Preoperative 3D Imaging Reconstruction Models for Predicting Infiltration of Major Vascular Structures in Patients During Pancreatic Surgery.

IntroductionVascular infiltration is the main limitation of resectability in locally advanced pancreatic cancer; thus, an accurate preoperative study is mandatory to plan an appropriate surgical strategy. In recent years, medical image fusion and three-dimensional reconstruction models have gained acceptance in general surgery, especially in the hepatic field. In pancreatic pathology, 3D reconstruction also may improves preoperative staging.

Robot‑assisted cholecystectomy with the new da Vinci SP surgical system: first report in Spain with video.

Robotic surgery has significantly advanced over the last decade, proving to be a safe and feasible technique in minimally invasive surgery. The latest innovation in robotic-assisted surgery is the da Vinci single-port (SP) by Intuitive, designed for greater precision and ergonomic efficiency. This report is supposed to be the first Spanish case of robot-assisted cholecystectomy performed using the da Vinci SP system, detailing system specifications, docking configurations, and surgical outcomes.

First experience in Spain of large ventral hernia treated with botulinum toxin combined with robot-assisted transversus abdominis release (R-TAR) using the Hugo RAS system.

We present the first documented case in Spain of a large midline incisional hernia treated with botulinum toxin A (Botox A) in conjunction with robot-assisted transversus abdominis release utilising the Hugo robot-assisted surgery (RAS) by Medtronic (Minneapolis, MN, USA). The patient, a woman in her late 40s, was referred to our outpatient clinic due to two significant midline incisional hernias which were causing abdominal discomfort and constipation. Her medical history included a laparoscopic myomectomy that had been converted to open surgery, resulting in a sub-umbilical incision.

Earlier Experience of Robotic Inguinal Hernia Repair With the New Hugo™ Robotic System in Europe.

Introduction: Minimally invasive robotic surgery has increasingly gained acceptance in abdominal wall surgery. The Hugo™ robotic system, with its modular design, offers enhanced maneuverability and flexibility, making it a promising alternative platform for inguinal hernia treatment. This article aims to present our experience with robotic inguinal hernia repair using the Hugo™ system, focusing on clinical outcomes and the challenges encountered during the learning curve.

HUGO™ system robotic eTEP technique for ventral hernia repair. A step-by-step medial bottom-up approach.

This study describes an innovative robotic extended totally extraperitoneal (eTEP) technique for ventral hernia repair via a medial bottom-up approach using the new HUGO system. The surgical steps and a novel setup guide for this approach are detailed. A 78-year-old male with an incisional umbilical hernia and concomitant rectus diastasis was treated using the HUGO™ system.

First worldwide surgical procedure of giant inguinoscrotal repair with the new Hugo robotic assisted system: video and docking presentation.

Giant inguinoscrotal (GIS) hernias are rarely present in clinical settings and its treatment with a minimally invasive approach is often considered a challenge. In recent years, robotic surgical techniques have gained prominence in the medical field, offering advantages over traditional laparoscopic methods. The Hugo robotic system introduces a fresh paradigm by employing independent robotic arms, enhancing manoeuverability in diverse surgical contexts.

Predicting treatment response and survival in rectal cancer: insights from 18 FDG-PET/MRI post-neoadjuvant therapy.

Introduction: Accurate identification of patients with pathologic complete response (pCR) following neoadjuvant radiochemotherapy (RCT) for locally advanced rectal cancer (LARC) is essential. 18-FDG PET/MRI provides metabolic information that complements the morphological assessment of standard MRI, potentially enhancing the differentiation between fibrotic and tumorous tissues post-treatment. This study aims to evaluate the performance of 18-FDG PET/MRI in assessing treatment response compared to standard MRI.

Cytoreductive surgery and HIPEC with oxaliplatin for the treatment of peritoneal carcinomatosis from recurrent fibrolamellar carcinoma.

Fibrolamellar hepatocellular carcinoma (FHCC) is a rare variant of hepatocellular carcinoma (HCC), characterised by a poorer prognosis in later stages compared with conventional HCC due to a high rate of local recurrence, lymph node metastasis and peritoneal metastasis. Conventional chemotherapy is generally ineffective, making surgery the only potentially curative treatment. Currently, surgery is also indicated in cases of recurrence, always aiming for an R0 resection.

Phase 2, Multicenter, Open-label, Nonrandomized Study of Neoadjuvant Chemotherapy Liposomal Irinotecan With 5-Fluorouracil, Leucovorin, and Oxaliplatin, Followed by Chemoradiotherapy in Patients With Rectal Cancer in a Watch-and-Wait Program.

Objective: To evaluate the efficacy of neoadjuvant chemotherapy combination with liposomal irinotecan, 5-fluorouracil, leucovorin, and oxaliplatin in patients with locally advanced rectal cancer.

