Journal of Surgical Innovation and Education

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Volume 2(1); June 2025

How I Do It

A Practical Guide to Robotic Transabdominal Preperitoneal Repair for Inguinal Hernia: Sungwoo Jung, Hyung Soon Lee; J Surg Innov Educ. 2025;2(1):1-4. Published online June 16, 2025; DOI: https://doi.org/10.69474/jsie.2025.00052

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Abstract PDF: Robotic transabdominal preperitoneal (R-TAPP) inguinal hernia repair offers enhanced visualization, ergonomic comfort, and improved instrument control compared to conventional laparoscopy. Although laparoscopic transabdominal preperitoneal repair has known benefits, its adoption remains limited due to technical challenges and a steep learning curve. The robotic platform addresses these limitations, making it well-suited for safe, precise dissection in the preperitoneal space. This article presents a practical, step-by-step guide to R-TAPP, highlighting key anatomical landmarks, standardized dissection techniques, and tension-free mesh placement without fixation.

Laparoscopic Extended Totally Extraperitoneal Hernia Repair with Posterior Component Separation with Transversus Abdominis Release for a Recurrent Incisional Hernia: Sa-Hong Kim, Kyoyoung Park, Chungyoon Kim, Jeesun Kim, Do-Joong Park, Hyuk-Joon Lee, Seong-Ho Kong; J Surg Innov Educ. 2025;2(1):5-8. Published online June 17, 2025; DOI: https://doi.org/10.69474/jsie.2025.00024

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Abstract PDF: A patient with multiple comorbidities, including hypertension, type 2 diabetes, hyperlipidemia, and edema, and a prior history of abdominal surgery presented to the gastrointestinal department with a recurrent incisional hernia larger than 10 cm. The patient underwent laparoscopic extended totally extraperitoneal (e-TEP) hernia repair under general anesthesia. The bilateral retrorectal spaces were accessed via three trocars, followed by midline crossover in the upper abdomen and caudal dissection along the fascial defect. Due to the large size of the defect and the anticipated tension, posterior component separation (PCS) with transversus abdominis release (TAR) was performed, with careful preservation of the neurovascular bundles running anterior to the head of the transversus abdominis muscle. After separate closure of the posterior and anterior layers using barbed sutures, a mesh was placed in the intercomponent space to avoid direct contact with intraperitoneal structures. Closed-suction drains were placed bilaterally to prevent seroma formation. The procedure was completed successfully, and the patient experienced no complications. The patient was discharged without complications. A follow-up computed tomography scan demonstrated the integrity of the hernia repair, with progressive resolution of fat infiltration and fluid collection. Laparoscopic e-TEP hernia repair with PCS and TAR provides a safe and effective approach for managing complex recurrent incisional hernias. This technique enables tension-free closure with mesh placement while minimizing intra-abdominal complications.

Biologic Mesh Augmentation for Repairing Diaphragmatic Hernia: Juno Yoo, Chung Sik Gong, Ba Ool Seong, Chang Seok Ko, Sa-Hong Min, In-Seob Lee, Moon-Won Yoo, Jeong Hwan Yook, Beom Su Kim; J Surg Innov Educ. 2025;2(1):9-13. Published online June 24, 2025; DOI: https://doi.org/10.69474/jsie.2025.00045

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Abstract PDF: Diaphragmatic hernias, whether congenital or acquired, often require surgical intervention to prevent life-threatening complications. The use of biologic mesh has gained increasing attention due to its favorable integration with host tissue and lower recurrence rates. This article presents a reproducible and effective method for diaphragmatic hernia repair using a biologic mesh via a laparoscopic approach. The technique emphasizes anatomical restoration and durable fixation, while minimizing tension and postoperative complications.

