Laparoscopic-assisted Surgery Research Articles

Short-term outcomes of robotic-assisted versus conventional laparoscopic-assisted surgery for rectal cancer: a propensity score-matched analysis.

It remains controversial whether the advantages of robotic-assisted surgery are beneficial for rectal cancer (RC). The study aimed to evaluate the short-term outcomes of robotic-assisted rectal surgery (RARS) compared with those of conventional laparoscopic-assisted rectal surgery. We retrospectively analyzed 539 consecutive patients with stage I-IV RC who had undergone elective surgery between January 2010 and December 2020, using propensity score-matched analysis. After propensity score matching, we enrolled 200 patients (n = 100 in each groups). Before matching, significant group-dependent differences were observed in terms of age (p = 0.04) and body mass index (p < 0.01). After matching, clinicopathologic outcomes were similar between the groups, but estimated operative time was longer and postoperative lymphorrhea was more frequent in the RARS group. Estimated blood loss, rate of conversion to laparotomy, and incidence of anastomotic leakage or reoperation were significantly lower in the RARS group. No surgical mortality was observed in either group. No significant differences were observed in terms of positive resection margins or number of lymph nodes harvested. RARS was safe and technically feasible, and achieved acceptable short-term outcomes. The robotic technique showed some advantages in RC surgery that require validation in further studies.

Does Additional Laparoscopic-Assisted Surgery after Endoscopic Submucosal Dissection Affect Short Outcomes in Patients with Stage T1 Colorectal Cancer? A Propensity Score-Based Analysis

Background: Additional surgery is necessary in cases with non-curative endoscopic submucosal dissection. It is still unknown whether preceding endoscopic submucosal dissection (ESD) for T1 colorectal carcinoma affects the short outcomes of patients who underwent additional surgery or not as compared with surgery alone without ESD. Methods: Patients (101 pairs) with T1 colorectal cancer who underwent additional laparoscopic-assisted surgery after endoscopic submucosal dissection (additional surgery group, n = 101) or laparoscopic-assisted surgery alone (surgery alone group, n = 101) were matched (1:1). Short-term morbidity, operation outcomes, and lymph node metastasis of the resected specimen were compared. Results: There were no significant differences between the additional laparoscopic-assisted surgery and laparoscopic-assisted surgery alone groups in lymph node metastasis (9.9 vs. 5.9%, respectively, p = 0.297), operative time (147.76 ± 52.00 min vs. 156.50 ± 54.28 min, p = 0.205), first flatus time (3.56 ± 1.10 days vs. 3.63 ± 1.05 days, p = 0.282), first stool time (4.30 ± 1.04 days vs. 4.39 ± 1.22 days, p = 0.293), time to intake (5.00 ± 1.18 days vs. 5.25 ± 1.39 days, p = 0.079), blood loss (44.75 ± 45.40 mL vs. 60.40 ± 78.98 mL, p = 0.603), harvest lymph nodes (18.74 ± 7.22 vs. 20.32 ± 9.69, p = 0.438), postoperative surgical complications (p = 0.733), and postoperative length of hospital stay (8.68 ± 4.00 days vs. 8.39 ± 1.94 days, p = 0.401). Conclusion: ESD did not increase the difficulty of additional laparoscopic-assisted surgery, hospital stay, or the incidence of postoperative complications. Additional laparoscopic-assisted surgery is safe and recommended for patients with T1 cancer at high risk of lymph node metastasis and residual cancer after non-curative ESD.

Diagnostic and Therapeutic Laparoscopy for Abdominal Trauma: A Single Surgeon’s Experience at a Level I Trauma Center

