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Article ; Online: Augmented reality improving intraoperative navigation in minimally invasive liver surgery: an interplay between 3D reconstruction and indocyanine green.

Ratti, Francesca / Serenari, Matteo / Corallino, Diletta / Aldrighetti, Luca

2024

Abstract: Technology have helped surgeons to increase MILS feasibility, so that currently liver surgery evolution is strongly based on technological advances and the same trend is expected even further soon. Aim of the present technical report is to provide ... ...

Abstract	Technology have helped surgeons to increase MILS feasibility, so that currently liver surgery evolution is strongly based on technological advances and the same trend is expected even further soon. Aim of the present technical report is to provide insights regarding the possible interplay between 3D reconstructions based on augmented reality and intraoperative navigation by indocyanine green fluorescence. Augmented reality methods based on reconstructions created through artificial intelligence interact synergistically. The better the understanding of the anatomy and characteristics of the lesion, the more accurate the preoperative planning may be scheduled. On the other hand, the better the intraoperative navigation, the more reproducible the preoperative planning becomes.
Language	English
Publishing date	2024-05-02
Publishing country	Italy
Document type	Journal Article
ZDB-ID	2572692-4
ISSN	2038-3312 ; 2038-131X
ISSN (online)	2038-3312
ISSN	2038-131X
DOI	10.1007/s13304-024-01857-9
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Article ; Online: Robo-Lap Approach Optimizes Intraoperative Outcomes in Robotic Left and Right Hepatectomy.

Ratti, Francesca / Marino, Rebecca / Ingallinella, Sara / Clocchiatti, Lucrezia / Corallino, Diletta / Catena, Marco / Aldrighetti, Luca

JSLS : Journal of the Society of Laparoendoscopic Surgeons

2023 Volume 27, Issue 3

Abstract: Background: The aim of the present study is to evaluate the possible advantages of the Robo-Lap (parenchymal transection by laparoscopic ultrasonic dissector and robotic bipolar forceps and scissors) compared with pure robotic technique (parenchymal ... ...

Abstract	Background: The aim of the present study is to evaluate the possible advantages of the Robo-Lap (parenchymal transection by laparoscopic ultrasonic dissector and robotic bipolar forceps and scissors) compared with pure robotic technique (parenchymal transection by use of robotic bipolar forceps and scissors) in major anatomical liver resections with specific focus on intraoperative outcomes. Methods: Major liver resections performed by robotic approach between February 1, 2021 and March 31, 2023 were stratified into two groups according to the approach used to address the phase of liver transection; Pure Robotic Group (n = 21) versus Robo-Lap Group (n = 48). The two groups were compared in terms of intra- and postoperative outcomes and in terms of rate of achievement of intraoperative textbook outcomes. Results: Conversion rate was similar between the two groups while incidence of adverse intraoperative events (according to Satava classification) was higher in the Pure Robotic compared with the Robo-Lap group (85.7% vs 39.6%, p < 0.001). Time to perform parenchymal transection was significantly shorter in the Robo-Lap group (180 min) compared with the Pure Robotic Group (240 min), p = 0.003. Intraoperative textbook outcomes were achieved in a lower proportion of patients in the Pure Robotic compared with the Robo-Lap group. Conclusion: Outcomes of the present study suggest a favorable role of the Robo-Lap approach in robotic major resections as it allows an improvement of the intraoperative results, a greater probability of an uneventful conduction of the procedure, and therefore, better management of the operating room time.
MeSH term(s)	Humans ; Hepatectomy/methods ; Robotic Surgical Procedures/methods ; Treatment Outcome ; Liver ; Robotics ; Liver Neoplasms/surgery ; Laparoscopy/methods
Language	English
Publishing date	2023-08-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2011211-7
ISSN	1938-3797 ; 1086-8089
ISSN (online)	1938-3797
ISSN	1086-8089
DOI	10.4293/JSLS.2023.00025
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Article ; Online: Long-Term Oncological Results After Laparoscopic Sigmoidectomy for Adenocarcinoma.

Balla, Andrea / Saraceno, Federica / Guida, Anna / Scaramuzzo, Rosa / Corallino, Diletta / Ettorre, Giuseppe Maria / Lepiane, Pasquale

Journal of laparoendoscopic & advanced surgical techniques. Part A

2023 Volume 33, Issue 4, Page(s) 397–403

Abstract: Purpose: ...

Abstract	Purpose:
MeSH term(s)	Humans ; Retrospective Studies ; Laparoscopy/methods ; Colon/surgery ; Postoperative Complications/surgery ; Adenocarcinoma/surgery ; Treatment Outcome ; Colectomy/methods
Language	English
Publishing date	2023-01-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	1381909-4
ISSN	1557-9034 ; 1092-6429
ISSN (online)	1557-9034
ISSN	1092-6429
DOI	10.1089/lap.2022.0565
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Article ; Online: Navigator nurse implementation within a fast track program of liver resections: How to improve the healthcare service and perioperative results.

