Laparoscopic approaches for splenic artery aneurysms

Abstract Background: Therapeutic options for splenic artery aneurysm include endovascular management, laparoscopic surgery, and open surgery, although their indications and applications as standard therapy remain controversial. Methods: Between August 2009 and March 2011, three patients with splenic artery aneurysm were treated at our institution. All patients underwent laparoscopic surgery. Results: There was no conversion to open surgery. The mean operative time was 204.7 min (range: 147-265 min) and the mean intraoperative blood loss was 30 mL (range: 0-90 mL). There was no mortality or morbidity. Conclusions: The laparoscopic approaches for splenic artery aneurysm were safe procedures.     

门静脉高压症合并脾动脉瘤的腹腔镜/开放同期手术治疗效果分析（附28例报告）

目的 比较门静脉高压症合并脾动脉瘤患者同期行腹腔镜/开放手术（脾动脉瘤近心端及远心端隔绝术、脾脏切除术和门-奇断流术）的临床治疗效果。方法 回顾性分析2013年1月-2020年12月28例于武汉市第一医院肝胆外科和深圳大学总医院普外科诊断为“门静脉高压症、脾功能亢进合并脾动脉瘤”的患者的临床资料,所有病例均同期腹腔镜下或者开放手术下应用“脾动脉瘤近、远心端隔绝术+脾切除术+门-奇断流术”进行治疗。患者术前均需完善腹部增强CT+CT血管造影（CTA）、彩色多普勒超声以及胃镜等检查,详细了解肝功能分级、脾脏肿大分级、脾功能亢进程度、食管胃底静脉曲张程度、脾动脉瘤在载瘤动脉上的位置、大小、外形以及与周围器官的毗邻关系等情况。术后常规复查血液分析、C反应蛋白（CRP）和肝功能。术后1～3个月门诊复查腹部增强CTA。术后门诊及电话随访7～84个月。结果 所有患者均痊愈,无腹腔积液、感染、深部脓肿、出血和胰瘘等术后并发症,围手术期及随访期间无死亡病例。腹腔镜手术组手术时间和术后住院时间较开放手术组短,术中出血量和术后3 d腹水量较开放手术组少,差异均有统计学意义（P <0.05）。术后第3天...     

Laparoscopic near-total splenectomy: a single-center experience of a standardized procedure

Abstract

Background: Near-total splenectomy (NTS) represents an innovative and effective surgery technique for spleen disease, reducing the risk of severe infections and thromboembolic events after total splenectomy. The authors reported a laparoscopic near-total splenectomy (LNTS) surgical experience following the optimal results of the open approach, describing a standardized and effective minimally invasive technique with the purpose of preserving a minimal residual spleen.

Material and methods: From November 2006 to September 2016, 15 patients with splenic and hematologic disease underwent LNTS, according to a laparoscopic procedure developed by the authors. The end criterion was to conserve a remanent spleen of 10–15?cm³ in size.

Results: Patient age ranged between 18 and 59 years. Mean operative time was 70?±?20?min. Mean hospital stay was 3.46 (range 3–7) days. One complication occurred during the surgery for a lesion of the inferior polar artery with need of a total splenectomy. No conversion to open surgery was necessary.

Conclusions: LNTS is a safe and effective technique for the management of splenic and hematologic disease with a low intra- and post-operative complication rate, and it can minimize the late sequelae of secondary splenectomy. However, it requires further studies with more cases to evaluate its role.     

Laparoscopic resection for splenic artery aneurysm using the lateral approach: Report of two cases

We report two cases of successful laparoscopic surgery for splenic artery aneurysm. In case 1, a 59‐year‐old man who had hypertension was admitted to the hospital with complaints of slight back pain. CT scan showed a winding splenic artery and an aneurysm behind the pancreas body. In case 2, a 71‐year‐old woman with hypertension consulted us and was diagnosed with splenic artery aneurysm. Her aneurysm increased from 1.2 mm to 20 mm at the 1‐year follow‐up. In both cases, we performed laparoscopic splenectomy, using the left lateral approach, to resect the aneurysm. Splenectomy was performed after the spleen had changed color. The operating times were 210 and 259 min, respectively and the bleeding was 60 and 100 mL, respectively. The postoperative course was uneventful. By using the lateral approach from the left side, we were able to precisely resect the splenic artery aneurysm under a stable laparoscopic view.     