PurposeLaparoscopy has various advantages over laparotomy in terms of postoperative recovery. The number of surgeons using laparoscopy as a diagnostic and therapeutic tool in abdominal trauma patients is increasing, whereas open conversion is becoming less common. This report summarizes a single surgeon’s experience of laparoscopy at a level I trauma center and evaluates the feasibility of laparoscopy as a diagnostic and therapeutic tool for abdominal trauma patients. MethodsIn total, 30 abdominal trauma patients underwent laparoscopy by a single surgeon from October 2014 to May 2020. The purpose of laparoscopy was categorized as diagnostic or therapeutic. Patients were classified into three groups by type of surgery: total laparoscopic surgery (TLS), laparoscopy-assisted surgery (LAS), or open conversion (OC). Univariate analysis was performed to determine the advantages and disadvantages. ResultsThe mechanism of injury was blunt in 19 (63.3%) and penetrating in 11 patients (36.7%). Eleven (36.7%) and 19 patients (63.3%) underwent diagnostic and therapeutic laparoscopy, respectively. The hospital stay was shorter for patients who underwent diagnostic laparoscopy than for those who underwent therapeutic laparoscopy (5.0 days vs. 13.0 days), but no other surgical outcomes differed between the groups. TLS, LAS, and OC were performed in 12 (52.2%), eight (34.8%), and three patients (13.0%), respectively. There was no significant difference in morbidity and mortality among the three groups. ConclusionsLaparoscopic surgery for selected cases of abdominal trauma may be feasible and safe as a diagnostic and therapeutic tool in hemodynamically stable patients due to the low OC rate and the absence of fatal morbidity and mortality.

Laparoscopic-assisted disinvagination and polypectomy for multiple intussusceptions induced by small intestinal polyps in patients with Peutz-Jeghers syndrome: a case report

BackgroundPeutz–Jeghers syndrome (PJS) is a very rare autosomal dominant genetic disorder characterized by hamartomatous polyps in the gastrointestinal tract and hyperpigmentation of the lips, hands, and feet. The hamartomatous polyps in the small intestine often cause intussusception and bleeding.Case presentationA 62-year-old male was hospitalized for treatment of deep vein thrombosis and pulmonary embolism. In the small intestine, computed tomography showed three small polyps with intussusceptions. Since the patient had gastrointestinal polyposis and pigmentation of his lips, fingers, and toes, he was diagnosed with PJS. After an inferior vena cava filter was placed, he underwent laparoscopic-assisted surgery. The polyps causing intussusception were resected as far as possible without intestinal resection, since they had caused progressive anemia and might cause intestinal obstruction in the future. The patient was discharged from the hospital on postoperative day 9 without complications.ConclusionsLaparoscopic-assisted disinvagination and polypectomy is a useful, minimally invasive treatment for multiple intussusceptions caused by small intestinal polyps in patients with PJS.

Clinical Characteristics, Ultrasonographic Findings, and Treatment of Pediatric Transverse Testicular Ectopia: A 10-Year Retrospective Review

To evaluate the clinical data, ultrasonic features, treatment, and long-term outcome of transverse testicular ectopia (TTE) in children. Children with TTE were enrolled in the study between November 2009 and August 2019 in Shenzhen Children's Hospital in China. Clinical information, including demographiccharacteristics, clinical manifestations, TTE-associated anomalies, ultrasonographic findings, and surgical procedures, were collected from all patients. Patients were re-evaluated at the end of 4 weeks and 6 months after the operation. A total of 16 cases were enrolled and underwent surgeries, all patients had undescended testis with contralateral inguinal hernia. The ultrasonic findings showed two testicles in 15 cases and no testes in 1 case. Müllerian ducts remnants were found by laparoscopy in 6 cases or by ultrasound in one case. Sixteen cases were treated with laparoscopy orchidopexy or laparoscopy assisted trans-septal orchidopexy-inguinal exploration. After surgery, 16 patients had both testicles in an orthotopic position and with equal size, with normal blood flow. TTE should be suspected in patients with nonpalpable undescended testis and contralateral inguinal hernia. The contralateral processus vaginalis sac occurs in all cases of TTE. Ultrasonography is essential for an early diagnosis of TTE. Laparoscopy-assisted surgery is safe, effective, and minimally invasive therapy for TTE.

Usefulness of laparoscopic surgery and preoperative examinations for chronic recurrent small bowel obstruction.

The aim of this study was to investigate the usefulness of laparoscopic surgery for patients with postoperative abdominal symptoms, including chronic recurrent small-bowel obstruction (SBO), and preoperative examinations of barium follow-through and computed tomography (CT) to predict the postoperative outcomes of laparoscopic surgery. Between 2016 and 2018, 49 patients with postoperative symptoms were treated by laparoscopic surgery at our institute. The data from two preoperative examinations were available for 42 patients. The patients were divided into 4 groups: CT-positive (CP, n = 18), barium follow-through-positive (BP, n = 1), both positive (AP [all positive] n = 13), and both negative (AN [all negative], n = 10). Among the 49 patients, 41 received pure laparoscopic surgery, 7 received laparoscopic-assisted surgery with mini-laparotomy, and 1 required conversion. Intra- and postoperative complications occurred in two and seven patients, respectively. Improvement of abdominal symptoms was observed in 40 patients. In terms of the medium-term outcomes, the rate of improvement of symptoms was poorer in the AN group than in the other three groups, but not to a significant degree. Laparoscopic surgery was safe and feasible for patients with chronic recurrent abdominal symptoms, including SBO. Furthermore, in patients with negative results on both preoperative examinations, laparoscopic surgery may yield only poor improvement of symptoms.

