Ismail Ahmet Bilgin

Aim: This study compared short‐ and long‐term outcomes of robotic and laparoscopic low anterior resection (LAR) for rectal adenocarcinoma using sex‐stratified analyses. Methods: Patients who underwent elective robotic or laparoscopic LAR for rectal cancer were included. Prospectively maintained database of outcomes was analysed retrospectively. To minimise selection bias, groups were matched. Results: Of 409 identified patients, 380 met the eligibility criteria (mean age: 61 years, BMI: 26.2 kg/m ² ). In a matched cohort of males ( n = 172) and females ( n = 114), robotic surgery was associated with significantly shorter hospital stay ( p < 0.01). Harvested lymph nodes, margins, morbidity and local recurrence were comparable in males ( p > 0.05). Robotic surgery in females was associated with fewer harvested lymph nodes ( p = 0.01). Five‐year disease‐specific survival rates did not significantly differ between approaches in either gender. Conclusions: Robotics and laparoscopic LAR achieved similar oncologic outcomes. The findings should be interpreted as sex‐stratified comparisons rather than evidence of differential effect of surgical approach according to sex.

Background: This study investigated the impact of previous abdominal surgery (PAS) on short‐term outcomes in robotic resection for colorectal cancer. Methods: 517 patients with colon or rectal cancer undergoing robotic resection between 2014 and 2024 were categorised into the no‐PAS ( n = 359) and PAS ( n = 158) groups with further subdivision into minor and major PAS. Thirty‐day outcomes and pathologic findings were compared. Results: No significant differences existed between the PAS and no‐PAS groups regarding preoperative characteristics. The rates of conversions (0.6% vs. 1.1%), intraoperative complications (2.5% vs. 2.2%), mean number of nodal harvest (32.5 ± 17.4 vs. 32.5 ± 17.1), and surgical margin positivity (2.5% vs. 0.6%) were similar. The minor PAS subgroup demonstrated a higher rate of surgical margin positivity (3.2% vs. 0%, p = 0.04). Conclusions: The results of this study suggest that robotic colorectal cancer surgery can be performed with similar short‐term outcomes and comparable oncologic resection quality in patients with PAS.

The ergonomic impact of robotic vs. laparoscopic surgery on operating room nurses: A multicenter survey analysis - Turkish Journal of Surgery

Aim: Pilonidal sinus disease (PSD) primarily affects young adults; rapid recovery is essential and yet lacks a standardized treatment approach. While excisional techniques delay recovery, minimally invasive options like laser ablation and phenol application are gaining interest, yet comparative long‐term evidence is scarce. This study compared short‐ and long‐term outcomes of laser versus phenol treatment in PSD. Method: In this multicentre retrospective cohort study (Nov. 2017–Sep. 2024), patients treated with laser or phenol were included. 1:3 propensity score matching using the nearest neighbour algorithm was performed based on age, gender, prior surgical history and year of operation. Categorical variables were analysed using chi‐squared or Fisher's exact tests, whereas continuous variables were compared using Student's t ‐test or Mann–Whitney U test depending on distribution normality. Results: Out of 897 eligible patients, 644 were included (median age: 26 years, body mass index [BMI]: 26.2 kg/m ² , male‐to‐female ratio: 4:1). The number of sinuses/pits was 2–3 in both groups. Operating time was significantly longer in the laser group. Complications occurred in 6.8% of laser patients, whereas none were reported in the phenol group. Pain scores were higher in the laser group (2 [1–3] vs. 1 [0–2]). Median follow‐up was 45 months (laser) and 40 months (phenol). Return to daily activities was delayed in the laser group, whereas complete healing was slower in the phenol group. Readmission, recurrence and recovery rates were comparable (85%–86%). Conclusion: Both treatments demonstrated low complication and recurrence rates with high recovery rates. Laser favoured faster healing and fewer sessions, whereas phenol allowed for shorter procedures and earlier return to daily life.

Introduction: Although laparoscopic total extraperitoneal (TEP) procedure has gained wide acceptance for inguinal hernia repair, there is still debate on the optimal technique in patients with a history of previous radical prostatectomy (RP). We aimed to evaluate the feasibility and safety of laparoscopic TEP in patients with a previous history of RP using a propensity score case-match analysis. Methods: This study included male patients undergoing laparoscopic TEP repair between 2013 and 2024. According to the RP status, patients were case-matched based on age, BMI, ASA score, site of hernia and the year of surgery. A total of 162 patients were matched in a 1:5 ratio. The RP and non-RP groups were compared with respect to perioperative outcomes. Results: The RP and non-RP group included 27 and 135 patients, respectively. The rate ofconversion to transabdominal preperitoneal repair (11.1%) or open surgery (14.8%) was significantly higher in the RP group (p<0.001). The RP group had longer operative times (160±57 vs. 94±38, p0.05). Conclusion: Laparoscopic TEP inguinal hernia repair in patients with a history of RP is feasible and safe with a similar morbidity profile but an increased conversion rate and operative time compared to those with no history of RP.