Fermi, Francesca / Ratti, Francesca / Stepanyan, Perthshanush / Corallino, Diletta / Ingallinella, Sara / Reineke, Raffaella / Beretta, Luigi / Aldrighetti, Luca

World journal of surgery

2023 Volume 48, Issue 1, Page(s) 193–202

Abstract: Background: The introduction into the clinical practice of the navigator nurse (NaNu) to address the task of counseling and short term follow-up help the effective implementation of the fast track protocol. The aim of the present study was to ... ...

Abstract	Background: The introduction into the clinical practice of the navigator nurse (NaNu) to address the task of counseling and short term follow-up help the effective implementation of the fast track protocol. The aim of the present study was to investigate the impact of the standardization of the NaNu's role in patients undergoing liver surgery. Methods: Patients undergoing elective liver surgery for all diagnosis and approach, from 2015, received counseling and postoperative follow-up by NaNu and constituted the study group (n = 890). This group was compared with the control group (n = 712) including patients treated in the era before the implementation of the NaNu role (2011-2014). Outcome was evaluated in terms of discrepancy between functional recovery and discharge, number of ER accesses, number of readmissions. Results: Preoperative characteristics of patients and disease, as well as type of resection and postoperative outcomes were similar between the two groups. The proportion of laparoscopic cases was higher in the study group (51.2% vs. 32% in the control). Time for discharge, interval between functional recovery and discharge, number of ER accesses and number of readmissions were reduced in the study group. Benign diagnosis, absence of complications, laparoscopic approach and presence of NaNu were independent predictors of shorter length of stay. The positive effect of NaNu's activation was recorded in patients with complications and undergoing open surgery. Conclusion: The implementation of NaNu's role has allowed to us optimize the level of healthcare service offered to patients. The wider benefit was offered in the setting of complex patients.
MeSH term(s)	Humans ; Hepatectomy ; Liver ; Body Fluids ; Elective Surgical Procedures ; Delivery of Health Care
Language	English
Publishing date	2023-12-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1002/wjs.12026
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Article ; Online: Correction: Safety of laparoscopic cholecystectomy performed by trainee surgeons with different cholangiographic techniques (SCOTCH): a prospective non-randomized trial on the impact of fluorescent cholangiography during laparoscopic cholecystectomy performed by trainees.

Ortenzi, Monica / Corallino, Diletta / Botteri, Emanuele / Balla, Andrea / Arezzo, Alberto / Sartori, Alberto / Reddavid, Rossella / Montori, Giulia / Guerrieri, Mario / Williams, Sophie / Podda, Mauro

Surgical endoscopy

2024 Volume 38, Issue 2, Page(s) 1116

Language	English
Publishing date	2024-01-17
Publishing country	Germany
Document type	Published Erratum
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-024-10698-x
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Article: Indocyanine Green Fluorescence Angiography During Laparoscopic Bariatric Surgery: A Pilot Study.

Balla, Andrea / Corallino, Diletta / Quaresima, Silvia / Palmieri, Livia / Meoli, Francesca / Cordova Herencia, Ingrid / Paganini, Alessandro M

Frontiers in surgery

2022 Volume 9, Page(s) 906133

Abstract: Aims: Indocyanine green (ICG) fluorescence angiography (FA) is used for several purposes in general surgery, but its use in bariatric surgery is still debated. The objective of the present pilot study is to evaluate the intraoperative utility of ICG-FA ... ...

Abstract	Aims: Indocyanine green (ICG) fluorescence angiography (FA) is used for several purposes in general surgery, but its use in bariatric surgery is still debated. The objective of the present pilot study is to evaluate the intraoperative utility of ICG-FA during bariatric surgery in order to focus future research on a reliable tool to reduce the postoperative leak rate. Methods: Thirteen patients (4 men, 30.8%, 9 women, 69.2%) with median age of 52 years (confidence interval, CI, 95% 46.2-58.7 years) and preoperative median body mass index of 42.6 kg/m Results: Fom January 2021 to February 2022, six patients underwent LSG (46.2%), three patients underwent LGB (23.1%), and four patients underwent re-do LGB after LSG (30.8%). No adverse effects to ICG were observed. In 11 patients (84.6%) ICG-FA score was 5. During two laparoscopic re-do LGB, the vascular supply was not satisfactory (score 2/5) and the surgical strategy was changed based on ICG-FA (15.4%). At a median follow-up of five months postoperatively, leaks did not occur in any case. Conclusions: ICG-FA during bariatric surgery is a safe, feasible and promising procedure. It could help to reduce the ischemic leak rate, even if standardization of the procedure and objective fluorescence quantification are still missing. Further prospective studies with a larger sample of patients are required to draw definitive conclusions.
Language	English
Publishing date	2022-05-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2773823-1
ISSN	2296-875X
ISSN	2296-875X
DOI	10.3389/fsurg.2022.906133
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Article ; Online: One-stage laparoscopic bilateral adrenalectomy, cholecystectomy and choledochotomy by a transperitoneal anterior approach Case report of a combined management for a challenging condition.