A Case of Retroperitoneal Pseudocyst Resected by Laparoscopic-assisted Surgery

A Case of Retroperitoneal Pseudocyst Resected by Laparoscopic-assisted Surgery

Total laparoscopic left hemicolectomy with preservation of inferior mesenteric artery and vein combined with natural orifice specimen extraction

Introduction: For left side colon cancer surgery, the roots of the inferior mesenteric artery and vein (IMA/IMV) are generally cut to perform the D3 lymph node dissection. In these cases, the extended resection of the colon would be required owing to the poor blood supply of the colon. In order to reduce the risk of distal bowel ischaemia and anastomosis leakage and preserve more normal sigmoid colon function, we aimed to introduce an innovative method to preserve the IMA/IMV and present its efficacy and safety. Materials and Methods: From January to February in 2019, two advanced colonic splenic flexure cancer (CSFC) patients received total laparoscopic left hemicolectomy with preservation of IMA/IMV combined with natural orifice specimen extraction surgery. The surgery followed the D3 lymph node dissection principle. Results: Two patients underwent a total laparoscopic surgery and no cases were converted to open or laparoscopic-assisted surgery. The mean time of operation was 148 min and mean blood loss was 50 ml. The harvested lymph nodes were 17 and 39 respective and the length of normal bowel both proximal and distal to the tumor more than 10 cm. The mean time of post-operative hospitalisation was 6 days. There were no cases of intra-or post-operative morbidity, or of bleeding owing to vessel injury. Conclusion: It is an efficient and safe technique to treat CSFC in a setting of surgeons experienced in laparoscopic colorectal surgery.

A Case of Sigmoid Colon Perforation by a Toothpick Treated by Laparoscopic-Assisted Surgery

A Case of Sigmoid Colon Perforation by a Toothpick Treated by Laparoscopic-Assisted Surgery

A brief review on technological evolution of vascular microcatheter design

Abstract Technological advances have revolutionized the healthcare in the last few decades. Recent methods of treatment focus on minimal invasive techniques like laparoscopic or robotic assisted surgery etc. Endovascular treatment is one such minimal invasive method carried inside blood vessel using small flexible tubes called microcatheter. Many types of procedures like opening of a blocked artery (angioplasty) blocking a bleeding artery (embolization), treating abnormally developed blood vessel (AVM) is carried out using microcatheter. To meet these various needs, the micro catheter’s design has been modified from a simple tube to complex structure. The ideal microcatheter should be strong, flexible, trackable and steerable. The existing design is not able meet all the characteristics. Recently emphasis is given on catheter design for better maneuverability. Indigenous research and improvised designs are contemplated by some great minds working unanimously around the world. The review deals with the implementation of micro sensing devices to control the bending characteristics in the microcatheter for an efficacious passage in the tortuous vasculature. Actuators like-polymer conducting layers, pressure sensors, CMOS circuits etc. are used to perceive an exceptional control method for precise bending of the layers. Artificial Intelligence (AI) and deep learning techniques are some potential techniques that can be used for optimized results and accurate control methods.

Update on transumbilical laparoscopic-assisted surgery in infants and neonates.