腹腔镜下保留脾脏胰体尾切除术治疗胰腺囊实性肿瘤中青年患者的临床效果（附30例报告）

目的 探讨腹腔镜下保留脾脏胰体尾切除术治疗胰腺囊实性肿瘤中青年患者的可行性和安全性。方法 回顾性分析该院收治的30例胰腺囊实性肿瘤中青年患者的临床资料,均实施腹腔镜下保留脾脏胰体尾切除术,观察统计患者的手术时间、出血量、术后下床时间、术后肛门恢复排气时间、术后住院时间、术后并发症及处理方法、病理类型及随访结果。结果 30例患者均于腹腔镜下顺利完成手术,无中转开腹。其中,29例成功保留脾脏,1例术中联合脾脏切除。手术时间（200.5±20.5） min,出血量（220.4±30.5） mL,术后下床时间（1.5±0.5） d,术后肛门恢复排气时间（2.1±1.1） d,术后住院时间（6.5±1.5） d。术后5例出现胰漏,4例经保守治疗治愈,1例经穿刺引流治愈。术后病理报告显示,胰腺实性假乳头状瘤12例,黏液性囊腺瘤10例,浆液性囊腺瘤3例,神经内分泌肿瘤5例。术后平均随访1年,未见肿瘤复发和大范围脾脏梗死。结论 腹腔镜下保留脾脏胰体尾切除术需要由具备丰富腹腔镜操作技能的医师实施,用该方法治疗胰腺囊实性肿瘤中青年患者安全且高效,其具有创伤小、恢复快和并发症少等优点。     

Laparoscopic single-port Burch colposuspension with an extraperitoneal approach and standard instruments for stress urinary incontinence: Early results from a series of 15 patients

Abstract

Objective:We aimed to investigate the use of single-port laparoscopy in a series of patients undergoing Burch colposuspension with an extraperitoneal approach as an alternative treatment for scarless surgery in stress urinary incontinence. Material and methods: From September 2010 to May 2011 we performed single-port extraperitoneal laparoscopic Burch colposuspension for stress incontinence in 15 patients. Fifteen women who were diagnosed with urodynamic stress incontinence were included in the study. Demographic and clinical data, intraoperative findings, and postoperative course were recorded. Results:The mean age was 45,80 ± 9,91 years (range: 38–70 years). The mean body mass index was 25,67 ± 4.06 kg/m2 (range: 22.23–35.38 kg/m²). The mean operation time and mean blood loss were 40.80 ± 5.94 minutes (range: 30–50 minutes) and 30.67 ± 11.00 cc (range: 10–50 cc), respectively. The single-port laparoscopic operations were technically completed successfully without placement of additional trocars and there were no complications. The cure and improvement rates following laparoscopic Burch colposuspension via single port were 73.3 % and 20 % respectively. Conclusion: Single-port laparoscopic Burch can be an alternative treatment for scarless surgery in stress incontinence. Single-incision laparoscopic Burch colposuspension can offer suitable, effective and safe treatment in women with stress incontinence.     

Treatment options for pulmonary multifocal ground glass opacity type adenocarcinoma: Surgery combine thermal ablation?

ObjectivesTo retrospectively analyze the clinical results of the treatment of pulmonary multifocal adenocarcinoma presenting as ground glass opacity (GGO) by surgery and thermal ablation.Methods87 GGO-type pulmonary adenocarcinomas of 48 patients (14 males and 34 females; mean age: 59.7 years old ±9.9, range: 33–79 years old) had been treated from March 2015 to March 2019. Treatment means included 43 wedge resections, 7 segmentectomy, 17 lobectomies, and 20 thermal ablations. The indication selected for treatment means, safety, and local tumor progression rate were evaluated.ResultsNo operation-related death occurred in all patients. 42 times of surgery were performed and 67 carcinomas were resected in 42 patients. 23 times of single-port Video-assisted thoracoscopic surgery (VATS), 8 times of two-port VATS and 11 times of three-port VATS were performed in total. There were 2 cases of air leak (exceeding 1 week), 1 case of chylothorax and 1 case of massive pleural effusion. Time duration of surgery was between 60 and 300mins (mean: 167mins). Intra-operative blood loss was between 5 and 300 ​mL (mean: 44 ​mL). Time of chest drainage was between 2 and 23d (mean 4.9d). Chest drainage volume was between 14 and 4633 ​mL (mean: 872 ​mL). Post-operation LOS (length of stay) was between 3 and 25d (mean: 6.2d). 15 times of thermal ablation were performed (1 case of air leak) and 20 carcinomas were ablated in 14 patients. The ablation time was between 30 and 120min (mean: 43min); post-operation LOS was between 1 and 10d (mean: 3.5d). During the mean follow-up period (16 months ​± ​13) (range: 5–60 months), no local tumor progression occurred.ConclusionsSurgery and thermal ablation are safe and effective options for the treatment of pulmonary multifocal GGO-type adenocarcinoma.     

