Comparison of safety and effectiveness of micropulse transscleral cyclophotocoagulation and "slow cook" diode laser transscleral cyclophotocoagulation in patients with refractory open-angle glaucoma

ABSTRACT Purpose: This study aimed to compare the safety and effectiveness of intraocular pressure reduction between micropulse transscleral cyclophotocoagulation and "slow cook" transscleral cyclophotocoagulation in patients with refractory primary open-angle glaucoma. Methods: We included patients with primary open angle glaucoma with at least 12 months of follow-up. We collected and analyzed data on the preoperative characteristics and postoperative outcomes. The primary outcomes were a reduction of ≥20% of the baseline value (criterion A) and/or intraocular pressure between 6 and 21 mmHg (criterion B). Results: We included 128 eyes with primary open-angle glaucoma. The preoperative mean intraocular pressure was 25.53 ± 6.40 and 35.02 ± 12.57 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean intraocular pressure was reduced significantly to 14.33 ± 3.40 and 15.37 ± 5.85 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups at the last follow-up, respectively (p=0.110). The mean intraocular pressure reduction at 12 months was 11.20 ± 11.46 and 19.65 ± 13.22 mmHg in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The median preoperative logMAR visual acuity was 0.52 ± 0.69 and 1.75 ± 1.04 in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p<0.001). The mean visual acuity variation was −0.10 ± 0.35 and −0.074 ± 0.16 in the micropulse- and "slow cook" transscleral cyclophotocoagulation, respectively (p=0.510). Preoperatively, the mean eye drops were 3.44 ± 1.38 and 2.89 ± 0.68 drugs in the micropulse- and "slow cook" transscleral cyclophotocoagulation groups, respectively (p=0.017), but those were 2.06 ± 1.42 and 1.02 ± 1.46 at the end of the study in the "slow cook" and micropulse transscleral cyclophotocoagulation groups, respectively (p<0.001). The success of criterion A was not significant between both groups. Compared with 11 eyes (17.74%) in the "slow cook" transscleral cyclophotocoagulation group, 19 eyes (28.78%) in the micropulse transscleral cyclophotocoagulation group showed complete success (p=0.171). For criterion B, 28 (42.42%) and 2 eyes (3.22%) showed complete success after micropulse- and "slow cook" transscleral cyclophotocoagulation, respectively (p<0.001). Conclusion: Both techniques reduced intraocular pressure effectively.

Antitrombóticos: investigación y aplicaciones en la atención médica / Antithrombotics: Research and applications in healthcare

Resumen: Los antitrombóticos son fármacos que se utilizan para prevenir la formación de coágulos sanguíneos, también conocidos como trombos. Estos coágulos pueden causar graves problemas de salud, como infartos o enfermedades cerebrovasculares. En este artículo se analizan diferentes tipos de antitrombóticos, como los antiplaquetarios y los anticoagulantes, y se discuten sus mecanismos de acción. Además, se examinan los beneficios y los riesgos asociados con el uso de antitrombóticos. Por un lado, estos fármacos pueden reducir el riesgo de eventos trombóticos, lo que puede ser especialmente beneficioso en pacientes con condiciones de alto riesgo, como aquellos que han sufrido un infarto o que tienen fibrilación auricular. Por otro lado, también se discuten los posibles efectos secundarios de los antitrombóticos, como el aumento del riesgo de sangrado. Además, se proporcionan pautas para su uso seguro en diferentes escenarios clínicos. Finalmente, se abordan las estrategias de monitoreo y ajuste de la dosis de estos medicamentos para garantizar su eficacia y seguridad en los pacientes.

Abstract: Antithrombotics are drugs used to prevent the formation of blood clots, also known as thrombi. These clots can cause serious health problems, such as heart attacks or strokes. Different types of antithrombotics, such as antiplatelets and anticoagulants, are analyzed and their mechanisms of action are discussed. Additionally, the benefits and risks associated with the use of antithrombotics are examined. On the one hand, these drugs can reduce the risk of thrombotic events, which may be especially beneficial in patients with high-risk conditions, such as those who have suffered a heart attack or who have atrial fibrillation. On the other hand, the possible side effects of antithrombotics, such as the increased risk of bleeding, are also discussed and guidelines for their safe use in different clinical scenarios are provided. Additionally, monitoring and dose adjustment strategies for these medications are addressed to ensure their effectiveness and safety in patients.