Endometriosis is an estrogen-dependent benign disease that generally affects women at childbearing age. Despite its high incidence, pathogenesis of endometriosis is poorly clarified. There are several theories explaining the mechanism of disease such as retrograde menstruation, coelomic metaplasia, vascular and lymphatic metastasis. While endometriosis has been described in many intra- and extra-abdominal organs including the ovaries, omentum, colon, liver, lungs and brain, parenchymal splenic endometriosis is a rare situation. In recent years, with reported cases, this rare condition came onto the scene. We also wanted to present our case and question the idea of splenic immunity against endometriosis according to current literature. From now on, splenic endometriosis can be thought of as a differential diagnosis for unidentified lesions of spleen.

Evisceration of the small intestine from a perforated rectum is a rare condition, particularly seen in elderly women. We present a case involving an 83-year-old woman with a history of chronic rectal prolapse and no other comorbidities. The patient declined surgical intervention for her rectal prolapse, and one month later, she presented with evisceration of the small intestine from the anus. The intervention was a laparotomy followed by Hartmann's procedure, which is the most recommended procedure. No small bowel resection was necessary. Although the management of this case was adequate and timely, the patient did not survive. This case underscores that elective repair of rectal prolapse might prevent this very rare but potentially fatal complication of transanal small intestinal evisceration.

Purpose Nowadays, surgical treatment of pilonidal sinus disease (PSD) with novel techniques is a topic of interest since conventional methods are associated with longer return to daily life and higher complication and recurrence rates. Recently, use of laser as a minimally invasive approach has become popular in the surgical treatment of PSD. In this study, we analyze the short- and mid-term results after laser treatment and the effect of endoscopic camera use on outcomes. Methods A total of 106 patients with PSD who underwent laser treatment between November 2017 and September 2021 were included in this study. All patients were treated with a 1470-nm diode laser. Endoscopic camera was used in 73 patients and results of these were compared with those in whom camera was not used. Follow-up period was determined as a minimum of 1 year. Data were analyzed retrospectively. Results There were 80 (75%) male and 26 female patients. The median age was 26 (range 13–50) years. On the first postoperative day, 26 (26.5%) patients did not have any pain and 42(42.8%) patients reported low-grade pain. The mean time to return to daily life was 4.5 ± 5.5 (median 2, range 1–30) days. The complication rate was 10.4%. Eighty-six (87.8%) patients completely recovered and the mean complete recovery time was 27.4 ± 15.9 days. The patient satisfaction rate was 99.0%. The recurrence rate was 11.0%. Neither history of previous surgery nor abscess was associated with recurrence. Use of an endoscopic camera had no effect on postoperative pain, complete recovery, complications, patient satisfaction, and recurrence (p < 0.05). Conclusion Laser treatment for PSD is a promising approach with the advantages of less postoperative pain, early return to daily life, high patient satisfaction, and acceptable complication and recurrence rates. Nevertheless, further studies are needed to investigate the role of endoscopic camera use in this procedure since its possible advantages could not be clarified.

Background: This study aimed to compare short‐ and long‐term outcomes after robotic versus laparoscopic approach in patients undergoing curative surgery for rectal cancer.Methods: Patients undergoing elective robotic and laparoscopic resection for rectal cancer were included. Perioperative clinical characteristics, postoperative short‐ and long‐term outcomes were compared between groups.Results: There were 72 and 44 patients in robotic (RG) and laparoscopic (LG) groups respectively. No differences were detected regarding patients' demographics, histopathologic outcomes, conversion rates and 30‐day overall postoperative complication rates. Operative time was longer in the RG (341 ± 111.7 vs. 263 ± 97.5 min, p = 0.001) and length of stay was longer in the LG (4.4 ± 1.9 vs. 6.4 ± 2.9 days, p = 0.001). The 5‐year overall and disease‐free survival rates were similar (97.1% and 94.9%, p = 0.78; 86.2% and 82.7%, p = 0.72) between the groups.Conclusion: This study showed both short and long‐term outcomes of a limited number of included patients between the robotic and laparoscopic surgery were similar. However, future studies and randomized trials are necessary to establish these findings.