{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T16:08:16Z","timestamp":1790352496891,"version":"4.1.0"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Surg Endosc"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Endoscopic submucosal dissection (ESD) is technically challenging for complex colorectal lesions, while endorobotic submucosal dissection (ERSD) has emerged as a transanal minimally invasive alternative offering high-definition 3D visualization and improved instrument dexterity. However, evidence-based technique selection criteria remain unclear. This study compares the technical success and operative efficiency between ERSD and ESD using a lesion size-stratified analysis to guide technique selection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Retrospective analysis of prospectively collected data from consecutive patients who underwent ERSD or ESD for distal colorectal lesions at a tertiary referral center (2020\u20132024). All procedures were performed by a single expert endoluminal surgeon to eliminate learning curve bias. The Da Vinci SP robot was used for ERSD. The primary outcomes included en bloc resection rates, operative time, and perioperative complications. Lesions were stratified by surface area: small (&lt;\u200910 cm\n                      <jats:sup>2<\/jats:sup>\n                      ), medium (10\u201325 cm\n                      <jats:sup>2<\/jats:sup>\n                      ), and large (\u2265\u200925 cm\n                      <jats:sup>2<\/jats:sup>\n                      ). Statistical analysis assessed the relationship between lesion size and operative time for both techniques.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 164 patients were analyzed (ERSD:\n                      <jats:italic>n<\/jats:italic>\n                      = 79, ESD:\n                      <jats:italic>n<\/jats:italic>\n                      = 85). ERSD patients had significantly larger lesions (median surface area 18.4 vs 6.3 cm\n                      <jats:sup>2<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001) while maintaining similar overall operative times (75 vs 78\u00a0min,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.42). En bloc resection rates were comparable (97.5% vs 96.5%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.99). Intraoperative perforation occurred in 2.5% of ERSD cases compared to 4.8% of ESD cases (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.75); all perforations were full-thickness defects successfully managed endoscopically or transanally without additional surgical intervention. Postoperative complications occurred in 10.1% vs 8.2% (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.88). The majority of complications were Clavien\u2013Dindo Grade I\u2013II, with no Grade IV or V events in either group. Operative time correlated with specimen size for both techniques (ERSD:\n                      <jats:italic>r<\/jats:italic>\n                      = 0.59; ESD:\n                      <jats:italic>r<\/jats:italic>\n                      = 0.46; both\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Size-stratified analysis revealed equivalent times for small lesions (71 vs 67\u00a0min,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.85) but significant ERSD advantages for medium (65 vs 119\u00a0min,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.03) and large lesions (87 vs 142\u00a0min,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.04), despite robotic setup overhead.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Endorobotic submucosal dissection demonstrated substantial time savings for lesions \u2265 10 cm\n                      <jats:sup>2<\/jats:sup>\n                      without compromising safety or resection quality, suggesting that lesion size may serve as a useful parameter for technique selection between ERSD and ESD.