Robot-Assisted Spleen-Preserving Distal Pancreatectomy for an Epithelial Cyst Arising from an Intrapancreatic Accessory Spleen: A Case Report

Masaki Ueno, et al.

INTRODUCTION: Epithelial cysts arising from an intrapancreatic accessory spleen (ECIPAS) are rare and often misdiagnosed as pancreatic cystic neoplasms because their imaging features frequently overlap. When malignancy cannot be ruled out, surgical resection is generally indicated, and minimally invasive approaches have become an appropriate treatment option. We report a case of ECIPAS initially suspected to be a mucinous cystic neoplasm (MCN), successfully treated with spleen-preserving distal pancreatectomy using the hinotori Surgical Robot System.

Emergency Laparoscopic Cholecystectomy for Acute Cholecystitis with Hepatic Segment 4 Hypoplasia and Gallbladder-Attached Accessory Liver: A Rare Dual Anomaly Case

Koki Miya, et al.

INTRODUCTION: Hepatic hypoplasia and accessory liver tissue are rare congenital anomalies, and their coexistence with acute cholecystitis is exceedingly uncommon. We report a case of acute cholecystitis in a patient with segment 4 hypoplasia and an accessory liver attached to the gallbladder serosa in whom laparoscopic cholecystectomy was performed safely.

Tension Viscerothorax with Concomitant Pneumothorax and Associated Intrathoracic Gastric Perforation after Thoracoabdominal Stab Wound in a Resource-Limited Setting: A Case Report

Amanuel Mesfin Oljira, et al.

INTRODUCTION: Traumatic diaphragmatic injury after penetrating thoracoabdominal trauma is rare and can be missed when CT is not available. Tension viscerothorax can mimic tension pneumothorax and may persist despite pleural decompression.

Parathyroid Carcinoma Disseminated Following Endoscopically-Assisted Surgery: A Case Report

Yoko Omi, et al.

INTRODUCTION: Endoscopically assisted surgery for parathyroid tumors has provided excellent cosmetic results and has been covered by Japan’s national insurance system since 2016. However, careful handling is essential because parathyroid tumor cells can easily disseminate.

Laparoscopic Rectopexy for Neorectal Prolapse after Robot-Assisted Intersphincteric Resection for Low Rectal Cancer: A Case Report

Yuzo Harada, et al.

INTRODUCTION: Intersphincteric resection (ISR) is a sphincter-preserving procedure for lower rectal cancer; however, it can cause neorectal prolapse. Transanal repairs are commonly described but may fail, while transabdominal approaches are less frequently reported because of adhesions, bowel injury, and stoma risks. We present a patient with neorectal prolapse after robot-assisted ISR in whom transanal repair failed and subsequent laparoscopic rectopexy achieved a successful outcome, with a review of the literature.

Emergency Surgery for Left Atrial Angiosarcoma Presenting with Acute Respiratory Failure: A Fatal Case Report

Anna Tsuji, et al.

INTRODUCTION: Primary cardiac angiosarcoma is an extremely rare and aggressive malignancy with a poor prognosis. Herein, we describe a case of left atrial angiosarcoma presenting with acute respiratory failure that required emergency surgical intervention, highlighting the condition’s diagnostic and therapeutic challenges.

A Case of Abscess Formation after Radiofrequency Ablation for Early Breast Cancer

Kenjiro Jimbo, et al.

INTRODUCTION: Breast-conserving surgery with whole-breast irradiation is the standard local treatment for early-stage breast cancer. Recently, less invasive approaches have gained attention with advances in imaging and ablative technologies. Radiofrequency ablation (RFA) induces thermal coagulative necrosis and has been explored as a potential alternative for selected small breast tumors, with favorable oncological and cosmetic outcomes reported. However, data regarding infectious complications remain limited. Because RFA creates devitalized tissue, secondary infection and abscess formation may occur. We report a rare case of delayed abscess formation after breast RFA that required surgical management.

Megacolon Associated with Multiple Endocrine Neoplasia Type 2B: A Case Successfully Managed with Ileostomy

Takeshi Ikeda, et al.

INTRODUCTION: Multiple endocrine neoplasia type 2B (MEN2B) is a rare genetic disorder characterized by medullary thyroid carcinoma, pheochromocytoma, mucosal neuromas, and Marfanoid body habitus. Megacolon is a common non-endocrine manifestation, with approximately 75% of patients experiencing gastrointestinal symptoms, such as constipation or diarrhea, often as early clinical signs. Although these symptoms may be important diagnostic signs, there are currently no distinct therapeutic guidelines. Here, we report a case of MEN2B-associated megacolon that was managed surgically, resulting in a favorable outcome.

Gastric Antral Perforation Caused by a Percutaneous Endoscopic Gastrojejunostomy Tube: A Case Report

Toru Zuiki, et al.

INTRODUCTION: Percutaneous endoscopic gastrojejunostomy (PEG-J) is used when gastric feeding via percutaneous endoscopic gastrostomy (PEG) is poorly tolerated due to gastroesophageal reflux or delayed gastric emptying. Gastrointestinal perforation related to PEG-J has been reported mainly in infants; gastric perforation in adults is extremely rare. We report a case of gastric antral perforation caused by the tube tip 12 days after exchange from a PEG tube to a PEG-J tube.

Robot-Assisted Total Gastrectomy for Juvenile Polyposis Syndrome-Associated Gastric Cancer Performed in a Patient with Factor XIII Deficiency: A Case Report

Toshifumi Saito, et al.

INTRODUCTION: Factor XIII deficiency (FXIIID) is a rare coagulation disorder that can cause severe or delayed bleeding and impair wound healing despite normal routine coagulation test results. Congenital FXIIID is caused by homozygous germline pathogenic variants of F13A or F13B. Herein, we report the successful treatment of a patient with FXIIID who underwent surgery for juvenile polyposis syndrome (JPS)-associated early gastric cancer.

Pathologic Complete Response to Modified FOLFIRINOX Enabling Conversion Surgery in Pancreatic Acinar Cell Carcinoma on Hemodialysis: A Case Report

Kazuki Sekine, et al.

INTRODUCTION: With recent advances in systemic chemotherapy for pancreatic cancer, a subset of patients with initially unresectable disease, particularly those who respond favorably to treatment, can now undergo conversion surgery (CS) and achieve prolonged survival. However, in patients undergoing hemodialysis (HD), optimal chemotherapy dosing and dialysis scheduling have not been established, raising concerns about increased chemotherapy-related toxicity and uncertain antitumor efficacy. Here, we report a case in which chemotherapy was successfully administered to a HD patient with unresectable locally advanced pancreatic cancer.

Laparoscopic Resection of a Colovesical Fistula Secondary to Diverticulitis Using Near-Infrared Fluorescent Ureteral Catheters

Yoki Endo, et al.

INTRODUCTION: A colovesical fistula is a rare complication most often caused by diverticulitis, typically requiring surgical repair due to the pressure gradient in which the intraluminal pressure within the colon exceeds that of the bladder.