We report on the growth of polarity-controlled ZnO epilayers by plasma-assisted molecular-beam epitaxy and the measurement of valence-band offset at the ZnO/GaN heterointerface. The polarity of ZnO epilayers is determined by coaxial-impact-collision ion-scattering spectroscopy. The band offset is determined by ultraviolet and x-ray photoelectron spectroscopy. The high-resolution transmission electron microscopy study reveals the formation of an interface layer between the ZnO and GaN epilayers in O-plasma preexposed samples, while no interface layer is formed in Zn preexposed samples. Zn preexposure prior to ZnO growth results in Zn-polar ZnO epilayers (Zn face), while O-plasma preexposure leads to the growth of O-polar ZnO epilayers (O face). The interface layer is identified to be single-crystalline, monoclinic ${\mathrm{Ga}}_2{\mathrm{O}}_3.$ The estimated valence band offset at the ZnO/GaN(0001) heterojunction with Zn preexposure is 0.8 eV with a type-II band alignment.

Background: Robotic living donor hepatectomy offers potential advantages but has been limited to high-volume centers, primarily in Asia and the Middle East. We report our experience establishing a robotic living donor right hepatectomy program in a U.S. center with low LDLT volume and no prior laparoscopic donor hepatectomy experience and analyze early outcomes. Methods: This retrospective cohort study analyzed 37 living donor right hepatectomies (13 robotic [including one open conversion], 24 open) performed between June 2022 and February 2024. Results: The robotic group had longer operative times (median [range], 451 [374–568] minutes vs 368 [276–421] minutes; P < 0.001) but less blood loss (median [range], 200 [50–700] mL vs 900 [300–2500] mL; P < 0.001). One case required unplanned open conversion due to gas embolism. Two hematomas/bleeding (Clavien–Dindo grade IIIB) occurred in the robotic group, but no biliary complications. Comprehensive Complication Index, liver function tests, and hospital stays were similar between the two groups, with no 90-day graft failure/mortality. Conclusion: With extensive surgical experience in both open donor hepatectomy and robotic surgery, along with meticulous preparation as a team, U.S. centers with lower LDLT volume and no laparoscopic experience can safely implement robotic living donor right hepatectomy, achieving comparable short-term outcomes to the open approach. Further research on long-term outcomes and donor quality of life is necessary.

Median arcuate ligament syndrome (MALS) can cause severe complications after pancreaticoduodenectomy (PD). Most of the reported cases of MALS have been diagnosed perioperatively and can be treated efficiently by interventional radiology or division of the median acute ligament (MAL) fibers. A 69-year-old woman underwent PD with resection of the SMV for pancreatic head cancer. Intraoperative exploration showed normal anatomy of the celiac trunk. Intraoperative digital palpation revealed normal pulsation of the common hepatic artery after resection of the gastroduodenal artery. On postoperative day (POD) 3, her liver function tests were abnormal, and bloody fluids were found in the drain. Abdominal CT showed necrosis of the pancreatic body and ischemia in the liver secondary to MALS which was not detected in the preoperative CT. Interventional radiology was tried first but failed. Division of the MAL fibers markedly increased the blood flow in the hepatic artery. Resection of the remnant pancreas and spleen was also performed simultaneously. Abdominal CT on POD 20 showed re-occlusion of the celiac artery. She experienced rupture of the gastrojejunostomy site, severe hepatic cytolysis, and choledochojejunostomy stricture thereafter. This is the third case of MALS that has developed acutely after PD. MALS can cause refractory complications even after MAL release.

Nutcracker syndrome can present with various disabling symptoms. To our knowledge, there are no reports that describe a robotic-assisted approach in its management. We present a patient who underwent robotic-assisted nephrectomy after the failure of conservative management of nutcracker syndrome and a second patient who underwent robotic-assisted nephrectomy with autotransplant. Surgery and immediate post-op courses were uncomplicated. Robotic-assisted nephrectomy with or without autotransplant can be a feasible, minimally invasive option for select patients with nutcracker syndrome.

Background: Mac‐2 binding protein glycosylation isomer (M2BPGi) is a novel serum glycomarker used to assess liver fibrosis. However, it has been reported that M2BPGi is likely to reflect other factors not limited to liver fibrosis.Methods: We retrospectively analyzed 79 patients with liver tumors who underwent liver resection. M2BPGi was measured within 1 week before operation and almost 1 month after operation. We introduced a value termed the “ΔM2BPGi ratio” (=M2BPGi_{after operation}/M2BPGi_{before operation}), and analyzed factors that influenced the ΔM2BPGi ratio.Results: The median value of the ΔM2BPGi ratio was 1.28 (range, 0.36‐5.68). In 64 patients (81.0%), the cutoff index values of M2BPGi were elevated approximately 1 month after operation, especially in patients who experienced post‐hepatectomy liver failure (PHLF). Multiple linear regression showed total Pringle time, PHLF grade ≥B, and preoperative value of creatinine were significant predictors of the ΔM2BPGi ratio. The mean values of the ΔM2BPGi ratio were 1.37 ± 0.07, 1.52 ± 0.22, and 2.94 ± 0.30 for PHLF grade 0, grade A, and grade B, respectively, resulting in statistically significant differences by the Kruskal‐Wallis test (P = 0.022).Conclusions: Total Pringle time, PHLF grade ≥B, and preoperative creatinine significantly influenced the elevation of M2BPGi almost 1 month after liver resection. This study strongly affirms the previous suggestion that M2BPGi is likely to reflect other factors not limited to liver fibrosis.