How to Perform Single-Incision Laparoscopic Totally Extraperitoneal Hernia Repair: Moon Jin Kim, Ji Hoon Kim, Ju Myung Song, Chae Dong Lim; J Surg Innov Educ. 2025;2(1):14-18. Published online June 26, 2025; DOI: https://doi.org/10.69474/jsie.2025.00059

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Abstract PDF: Surgery for inguinal hernia has made significant progress over a period of more than a century. The advent of minimally invasive techniques prompted further innovations. Among these, single-incision surgery offers significant advantages in creating the preperitoneal space. Therefore, it is essential for surgeons to understand and be able to perform single-incision laparoscopic totally extraperitoneal (SIL-TEP) hernia repair. This article presents a detailed description of the surgical technique for SIL-TEP.

Technique of Temporary Abdominal Closure Using Negative-Pressure Wound Therapy: Abdallah Alferdaus, Ye Rim Chang, Suk-Kyung Hong; J Surg Innov Educ. 2025;2(1):19-21. Published online June 19, 2025; DOI: https://doi.org/10.69474/jsie.2025.00010

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Abstract PDF: Temporary abdominal closure (TAC) is an abridged technique used after damage control surgery when primary closure is unattainable or can place patients at risk of complications such as intra-abdominal hypertension. Several techniques have been described for TAC. The ideal method should prevent bowel evisceration, prevent abdominal wall retraction or loss of domain, allow removal of infected fluids, and facilitate early definitive closure. Herein, we present a case where negative-pressure wound therapy was used for TAC. We describe the technique’s steps, aiming to simplify the procedure for experienced surgeons.

Dynamic Educational Manuscripts

Different Choices of Surgical Methods for Duodenal Gastrointestinal Stromal Tumors: Zhuang Chun, Mohd Firdaus Che Ani, Abdullah Almayouf, Jee-sun Kim, Seong-Ho Kong, Do-Joong Park, Han-Kwang Yang, Hyuk-Joon Lee; J Surg Innov Educ. 2025;2(1):22-23. Published online June 16, 2025; DOI: https://doi.org/10.69474/jsie.2024.00150

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Abstract PDF: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal (GI) tract. Although GISTs can occur anywhere along the GI tract, they are most frequently found in the stomach and small intestine. Duodenal GISTs are rare but clinically significant due to their symptomatology and potential for malignant transformation. Surgical resection remains the cornerstone of curative treatment. Laparoscopic surgery is now the main method for duodenal GIST due to its advantages, including a faster recovery, less pain, and shorter hospital stay. In this video, we demonstrate how we make different choices regarding the surgical methods for duodenal GIST during operation. The technical points are as follows: (1) preliminary judgment of the tumor location according to the preoperative computed tomography scan and gastroscopy findings, (2) fine dissection of the soft tissue and vessels around the duodenum, (3) intraoperative gastroscopy to confirm the tumor location, (4) the final decision regarding the surgical method according to the tumor location and size, (5) confirmation of luminal patency and hemostasis by intraoperative endoscopy.

Methods of Insertion and Examination in Esophagogastroduodenoscopy: A Comprehensive Video Guide: Eun Young Kim, Ki Bum Park, Han Mo Yoo, Dong Jin Kim, Sang-Ho Jeong; J Surg Innov Educ. 2025;2(1):24-25. Published online June 26, 2025; DOI: https://doi.org/10.69474/jsie.2025.00080

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Abstract PDF: Esophagogastroduodenoscopy (EGD) is a fundamental diagnostic and therapeutic modality for various gastrointestinal diseases. As endoscopic techniques evolve, mastering the step-by-step process of EGD—including insertion, navigation, and systematic observation—is essential for ensuring patient safety and diagnostic accuracy. This video article provides a comprehensive, narrated demonstration of the techniques involved in EGD, from patient preparation to scope control and anatomical orientation. It emphasizes key technical details such as endoscope handling, the role of hand movements in scope navigation, and systematic evaluation of the esophagus, stomach, and duodenum. All demonstrations were performed using a simulation model (UGI Endoscopy Simulator; MEDICAL IP, Korea) with an Olympus GIF-HQ290 endoscope. This educational video serves as a practical guide for trainees seeking to refine their technique and increase procedural efficacy.

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