Purpose: Although there have been numerous studies on single-incision laparoscopic inguinal hernia repair (SIL-IHR), the short- and long-term outcomes in patients from a large single institution who underwent single-incision laparoscopic transabdominal preperitoneal hernioplasty (SIL-TAPP) have rarely been reported. The purpose of this study is to evaluate the short- and long-term outcomes of SIL-TAPP and its safety and feasibility in patients from a large single institution. Methods: The details of 1,054 procedures in 966 patients who underwent SIL-TAPP at the Affiliated Hospital of Nantong University from January 2015 to October 2022 were retrospectively analysed. SIL-TAPP was performed completely through the umbilicus using conventional laparoscopic instruments. Short-term and long-term outcomes of SIL-TAPP were collected by outpatient and telephone follow-ups. In addition, we further compared the operation time, length of postoperative hospital stay, and postoperative complications of patients with simple and complicated unilateral inguinal hernias. Results: A total of 1,054 procedures were performed for 878 unilateral inguinal hernias and 88 bilateral inguinal hernias. In total, there were 803 (76.2%) indirect inguinal hernias, 192 (18.2%) direct inguinal hernias, 51 (4.8%) femoral hernias and 8 (0.8%) combined hernias. The mean operative time was 35.5 ± 17.0 min for unilateral inguinal hernias and 51.9 ± 25.5 min for bilateral inguinal hernias. There was one (0.1%) conversion to two-incision laparoscopic transabdominal preperitoneal hernioplasty. No intraoperative haemorrhages, inferior epigastric vessel injury or nerve damage occurred. Postoperative complications were minor and could be resolved without surgical intervention. The mean length of hospital stay was 1.3 ± 0.8 days. The median follow-up was 44 months, no trocar hernia occurred, and there was one (0.1%) recurrence. The operation time in the complicated inguinal hernia group was significantly higher than that in the simple inguinal hernia group (38.9 ± 22.3 vs. 35.0 ± 15.6, p = 0.025). The length of postoperative hospital stay and complication rate of the complicated inguinal hernia group were slightly higher than those of the simple inguinal hernia group, but the difference was not statistically significant. Conclusion: SIL-TAPP is safe and technically feasible, and both short- and long-term outcomes are acceptable.

Research progress on the immune microenvironment of the gallbladder in patients with cholesterol gallstones

To analyze and compare the clinical efficacy of transumbilical single-incision laparoscopic surgery TAPP(SILS-TAPP) and conventional laparoscopic TAPP(CL-TAPP) in the treatment of senile inguinal hernia. From January 2019 to June 2021, a total of 221 elderly patients (≥60 years old) with inguinal hernia received SILS-TAPP and CL-TAPP in General Surgery Department of Affiliated Hospital of Nantong University. The perioperative indicators, postoperative complications and follow-up of the two groups were compared to explore the feasibility and superiority of SILS-TAPP in the treatment of inguinal hernia in the elderly. There was no difference in demographic characteristics between the two groups. The mean operation time (28.6 ± 4.2 min vs 28.2 ± 5.3 min) in the SILS-TAPP group was not significantly different from that in the CL-TAPP group (Ρ = 0.623), and there was no significant increase in hospital costs(Ρ = 0.748). The intraoperative blood loss (7.4 ± 3.4 ml), VAS score on the postoperative day (2.2 ± 0.7), mean time of resuming activity (8.2 ± 1.9 h) and mean postoperative hospital stay (0.8 ± 0.2 d) in the SILS-TAPP group were better than those in the CL-TAPP group (Ρ < 0. 05).There was no statistical difference in the overall incidence of intraoperative (Ρ = 0.128) and postoperative complications (Ρ = 0.125) between the two groups. Single-incision laparoscopic surgery TAPP (SILS-TAPP) is feasible and effective in elderly patients, providing a new alternative surgical method for patients who can tolerate general anesthesia.

Qingsong Guo, Jian Wan, Yan Huang, Dongzhi Wang, Qiyang Chen, Chenhao Wu, Xiangjun Fan, Peng Wang, Yuhua Lu. Ann Hepatobiliary Pancreat Surg -0001;0:. https://doi.org/10.14701/ahbps.25-123

BACKGROUND Robotic-assisted partial splenectomy (RAPS) is a superior approach for treating splenic cysts and splenic hemangiomas, as it preserves the immune function of the spleen and reduces the risk of overwhelming post splenectomy infection. Currently, there are no standardized guidelines for performing a partial splenectomy. CASE SUMMARY Four patients with splenic cysts or splenic hemangiomas were treated by RAPS. Critical aspects with RAPS include carefully dissecting the splenic pedicle, accurately identifying and ligating the supplying vessels of the targeted segment, and ensuring precise hemostasis during splenic parenchymal transection. Four successful RAPS cases are presented, where the tumors were removed by pretreating the splenic artery, dissecting and ligating the corresponding segmental vessels of the splenic pedicle, transecting the ischemic segment of the spleen, and using electrocautery for optimal hemostasis. Four patients underwent successful surgeries with minimal bleeding during the procedure, and there were no signs of bleeding or recurrence postoperatively. CONCLUSION Four cases confirm the feasibility and superiority of RAPS for the treatment of benign splenic tumors.

Biliary tract cancers (BTCs) are aggressive malignancies with rising incidence and dismal outcomes. This review synthesizes transformative advances in precision oncology and immunotherapy reshaping BTC management. Genomic profiling reveals targetable alterations—IDH1/2 mutations, FGFR2 fusions, HER2 aberrations, BRAF V600E—driving the clinical success of specific inhibitors (ivosidenib, FGFR inhibitors, HER2-targeted ADCs/antibodies, dabrafenib/trametinib). These agents demonstrate unprecedented response rates and survival benefits in molecularly defined subsets compared to chemotherapy. Emerging immunotherapies, including checkpoint blockade (especially for MSI-H/dMMR tumors), adoptive cell therapy, and cancer vaccines, show promise, often synergizing with targeted approaches. However, overcoming tumor heterogeneity, resistance mechanisms, and optimizing combination strategies remain critical challenges. This paradigm shift towards molecularly guided therapies offers significant hope for improving BTC patient survival.