2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:Ta00,The use of robotic-assisted groin hernia repair is increasing rapidly across the US, but evidence regarding its comparative effectiveness to more established laparoscopic or open approaches is limited. To compare the incidence of long-term operative hernia recurrence between robotic-assisted, laparoscopic, and open groin hernia repairs. This retrospective cohort study analyzed groin hernia repairs among Medicare beneficiaries aged 65 years and older from January 2010 to December 2021, with 5-year follow-up, using a population-based analysis of US inpatient and outpatient administrative claims. Data were analyzed between August 2024 and April 2025. Surgical approach: robotic-assisted, laparoscopic, or open groin hernia repair. The main outcome was operative recurrence up to 5 years after initial groin hernia repair. Cox proportional hazards modeling was used to estimate the risk-adjusted cumulative incidence of operative recurrence up to 5 years after the initial procedure, controlling for patient demographics, comorbidities, hernia type (inguinal or femoral), and procedure type (unilateral or bilateral). A total of 199 163 Medicare beneficiaries (mean [SD] age, 72.6 [9.3] years; 29 307 female patients [14.7%]) were included in the study. From January 2010 to December 2021, the proportion of robotic-assisted procedures increased 8.6-fold, from 0.3% to 2.6%. The proportion of open procedures decreased 0.6-fold (84.4% to 51.9%), while laparoscopic procedures increased 3.0-fold (15.3% to 45.5%). Patients undergoing robotic-assisted hernia repair had the highest 5-year risk-adjusted cumulative incidence of operative recurrence (3.78%; 95% CI, 3.76%-3.79%), followed by open (3.37%; 95% CI, 3.36%-3.37%) and laparoscopic (3.21%; 95% CI, 3.21%-3.22%) approaches. Compared to open repairs, the laparoscopic approach was associated with a lower risk of operative recurrence (hazard ratio [HR], 0.75; 95% CI, 0.66-0.86), while there was no difference in risk of operative recurrence between the open and robotic cohorts (HR, 1.29; 95% CI, 0.48-2.10). In this cohort study among Medicare beneficiaries, robotic-assisted groin hernia repair was associated with a higher long-term cumulative incidence of operative recurrence compared to open and laparoscopic approaches. With low operative recurrence rates across all surgical techniques, these findings suggest that alternative measures of clinical value may be necessary to assess the benefits of minimally invasive approaches, particularly as robotic-assisted repair continues to expand.31:Ted3, Importance The use of robotic-assisted groin hernia repair is increasing rapidly across the US, but evidence regarding its comparative effectiveness to more established laparoscopic or open approaches is limited. Objective To compare the incidence of long-term operative hernia recurrence between robotic-assisted, laparoscopic, and open groin hernia repairs. Design, Setting, and Participants This retrospective cohort study analyzed groin hernia repairs among Medicare beneficiaries aged 65 years and older from January 2010 to December 2021, with 5-year follow-up, using a population-based analysis of US inpatient and outpatient administrative claims. Data were analyzed between August 2024 and April 2025. Exposure Surgical approach: robotic-assisted, laparoscopic, or open groin hernia repair. Main Outcomes and Measures The main outcome was operative recurrence up to 5 years after initial groin hernia repair. Cox proportional hazards modeling was used to estimate the risk-adjusted cumulative incidence of operative recurrence up to 5 years after the initial procedure, controlling for patient demographics, comorbidities, hernia type (inguinal or femoral), and procedure type (unilateral or bilateral). Results A total of 199 163 Medicare beneficiaries (mean [SD] age, 72.6 [9.3] years; 29 307 female patients [14.7%]) were included in the study. From January 2010 to December 2021, the proportion of robotic-assisted procedures increased 8.6-fold, from 0.3% to 2.6%. The proportion of open procedures decreased 0.6-fold (84.4% to 51.9%), while laparoscopic procedures increased 3.0-fold (15.3% to 45.5%). Patients undergoing robotic-assisted hernia repair had the highest 5-year risk-adjusted cumulative incidence of operative recurrence (3.78%; 95% CI, 3.76%-3.79%), followed by open (3.37%; 95% CI, 3.36%-3.37%) and laparoscopic (3.21%; 95% CI, 3.21%-3.22%) approaches. Compared to open repairs, the laparoscopic approach was associated with a lower risk of operative recurrence (hazard ratio [HR], 0.75; 95% CI, 0.66-0.86), while there was no difference in risk of operative recurrence between the open and robotic cohorts (HR, 1.29; 95% CI, 0.48-2.10). Conclusions and Relevance In this cohort study among Medicare beneficiaries, robotic-assisted groin hernia repair was associated with a higher long-term cumulative incidence of operative recurrence compared to open and laparoscopic approaches. With low operative recurrence rates across all surgical techniques, these findings suggest that alternative measures of clinical value may be necessary to assess the benefits of minimally invasive approaches, particularly as robotic-assisted repair continues to expand. 