A case of spontaneous bilateral epidural hematoma associated with decreased coagulation factor XII activity: case report and literature review.

Epidural hematoma typically manifests following craniocerebral trauma, stemming from injury to the meningeal artery or venous system, predominantly on one side. Instances of spontaneous epidural hematoma are uncommon, with occurrences of spontaneous bilateral epidural hematoma being exceedingly rare. Sickle cell disease, adjacent paranasal sinusitis, and tumor metastases are the most prevalent causes of spontaneous epidural hematoma. This case study presents an individual with abdominal liposarcoma exhibiting reduced coagulation factor XII activity, who experienced sudden unconsciousness due to spontaneous acute bilateral epidural hematoma, and subsequently achieved a favorable outcome following surgical intervention.

First description of oesophageal melanoma in a cat and palliative treatment by endoscopic argon plasma coagulation laser.

Case summary: An 11-year-old castrated male domestic shorthair cat presented with chronic regurgitation and weight loss. Despite a 2-month history of weight loss, regurgitation intensified over 4 weeks, occurring with every food intake, even on a semi-liquid diet. Physical examination revealed thinness and dehydration, and a focal oval mass was noted in the middle mediastinum on thoracic radiography. Oesophagoscopy identified a 6 cm neoformation almost completely obstructing the oesophageal lumen. Biopsies were taken and histopathology, positivity to melanoma triple cocktail and PNL-2 by immunohistochemistry led to the diagnosis of melanocytic neoplasm. Palliative debulking with argon plasma coagulation (APC) was performed, significantly improving the cat's quality of life for 2 months. The cat survived for 107 days after diagnosis. Relevance and novel information: This case report describes the first report of melanocytic neoplasia originating from the oesophageal mucosa in a cat. In cats, melanomas outside the eyes are exceedingly rare and oesophageal neoplasms are exceptionally rare in veterinary medicine, particularly melanomas. The diagnosis relied on positive immunohistochemistry markers aligning with previous research. Treatment with APC emerged as a novel, potentially palliative approach, successfully alleviating regurgitation for 3 months. This underscores APC's potential in feline oesophageal neoplasia palliative care, which deserves further investigation in a broader feline cohort to confirm its efficacy. Overall, this report provides valuable insights into the diagnosis and treatment of oesophageal melanoma in cats.

Effect of mild hypothermia vs normothermia cardiopulmonary bypass on postoperative bleeding in patients undergoing coronary artery bypass grafting: protocol of a multi-center, randomized, controlled trial.

BACKGROUND: Coronary artery bypass grafting (CABG) is often performed with hypothermic cardiopulmonary bypass (CPB) to reduce metabolic demands and protect the myocardium. However, hypothermia can increase bleeding risks and other complications. METHODS: This is a prospective, multi-center, randomized controlled trial. From September 2023 to December 2024, a total of 336 eligible patients planning to undergo on-pump CABG will be enrolled. All participants will be randomly divided into mild hypothermia CPB group (target oxygenator arterial outlet blood temperature at 32-33℃) or normothermia CPB group (target oxygenator arterial outlet blood temperature at 35-36℃). The primary endpoint is Universal Definition of Perioperative Bleeding (UDPB) class 2-4. Secondary endpoints are class of UDPB, levels of coagulation and inflammatory factors, in-hospital mortality, perioperative related complications, ICU length of stay, and hospital length of stay. DISCUSSION: This clinical trial aims to compare the effects of different target temperature during CPB on postoperative bleeding and to explore optimal temperature strategy to provide new clinical evidence. TRIAL REGISTRATION: Chictr.org.cn : ChiCTR2300075405. The trial was prospectively registered on 4 September 2023.

Anesthetic management for fetal surgery: Lessons from a single-center experience (2019-2023).