Background:Because of the restricted space of the peritoneal cavity and the easy mobility of abdominal and pelvic organs in infants and neonates, the boundary of minimally invasive surgery was extended to complete the operation outside the abdomen. The objective of this study was to report our experience with transumbilical laparoscopic-assisted surgery (TULS) in different abdominal pathologies in infants and neonates.Patients and Methods:A retrospective study was conducted on 59 patients who underwent TULS from 2014 to 2020. The study outcomes were the conversion to open approach, length of hospital stay and post-operative complications.Results:The most common indications were explorations for intra-abdominal testes (n = 15) and inguinal herniorrhaphy (n = 13). Patients who had surgery for pyloric stenosis were younger (1.03 ± 0.25 months). The average operative time was 45.9 ± 18.39 min. The longest operative time was reported with surgery for liver cysts (94.5 ± 10.6 min). Oral intake was started after 48–56 h in patients who had excision of duplication cysts. The average post-operative hospital stay was 2.6 ± 1.52 days. No major complications were reported. Wound infection occurred in one patient with a duplication cyst. Three patients were converted to open repair (5.1%) and no late complications were reported during the mean follow-up time of 11.2 ± 5.1 months.Conclusions:The transumbilical approach is a safe alternative method to laparotomy in several abdominal pathologies in infants and neonates. It has a short operative time and hospital stay. The technique is associated with few complications and conversion rates.

The Safety and Learning Curve of Laparoscopic-assisted Surgery for Major Hepatectomy: A Single-center Experience

The Safety and Learning Curve of Laparoscopic-assisted Surgery for Major Hepatectomy: A Single-center Experience

'Ball valve' small bowel obstruction caused by a large caecal faecolith.

Small bowel obstruction is a common surgical presentation, but intestinal faecoliths are rarely reported as a cause. A 75-year-old woman presented with small bowel obstruction from a large faecolith lodged in the caecum. This required removal at laparoscopy-assisted surgery. This case highlights the need to deal promptly with symptomatic intestinal faecoliths as they are unlikely to pass spontaneously and are prone to cause acute obstruction.

Robotic Assisted Laparoscopic Tubal Anastomosis: Single Institution Analysis

Study Objective To study operative time and cost of robotic assisted laparoscopic tubal anastomosis beyond the learning curve. Secondary objective was to assess pregnancy rate. Design Retrospective Cohort Study. Setting University-affiliated hospital. Patients or Participants All patients who underwent robotic assisted laparoscopic tubal anastomosis from April 2013 to December 2018, performed by a single surgeon at a university-affiliated hospital. Interventions Robotic assisted laparoscopic tubal anastomosis surgery. Measurements and Main Results 109 patients were identified who underwent robotic tubal reversal. Retrospective analysis of EMR was performed. Phone survey was conducted. Operative times were evaluated for 106 cases. Age ranged from 27 to 46 (median 36 ± 4.7), BMI ranged from 18 to 47 (median 29 ± 5.8). Previous ligations included excisional (63%), cautery (13%), and mechanical obstruction (24%). 60% of patients had previous laparotomy. Mean operative time decreased with experience. In 2013, the average operative time was 140.7 ± 27.0 minutes. Average operative time in 2018 was 60.0 ± 9.1 minutes. Downward trend in operative time was highly significant (p The average cost of the surgery was $7,153.46 ± $1,484.41. Direct cost was $4798.25. Follow up information regarding pregnancy outcome was available in 59 patients. Mean follow up time was 37.5 months. 36 patients conceived spontaneously and 23 had not conceived (61%). 75% of patients under 37 became pregnant (n=24), whereas the pregnancy rate was 44% and 45% in the age groups 37-39 (n=7) and >40 years (n=5) respectively. Conclusion There is significant improvement in operative time for robotic assisted tubal anastomosis over time. The operative time of robotic assisted tubal anastomosis beyond the learning curve compares favorably, and may even surpass that of the laparoscopic approach, in our experience. Additionally, this is a cost-effective procedure in our institution when compared to laparoscopic approach.

Most Adult Intussusceptions are Caused by Tumors: A Single-Centre Analysis.

BackgroundAdult intussusception is less common than paediatric intussusception. The aim of this study was to explore the clinical presentation, aetiology, diagnosis and treatment of adult intussusception.MethodsAdults (>18 years) with intussusception treated by surgical or conservative measures were included from January 2005 to January 2018, and the manifestation, types, diagnosis and treatment of adult intussusception in our centre were reviewed.ResultsA total of 150 patients with adult intussusception were included in this study. The clinical manifestations included 111 cases (74%) of abdominal pain, 38 cases (25.3%) of bloody stool, 37 cases (24.7%) of bowel obstructions, 33 cases (22%) of abdominal distension, 29 cases (19.3%) of nausea and vomiting, 19 cases (12.7%) of an abdominal mass, and 12 cases (8.0%) of diarrhoea. The types of intussusception were classified into 36 cases (24%) of enteric intussusception, 87 cases (58%) of intestine-colon intussusception and 27 cases (18%) of colonic intussusception. Surgical intervention was applied in 139 cases (92.7%), including 115 patients who underwent open surgery, and laparoscopy-assisted surgery was performed in 24 patients. The main pathogenesis of intussusception was malignant tumors in 51 cases (36.7%) and benign tumors and polyps in 49 cases (35.3%).ConclusionMalignant and benign tumors are the main causes of adult intussusception. Abdominal CT is the preferred evaluation method for the preoperative diagnosis of this condition. The choice of surgical procedure depends on the location and type of intussusception.

