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Related Concept Videos

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

38
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
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Related Experiment Video

Updated: May 20, 2025

Author Spotlight: Assessing Surgical Frailty with Point-of-Care Ultrasound of Quadriceps Muscles
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Minimally Invasive Surgery Benefits Frail Patients Undergoing Emergency Hernia Repairs.

Anna Distler1, Ruben Salas Parra1, Xueqi Huang2

  • 1Department of Surgery, Northwell Health, New Hyde Park, New York, USA. (Drs. Distler, Salas Parra, Ahmed, Barrera, Patel, and Hansen).

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|March 27, 2025
PubMed
Summary

Minimally invasive emergent hernia repair in frail patients shortens hospital stays compared to open surgery. This approach does not increase 30-day mortality or affect discharge destination, offering a potentially safer option for vulnerable populations.

Keywords:
EmergencyFrailHerniaMinimally invasive surgeryOutcomes

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Area of Science:

  • Surgical outcomes research
  • Geriatric surgery
  • Health services research

Background:

  • Emergent hernia repairs have higher morbidity than elective procedures.
  • Frailty is an independent predictor of adverse postoperative outcomes.
  • Optimal surgical approaches for frail patients undergoing emergent hernia repair require investigation.

Purpose of the Study:

  • To compare outcomes of minimally invasive surgery versus open repair for emergent hernia repair in frail patients.
  • To evaluate the impact of surgical approach on length of stay, discharge destination, and mortality.

Main Methods:

  • Analysis of the National Surgical Quality Improvement Program database (2018-2020).
  • Inclusion of frail patients (modified frailty index-5 score ≥2) undergoing emergent hernia repair (CPT codes 49505-49659).
  • Multivariate analysis to assess the effect of surgical approach on outcomes.

Main Results:

  • 1,893 frail patients met inclusion criteria; most were female and ≥65 years old.
  • Minimally invasive surgery was associated with a shorter length of stay compared to open surgery (HR 1.22; P=.006).
  • Surgical approach did not significantly impact 30-day mortality (P=.28) or discharge destination (P=.97).

Conclusions:

  • Minimally invasive emergent hernia repair in frail patients is linked to reduced length of stay without compromising safety.
  • Further prospective studies are recommended to confirm these findings and guide clinical practice.
  • This study highlights potential benefits of minimally invasive approaches for frail surgical patients.