The role of ERCP and laparoscopic cholecystectomy in gallstone-related pancreatitis

Summary

Laparoscopic surgery has become the routine for elective cholecystectomy, but its place in the management of gallstone-related pancreatitis has not yet been identified. We prospectively assessed a minimally invasive treatment regime for gallstone pancreatitis combining endoscopic retrograde cholangiopancreatography (ERCP) and laparoscopic cholecystectomy, over a 24 month period. Twenty-two patients were found to have gallstone pancreatitis. The mean age was 52 ± 18 years. All patients presented with abdominal pain. Five were jaundiced. The Ranson score severity of pancreatitis averaged 1.6 (range 0–6). Our management protocol was to perform ERCP when clinical and biochemical markers had settled, followed by laparoscopic cholecystectomy during the same admission. The time interval between presentation and ERCP was 8.9d (range 2–15d), ERCP to surgery was 4.5d (range 2–35d) and surgery to discharge was 4d (range 1–21 d). The median hospital stay was 16d. ERCP showed stones in the common bile duct in five patients, four of whom had them removed at ERCP. Twenty patients underwent laparoscopy. The gallbladder was removed in 18 and two required conversion (one pseudocyst, one cystic artery bleed). Two patients had elective open cholecystectomy (one pseudocyst, one previous surgery). Only one patient developed a post-operative complication (pseudocyst). The majority of patients had multiple small stones in their gallbladder and it was not possible to predict the presence of common bile duct stones prior to ERCP. No patient developed post-operative pancreatitis. There was no mortality. This study shows that combined ERCP and laparoscopic cholecystectomy is an efficient and safe minimally invasive management for gallstone pancreatitis.     

Laparoscopic cytoreductive nephrectomy with cytokine therapy for metastatic renal cell carcinomas compared with open nephrectomy

Introduction: We retrospectively reviewed and compared the operation records and long‐term results of patients with metastatic renal cell carcinoma (mRCC) who underwent laparoscopic cytoreductive nephrectomy and those who underwent open procedure. Methods: A total of 75 patients with mRCC who underwent cytoreductive nephrectomy between 1997 and 2007 were studied: 23 patients in the laparoscopy group (LCN group) and 52 in the open group (OCN group). Most patients received interferon‐based cytokine therapy after surgery. Patients with tumor thrombus in the inferior vena cava were excluded from this study. Results: Operating time in the LCN group was significantly longer than in the OCN group (320.3 min vs 269.6 min, P=0.049). Blood loss was less in the LCN group (527.8 ml) than in the OCN group (1372.3 ml, P=0.072). Convalescence was shorter in the LCN group (18.1 d) than in the OCN group (32.9 d, P<0.0001). Median follow‐up periods were 15 months (range 2–110 months) and 17 months (range 1–103 months) in the LCN group and OCN group, respectively. There was no statistically significant difference between the two groups with regard to disease‐specific patient survival and progression‐free survival. Conclusions: Laparoscopic cytoreductive nephrectomy is a feasible alternative for patients with mRCC because its benefits include less blood loss and shorter convalescence. In addition, the long‐term oncological results of laparoscopic cytoreductive nephrectomy are comparable to those of the open procedure.     

腹腔镜与开腹再次肝切除治疗复发性肠癌肝转移患者的术后短期预后比较

目的： 探讨腹腔镜与开腹再次肝切除治疗复发性肠癌肝转移患者的术后短期预后情况。方法： 选择2011年1月至2019年12月接受肝脏再切除的289例复发性肠癌肝转移患者，其中40例接受腹腔镜手术，249例接受开腹手术。将腹腔镜及开腹组按1∶2进行倾向匹配评分，比较2组的围手术期情况。结果： 倾向匹配后，腹腔镜组及开腹组分别有40、80例患者纳入研究。2组均无围手术期死亡发生，输血率、肝门阻断时间、30 d内非计划再入院率差异均无统计学意义。与开腹组相比，腹腔镜组术中出血量更少（50 mL vs 200 mL，P=0.001），各级术后并发症发生率更低（25.0%vs 47.5%，P=0.030），术后住院时间更短（6 d vs 7 d，P=0.009）。结论： 复发性肠癌肝转移接受腹腔镜再次肝切除较接受开腹手术患者的围手术期预后更好。     