32:T794,Inguinal hernia is a common condition in children, and day-case surgery has been widely implemented in pediatric specialty hospitals, benefiting patients and their families. However, overnight hospital stays pose various inconveniences to children and parents. In this study, we aimed to optimize the day-case surgery model for inguinal hernia repair, evaluate the effectiveness and safety of day-case surgery in children with inguinal hernias, and compare the effects of different surgical methods on hospitalization duration and medical cost. A retrospective cohort study was conducted to analyze surgical data from 14,197 children with inguinal hernias admitted from January 2019 to December 2023 using statistical methods, including independent sample t-tests, analysis of variance, and multiple linear regression analysis. The results showed that the day-case surgery model significantly shortened hospitalization duration and reduced medical cost. The hospitalization duration and medical cost in the laparoscopic percutaneous internal ring suturing group were significantly higher than those in the open traditional high ligation of the hernia sac group (P < 0.05). However, the recurrence rate in the laparoscopic percutaneous internal ring suturing group was 0.035%, which was lower than that (0.107%) observed in the open traditional high ligation of the hernia sac group. Laparoscopic percutaneous internal ring suturing aided the detection of hidden hernia at a rate of 49.61%. Day-case surgery offers significant benefits by reducing hospitalization duration and medical cost, whereas laparoscopic percutaneous internal ring suturing is better for detecting hidden hernias and shows excellent performance in reducing recurrence rates. Future research should focus on the promotion and optimization of day-case laparoscopic percutaneous internal ring suturing to enhance the treatment outcomes in pediatric inguinal hernias.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Open Surgery: modality Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Open Surgery (modality). Clinician-written summaries and actionable practice insights. 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Only 2.6% (n=70) required completion cholecystectomy, but that procedure was open in 47.1% of cases and carried a 7.1% bile duct injury rate — nearly 8× the 0.9% rate seen with subtotal cholecystectomy itself.","limitations":"Retrospective design using administrative claims data limits ability to confirm diagnosis accuracy or surgical technique details. Study draws from only two states (NY and FL), which may limit generalizability. Median follow-up of 2 years may underestimate long-term remnant cholecystitis risk.","practice_takeaway":"Subtotal cholecystectomy is a durable bailout for the difficult gallbladder, but counsel patients that ~1 in 8 will develop remnant cholecystitis, mostly within 6 months. When completion cholecystectomy is needed, the high rate of open conversion and 7.1% bile duct injury rate strongly support referral to an experienced hepatobiliary center."}},{"doi":"10.1002/jhbp.70135","pmid":"42186132","title":"Expert Survey on Chyle Leakage After Pancreaticoduodenectomy: The Precision Anatomy for Minimally Invasive Hepato‐Biliary‐Pancreatic Surgery (\n PAM\n ‐\n HBP\n Surgery) Project 2024","journal_title":"Journal of Hepato-Biliary-Pancreatic Sciences","journal_issn":"1868-6974","published_at":"2026-05-25T00:00:00.000Z","url":"https://doi.org/10.1002/jhbp.70135","source_score":6,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-31T13:35:31.239Z","updated_at":"2026-05-31T13:35:31.239Z","tags":[{"paper_doi":"10.1002/jhbp.70135","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"condition","value":"Chyle Leakage","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"condition","value":"Pancreaticoduodenectomy