Fetal surgery presents distinctive anesthetic challenges due to the need to balance maternal and fetal safety. This retrospective study evaluates the anesthetic management strategies used at a single center for various fetal interventions, including fetoscopic laser photocoagulation, fetal endoluminal tracheal occlusion, bipolar cord coagulation, and fetoscopic spina bifida repair. We reviewed 195 fetal procedures performed between 2019 and 2023 at Rabin Medical Center. Data collected included maternal and fetal characteristics, anesthetic techniques (spinal, combined spinal-epidural, general), intraoperative hypotension, and perioperative complications. We examined the evolution of anesthetic practice, particularly focusing on hemodynamic management and postoperative pain control. Spinal anesthesia was increasingly preferred for shorter procedures such as fetoscopic laser photocoagulation and bipolar cord coagulation, while general anesthesia was used exclusively for spina bifida repair. Intraoperative hypotension was a significant issue, leading to the implementation of prophylactic phenylephrine infusions, which improved blood pressure control. A shift from volatile anesthesia to total intravenous anesthesia in spina bifida repair resulted in fewer complications, including reduced bleeding. Postoperative pain management was optimized with a multimodal approach, improving pain scores. This study underscores the importance of tailoring anesthetic techniques to the specific fetal surgery. Key improvements in hypotension management, adopting total intravenous anesthesia for complex surgeries, and optimized postoperative pain control have contributed to better maternal and fetal outcomes. Ongoing reassessment and adaptation of anesthetic protocols remain critical as fetal surgery evolves.

Anemia Secondary to Gastric Antral Vascular Ectasia Successfully Treated With Antral Gastrectomy.

Gastric antral vascular ectasia (GAVE) is a rare but significant cause of chronic gastrointestinal bleeding and anemia, particularly in elderly patients. We report the case of a 75-year-old female who presented with severe anemia secondary to GAVE. Despite multiple endoscopic interventions with argon plasma coagulation (APC) treatments and endoscopic band ligation (EBL), the patient's condition persisted, necessitating an antral gastrectomy with intraoperative endoscopy to delineate the proximal resection margin. Postoperative outcomes were favorable, with no recurrence of anemia or gastrointestinal bleeding observed during follow-up.

Why is DIC a Rare Diagnosis in the 21st Century?

Disseminated Intravascular Coagulation (DIC) has been a common diagnosis made by health care givers since the dawn of the 20th century. However, currently, this diagnosis is entertained rarely in clinical settings that can predispose to this complication. The incidence of four common clinical scenarios traditionally associated with DIC, sepsis, trauma, obstetrical disorders, and cancers, are on the increase due to better diagnostics and management strategies, but DIC is rarely diagnosed in these disease categories currently. The authors suggest the rarity of a DIC diagnosis is due to varied understanding of the pathophysiology of this condition. In this perspectives, we would like to present reasons for this change in consideration and encourage caregivers to consider a DIC diagnosis at an early stage based on new criteria to help patients benefit from available treatments.

Comprehensive Analysis of a Platelet- and Coagulation-Related Prognostic Gene Signature Identifies CYP19A1 as a Key Tumorigenic Driver of Colorectal Cancer.

BACKGROUND: The intricate interplay between the platelet-coagulation system and the progression of malignant tumors has profound therapeutic implications. However, a thorough examination of platelet and coagulation markers specific to colorectal cancer (CRC) is conspicuously absent in the current literature. Consequently, there is an urgent need for further exploration into the mechanistic underpinnings of these markers and their potential clinical applications. METHODS: By integrating RNA-seq data and clinicopathological information from patients with CRC in the cancer genome atlas, we identified genes related to the platelet-coagulation system using weighted gene co-expression networks and univariate Cox analysis. We established a prognostic risk model based on platelet- and coagulation-related genes using Lasso Cox regression analysis and validated the model in two independent CRC cohorts. We explored potential biological functional disparities between high-risk and low-risk groups through comprehensive bioinformatics analysis. RESULTS: Our findings indicate that colorectal cancer patients classified as high-risk generally exhibit poorer prognoses. Moreover, the model's risk scores were associated with the differential composition of the immune tumor microenvironment, suggesting its applicability to infer immunotherapy responsiveness. Cellular functional experiments and animal experiments indicated that CYP19A1 expression in CRC influences malignant phenotype and platelet activation. CONCLUSIONS: In summary, we present a novel platelet- and coagulation-related risk model for prognostic assessment of patients with CRC and confirm the important role of CYP19A1 in promoting malignant progression of CRC.

Evaluation of Red Blood Cell Biochemical Markers and Coagulation Profiles Following Cell Salvage in Cardiac Surgery: A Systematic Review and Meta-Analysis.