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00464-026-13316-0","type":"journal-article","created":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:45:38Z","timestamp":1790351138000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Transanal robotic versus endoscopic submucosal dissection for complex distal colorectal lesions: a comparative study"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4707-6059","authenticated-orcid":false,"given":"Metincan","family":"Erkaya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Oruc","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josh","family":"Sommovilla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salih","family":"Karahan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A.","family":"Trunzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Valente","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott R.","family":"Steele","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Liska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emre","family":"Gorgun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,25]]},"reference":[{"issue":"1","key":"13316_CR1","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1159\/000538958","volume":"10","author":"K \u0160emanjski","year":"2023","unstructured":"\u0160emanjski K, Lu\u017eai\u0107 K, Brki\u0107 J (2023) Current surgical methods in local rectal excision. Gastrointest Tumors 10(1):44\u201356. https:\/\/doi.org\/10.1159\/000538958","journal-title":"Gastrointest Tumors"},{"issue":"6","key":"13316_CR2","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1055\/a-1811-7025","volume":"54","author":"P Pimentel-Nunes","year":"2022","unstructured":"Pimentel-Nunes P, Lib\u00e2nio D, Bastiaansen BAJ et al (2022) Endoscopic submucosal dissection for superficial gastrointestinal lesions: European Society of Gastrointestinal Endoscopy (ESGE) guideline - update 2022. Endoscopy 54(6):591\u2013622. https:\/\/doi.org\/10.1055\/a-1811-7025","journal-title":"Endoscopy"},{"issue":"4","key":"13316_CR3","doi-asserted-by":"publisher","first-page":"2574","DOI":"10.1007\/s00464-022-09742-5","volume":"37","author":"I Steinbr\u00fcck","year":"2023","unstructured":"Steinbr\u00fcck I, Faiss S, Dumoulin FL et al (2023) Learning curve of endoscopic submucosal dissection (ESD) with prevalence-based indication in unsupervised Western settings: a retrospective multicenter analysis. Surg Endosc 37(4):2574\u20132586. https:\/\/doi.org\/10.1007\/s00464-022-09742-5","journal-title":"Surg Endosc"},{"key":"13316_CR4","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-026-12671-2","author":"M Erkaya","year":"2026","unstructured":"Erkaya M, Karahan S, Oruc M et al (2026) Endorobotic submucosal dissection using the da Vinci SP system: a 101-case experience in robotic transanal surgery. Surg Endosc. https:\/\/doi.org\/10.1007\/s00464-026-12671-2","journal-title":"Surg Endosc"},{"issue":"8","key":"13316_CR5","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1097\/DCR.0000000000001999","volume":"64","author":"JH Marks","year":"2021","unstructured":"Marks JH, Kunkel E, Salem JF, Martin CT, Anderson B, Agarwal S (2021) First clinical experience with single-port robotic transanal minimally invasive surgery: phase II trial of the initial 26 cases. Dis Colon Rectum 64(8):1003\u20131013. https:\/\/doi.org\/10.1097\/DCR.0000000000001999","journal-title":"Dis Colon Rectum"},{"issue":"1","key":"13316_CR6","doi-asserted-by":"publisher","DOI":"10.1002\/rcs.70026","volume":"21","author":"IK Kim","year":"2025","unstructured":"Kim IK, Bae JH, Lee YS, Lee IK (2025) Clinical feasibility and technical aspects of single port robotic transanal minimally invasive surgery (SP-rTAMIS) for rectal neoplasm. Int J Med Robot 21(1):e70026. https:\/\/doi.org\/10.1002\/rcs.70026","journal-title":"Int J Med Robot"},{"issue":"5","key":"13316_CR7","doi-asserted-by":"publisher","first-page":"3398","DOI":"10.1007\/s00464-022-09853-z","volume":"37","author":"PCH Jakobsen","year":"2023","unstructured":"Jakobsen PCH, Krarup PM, Jensen KK, Nordholm-Carstensen A (2023) Robot-assisted TAMIS: a systematic review of feasibility and outcomes. Surg Endosc 37(5):3398\u20133409. https:\/\/doi.org\/10.1007\/s00464-022-09853-z","journal-title":"Surg Endosc"},{"issue":"1","key":"13316_CR8","doi-asserted-by":"publisher","DOI":"10.1007\/s11701-026-03158-2","volume":"20","author":"A Ibrahim","year":"2026","unstructured":"Ibrahim A, Moscovici A, Marks J (2026) Transanal excision of rectal lesions using a single port robot: outcomes of initial 81 resections. J Robot Surg 20(1):183. https:\/\/doi.org\/10.1007\/s11701-026-03158-2","journal-title":"J Robot Surg"},{"issue":"5","key":"13316_CR9","doi-asserted-by":"publisher","first-page":"884","DOI":"10.1097\/SLA.0000000000006346","volume":"281","author":"A Alipouriani","year":"2025","unstructured":"Alipouriani A, Ozgur I, Bhatt A, Steele SR, Sommovilla J, Gorgun E (2025) Early experience with endorobotic submucosal dissection (ERSD): pathologic and short-term outcomes in the first 28 patients. Ann Surg 281(5):884\u2013889. https:\/\/doi.org\/10.1097\/SLA.0000000000006346","journal-title":"Ann Surg"},{"issue":"3","key":"13316_CR10","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1016\/j.gie.2013.09.014","volume":"79","author":"N Hayashi","year":"2014","unstructured":"Hayashi N, Tanaka S, Nishiyama S et al (2014) Predictors of incomplete resection and perforation associated with endoscopic submucosal dissection for colorectal tumors. Gastrointest Endosc 79(3):427\u2013435. https:\/\/doi.org\/10.1016\/j.gie.2013.09.014","journal-title":"Gastrointest Endosc"},{"issue":"7","key":"13316_CR11","doi-asserted-by":"publisher","first-page":"3114","DOI":"10.1007\/s00464-018-6026-2","volume":"32","author":"E Gorgun","year":"2018","unstructured":"Gorgun E, Benlice C, Abbas MA, Steele S (2018) Experience in colon sparing surgery in North America: advanced endoscopic approaches for complex colorectal lesions. Surg Endosc 32(7):3114\u20133121. https:\/\/doi.org\/10.1007\/s00464-018-6026-2","journal-title":"Surg Endosc"},{"issue":"2","key":"13316_CR12","doi-asserted-by":"publisher","DOI":"10.1111\/codi.70400","volume":"28","author":"E Erenler","year":"2026","unstructured":"Erenler E, Erkaya M, Oruc M, Karahan SN, Gorgun E (2026) Facilitating endorobotic submucosal dissection (ERSD) in transanal single-port surgery: a comparative analysis of two ports-A video vignette. Colorectal Dis 28(2):e70400. https:\/\/doi.org\/10.1111\/codi.70400","journal-title":"Colorectal Dis"},{"issue":"4","key":"13316_CR13","doi-asserted-by":"publisher","first-page":"e150","DOI":"10.1097\/DCR.0000000000003591","volume":"68","author":"K Erozkan","year":"2025","unstructured":"Erozkan K, Erkaya M, Kuzu MA, Gorgun E (2025) Endorobotic submucosal dissection after total neoadjuvant treatment in rectal cancer. Dis Colon Rectum 68(4):e150. https:\/\/doi.org\/10.1097\/DCR.0000000000003591","journal-title":"Dis Colon Rectum"},{"issue":"9","key":"13316_CR14","doi-asserted-by":"publisher","first-page":"1458","DOI":"10.1177\/00031348251358439","volume":"91","author":"E Dobbs","year":"2025","unstructured":"Dobbs E, Samanta D, Richmond BK (2025) A comparison of the laparoscopic vs robotic approaches for transanal minimally invasive surgery (TAMIS). Am Surg 91(9):1458\u20131463. https:\/\/doi.org\/10.1177\/00031348251358439","journal-title":"Am Surg"},{"issue":"9","key":"13316_CR15","doi-asserted-by":"publisher","first-page":"928","DOI":"10.1097\/DCR.0000000000000884","volume":"60","author":"L Lee","year":"2017","unstructured":"Lee L, Edwards K, Hunter IA et al (2017) Quality of local excision for rectal neoplasms using transanal endoscopic microsurgery versus transanal minimally invasive surgery: a multi-institutional matched analysis. Dis Colon Rectum 60(9):928\u2013935. https:\/\/doi.org\/10.1097\/DCR.0000000000000884","journal-title":"Dis Colon Rectum"},{"issue":"1","key":"13316_CR16","doi-asserted-by":"publisher","DOI":"10.1186\/s12893-022-01543-w","volume":"22","author":"ME Schwab","year":"2022","unstructured":"Schwab ME, Hernandez S, Watanaskul S, Chern H, Varma M, Sarin A (2022) Comparison of advanced techniques for local excision of rectal lesions: a case series. BMC Surg 22(1):117. https:\/\/doi.org\/10.1186\/s12893-022-01543-w","journal-title":"BMC Surg"},{"issue":"6","key":"13316_CR17","doi-asserted-by":"publisher","first-page":"1981","DOI":"10.1007\/s00464-018-6502-8","volume":"33","author":"SG Lee","year":"2019","unstructured":"Lee SG, Russ AJ, Casillas MA (2019) Laparoscopic transanal minimally invasive surgery (L-TAMIS) versus robotic TAMIS (R-TAMIS): short-term outcomes and costs of a comparative study. Surg Endosc 33(6):1981\u20131987. https:\/\/doi.org\/10.1007\/s00464-018-6502-8","journal-title":"Surg