Complications","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"modality","value":"Laparoscopic Surgery","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"modality","value":"Minimally Invasive Surgery","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"modality","value":"Open Surgery","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"modality","value":"Robotic Surgery","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"sample_size","value":"n=57","value_numeric":57},{"paper_doi":"10.1002/jhbp.70135","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"study_design","value":"Expert Survey","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"warning","value":"Study design is an expert survey, which may overrepresent high-volume centers and may not reflect typical practice.","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"warning","value":"The 'level of evidence' is assigned as 5 (expert opinion) given the survey-based methodology.","value_numeric":null},{"paper_doi":"10.1002/jhbp.70135","tag_type":"warning","value":"The sample of 57 surgeons represents expert opinion only; no patient outcomes or incidence rates are quantified, limiting clinical applicability.","value_numeric":null}],"summaries":{"what_studied":"A structured expert survey of 57 surgeons from 10 countries examined the incidence, anatomical pitfalls, and surgical techniques related to chyle leakage (CL) after pancreaticoduodenectomy (PD), comparing open, laparoscopic, and robotic approaches.","key_result":"Experts reported CL incidence as open ≥ laparoscopic, open > robotic, and laparoscopic = robotic. Three key anatomical risk zones were identified: (i) transverse mesocolon at the ventral SMA/SMV, (ii) meso-jejunum at the dorsal SMA/SMV, and (iii) fusion fascia of Treitz at the ventral IVC. No consensus was reached on the optimal dissection plane at Treitz fascia (21% pancreatic surface, 31% within fascia, 38% IVC-exposing).","limitations":"Survey-based design captures expert opinion rather than objective outcome data; no patient-level data or incidence rates reported; potential selection bias toward high-volume, experienced surgeons.","practice_takeaway":"Focus lymphatic control at three key anatomical zones during PD—transverse mesocolon, meso-jejunum, and Treitz fascia—using energy devices as the preferred modality across all surgical approaches. Robotic PD may carry a lower CL risk than open surgery per expert consensus, though prospective data are lacking."}},{"doi":"10.1001/jamasurg.2026.1503","pmid":"42160093","title":"Activity and Physiological Stress Within 90 Days After Minimally Invasive and Open Pancreatoduodenectomy","journal_title":"JAMA Surgery","journal_issn":"2168-6254","published_at":"2026-05-20T00:00:00.000Z","url":"https://doi.org/10.1001/jamasurg.2026.1503","source_score":9,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-26T13:34:50.042Z","updated_at":"2026-05-26T13:34:50.042Z","tags":[{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"condition","value":"Pancreatic Neoplasm","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"condition","value":"Periampullary Neoplasm","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"modality","value":"Minimally Invasive Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"modality","value":"Open Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"sample_size","value":"n=288","value_numeric":288},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"warning","value":"HRV as a proxy for physiological stress/recovery is an indirect measure; clinical significance of a 9 ms difference is not firmly established in this surgical context.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"warning","value":"The 2:1 randomization ratio (MIPD:OPD) means the OPD group (n=81 with tracker data) is notably smaller, which may reduce precision for OPD subgroup estimates.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2026.1503","tag_type":"warning","value":"The paper is dated May 2026, which is recent; findings have not yet been replicated in lower-volume or non-European centers, as the authors themselves note.","value_numeric":null}],"summaries":{"what_studied":"The DIPLOMA-2 RCT compared postoperative recovery after minimally invasive pancreatoduodenectomy (MIPD) vs. open pancreatoduodenectomy (OPD) in 288 patients with upfront resectable pancreatic head or periampullary neoplasms across 14 high-volume European centers, using wearable activity trackers (Fitbit Inspire 2) from 2 weeks pre-op through 90 days post-op.","key_result":"At postoperative day 30, MIPD patients averaged **659 more daily steps** (95% CI, 79–1240; P=.03), **22 more active minutes/day** (95% CI, 3–40; P=.03), and **9 ms higher HRV** (95% CI, 2–15; P=.006) vs. OPD. Step count and active minutes equalized by day 90, but HRV remained higher in the MIPD group through 3 months.","limitations":"- Only 82% of enrolled patients had usable tracker data, introducing potential selection bias.