Background: Individuals undergoing cardiac surgery face an increased risk of bleeding, as well as alterations in biochemical and coagulation patterns. Therefore, assessing the effectiveness of systems such as Cell Salvage is necessary to prevent potential surgical complications. Objective: To evaluate the efficacy of Cell Salvage in relation to the biochemical parameters of the red blood series and coagulation, as well as the risk of hemorrhage. Methods: A systematic review, accompanied by a meta-analysis, was executed via an extensive literature exploration encompassing Medline, CINAHL, Scopus, Web of Science, and the Cochrane Library. The inclusion criteria comprised studies in English or Spanish, without year restrictions, conducted in adults and with a randomized controlled trial design. Results: Twenty-six studies were included in the systematic review, involving a total of 2850 patients (experimental group = 1415; control group = 1435). Cell Salvage did not demonstrate superior outcomes compared to allogeneic transfusions in the management of post-surgical hemorrhage, as well as in total blood loss, platelet count, fresh frozen plasma, and fibrinogen. However, Cell Salvage showed a greater effectiveness for hemoglobin (moderate evidence), hematocrit (low evidence), post intervention D-dimer (low evidence), and some coagulation-related parameters (low evidence) compared to allogeneic transfusions. Finally, better results were found in the control group for INR parameters. Conclusions: The use of the Cell Salvage system holds high potential to improve the postoperative levels of biochemical and coagulation parameters. However, the results do not provide definitive evidence regarding its effectiveness for hemorrhage control, platelet count, fresh frozen plasma, and fibrinogen. Therefore, it is recommended to increase the number of studies to assess the impact of the Cell Salvage system on improvements in the red blood cell count and patient coagulation patterns. In addition, protocols should be homogenized, and variables such as the sex of the participants should be taken into account.

Characterization of Kunitz-Domain Anticoagulation Peptides Derived from Acinetobacter baumannii Exotoxin Protein F6W77.

Recent studies have revealed that the coagulation system plays a role in mammalian innate defense by entrapping bacteria in clots and generating antibacterial peptides. So, it is very important for the survival of bacteria to defend against the host coagulation system, which suggests that bacterial exotoxins might be a new source of anticoagulants. In this study, we analyzed the genomic sequences of Acinetobacter baumannii and a new bacterial exotoxin protein, F6W77, with five Kunitz-domains, KABP1-5, was identified. Each Kunitz-type domain features a classical six-cysteine framework reticulated by three conserved disulfide bridges, which was obviously similar to animal Kunitz-domain peptides but different from plant Kunitz-domain peptides. Anticoagulation function evaluation showed that towards the intrinsic coagulation pathway, KABP1 and KABP5 had apparently inhibitory activity, KABP4 had weak inhibitory activity, and KBAP2 and KABP3 had no effect even at a high concentration of 20 µg/mL. All five Kunitz-domain peptides, KABP1-5, had no inhibitory activity towards the extrinsic coagulation pathway. Enzyme-inhibitor experiments showed that the high-activity anticoagulant peptide KABP1 had apparently inhibitory activity towards two key coagulation factors, Xa and XIa, which was further confirmed by pull-down experiments that showed that KABP1 can bind to coagulation factors Xa and XIa directly. Structure-function relationship analyses of five Kunitz-type domain peptides showed that the arginine of the P1 site of three new bacterial anticoagulants, KABP1, KABP4 and KABP5, might be the key residue for their anticoagulation activity. In conclusion, with bioinformatics analyses, peptide recombination, and functional evaluation, we firstly found bacterial-exotoxin-derived Kunitz-type serine protease inhibitors with selectively inhibiting activity towards intrinsic coagulation pathways, and highlighted a new interaction between pathogenic bacteria and the human coagulation system.

A method of "Noninjecting Resection using Bipolar Soft coagulation mode; NIRBS" for superficial non-ampullary duodenal epithelial tumor: a pilot study.