Outcomes in robotic versus laparoscopic-assisted choledochal cyst excision and hepaticojejunostomy in children.

Robotic-assisted surgery (RAS) is becoming more popular because of the excellent performance in anastomosis and knot tying, especially in complex surgical procedures such as hepaticojejunostomy. As for operative time and costs, laparoscopic-assisted surgery (LAS) seem to be more advantageous. To date, there are only limited studies focusing on the comparison between RAS and LAS. This study aims to investigate differences in intraoperative and postoperative outcomes between robotic and laparoscopic approaches. We performed a retrospective case-control study of 140 patients operated via mini-invasive approaches for choledochal cyst (CC) excision and hepaticojejunostomy at the Wuhan Union Hospital from Jun 2014 to Dec 2019. A multivariable logistic regression model for odds to having complications was built. The two groups were similar in age, sex, follow-up time, and Todani modification of the Alonso-Lej classification distribution. Patients undergoing RAS had longer overall operative time, shorter cyst excision time, shorter hepaticojejunostomy time, less estimated blood loss, a smaller postoperative high fever rate, shorter postoperative LOS, and a lower postoperative complication rate. Moreover, the intraoperative anatomy structures were more explicit in group RAS, such as the exposure of left or right hepatic duct opening and intrapancreatic bile duct. Multivariable logistic regression showed that longer hepaticojejunostomy time was the only risk factor of postoperative complications. Robotic-assisted CC excision and hepaticojejunostomy was associated with better intraoperative and short-term postoperative outcomes when compared to laparoscopic-assisted surgery.

Jejuno-ileal atresia: evaluation of the efficacy of laparoscopic approach

Jejuno-ileal atresia is a main cause of neonatal intestinal obstructions, and minimal access technique is gaining popularity. Aim of this study was to perform systematic review of laparoscopic approach with regards its management efficacy. Pubmed® was searched using terms ‘jejunal’, ‘jejuno-intestinal atresia’, ‘laparoscopic’ or ‘laparoscopic-assisted’. Data collected included gender, age, weight, comorbidities, surgical technique, duration of surgery, complications, reoperation, mortality, parenteral feeding time. 5 articles (2004–2020) met the inclusion criteria with 63 neonates. Mean weight was 2.6 kg. There were n = 16 comorbidities: cardiac anomalies (n = 5), Meckel’s diverticulum (n = 2), meconium peritonitis (n = 4), unknown (n = 5). All patients had laparoscopic-assisted surgery, out of which n = 25 were single-port approach. Conversion was reported in n = 4 cases due to meconium ileus (n = 2), or significantly dilated bowel (n = 2). There were n = 7 complications (n = 1 sepsis, n = 2 anastomotic leaks, n = 1 cholestasis, n = 3 adhesive ileus). Two reoperations were necessary because of anastomotic dehiscence (n = 1) and adhesive ileus (n = 1). Mean parenteral feeding time was 13 days. There were three lethal outcomes, due to sepsis after anastomotic leak (n = 1), severe cardiac defect (n = 1), pneumonia and adhesive ileus (n = 1). Laparoscopic-assisted is opted for jejuno-ileal atresia when minimal access approach is preferred. It is fast and feasible technique, which offers better cosmesis, may result shorter length of operation and recovery. There is > 10% complication rate, which rarely require reoperation. Limitation of this approach are low weight babies with associated anomalies, or significantly dilated proximal bowels. These remain the main concern for laparoscopic-assisted surgery, which require open approach or conversion.