Corallino, Diletta / Meoli, Francesca / Palmieri, Livia / Puliani, Giulia / Isidori, Andrea / Paganini, Alessandro M

Annali italiani di chirurgia

2020 Volume 91, Page(s) 314–320

Abstract: Laparoscopic adrenalectomy (LA) is the treatment of choice for management of adrenal tumors. Several approaches are proposed, including the transperitoneal one with patient in lateral or supine position, and the retroperitoneal one, with patient in ... ...

Abstract	Laparoscopic adrenalectomy (LA) is the treatment of choice for management of adrenal tumors. Several approaches are proposed, including the transperitoneal one with patient in lateral or supine position, and the retroperitoneal one, with patient in lateral or prone position. The best approach, however, has yet to be defined. In patients with gallstones and common bile duct (CBD) stones, available options are one-stage [including laparoscopic cholecystectomy (LC) with CBD exploration (LC-LCBDE) and LC with endoscopic rendez-vous (LC-ERV)], or two-stage management [LC and pre or postoperative Endoscopic-Retrograde-Cholangio-Pancreatography (ERCP) with endoscopic sphincterotomy (ES)]. Both are safe and effective, with lower hospital stay after one-stage option. The decision for one or the other depends on local resources and patient conditions. We report the case of a hypertensive 53-years-old man with Cushing's disease from pituitary ACTH-secreting adenoma, after three failed trans-sphenoidal pituitary gland surgical resection procedures, and recurrent biliary symptoms from gallstones and CBD stones. The patient underwent laparoscopic transperitoneal bilateral adrenalectomy in supine position (anterior approach on the right, submesocolic approach on the left) together with LC, intraoperative cholangiography, choledochotomy, CBD exploration, T-tube drainage. In this challenging case, laparoscopic transperitoneal bilateral adrenalectomy with patient in supine position together with one-stage laparoscopic management of gallstones and CBD stones, offered the patient the opportunity to solve both adrenal and biliary problems in the same session, reducing hospital stay and costs. In experienced hands, the transperitoneal combination of different surgical approaches during the same anesthesia with patient in supine position may provide safe and effective patient management. KEY WORDS: Bilateral adrenalectomy, Laparoscopic adrenalectomy (LA), Choledochotomy, Common bile duct (CBD) stones, Laparoscopic cholecystectomy (LC) Laparoscopic common bile duct exploration (LCBDE), Submesocolic approach, Transperitoneal anterior approach.
MeSH term(s)	Adrenal Gland Neoplasms/surgery ; Adrenalectomy ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy, Laparoscopic ; Humans ; Male ; Middle Aged ; Sphincterotomy, Endoscopic ; Supine Position
Language	English
Publishing date	2020-09-02
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article ; Online: Endo-SPONGE pulley system for the treatment of chronic anastomotic leakage after rectal resection. A case report.

Palmieri, Livia / Corallino, Diletta / Herencia, Ingrid E C / Meoli, Francesca / Paganini, Alessandro M

Annali italiani di chirurgia

2020 Volume 91, Page(s) 538–543

Abstract: Aim: Anastomotic leakage (AL) after anterior rectal resection unresponsive to diverting ileostomy is difficult to manage. Endoscopic vacuum-assisted (E-VAC) wound closure system is a new approach based on co-axial sponge positioning under endoscopic ... ...

