomas (with video).

Surgery, especially if minimally invasive, still plays a role in the diagnosis of suspect lymphoproliferative lesions in challenging locations such as the retroperitoneum. Fluorescence guidance may help in such cases facilitating the visualization of highly vascularized lesions. Our recent experience with a 71-year-old woman with retroperitoneal lymphadenopathy and suspected lymphoma supports this hypothesis.

Laparoscopic right hemicolectomy with complete mesocolon excision and cranial approach.

Background: Complete mesocolon excision (CME) and D3-lymphadenectomy concepts have gained popularity for the surgical treatment of right colon cancer in comparison to the conventional laparoscopic right hemicolectomy (CLRH). The rationale of CME is to dissect the embryological planes between the mesenteric plane and the parietal fascia to remove the mesentery within a complete envelope of mesenteric fascia and visceral peritoneum that contains lymph nodes, the central vascular ligation, and adequate bowel length to remove involved pericolic lymph nodes in the longitudinal direction, having as the main goal to improve the oncological results. CME with D3-lymphadenectomy is challenge since involves the excision of the lymph adipose tissue covering the medial edge of the superior mesenteric vein (SMV) (trunk of Gillot, TG), and the gastrocolic trunk of Henle (GTH).

Inferior mesenteric artery preservation techniques in the treatment of diverticular disease: a systematic review of the literature.

Purpose: The aim of this study is to analyze the impact of different surgical techniques used to preserve the inferior mesenteric artery on patient outcomes following left colonic resection.

Methods: A search was conducted in PubMed, Embase and Web of Science, founding 4795 articles. The review was registered on PROSPERO (registration number: CRD42024572291).

Intragallbladder versus intravenous indocyanine green (ICG) injection for enhanced bile duct visualization by fluorescent cholangiography during laparoscopic cholecystectomy: a retrospective cohort study.

Background: Iatrogenic bile duct injuries (BDIs) prevention during laparoscopic cholecystectomy (LC) relies on meticulous anatomical dissections through direct visualization. Near-infrared fluorescence (NIRF) with indocyanine green (ICG) improves the visualization of extrahepatic biliary structures. Although ICG can be administered either intravenously or intragallbladder, there remains uncertainty regarding the optimal method for different patient populations.

Fluorescence and tracers in surgery: the coming future.

The revolution that we are seeing in the world of surgery will determine the way we understand surgical approaches in coming years. Since the implementation of minimally invasive surgery, innovations have constantly been developed to allow the laparoscopic approach to go further and be applied to more and more procedures. In recent years, we have been in the middle of another revolutionary era, with robotic surgery, the application of artificial intelligence and image-guided surgery.