\n- All centers were high-volume European sites, limiting generalizability to lower-volume or non-European settings.\n- Activity differences between groups were modest and equalized by day 90 for most measures.","practice_takeaway":"MIPD offers a meaningful but time-limited recovery advantage over OPD — more activity and less physiological stress for roughly the first 5 weeks post-discharge. For eligible patients at high-volume centers, MIPD appears to support a faster return to physical function, though longer-term differences beyond 90 days remain unclear."}},{"doi":"10.1001/jamasurg.2026.1126","pmid":"42054012","title":"Surgical Approach and Long-Term Operative Recurrence Following Groin Hernia Repair","journal_title":"JAMA Surgery","journal_issn":"2168-6254","published_at":"2026-04-29T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13130069/","source_score":31,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-05-06","doi":"10.1001/jamasurg.2026.1126","days":"14","issn":"2168-6254","rank":"5","field":"Clinical Medicine","score":"31","category":"Surgery","categories":["Surgery"],"_categories":["Surgery"]},"pubmed":{"doi":"10.1001/jamasurg.2026.1126","title":"Surgical Approach and Long-Term Operative Recurrence Following Groin Hernia Repair.","journal":"JAMA surgery","methods":"","results":"A total of 199 163 Medicare beneficiaries (mean [SD] age, 72.6 [9.3] years; 29 307 female patients [14.7%]) were included in the study. From January 2010 to December 2021, the proportion of robotic-assisted procedures increased 8.6-fold, from 0.3% to 2.6%. The proportion of open procedures decreased 0.6-fold (84.4% to 51.9%), while laparoscopic procedures increased 3.0-fold (15.3% to 45.5%). Patients undergoing robotic-assisted hernia repair had the highest 5-year risk-adjusted cumulative incidence of operative recurrence (3.78%; 95% CI, 3.76%-3.79%), followed by open (3.37%; 95% CI, 3.36%-3.37%) and laparoscopic (3.21%; 95% CI, 3.21%-3.22%) approaches. Compared to open repairs, the laparoscopic approach was associated with a lower risk of operative recurrence (hazard ratio [HR], 0.75; 95% CI, 0.66-0.86), while there was no difference in risk of operative recurrence between the open and robotic cohorts (HR, 1.29; 95% CI, 0.48-2.10).","abstract":"$30","keywords":[],"pubmed_id":"42054012","conclusions":"","publication_date":"2026-04-29T00:00:00"},"crossref":{"DOI":"10.1001/jamasurg.2026.1126","URL":"https://doi.org/10.1001/jamasurg.2026.1126","ISSN":["2168-6254"],"link":[{"URL":"https://jamanetwork.com/journals/jamasurgery/articlepdf/2847964/jamasurgery_niba_2026_oi_260020_1776103854.48082.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":null,"score":1,"title":["Surgical Approach and Long-Term Operative Recurrence Following Groin Hernia Repair"],"author":[{"given":"Vanessa S.","family":"Niba","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Michigan, Ann Arbor"},{"name":"Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor"},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor"},{"name":"National Clinical Scholars Program, University of Michigan, Ann Arbor"}]},{"given":"Ryan A.","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Michigan, Ann Arbor"},{"name":"Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor"},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor"}]},{"given":"Jyothi","family":"Thumma","sequence":"additional","affiliation":[{"name":"Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor"}]},{"given":"Edward C.","family":"Norton","sequence":"additional","affiliation":[{"name":"Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor"},{"name":"Department of Health Management and Policy, University of Michigan, Ann Arbor"},{"name":"Department of Economics, University of Michigan, Ann Arbor"}]},{"given":"Justin B.","family":"Dimick","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Michigan, Ann Arbor"},{"name":"Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor"},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor"}]},{"given":"Kyle","family":"Sheetz","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Michigan, Ann