Endosc"},{"issue":"2","key":"13316_CR18","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1007\/s11701-022-01469-8","volume":"17","author":"S Watanaskul","year":"2023","unstructured":"Watanaskul S, Schwab ME, Chern H, Varma M, Sarin A (2023) Robotic transanal excision of rectal lesions: expert perspective and literature review. J Robot Surg 17(2):619\u2013627. https:\/\/doi.org\/10.1007\/s11701-022-01469-8","journal-title":"J Robot Surg"},{"issue":"4","key":"13316_CR19","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1007\/s10151-022-02577-1","volume":"26","author":"M Morino","year":"2022","unstructured":"Morino M, Forcignan\u00f2 E, Arezzo A (2022) Initial clinical experience with a novel flexible endoscopic robot for transanal surgery. Tech Coloproctol 26(4):301\u2013308. https:\/\/doi.org\/10.1007\/s10151-022-02577-1","journal-title":"Tech Coloproctol"},{"key":"13316_CR20","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-025-09617-4","author":"M Erkaya","year":"2026","unstructured":"Erkaya M, Dermuth F, Ulgur H, Oruc M, Gorgun E (2026) Traction-assisted endoscopic submucosal dissection for two complex colorectal lesions. Dig Dis Sci. https:\/\/doi.org\/10.1007\/s10620-025-09617-4","journal-title":"Dig Dis Sci"},{"issue":"10","key":"13316_CR21","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1016\/j.vgie.2022.07.002","volume":"7","author":"C Simsek","year":"2022","unstructured":"Simsek C, Thompson CC, Alkhateeb KJ, Jofre SA, Aihara H (2022) Novel articulating through-the-scope traction device. VideoGIE 7(10):353\u2013357. https:\/\/doi.org\/10.1016\/j.vgie.2022.07.002","journal-title":"VideoGIE"},{"issue":"16","key":"13316_CR22","doi-asserted-by":"publisher","first-page":"2883","DOI":"10.3748\/wjg.v23.i16.2883","volume":"23","author":"M Mortagy","year":"2017","unstructured":"Mortagy M, Mehta N, Parsi MA et al (2017) Magnetic anchor guidance for endoscopic submucosal dissection and other endoscopic procedures. World J Gastroenterol 23(16):2883\u20132890. https:\/\/doi.org\/10.3748\/wjg.v23.i16.2883","journal-title":"World J Gastroenterol"},{"issue":"1","key":"13316_CR23","doi-asserted-by":"publisher","DOI":"10.1002\/deo2.394","volume":"5","author":"A Qatomah","year":"2024","unstructured":"Qatomah A, Aihara H (2024) Colorectal endoscopic submucosal dissection in the USA: the current state and future perspectives. DEN Open 5(1):e394. https:\/\/doi.org\/10.1002\/deo2.394","journal-title":"DEN Open"},{"issue":"6","key":"13316_CR24","doi-asserted-by":"publisher","first-page":"851","DOI":"10.1111\/den.13591","volume":"32","author":"TR McCarty","year":"2020","unstructured":"McCarty TR, Aihara H (2020) Current state of education and training for endoscopic submucosal dissection: translating strategy and success to the USA. Dig Endosc 32(6):851\u2013860. https:\/\/doi.org\/10.1111\/den.13591","journal-title":"Dig Endosc"},{"issue":"10","key":"13316_CR25","doi-asserted-by":"publisher","first-page":"1383","DOI":"10.1097\/DCR.0000000000002773","volume":"66","author":"DN Giugliano","year":"2023","unstructured":"Giugliano DN, Feinberg AE, Sapci I et al (2023) The learning curve for advanced endoscopy for colorectal lesions: a surgeon\u2019s experience at a high-volume center. Dis Colon Rectum 66(10):1383\u20131391. https:\/\/doi.org\/10.1097\/DCR.0000000000002773","journal-title":"Dis Colon Rectum"},{"issue":"3","key":"13316_CR26","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1097\/DCR.0000000000003917","volume":"69","author":"M Erkaya","year":"2026","unstructured":"Erkaya M, Oruc M, Karahan SN, Gorgun E (2026) Adapting the bubble port for transanal robotic single-port surgery in rectal lesions enabling submucosal dissection. Dis Colon Rectum 69(3):460. https:\/\/doi.org\/10.1097\/DCR.0000000000003917","journal-title":"Dis Colon Rectum"},{"issue":"7","key":"13316_CR27","doi-asserted-by":"publisher","first-page":"3976","DOI":"10.1007\/s00464-024-10895-8","volume":"38","author":"DS Keller","year":"2024","unstructured":"Keller DS, Reif de Paula T, Ikner TP et al (2024) Comparing advanced platforms for local excision of rectal lesions. Surg Endosc 38(7):3976\u20133983. https:\/\/doi.org\/10.1007\/s00464-024-10895-8","journal-title":"Surg