Abstract	Aim: Anastomotic leakage (AL) after anterior rectal resection unresponsive to diverting ileostomy is difficult to manage. Endoscopic vacuum-assisted (E-VAC) wound closure system is a new approach based on co-axial sponge positioning under endoscopic control. If the abscess is not co-axial, however, endoscopic positioning is not feasible. Aim is to report an original method of sponge positioning. Case experience: A 62-year-old woman with chronic AL after anterior rectal resection for cancer was referred. AL had been treated with diverting ileostomy without healing. Due to the peri-rectal abscess anatomy, standard E-VAC positioning was not possible. A combined endoscopic-interventional radiology procedure for Endo-SPONGE® (B. Braun Aesculap AG, Germany) positioning was thus employed. Under general anesthesia, a guidewire was passed after small counter-incision on the left gluteus and through the left levator muscle, reaching the anastomotic dehiscence and rectal lumen through the chronic abscess. The guidewire was retrieved through the anus and connected to a long silk thread. By retracting the trans-gluteal guidewire, the silk thread was pulled through the abscess to exit from the gluteal skin incision. A tailored Endo-SPONGE® was then connected to the trans-anal silk thread. By pulling on the gluteal silk thread, the sponge was positioned inside the abscess. The silk thread remained in place under a medication for sponge replacements. Discussion and results: Twelve Endo-SPONGE replacements under sedation were required until AL completely resolved after 35 days. Conclusion: When traditional endoscopic sponge insertion into AL is not possible, this original "pulley system" proved effective for sponge introduction and replacement. Key words: Anastomotic leakage (AL), Anterior rectal resection, Endo-SPONGE, Endoscopic-Interventional radiology, Pulley system.
MeSH term(s)	Anastomosis, Surgical/instrumentation ; Anastomotic Leak/etiology ; Anastomotic Leak/surgery ; Female ; Humans ; Ileostomy ; Middle Aged ; Proctectomy/adverse effects ; Rectal Neoplasms/surgery ; Rectum/surgery
Language	English
Publishing date	2020-11-30
Publishing country	Italy
Document type	Case Reports ; Journal Article
ZDB-ID	418927-9
ISSN	2239-253X ; 0003-469X
ISSN (online)	2239-253X
ISSN	0003-469X
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Article ; Online: Safety of laparoscopic cholecystectomy performed by trainee surgeons with different cholangiographic techniques (SCOTCH): a prospective non-randomized trial on the impact of fluorescent cholangiography during laparoscopic cholecystectomy performed by trainees.

Surgical endoscopy

2023 Volume 38, Issue 2, Page(s) 1045–1058

Abstract: Aims: The identification of the anatomical components of the Calot's Triangle during laparoscopic cholecystectomy (LC) might be challenging and its difficulty may increase when a surgical trainee (ST) is in charge, ultimately allegedly affecting also ... ...

Abstract	Aims: The identification of the anatomical components of the Calot's Triangle during laparoscopic cholecystectomy (LC) might be challenging and its difficulty may increase when a surgical trainee (ST) is in charge, ultimately allegedly affecting also the incidence of common bile duct injuries (CBDIs). There are various methods to help reach the critical view of safety (CVS): intraoperative cholangiogram (IOC), critical view of safety in white light (CVS-WL) and near-infrared fluorescent cholangiography (NIRF-C). The primary objective was to compare the use of these techniques to obtain the CVS during elective LC performed by ST. Methods: This was a multicentre prospective observational study (Clinicalstrials.gov Registration number: NCT04863482). The impact of three different visualization techniques (IOC, CVS-WL, NIRF-C) on LC was analyzed. Operative time and time to achieve the CVS were considered. All the participating surgeons were also required to fill in three questionnaires at the end of the operation focusing on anatomical identification of the general task and their satisfaction. Results: Twenty-nine centers participated for a total of 338 patients: 260 CVS-WL, 10 IOC and 68 NIRF-C groups. The groups did not differ in the baseline characteristics. CVS was considered achieved in all the included case. Rates were statistically higher in the NIR-C group for common hepatic and common bile duct visualization (p = 0.046; p < 0.005, respectively). There were no statistically significant differences in operative time (p = 0.089) nor in the time to achieve the CVS (p = 0.626). Three biliary duct injuries were reported: 2 in the CVS-WL and 1 in the NIR-C. Surgical workload scores were statistically lower in every domain in the NIR-C group. Subjective satisfaction was higher in the NIR-C group. There were no other statistically significant differences. Conclusions: These data showed that using NIRF-C did not prolong operative time but positively influenced the surgeon's satisfaction of the performance of LC.
MeSH term(s)	Humans ; Cholecystectomy, Laparoscopic/methods ; Prospective Studies ; Cholangiography/methods ; Coloring Agents ; Bile Duct Diseases ; Surgeons
Chemical Substances	Coloring Agents
Language	English
Publishing date	2023-12-22
Publishing country	Germany
Document type	Observational Study ; Multicenter Study ; Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-023-10613-w
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Article ; Online: Author's Reply: Are Adrenal Lesions of 6 cm or more in Diameter a Contraindication to Laparoscopic Adrenalectomy? A Case Control Study.

Balla, Andrea / Palmieri, Livia / Meoli, Francesca / Corallino, Diletta / Ortenzi, Monica / Ursi, Pietro / Guerrieri, Mario / Quaresima, Silvia / Paganini, Alessandro M

World journal of surgery

2021 Volume 45, Issue 7, Page(s) 2303–2304

MeSH term(s)	Adrenal Gland Neoplasms/surgery ; Adrenalectomy ; Case-Control Studies ; Contraindications ; Humans ; Laparoscopy
Language	English
Publishing date	2021-04-12
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	224043-9
ISSN	1432-2323 ; 0364-2313
ISSN (online)	1432-2323
ISSN	0364-2313
DOI	10.1007/s00268-021-06113-4
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