Arbor"},{"name":"Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor"},{"name":"Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor"}]}],"issued":{"date-parts":[[2026,4,29]]},"member":"10","prefix":"10.1001","source":"Crossref","volume":null,"created":{"date-time":"2026-04-29T15:30:57Z","timestamp":1777476657000,"date-parts":[[2026,4,29]]},"indexed":{"date-time":"2026-05-02T23:53:16Z","timestamp":1777765996289,"date-parts":[[2026,5,2]]},"subject":[],"abstract":"$31","language":"en","relation":{},"resource":{"primary":{"URL":"https://jamanetwork.com/journals/jamasurgery/fullarticle/2847964"}},"subtitle":[],"deposited":{"date-time":"2026-04-29T15:30:58Z","timestamp":1777476658000,"date-parts":[[2026,4,29]]},"issn-type":[{"type":"print","value":"2168-6254"}],"published":{"date-parts":[[2026,4,29]]},"publisher":"American Medical Association (AMA)","reference":[{"DOI":"10.1001/jamanetworkopen.2019.18911","key":"soi260020r1","year":"2020","issue":"1","author":"Sheetz","volume":"3","first-page":null,"unstructured":null,"article-title":"Trends in the adoption of robotic surgery for common surgical 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undergoing robotic-assisted, laparoscopic, or open groin hernia repair using US administrative claims data from January 2010 to December 2021 (n=199,163).","key_result":"Laparoscopic repair had the lowest 5-year risk-adjusted cumulative recurrence (3.21%), followed by open (3.37%) and robotic-assisted (3.78%). Compared to open, laparoscopic repair reduced recurrence risk (HR 0.75; 95% CI 0.66–0.86), while robotic-assisted showed no statistically significant difference from open (HR 1.29; 95% CI 0.48–2.10). Robotic use grew 8.6-fold (0.3% → 2.6%) from 2010 to 2021.","limitations":"- Administrative claims data cannot capture all clinical nuances (e.g., surgeon experience, hernia complexity, or non-operative recurrences).\n- Study is limited to Medicare beneficiaries aged ≥65, so findings may not generalize to younger patients.\n- Robotic-assisted cases represented a very small proportion of procedures, which may explain the wide confidence interval and statistical non-significance for the robotic vs. open comparison.","practice_takeaway":"Laparoscopic groin hernia repair remains associated with the lowest operative recurrence risk in older adults. Given the rapid growth of robotic-assisted repair and its numerically higher recurrence rate (though not statistically superior to open), surgeons should weigh cost and clinical value carefully before defaulting to robotic approaches for groin hernias."}},{"doi":"10.1001/jamasurg.2025.6726","pmid":"41706492","title":"Long-Term Outcomes After Laparoscopic vs Open Adhesiolysis for Small Bowel Obstruction","journal_title":"JAMA Surgery","journal_issn":"2168-6254","published_at":"2026-02-18T00:00:00.000Z","url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12917750/","source_score":98,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-07T22:49:20.736Z","updated_at":"2026-05-07T22:49:20.736Z","tags":[{"paper_doi":"10.1001/jamasurg.2025.6726","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6726","tag_type":"category","value":"Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6726","tag_type":"condition","value":"Adhesive Small Bowel Obstruction","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6726","tag_type":"condition","value":"Small Bowel Obstruction","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6726","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6726","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6726","tag_type":"modality","value":"Laparoscopic Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6726","tag_type":"modality","value":"Open Surgery","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6726","tag_type":"sample_size","value":"n=100","value_numeric":100},{"paper_doi":"10.1001/jamasurg.2025.6726","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6726","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6726","tag_type":"warning","value":"Mean patient age was 69.2 years with 65% female; results may not apply equally to younger or predominantly male cohorts.