To explore the feasibility of using indocyanine green(ICG) visualizing the deep infiltrating endometriosis (DIE) during robotic surgery.

A patient with DIE in Department of Genecology and Obstetrics, Chinese PLA General Hospital was selected and underwent total hysterectomy with bilateral adnexectomy and endometriosis lesion excision with perfect preoperative examination and no surgical contraindication. Near-infrared fluorescence imaging with indocyanine green was used in the operation to visualize the endometriosis lesions.

The location of the lesions were accurate and the patient discharged from hospital successfully.

Near-infrared fluorescence imaging system with indocyanine green may clearly visualize the deep infiltrating endometriosis during robotic surgery. It is characterized by brief operation, accuracy and real time. With this technique, we can comprehensively evaluate the scope of our surgery.

This article presents a case of advanced renal cell carcinoma in a male patient, diagnosed following the identification of a pulmonary space-occupying lesion. The patient presented to Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine due to persistent coughing for one year and anterior chest pain for two weeks. Chest and abdominal CT scans revealed lung cancer located in the lower lobe of the left lung, accompanied by multiple intrapulmonary metastases as well as metastatic tumors throughout other regions of the body including both kidneys. A biopsy was performed on the pulmonary mass, with pathological analysis confirming adenocarcinoma. Based on immunohistochemical findings, it was determined that the tumor likely originated from the kidney. Following multidisciplinary discussions within the hospital and consultations with the patient's family, a treatment plan involving toripalimab combined with axitinib for targeted therapy and immunotherapy was established, alongside traditional Chinese medicine tailored to syndrome differentiation and dietary therapy. After five courses of this combined treatment regimen, significant regression of the patient's tumors was observed. Subsequent multidisciplinary consultation conducted by Guangdong Urological Association, the experts recommended continuing targeted therapy and immunotherapy while monitoring liver function closely, they also suggested integrating traditional Chinese medicine treatments along with performing PET-CT imaging and renal biopsy if feasible. Upon further discussion with the patient's family, continuation of targeted therapy and immunotherapy proceeded as planned. The PET-CT results indicated substantial reductions in both lung and kidney tumors without any evident hypermetabolism detected in other areas. In conclusion, this case illustrates that combining targeted therapies with immunotherapy alongside traditional Chinese medicine can yield effective outcomes for patients suffering from advanced renal cell carcinoma.

To introduce a new surgical technique for low anterior resection with anal sphincter preservation: coloanal intussusception anastomosis.

A descriptive study was conducted on two typical cases, using an optimized anastomotic method that integrates the advantages of Parks procedure and modified Bacon procedure.

Both patients underwent successful surgery without stoma. The average anastomosis time was 22 minutes. Ischemic intestinal loops completely sloughed off within 3 to 8 days. The anal appearance was favorable, with no anastomotic fistula. Both the surgeon’s operational convenience and the patients’ postoperative comfort (pain and perianal discomfort) were satisfactory.

Coloanal intussusception anastomosis is a feasible anastomotic technique, applicable to various anal-sphincter-preserving needs where double-stapling anastomosis is infeasible. It shows research prospects in reducing the incidence of anastomotic leakage and the utilization rate of protective stomas.