腹腔镜脾切除术中出血及周围脏器损伤的预防及处理

目的:探讨腹腔镜脾切除术中出血及周围脏器损伤的预防和处理方法。方法:共纳入32例行腹腔镜脾切除术的患者,术前均进行影像学检查,评估脾血管走行及解剖变异;术中预处理脾动脉,精准解剖脾门,悬吊脾门。结果:32例患者中,31例顺利完成腹腔镜脾切除术,手术时间87~190 min,平均(128±90)min;术中出血量110~790 ml,平均出血量(358±34)mL。术后2例出现无症状性胰漏。结论:在腹腔镜脾切除术中,脾动脉预处理及脾门悬吊等技术值得推广应用。     

Laparoscopic distal pancreatectomy in the pig using ultrasonic dissector device

Summary

Objective: To analyse in a porcine model the outcome of laparoscopic distal pancreatectomy using an ultrasonic dissection device. Design and subjects: Six week survival study in Suabian Hall landrace pigs. Interventions: Laparoscopic distal pancreatectomy using an ultrasonic dissection device. Main outcome measures: Analysis of inflammatory response, healing complications and tissue injury. Results: In four of five animals the left pancreatic segment was resected via the laparoscopic approach, preserving the spleen and splenic vessels. In one animal the operative procedure had to be converted to open access surgery due to bleeding from the splenic vein with resection of the spleen and distal pancreatectomy using the ultrasonic dissector. All animals survived the 6-week observation period without signs of fistula or infection. There was no increase of WBC count and serum p-amylase during post-operative follow up, indicating absence of systemic inflammatory response and local tissue injury. Histomorphologic analysis of the pancreatic stump 6 weeks after ultrasonic resection confirmed intact pancreatic acinar tissue without signs of inflammation or fibrosis/necrosis. Conclusion: We propose that laparoscopic resection of the left pancreatic segment with the ultrasonic dissector represents a promising new approach for distal pancreatectomy.     

Abdominal ventral rectopexy with colectomy for obstructed defecation syndrome: An alternative option for selected patients

BACKGROUNDAbdominal ventral rectopexy (AVR) with colectomy is controversial in the treatment of obstructed defecation syndrome (ODS). Literature data on this technique for ODS are very limited.AIMTo evaluate the safety and efficacy of AVR with colectomy for selected patients with ODS.METHODSConsecutive patients who underwent AVR with colectomy for ODS were identified prospectively from 2016 to 2017 in our department. Patient demographics, perioperative surgical results, and postoperative follow-up outcomes were collected and analyzed. Long-term follow-up was evaluated with standardized questionnaires. The severity of symptoms was assessed by the objective Wexner Constipation Score (WCS) and ODS Score. The quality of life was assessed by the Patients Assessment of Constipation Quality of Life score. Functional outcome was compared pre- and post-operatively for each patient. The primary outcomes were determined by the improvement in symptoms and quality of life. Secondary outcome measures were operating time, postoperative length of stay, morbidity and mortality, improvement of pelvic floor structure, and patient satisfaction.RESULTSFour patients underwent robotic-assisted surgery, and two patients underwent a laparoscopic-assisted procedure. The mean operating time for the robotic approach was 243 min (range 160–300 min), and the mean operating time for the laparoscopic approach was 230 min (range 220-240 min). The mean postoperative length of stay was 8.2 d (range 6-12 d). There was no conversion to open procedure and no postoperative mortality. No urinary retention, wound infection, prolonged ileus, pelvic infection and anastomosis leakage occurred. Six patients were followed up for 36 mo. The WCS, ODS, and Patients Assessment of Constipation Quality of Life score improved significantly postoperatively (P < 0.05). The WCS and ODS scores showed the best remission and stabilization at 6 to 12 mo after surgery. There was no recurrence or novel constipation after surgery. None of the patients used laxative medication.CONCLUSIONRobotic and laparoscopic-assisted ventral rectopexy with colectomy is a safe and effective procedure for selected patients with ODS. However, comprehensive preoperative evaluation and careful patient selection are essential.     