Methods: This was a phase 2, nonrandomized, multicenter study in adults with stage II or III rectal cancer and an Eastern Cooperative Oncology Group performance status of 0 to 1. Total neoadjuvant therapy (TNT) consisted of neoadjuvant chemotherapy combination with liposomal irinotecan (60 mg/m 2 ), oxaliplatin (60 mg/m 2 ), leucovorin (400 mg/m 2 ), and fluorouracil (2400 mg/m²), followed by chemoradiotherapy [ie, capecitabine (825 mg/m 2 ) and radiotherapy according to the standard of care].

α-Synuclein Oligomers in Skin Biopsies Predict the Worsening of Cognitive Functions in Parkinson's Disease: A Single-Center Longitudinal Cohort Study.

α-synuclein oligomers within synaptic terminals of autonomic fibers of the skin reliably discriminate Parkinson's disease (PD) patients from healthy controls. Nonetheless, the prognostic role of oligomers for disease progression is unknown. We explored whether α-synuclein oligomers evaluated as proximity ligation assay (PLA) score may predict the worsening of cognitive functions in patients with Parkinson's disease.

Sarcopenia, low muscle strength, cognitive functions, and quality of life in parkinsonian syndromes.

Objectives: Parkinsonian syndromes are disabling neurodegenerative diseases resulting in reduced muscle function/performance and sarcopenia, but clinical manifestations could be systemic, including deterioration of cognitive function. As studies have reported an association between muscle dysfunction and cognitive decline yet no information on these syndromes is available, we investigated the relationship between sarcopenia, its components, and cognitive function, fatigue, and quality of life (QoL).

Methods: Consecutive patients affected by parkinsonian syndromes were assessed for the presence of sarcopenia using the European Working Group on Sarcopenia in Older People-2 algorithm: low strength (handgrip strength: <27 kg [men]; <16 kg [women]) and low appendicular skeletal muscle index by impedance (<7.

Comparing GBA1-Parkinson's disease and idiopathic Parkinson's disease: α-Synuclein oligomers and synaptic density as biomarkers in the skin biopsy.

The main genetic risk factors for Parkinson's disease (PD) are presently represented by variants in GBA1 gene encoding for the β-glucocerebrosidase (GCase). Searching for a peripheral biomarker that can be used for selecting and monitoring patients in clinical trials targeting GBA1-associated PD (GBA1-PD) is a current challenge. We previously demonstrated that α-synuclein oligomers expressed as proximity ligation assay (PLA) score in synaptic terminals of skin biopsy are a reliable biomarker for distinguishing idiopathic PD (iPD) from healthy controls (HC).

Fully laparoscopic distal splenic pancreatectomy with prophylactic hyperthermic intraperitoneal chemotherapy (with video).

Peritoneal involvement represents one of the major difficulties that arise during the treatment of pancreatic adenocarcinoma. In fact, currently, there is a growing interest in the administration of intraoperative hyperthermic intraperitoneal chemotherapy (HIPEC) as an adjunct to surgical pancreatic resection, both with prophylactic or therapeutic intent. With this video, we report a case of pancreatic body adenocarcinoma treated with fully laparoscopic distal splenic pancreatectomy with intraoperative HIPEC with gemcitabine, administered initially with a prophylactic intent, based on a preliminary negative peritoneal washing cytology result.

The era of 3D-reconstruction techniques in a medical setting: Earlier experience with video using botulinum toxin for complex ventral incisional hernia.

Introduction And Importance: Incisional hernias occur in about 15 % of all patients that undergo abdominal surgery. Treatment of giant incisional ventral hernias (GIH) results in a surgical challenge associated with postoperative morbidities, risk of hernia recurrence, and costs. In recent years the use of both botulinum toxin (BT) to overcome abdominal cavity leakage and improved preoperative imaging studies by 3D-reconstruction has improved outcomes after these complex procedures.

Cost-effectiveness of robotic vs laparoscopic distal pancreatectomy. Results from the national prospective trial ROBOCOSTES.

Introduction: Although several studies report that the robotic approach is more costly than laparoscopy, the cost-effectiveness of robotic distal pancreatectomy (RDP) over laparoscopic distal pancreatectomy (LDP) is still an issue. This study evaluates the cost-effectiveness of the RDP and LDP approaches across several Spanish centres.

Methods: This study is an observational, multicenter, national prospective study (ROBOCOSTES).

Same-day post-therapy imaging with a new generation whole-body digital SPECT/CT in assessing treatment response to [Lu]Lu-PSMA-617 in metastatic castration-resistant prostate cancer.