BACKGROUND: Complete endoscopic resection of superficial non-ampullary duodenal epithelial tumors (SNADETs) is technically difficult, especially with an extremely high risk of adverse event (AE), although various endoscopic resection methods including endoscopic mucosal resection (EMR), underwater EMR (UEMR), and endoscopic submucosal dissection (ESD) have been tried for SNADETs. Accordingly, a novel simple resection method that can completely resect tumors with a low risk of AEs should be developed. AIMS: A resection method of Noninjecting Resection using Bipolar Soft coagulation mode (NIRBS) which has been reported to be effective and safe for colorectal lesions is adapted for SNADETs. In this study we evaluated its effectiveness, safety, and simplicity for SNADETs measuring ≤ 20 mm. RESULTS: This study included 13 patients with resected lesions with a mean size of 7.8 (range: 3-15) mm. The pathological distributions of the lesions were as follows: adenomas, 77% (n = 10) and benign and non-adenomatous lesions, 23% (n = 3). The en bloc and R0 resection rate was 100% (n = 13). The median procedure duration was 68 s (32-105). None of the patients presented with major AEs including bleeding and perforation. CONCLUSIONS: Large studies such as prospective, randomized, and controlled trials should be conducted for the purpose of validating effectiveness, safety, and simplicity of the NIRBS for SNADETs measuring ≤ 20 mm suggested in this study.

Significance of prothrombin, activated partial thromboplastin, and thrombin times in early rehabilitation after tibial fracture surgery.

OBJECTIVE: To assess the role of prothrombin time (PT), activated partial thromboplastin time (APTT), and thrombin time (TT) in guiding early rehabilitation following tibial fracture surgery. METHODS: A retrospective analysis was conducted on 168 patients treated for tibial fractures from May 2020 to May 2022. Patients were divided into good and poor rehabilitation groups based on treatment outcomes. Data on age, gender, BMI, Schatzker classification, operation time, blood loss, PT, APTT, and TT were collected for univariate analysis. ROC curve analysis determined optimal cut-off values, followed by multivariable logistic regression to identify independent risk factors. A nomogram prediction model was then constructed. RESULTS: Independent risk factors for early recovery included age ≥45 years, Schatzker type III, operation time ≥99.5 minutes, APTT≥28.5 seconds, and TT≥13.5 seconds. The nomogram model demonstrated high prediction accuracy with a C-index of 0.980. CONCLUSION: Prolonged APTT, extended TT, longer operation time, and higher Schatzker classification were identified as independent risk factors influencing early recovery post-surgery. A logistic regression-based prediction model was developed, facilitating the design of personalized rehabilitation training programs to improve patient outcomes.

Incidence of Hematoma Following Breast Reduction in Patients Taking Selective Serotonin Reuptake Inhibitor or Serotonin-Norepinephrine Reuptake Inhibitor: A Retrospective Review.

Background Selective serotonin reuptake inhibitor (SSRI) and serotonin-norepinephrine reuptake inhibitor (SNRI) use is more common in the plastic surgery population compared to the general population. This study was designed to assess the theoretical effect of SSRIs and SNRIs on platelet function and the potential for increased bleeding risk. This study sought to establish the incidence of postoperative bleeding following routine bilateral breast reduction for patients on SSRIs or SNRIs. The outcomes of this study contribute to the discussion of whether these medications should be discontinued before elective surgery. Methodology A retrospective chart review of all patients who received bilateral breast reduction surgery over a 10-year period was performed. Patient charts were reviewed for postoperative hematoma formation as well as medications being used around the time of surgery. The rate of hematoma formation in patients actively taking SSRIs or SNRIs at the time of surgery was compared with the rest of the study population. Results A total of 1,022 patients met the inclusion criteria for the study. The overall incidence of postoperative hematoma was 7.7%. Of these, 1.9% of patients had clinically significant hematomas that required operative evacuation, and the remaining were treated conservatively. The only variable associated with a significantly higher risk of hematoma formation was advanced age (p = 0.005). Conclusions There was no significant difference in hematoma incidence after breast reduction in patients taking SNRIs or SSRIs compared with the general population. This contradicts some of the previously published literature and can hopefully guide clinicians in counseling their patients preoperatively.

Spontaneous postoperative bleeding after periodontal procedure: An alarming sign of bleeding disorder.

The prevalence of inherited bleeding disorders (BDs) is low in the general population (10-20 per 100,000 individuals), particularly hemophilia B cases, which may remain undiagnosed for a very long time until exposed to some surgical procedure. The dental professional must be aware of the possibility that patients with no previous history of abnormal bleeding may manifest their first bleeding episode in the dental office. Particularly as periodontists, we often encounter patients with bleeding gums and severe bleeding complications may precipitate while performing routine periodontal procedures. Hence, we must have a thorough knowledge of BDs and their management in challenging hemorrhagic situations. Management of such patients necessitates a multidisciplinary approach by involving the patient's hematologist and advanced laboratory facilities. The present case report is an attempt to discuss the diagnosis and management of a bleeding episode that occurred post periodontal flap surgery in an undiagnosed hemophilia B patient.