Mini-laparatomy radical cysto-prostatectomy for urinary bladder carcinoma

Introduction: Open radical cysto-prostatectomy (RCP) is the gold standard for invasive urinary bladder cancer in male. Though minimal invasive technique like laparoscopic or robotic assisted surgery is gaining popularity for surgical management in developed countries, open mini laparotomy is equally effective with similar oncological outcome and morbidity result. Our study aims to evaluate the feasibility of Mini-laparotomy RCP with ileal conduit (IC) or neobladder.&#x0D; Methods: This is a descriptive cross-sectional study of 25 patients conducted from October 2016 to December 2019. Nineteen patients had muscle invasive urinary bladder cancer (MIBC), four had multifocal high grade non-muscle invasive bladder cancer (NMIBC) and two were BCG failure patients. Nineteen patients underwent RCP with IC and six with RCP and ileal Neobladder. We analyzed technical difficulty, operative time, blood loss, peri-operative complication for minilaparotomy RCP.&#x0D; Results: The mean age of patients was 63.2 years (46-81years). The mean operative time was 274 minute (180-420 minutes) with mean blood loss of 470 ml (300-2000 ml). Mean post-operative ileus was observed for 2.8 days (2-4 days). All patients stayed in the hospital for mean days of 12.84 (7 to 25 days). All patients were mobilized early with mean intensive care unit (ICU) stay of 2.52 days. Mean lymph node extraction was 17.6. Two patients died of renal failure and hyperosmolar diabetes mellitus.&#x0D; Conclusion: Minilaparatomy RCP is a feasible option in terms of early recovery with acceptable morbidity without compromising the oncological principles.

Disseminated Colitic Cancer Identified in Two Patients who had Undergone Surveillance Colonoscopies: A Case Report

Background: It was reported that in surveillance colonoscopy (SC), targeted and random biopsies detected similar proportions of neoplasias. However, that study was conducted by experienced endoscopists familiar with colitic cancer. We report two cases of disseminated colitic cancer in patients who had undergone SC. Case Presentation: Case-1: A 69-year-old Japanese man first suffered from ulcerative colitis (UC) in 1979. Annual SCs had been performed since 1998. In 2017, colonoscopy confirmed a cancer in the ascending colon. A laparoscopy-assisted anal-preserving total proctocolectomy was performed in 2018. Histological findings showed the cancer reaching serosa and lymph node metastasis. Peritoneal dissemination occurred 1 year after the surgery. Two years after the first surgery, an ileostomy was created due to bowel obstruction caused by peritoneal dissemination. Case-2: A 77-year-old Japanese man was diagnosed with UC at another hospital in 2010. SCs were performed annually since 2011. In April 2019, he developed frequent bowel movements, bleeding, and weight loss. Colonoscopy revealed stenosis at the rectum and sigmoid colon. The biopsy revealed adenocarcinoma. Laparoscopy-assisted surgery was performed in July 2019. The yellow ascites was aspirated and submitted for lavage cytology, which revealed signet-ring cell carcinoma. Many white nodules were found in the peritoneum and were diagnosed as peritoneal dissemination. A colostomy was performed. Chemotherapy was administered. Five months have passed since the operation, and the patient is alive. Conclusion: Chromoendoscopy had not been performed in either patient. It is advisable to use chromoendoscopy when a target biopsy is performed.

GelPOINT single-port laparoscopy-assisted transanal minimum invasive surgery for low rectal cancer: a preliminary report on the use of the GOD VISION wireless smart glass-shaped monitor

BackgroundThe GOD VISION wireless smart glass-shaped monitor (INBYTE) was used in the treatment of an elderly patient with mixed breathing disorder undergoing transanal minimally invasive surgery (TAMIS) for low rectal cancer under lumbar anesthesia.MethodAfter wearing the GOD VISION wireless smart glass-shaped monitor, we attached it to the Gel POINT Path® (Applied Medical). The tumor was surgically removed from all layers of the rectum using an ENDOPATH Electrosurgery PROBE PLUS II System® (a spatula-type electric scalpel) and the site was closed after sufficient washing.ResultsThe total operation time was 93 min, and the estimated blood loss was 6 mL. The patient was discharged without complications on postoperative day 14. No local recurrence or distant metastasis in the 7 months after the operation. The patient remained in a good condition with the preservation of the anal function.ConclusionsIt is necessary to accumulate cases and to perform long-term follow-up. In addition, the anal side operators are able to operate without discomfort. In the present case, the GOD VISION wireless smart glass-shaped monitor allowed the TAMIS operation to be performed more comfortably.