Purpose: Lutetium-177 [Lu]Lu-PSMA-617 radioligand therapy (RLT) represents a significant advancement for metastatic castration-resistant prostate cancer (mCRPC), demonstrating improvements in radiographic progression free survival (rPFS) and overall survival (OS) with a low rate of associated side effects. Currently, most post-therapy SPECT/CT is conducted at 24 h after infusion. This study examines the clinical utility of a next-generation multi-detector Cadmium-Zinc-Telluride (CZT) SPECT/CT system (StarGuide) in same-day post-infusion assessment and early treatment response to [Lu]Lu-PSMA-617.

New era of robotic surgery: first case in Spain of right hemicolectomy on Hugo RAS surgical platform.

We describe the first robot-assisted right hemicolectomy performed in Spain using the new Hugo RAS (robotic-assisted surgery) (Medtronic, Minneapolis, Minnesota, USA). No conversion was registered, and no intraoperative complications or technical failures of the system were recorded. The operative time was 200 min, the docking time was 5 min and the length of the hospital stay was 8 days.

Light and shadow of watch-and-wait strategy in rectal cancer: oncological result, clinical outcomes, and cost-effectiveness analysis.

Background: The watch-and-wait (WW) strategy is a potential option for patients with rectal cancer who obtain a complete clinic response after neoadjuvant therapy. The aim of this study is to analyze the long-term oncological outcomes and perform a cost-effectiveness analysis in patients undergoing this strategy for rectal cancer.

Material And Methods: The data of patients treated with the WW strategy were prospectively collected from January 2015 to January 2020.

Can 3D imaging modeling recognize functional tissue and predict liver failure? A retrospective study based on 3D modelling of the major hepatectomies after hepatic modulation.

Background: Thanks to the introduction of radiomics, 3d reconstruction can be able to analyse tissues and recognise true hypertrophy from non-functioning tissue in patients treated with major hepatectomies with hepatic modulation.The aim of this study is to evaluate the performance of 3D Imaging Modelling in predict liver failure.

Methods: Patients submitted to major hepatectomies after hepatic modulation at Sanchinarro University Hospital from May 2015 to October 2019 were analysed.

Robot-assisted cholecystectomy with the new HUGO™ robotic-assisted system: first worldwide report with system description, docking settings, and video.

Robotic surgery has gained worldwide acceptance in the past decade, and several studies have shown that this technique is safe and feasible. The innovation of this system is the open surgical console with an HD-3D display, a system tower, and four independent arm carts. We describe the first robot-assisted cholecystectomy performed with the new Hugo RAS (robotic-assisted surgery) system (Medtronic, Minneapolis, MN, USA) in Spain.

Pancreatic head resection with segmental duodenectomy for the treatment of benign and malign pancreatic diseases. Case series experience of a single center.

Introduction And Importance: Duodenum-preserving pancreatic resections (DPPHR) is a reasonable surgical option for benign or low-grade malignant tumours of the pancreatic head. Several techniques have been proposed, with or without common biliary duct preservation.

Case Presentation: We report for the first time two cases of pancreas divisum treated with this technique and we illustrate two other cases of pancreatic disease in which this procedure was realized from January 2015 to January 2020 in the HM Sanchinarro University Hospital.

Robot-assisted Nissen fundoplication with the new HUGO™ Robotic assisted system: First worldwide report with system description, docking settings and video.

Background: Robotic surgery has gained worldwide acceptance over the past decade, with several studies showing that this technique is safe and feasible.

Methods: We describe the first robot-assisted Nissen fundoplication for hiatal hernia performed with the new Hugo™ RAS (Robotic assisted surgery) system (Medtronic, Minneapolis, MN, USA) in Spain. The innovation of this system is the open surgical console with a 3D-HD display, a system tower and four independent arm carts.

SPECT at the speed of PET: a feasibility study of CZT-based whole-body SPECT/CT in the post Lu-DOTATATE and Lu-PSMA617 setting.

Purpose: To evaluate the feasibility of using the StarGuide (General Electric Healthcare, Haifa, Israel), a new generation multi-detector cadmium-zinc-telluride (CZT)-based SPECT/CT, for whole-body imaging in the setting of post-therapy imaging of Lu-labeled radiopharmaceuticals.

Methods: Thirty-one patients (34-89 years old; mean ± SD, 65.5 ± 12.

Closed hyperthermic intraperitoneal chemotherapy with CO recirculation system compared with the open Coliseum technique in peritoneal malignity treatment.

Background: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal carcinomatosis can be performed in two ways: first, the standard open abdominal technique (Open HIPEC); or second, the closed technique. In recent years, a new technique has been introduced to perform closed HIPEC; the Peritoneal Recirculation System (PRS-1.0 Combat) with CO recirculation technology (PRS Closed HIPEC).