Endosc"},{"issue":"2","key":"13316_CR28","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1177\/1553350619892490","volume":"27","author":"HL Yao","year":"2020","unstructured":"Yao HL, Ngu JCY, Lin YK, Chen CC, Chang SW, Kuo LJ (2020) Robotic transanal minimally invasive surgery for rectal lesions. Surg Innov 27(2):181\u2013186. https:\/\/doi.org\/10.1177\/1553350619892490","journal-title":"Surg Innov"},{"issue":"6","key":"13316_CR29","doi-asserted-by":"publisher","DOI":"10.1111\/codi.70521","volume":"28","author":"C Buyuker","year":"2026","unstructured":"Buyuker C, Erkaya M, Gorgun E (2026) Endorobotic submucosal dissection of a sigmoid lesion 24\u2009cm from the anal verge: a video vignette. Colorectal Dis 28(6):e70521. https:\/\/doi.org\/10.1111\/codi.70521","journal-title":"Colorectal Dis"},{"issue":"5","key":"13316_CR30","doi-asserted-by":"publisher","first-page":"1352","DOI":"10.1053\/j.gastro.2018.01.003","volume":"154","author":"AF Peery","year":"2018","unstructured":"Peery AF, Cools KS, Strassle PD et al (2018) Increasing rates of surgery for patients with nonmalignant colorectal polyps in the United States. Gastroenterology 154(5):1352-1360.e3. https:\/\/doi.org\/10.1053\/j.gastro.2018.01.003","journal-title":"Gastroenterology"},{"issue":"5","key":"13316_CR31","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1002\/bjs.9454","volume":"101","author":"R Hompes","year":"2014","unstructured":"Hompes R, Rauh SM, Ris F, Tuynman JB, Mortensen NJ (2014) Robotic transanal minimally invasive surgery for local excision of rectal neoplasms. Br J Surg 101(5):578\u2013581. https:\/\/doi.org\/10.1002\/bjs.9454","journal-title":"Br J Surg"},{"key":"13316_CR32","doi-asserted-by":"publisher","first-page":"134","DOI":"10.1016\/j.jss.2018.03.022","volume":"229","author":"H Cheng","year":"2018","unstructured":"Cheng H, Clymer JW, Po-Han Chen B et al (2018) Prolonged operative duration is associated with complications: a systematic review and meta-analysis. J Surg Res 229:134\u2013144. https:\/\/doi.org\/10.1016\/j.jss.2018.03.022","journal-title":"J Surg Res"},{"key":"13316_CR33","doi-asserted-by":"publisher","DOI":"10.1186\/s13561-024-00487-6","volume":"14","author":"E Wagenschieber","year":"2024","unstructured":"Wagenschieber E, Blunck D (2024) Impact of reimbursement systems on patient care \u2013 a systematic review of systematic reviews. Health Econ Rev 14:22. https:\/\/doi.org\/10.1186\/s13561-024-00487-6","journal-title":"Health Econ Rev"}],"container-title":["Surgical Endoscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-026-13316-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00464-026-13316-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00464-026-13316-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:45:39Z","timestamp":1790351139000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00464-026-13316-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,25]]},"references-count":33,"alternative-id":["13316"],"URL":"https:\/\/doi.org\/10.1007\/s00464-026-13316-0","relation":{},"ISSN":["0930-2794","1432-2218"],"issn-type":[{"value":"0930-2794","type":"print"},{"value":"1432-2218","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,25]]},"assertion":[{"value":"20 March 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 August 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Dr. Emre Gorgun is a consultant for Boston Scientific, DiLumen and Intuitive. David Liska, Metincan Erkaya, Mustafa Oruc, Joshua Sommovilla, Salih Karahan, Joseph A. Trunzo, Michael Valente, and Scott R. Steele declare that they have no conflicts of interest related to this work.","order":1,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Institutional Review Board of the Cleveland Clinic, which waived the requirement for informed consent due to its retrospective design. All procedures were conducted in accordance with the institutional guidelines.This study was presented as a podium presentation at the 2026 SAGES Annual Scientific Meeting, held March 25\u201328, 2026, at the Tampa Convention Center, Tampa, Florida, USA.","order":2,"name":"Ethics","label":"Ethical approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}