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.

Gastrointestinal

Laparoscopic Paraaortic Lymph Node Sampling in Gastric Cancer Patients with Suspected Paraaortic Lymph Node Metastasis

Ba Ool Seong, Ju No Yoo, Chang Seok Ko, Sa-Hong Min, Chung Sik Gong, In-Seob Lee, Moon-Won Yoo, Jeong Hwan Yook, Beom Su Kim

J Surg Innov Educ. 2024;1(2):34-38.   Published online December 27, 2024

DOI: https://doi.org/10.69474/jsie.2024.00206

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Abstract PDF

D2 lymphadenectomy is the standard approach for lymph node dissection in curable gastric cancer. However, paraaortic lymph node (PALN) dissection in addition to D2 lymphadenectomy has not been shown to improve survival rates and is therefore not routinely performed. Nevertheless, PALN sampling may be indicated for diagnostic purposes because it can provide critical information for accurate staging and treatment planning. Laparoscopic PALN sampling, however, poses significant challenges due to limited accessibility and visibility in the paraaortic region. Moreover, the proximity of major blood vessels, such as the abdominal aorta and renal vein, is another difficult aspect of the procedure. In this context, we present two cases to demonstrate practical strategies for facilitating laparoscopic PALN sampling. The procedure can be effectively performed by first identifying the ligament of Treitz and then, when necessary, fixing the small bowel mesentery to the abdominal wall using a tagging suture so that there is adequate vision and enough working space. This enables careful and precise dissection of the target tissue without compromising the feasibility and safety of the operation.

Bariatric

Laparoscopic Sleeve Gastrectomy: Ensuring Safety and Achieving an Aesthetic Gastric Tube Shape

Ba Ool Seong, Chang Seok Ko, Seul-Gi Oh, Seong-A Jeong, Jeoung Hwan Yook, Moon-Won Yoo, Beom Su Kim, In-Seob Lee, Chung Sik Gong, Sa-Hong Min

J Surg Innov Educ. 2024;1(1):22-25.   Published online June 25, 2024

DOI: https://doi.org/10.69474/jsie.2024.00017

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Abstract PDF

Sleeve gastrectomy was first performed in Korea in the 2000s, and its frequency has gradually increased thereafter. It is now the most commonly performed procedure for bariatric surgery today. However, there are few detailed reports on this surgical method, and, in particular, no papers that include accompanying videos. Herein, we present the case of a 29-year-old male with a preoperative body mass index of 44 kg/m2, who also had hypertension and hyperlipidemia. A conventional laparoscopic sleeve gastrectomy was performed using a 5-port technique. The surgeon employed two methods to ensure a consistent and aesthetic gastric tube, as well as patient safety: the non-tension method and a Lembert suture on the staple line at the neo–greater curvature. By utilizing the aforementioned two tips effectively, even inexperienced surgeons can perform laparoscopic sleeve gastrectomy relatively safely and effectively.

Gastrointestinal

Techniques in Jejunojejunostomy, Gastrojejunostomy, and Esophagojejunostomy in Reduced-Port Gastrectomy

Sa-Hong Min

J Surg Innov Educ. 2024;1(1):3-5.   Published online June 25, 2024

DOI: https://doi.org/10.69474/jsie.2024.00031

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Minimally invasive gastric cancer surgery aims to reduce morbidity and mortality while maintaining satisfactory oncological outcomes. Laparoscopic gastrectomy is a standard treatment, offering reduced pain, shorter hospital stays, and faster recovery. Reduced-port gastrectomy has gained popularity due to its requirement for limited assistants; however, it poses unique challenges. This paper shares the techniques used in three cases of jejunojejunostomy, gastrojejunostomy, and esophagojejunostomy during reduced-port gastrectomy. Reduced-port techniques were successfully implemented in all three cases. Key steps included proper port placement, the use of tagging sutures, and strategic stapler insertion and adjustment. The reduced-port approach demonstrated feasibility and effectiveness despite its inherent challenges. Reduced-port gastrectomy can be effectively performed with a careful technique and meticulous planning, despite the challenges of transitioning from conventional five-port techniques. Using fewer ports results in less pain, fewer complications, and shorter hospital stays without compromising oncologic outcomes. These techniques can be helpful for trainees and novice surgeons, though careful candidate selection is paramount.

Feasibility and Competency Outcomes of a Standardized Colonoscopy Curriculum in General Surgery Residency

Dae Kyung Sohn, Sang-Ho Jeong, Seung Jae Roh, Sa-Hong Min, In-Seob Lee

Received March 18, 2026  Accepted May 3, 2026  Published online May 27, 2026  

DOI: https://doi.org/10.69474/jsie.2026.00010

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Abstract

Background
Integrating structured colonoscopy training into general surgery residency programs remains both a logistical and educational challenge. This study evaluated the feasibility and educational outcomes of a standardized colonoscopy training curriculum for surgical residents using objective competency assessments and trainee perceptions.
Methods
A retrospective mixed-methods analysis was conducted among general surgery residents who participated in a standardized colonoscopy training program between 2022 and 2025. Faculty assessed objective procedural competency using the Direct Observation of Procedural Skills framework across three domains: basic manipulation, anatomical understanding, and insertion & advancement. Trainee perceptions regarding the training environment, procedural difficulty, and perceived educational value were evaluated using a post-training survey.
Results
Objective competency data from 369 residents were analyzed. Residents demonstrated high performance in the basic manipulation and anatomical understanding domains following completion of the training program. In contrast, scores in the insertion & advancement domain were comparatively lower, suggesting greater technical difficulty. Post-graduate year (PGY)-3 residents achieved significantly higher scores than PGY-2 residents in this domain (p=0.015), whereas performance in the other domains was comparable between the groups. Post-training survey responses indicated that most residents considered the training duration and group size appropriate, and more than 94% reported that the program would be beneficial for their future clinical practice.
Conclusions
A standardized colonoscopy training curriculum implemented during surgical residency was feasible and was associated with high levels of competency in fundamental endoscopic skills. However, insertion and advancement techniques remained more challenging for junior trainees, suggesting that additional practice opportunities targeting complex insertion skills may improve future training programs.