Identification of key biomarkers and therapeutic targets in sepsis through coagulation-related gene expression and immune pathway analysis.

Sepsis, characterized by a widespread and dysregulated immune response to infection leading to organ dysfunction, presents significant challenges in diagnosis and treatment. In this study, we investigated 203 coagulation-related genes in sepsis patients to explore their roles in the disease. Through differential gene expression analysis, we identified 20 genes with altered expression patterns. Subsequent correlation analysis, visualized through circos plots and heatmaps, revealed significant relationships among these genes. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses indicated that these genes are involved in immune response activation, coagulation, and immune receptor activity. Disease Ontology (DO) enrichment analysis further linked these genes to autoimmune hemolytic anemia and tumor-related signaling pathways. Additionally, the CIBERSORT analysis highlighted differences in immune cell composition in sepsis patients, revealing an increase in neutrophils and monocytes and a decrease in inactive NK cells, CD8 T cells, and B cells. We employed machine learning techniques, including random forest and SVM, to construct a diagnostic model, identifying FCER1G and FYN as key biomarkers. These biomarkers were validated through their expression levels and ROC curve analysis in an independent validation cohort, demonstrating strong diagnostic potential. Single-cell analysis from the GSE167363 dataset further confirmed the distinct expression profiles of these genes across various cell types, with FCER1G predominantly expressed in monocytes, NK cells, and platelets, and FYN in CD4+ T cells and NK cells. Enrichment analysis via GSEA and ssGSEA revealed that these genes are involved in critical pathways, including intestinal immune networks, fatty acid synthesis, and antigen processing. In conclusion, our comprehensive analysis identifies FCER1G and FYN as promising biomarkers for sepsis, providing valuable insights into the molecular mechanisms of this complex condition. These findings offer new avenues for the development of targeted diagnostic and therapeutic strategies in sepsis management.

Blood hypercoagulability and thrombosis mechanisms in cancer patients -A brief review.

Patients with malignant tumors are prone to present hypercoagulability of blood and form thrombosis, and its pathogenesis is complex involving various factors from clinical and histopathological to genetic influences. Current studies on the potential mechanism of blood hypercoagulability in patients with malignant tumors focus on the following aspects but are not limited: (1) tumor cells release coagulant-promoting substances, (2) tumor cells interact with the fibrinolytic system, (3) tumor cell-mediated platelet activation, (4) tumor-associated complement activation, and (5) genetic factors and clinical factors. Especially, the pathogenesis of blood hypercoagulability is in-depth analyzed covering tumor cells' release of procoagulant substances, the interplay of cancer cells and fibrinolytic system, platelet activation mediated by cancer cells, cancer-associated complement activation, and the action of genetic and clinical factors. We review the pathogenesis of blood hypercoagulability in patients with malignant tumors, which will assist in the research and development of new drugs and providing theoretical support for the formulation of the best treatment plan for patients, to prolong the survival of patients.

Ergonomic and sustainable posture for gynecological laparoscopic surgeons determined based on images analyzed using artificial intelligence.

Studies have reported the emergence of work-related musculoskeletal disorders (WMSD) due to surgery. In fact, the usfige of long-shafted instruments has been suspected to induce WMSD in laparoscopic surgery. The present study therefore investigated whether differences in the range of motion of the face and neck, and the shoulder, elbow and hand on the dominant hand side, existed when using short- and long-shafted laparoscopic coagulation shears (LCS) during a gynecological laparoscopic surgery, based on images analyzed using artificial intelligence. After identifying the corresponding body parts in the video, the range of motion was illustrated graphically for each joint coordinate, followed by statistical analysis for changes in the position of each part. The range of motion for the face and neck did not significantly differ, whereas those for the shoulder, elbow and hand became noticeably broader when using the 36-cm long-shafted LCS than when using the 20-cm short-shafted LCS. Overall, the shorter LCS promoted a narrower range of motion compared with the 36-cm LCS, suggesting its potential for reducing the physical strain placed on the surgeon's body during gynecological laparoscopic surgery.