开腹手术与腹腔镜下子宫肌瘤剔除术对患者肌瘤复发、氧化应激及血清学创伤指标的影响

目的 探讨开腹手术与腹腔镜下子宫肌瘤剔除术对患者肌瘤复发、氧化应激及血清学创伤指标的影响.方法 选取2018年6月-2019年12月于该院妇产科住院治疗的90例子宫肌瘤患者作为研究对象,按照随机数字表法将患者分为对照组和观察组,每组45例,对照组行开腹手术切除子宫肌瘤,观察组行腹腔镜下子宫肌瘤剔除术.观察两组患者的复发...     

Ablative and reconstructive robotic-assisted laparoscopic renal surgery

Introduction: The increasing role of robotic technology to facilitate surgical procedures has attracted much attention from surgeons and patients alike. In particular, the dramatic increase in the number of laparoscopic radical prostatectomies performed using the da Vinci^TM surgical system has led to interest in using this technology for other procedures. We have evaluated our own experience performing ablative and reconstructive laparoscopic renal surgery using the da Vinci^TM system to determine its potential role. Aims: To review our experience of robotic‐assisted laparoscopic procedures of the upper urinary tract. Materials and methods: Our da Vinci^TM system was installed in June 2004. A prospective database has been maintained concerning all patients and procedures performed from that time. Procedures involving the upper urinary tract were identified and the data was examined. This included patient demographics, operative time, blood loss, hospital stay and patient outcomes. Results: Twenty‐six robotic procedures involved the upper urinary tract. Of these, two had to be converted to conventional laparoscopic surgery because of da Vinci^TM mechanical failure. Robotic‐assisted procedures included pyeloplasty (n = 15), simple nephrectomy (n = 2), radical nephrectomy (n = 1), nephroureterectomy (n = 2), and live donor nephrectomy (n = 4). The mean operative time was 215 min. The anastomotic time for the pyeloplasties averaged 47 min. The mean blood loss was 75 ml. There were no conversions to open surgery. The complication rate was 8.7%. Postoperative stay averaged 2.9 days. Conclusion: The da Vinci^TM surgical system may be safely used to assist in the performance of laparoscopic renal surgery.     

Single-incision transabdominal preperitoneal and totally extraperitoneal repair for inguinal hernia: early experience from a single center in Asia

Introduction: Laparoscopic inguinal hernia repair is currently one of the most commonly performed minimally invasive surgical procedures. In recent years, single‐incision operations have been developed to further reduce the invasiveness of the surgery. Herein, we report our early experience with single‐incision laparoscopic inguinal hernia repair in Asia, with both the transabdominal preperitoneal (TAPP) and totally extraperitoneal (TEP) approaches. Methods: This is a retrospective review of prospectively collected data on a cohort of consecutive patients with inguinal hernia who underwent single‐incision laparoscopic inguinal hernia repair in a minimal access surgical center in Hong Kong between January 2010 and January 2011. Results: Our cohort consists of 15 patients who underwent single‐incision laparoscopic inguinal hernia; 13 were unilateral and two were bilateral hernias. The mean age was 59.8 years old (range, 28–74 years). The overall mean operative time was 59.53 min (range, 25–120 min). For unilateral hernia repair, the mean operative time was 56 min (range, 25–75 min) and 48.5 min (range, 41–55 min) for TAPP and TEP, respectively. In all cases single‐incision laparoscopic hernia repair was successfully performed, no additional trocars were required, and there were no conversions to conventional laparoscopic or open inguinal hernia repair. All patients were discharged on the same day as the procedure. Conclusion: Single‐incision laparoscopic inguinal hernia is feasible in both TEP and TAPP approaches. The procedure should be performed by laparoscopic surgeons with a high level of experience in single‐incision surgery. Further randomized trials should be performed to evaluate the full potential and clinical application of single‐incision TAPP and TEP.     