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6726","tag_type":"warning","value":"The 5-year per-protocol denominators (31–32 per group) are notably smaller than the randomized groups (49–51), suggesting substantial attrition; the paper does not fully detail reasons for loss to follow-up, which may affect long-term result reliability.","value_numeric":null},{"paper_doi":"10.1001/jamasurg.2025.6726","tag_type":"warning","value":"The trial was conducted exclusively in Finland and Italy, which may limit generalizability to other healthcare settings or patient populations.","value_numeric":null}],"summaries":{"what_studied":"The LASSO RCT compared laparoscopic vs open adhesiolysis in 100 patients with adhesive small bowel obstruction (SBO) not resolving conservatively, across 8 hospitals in Finland and Italy (July 2013–April 2018), reporting 5-year outcomes including SBO recurrence, incisional hernia, and quality of life.","key_result":"No significant differences at 5 years: SBO recurrence in 9.7% (open) vs 12.5% (laparoscopic) (OR 1.33; 95% CI 0.27–6.51; P >.99); incisional hernia in 6.1% vs 6.3% (OR 1.03; P >.99); SF-36 scores 73.2 vs 67.1 (P = .23); GIQLI scores 118 vs 119 (P = .54).","limitations":"- Small sample (n=100) limits power to detect meaningful long-term differences.\n- Open-label design with potential for performance and detection bias.\n- High dropout/loss to follow-up implied by smaller per-protocol denominators (31–32 patients per group at 5 years vs 49–51 at enrollment).","practice_takeaway":"Laparoscopy for adhesive SBO offers short-term recovery benefits but does not reduce recurrence, incisional hernia, or improve quality of life at 5 years compared to open surgery. Surgeons can choose approach based on patient factors and operative expertise without concern for inferior long-term outcomes with either technique."}},{"doi":"10.1186/s12887-025-06362-5","pmid":"41462164","title":"Evaluation of the feasibility and clinical benefits of day-case laparoscopic percutaneous internal ring suturing for pediatric inguinal hernia in a single institution","journal_title":"BMC Pediatrics","journal_issn":"1471-2431","published_at":"2025-12-30T00:00:00.000Z","url":"https://doi.org/10.1186/s12887-025-06362-5","source_score":19,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-04","doi":"10.1186/s12887-025-06362-5","days":"7","issn":"1471-2431","rank":"2","field":"Clinical Medicine","score":"19","category":"Pediatrics","categories":["Pediatrics"],"_categories":["Pediatrics"]},"pubmed":{"doi":"10.1186/s12887-025-06362-5","title":"Evaluation of the feasibility and clinical benefits of day-case laparoscopic percutaneous internal ring suturing for pediatric inguinal hernia in a single institution.","journal":"BMC pediatrics","methods":"","results":"The results showed that the day-case surgery model significantly shortened hospitalization duration and reduced medical cost. The hospitalization duration and medical cost in the laparoscopic percutaneous internal ring suturing group were significantly higher than those in the open traditional high ligation of the hernia sac group (P < 0.05). However, the recurrence rate in the laparoscopic percutaneous internal ring suturing group was 0.035%, which was lower than that (0.107%) observed in the open traditional high ligation of the hernia sac group. 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Ethical approval was obtained from the Ethics Committee of the Children’s Hospital affiliated with the Zhejiang University School of Medicine (Hangzhou, China; approval number: 2024-IRB-0303-P-01). Owing to the retrospective nature of this study and its minimal risk, the need for patient consent was waived."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"},"order":3,"value":"Not applicable."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"},"order":4,"value":"The authors declare no competing interests."}],"deposited":{"date-time":"2025-12-29T16:19:03Z","timestamp":1767025143000,"date-parts":[[2025,12,29]]},"issn-type":[{"type":"electronic","value":"1471-2431"}],"published":{"date-parts":[[2025,12,29]]},"publisher":"Springer Science and Business Media LLC","reference":[{"DOI":"10.1308/rcsann.2024.0058","key":"6362_CR1","year":"2024","issue":null,"author":"S Kılıç","volume":"106","first-page":"718","unstructured":"Kılıç S. Comparison of long-term outcomes of laparoscopic percutaneous internal ring suturing and classic open approach for inguinal hernia repair in children. 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Recurrence was 4/11,386 (0.035%) after LPIRS vs 3/2,811 (0.107%) after open, and LPIRS detected contralateral occult hernia in 5,204/10,127 (49.61%).","limitations":"Retrospective, single-institution design with parental selection of surgical approach and imbalanced groups (age, sex, bilateral hernia rates), risking selection confounding. The recurrence difference was based on very low event counts and was not statistically significant.","practice_takeaway":"A structured day-case pathway for pediatric inguinal hernia can cut hospital time and costs. 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