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Pyloroplasty reduces complications in minimally invasive esophagectomy

Adding pyloroplasty during esophagectomy significantly lowers the risk of short-term complications.

  • Patients undergoing pyloroplasty had a pneumonia or anastomotic leak rate of 18% compared to 27% in those without the procedure.
  • The trial led to early stopping when superiority of pyloroplasty was confirmed with a 90% probability.

Surgeons can confidently incorporate pyloroplasty to enhance patient outcomes in these procedures.

Clinical Trial, Phase III by Luketich JD, Sarkaria ID (…) Pennathur A et 10 al. in Ann Surg

Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.

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Multimodal Prehabilitation Doesn’t Cut Surgical Complications

Multimodal prehabilitation didn’t show significant benefits for postoperative outcomes in a diverse surgical population.

  • No notable reduction in major complications (adjusted risk ratio 1.02) or length of stay (adjusted incidence rate ratio 1.04).
  • In high-risk GI oncological surgery patients, a non-significant 9% reduction in complications was observed.

Surgeons should consider targeted prehabilitation for high-risk patients, as broader implementations may be ineffective.

Journal Article by Drager LD, Atsma F (…) van den Heuvel B et 8 al. in Br J Surg

© The Author(s) 2026. Published by Oxford University Press on behalf of BJS Foundation Ltd.

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Gas Bloat Syndrome Post-Nissen Fundoplication Linked to Failures

Gas bloat syndrome significantly worsens outcomes after Nissen fundoplication, revealing critical insights for surgical practice.

  • 24.7% of patients experienced gas bloat syndrome one year post-surgery.
  • Those with gas bloat reported higher GERD-HRQL scores, lower satisfaction, and increased PPI use (p < 0.01).
  • By year five, 46.7% of gas bloat patients had anatomical failures vs. 15.3% without (p < 0.0001), and 28.5% required revisional surgery compared to 8.5% (p < 0.001).

Monitoring gas bloat syndrome is essential for improving long-term surgical outcomes and addressing patient concerns.

Journal Article by Sarici IS, Eriksson SE (…) Ayazi S et 3 al. in J Am Coll Surg

Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Surgeons.

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Minimally invasive surgery cuts costs in liver and pancreatic procedures

Minimally invasive approaches in liver and pancreatic surgery show significant cost advantages.

  • Laparoscopic ($77,657) and robotic ($89,713) surgeries have lower median hospital charges compared to open surgery ($111,051) (p < .001).
  • In liver resections, laparoscopic surgery results in adjusted charge reductions of $23,564 overall, and $14,140 for early discharges.

Surgeons should consider minimally invasive techniques for both clinical benefits and cost-saving potential.

  • Complications and late discharge are major predictors of increased costs (+$83,816 and +$82,039, respectively).

Journal Article by Alizai Q, Chatzipanagiotou OP (…) Pawlik TM et 6 al. in BMC Surg

Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved.

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Colovac 2 device shows promise for colorectal surgery

Colovac 2 may reduce the need for diverting ostomies after low anterior resection.

  • 100% of Colovac devices were successfully placed and removed without complications.
  • Only 8.3% experienced clinically significant migration, all retrieved successfully with no ostomy conversions.

Surgeons can potentially avoid diverting ostomies in 87.5% of patients within 10 days post-surgery.

  • 95.8% achieved fecal diversion success before device retrieval.

Journal Article by Lefevre JH, Karachun A (…) Sylla P et 6 al. in Surg Endosc

© 2026. The Author(s).

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AI Platform Boosts Safety in Laparoscopic Cholecystectomy

An AI-based tool shows promise in improving the critical view of safety during laparoscopic cholecystectomy, reducing bile duct injury risks.

  • The AI platform achieved impressive accuracy scores: 0.91 for CVS I, 0.86 for CVS II, and 0.73 for CVS III.
  • Significant improvement in CVS assessment was observed post-deployment (p < 0.01).

Surgeons reported high satisfaction, with 15 out of 18 indicating improved performance (p < 0.05).

  • Feedback highlighted the need for enhanced training and ongoing development of the AI model.

Journal Article by Tang M, Hu R (…) Wang X et 18 al. in Surg Endosc

© 2026. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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New Robotic Procedure Shows Promise for Colorectal Lesions

Endorobotic submucosal dissection (ERSD) using the da Vinci SP system is a safe and effective option for resecting distal colorectal lesions.

  • En-bloc resection rate was 96%, with a median procedure time of 73 minutes.
  • Patients had a median hospital stay of 0 days and minimal long-term complications.

This indicates ERSD could expand surgical options for select patients, reducing recovery time.

  • The median specimen size was 19 cm, suggesting effective lesion removal.

Journal Article by Erkaya M, Karahan S (…) Gorgun E et 6 al. in Surg Endosc

© 2026. The Author(s).

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PIPAC Treatment Linked to Longer Survival in Unresectable Malignancies

More treatments with pressurized intraperitoneal aerosol chemotherapy (PIPAC) lead to better survival outcomes for patients with unresectable peritoneal surface malignancies (PSMs).

  • Patients receiving 3 or more PIPAC procedures showed significantly improved survival.
  • Disease progression (56%) was the main reason for stopping treatment, signaling the need for ongoing evaluation of therapy effectiveness.

Surgeons should consider the number of PIPAC treatments when evaluating patient prognosis and plan for potential progression management strategies.

  • Initiating PIPAC in a timely manner may enhance patient outcomes, particularly for those with specific PSM origins.

Journal Article by Orgad R, Bakrin N (…) Kepenekian V et 5 al. in Ann Surg

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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Postoperative complications don’t impact survival after esophagectomy for cancer.

  • In a study of 541 patients with esophageal cancer undergoing neoadjuvant therapy, complications like pneumonia and anastomotic leakage showed no significant effect on overall survival across treatment arms.
  • The shift from open to thoracoscopic esophagectomy reduced the prognostic impact of complications, with hazard ratios for overall survival decreasing significantly.

Minimally invasive techniques may enhance patient outcomes by mitigating the risks associated with complications.

  • Intensified neoadjuvant therapy may further support this positive trend.

Journal Article by Booka E, Kato K (…) Takeuchi H et 17 al. in Ann Surg

Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved.

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Endoscopic Necrosectomy: No Major Differences Found

Upfront endoscopic necrosectomy (UEN) and step-up endoscopic necrosectomy (SUEN) show similar outcomes for walled-off pancreatic necrosis, impacting how you approach patient management.

  • No significant difference in clinical success (RR: 1.04) or technical success (RR: 1.27) between UEN and SUEN.
  • Patient safety outcomes, including post-procedural bleeding (RR: 0.66) and recurrence (RR: 0.71), were comparable.

Individualized treatment strategies remain crucial in optimizing patient outcomes.

  • Average length of hospital stay was nearly identical (SMD: -0.03).

Review by Tazinkeng N, Elmustafa F (…) Igbinedion S et 6 al. in Gastrointest Endosc

Copyright © 2026. Published by Elsevier Inc.

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