精索结构全程非去腹膜化在青年腹股沟疝腹腔镜经腹膜前疝修补术中的应用探索

目的 探讨精索结构全程非去腹膜化在青年腹股沟疝腹腔镜经腹膜前疝修补术（TAPP）中的可行性及安全性，旨在保护青年腹股沟疝患者的生育功能。方法 回顾性分析2019年7月－2020年12月丽水市中心医院胃肠腹壁疝外科52例行精索结构全程非去腹膜化的腹腔镜TAPP患者的临床资料，观察患者术后疗效。采用门诊就诊和电话随访等方式收集患者术后恢复非限制性活动时间和术后并发症发生情况（术后血清肿、切口感染、慢性疼痛、睾丸萎缩、疝复发和补片移位情况）。结果 所有患者术中均未发生严重并发症，围手术期无死亡病例。手术时间单侧为（56.4±12.7）min，双侧为（87.3±11.7）min，术中出血量小于5 mL，无中转改开放手术患者。术后肛门首次排气时间为（21.5±9.2）h，92.3%（48/52）的患者术后不需要使用镇痛药物，术后2 d内均可按计划出院，出院前均未发现术区水肿、阴囊积液和术后发热。术后所有患者均维持电话随访，随访时间9～26个月。其中，随访1年的9例，随访1年以上的43例。电话随访患者出院2周后均已恢复非限制性活动。其中，术后阴囊积液2例，发生率为3.8%（2/52）。长期随访未发现切口感染及慢性疼痛，未发现疝复发情况。结论 精索结构全程非去腹膜化在青年腹股沟疝腹腔镜TAPP中的应用是安全、可行的。     

Management of traumatic peripheral artery pseudoaneurysm: A 10-year experience at a single center

PurposeThis study aimed to report our 10-year experience with the management of iatrogenic (penetrating trauma) and traumatic (blunt or penetrating trauma) peripheral artery pseudoaneurysms, based on data from a tertiary referral center.MethodsFrom January 2012 to December 2021, the medical records of consecutive patients with iatrogenic and traumatic peripheral artery pseudoaneurysms were retrospectively reviewed. Patient demographics, clinical features, imaging data, treatment details, and follow-up results were analyzed.ResultsSixty-one consecutive patients were included in this study; 48 (79%) were men and 13 (21%) women, with a mean age of 49.4 ​± ​13.4 years (range 24–73 years). There were 42 patients (69%) who underwent open surgery, 18 (29%) undergoing endovascular embolization or stent implantation, and one (2%) undergoing ultrasound-guided thrombin injection. All patients successfully underwent open or interventional treatment. The median follow-up was 46.8 months (2.5–117.9 months), and the overall reintervention rate was 10%. Of these, one (5%) patient in the interventional treatment group and five (12%) patients in the open surgery group underwent reintervention. The overall complication rate was 8%, with complications occurring only in the open surgery group. No deaths occurred in the peri-operative period. No late complications, such as thrombosis or pseudoaneurysm recurrence, were observed.ConclusionPeripheral artery pseudoaneurysms arising from iatrogenic or traumatic causes can be effectively treated by both open surgery and interventional procedures in selected patients with acceptable mid- and long-term outcomes.     

甲状腺功能亢进患者行乳晕入路腔镜下甲状腺手术的技巧探讨

目的 探讨乳晕入路腔镜下甲状腺手术治疗甲状腺功能亢进的操作技巧。方法 回顾性分析该院34例甲状腺功能亢进患者的病例资料,对手术情况及术中出血和腺体切除的方式进行分析。结果 该组病例无中转手术,手术时间（128.9±28.6）min,术中出血量（75.3±28.4）mL,术后2例出现甲状旁腺激素（PTH）降低,术中腺体血管出血200 mL以上者6例（17.6%）,腺体分块切除27例（79.4%）。结论 腔镜手术治疗甲状腺功能亢进难度较大,术中要控制出血,医师需掌握操作技巧,通过一定数量病例学习曲线的练习,才可保障手术的成功。     

A program of telementoring in laparoscopic bariatric surgery

Background This study proposes a system for teaching and surgical support with the benefits of online Information and Communications Technology (ITC) -based telementoring for laparoscopic bariatric surgery (LBS). Material and methods A system of telementoring was established between a university center and two community hospitals. Telementoring was performed via internet protocol using a direct point-to-point connection, ASDL 1.2 Mbps, time delay 150 ms, 256-bit advanced encryption standard (AES). In the period of time selected, all interventions for LBS in both hospitals were included. When patients agree with telementoring, data outcomes (operating time, hospital stay, conversion to open surgery and complications) were collected. The rest of these interventions were recorded. Results Thirty-six patients underwent elective LBS, 20 of whom were referred and accepted for telementoring. Patients selected without telementoring took longer: 200 (46) min vs 139 (33) min, p?<?0.01. There were two conversions in non-mentored groups. The hospital stay was 4.6 (0.5) days for telementored interventions and 6.7 (0.5) days without mentoring (p?<?0.01). Four patients (12,5%) in non-mentored groups suffered minor complications. Conclusions This program supports the safety and feasibility of telementoring in LBS. Telementoring is an alternative in community hospitals because it can improve the quality of advanced procedures of laparoscopic surgery.