Monthly general surgery bulletin — September 16, 2026

GENERAL SURGERY BULLETIN — week of September 9–16, 2026

Moderate-volume week: 9 verified items. Method note: this week JAMA Network, PubMed, Medscape and General Surgery News blocked automated access, so the sweep relied on BJS, ACS Brief, Springer and regional open-access journals. Searches in Japanese, Chinese, Korean, Russian, Arabic, Turkish and Portuguese returned no publications dated within the week that met the bar; the only item from outside North America/Western Europe is the Brazilian meta-analysis.

Abdominal wall and hernias

1. Prophylactic mesh to prevent incisional hernia in hepatobiliopancreatic surgery

[Clinical trial] [Spain]
Randomized, prospective, double-blind trial from the Seville group (Bellido-Luque, Morales-Conde, Nogales Muñoz), published online in JAMA Surgery on September 9. Evaluates whether prophylactic mesh at wall closure after hepatic, biliary and pancreatic surgery reduces the incidence of incisional hernia, a high-risk population with few dedicated trials.
Why it matters: this is the heaviest-weight item of the week, but the abstract with the n and outcome figures could not be opened (site blocked); read it at the source before extrapolating PRIMA data to subcostal/HPB laparotomy.
https://jamanetwork.com/journals/jamasurgery/article-abstract/2853952

2. Women have more complications but report better quality of life after elective ventral hernia repair

[Publication] [USA]
Retrospective cohort from the ACHQC registry (2012–2023), 32,956 elective clean-wound ventral hernia repairs (46.7% women). Women vs. men: surgical site infection 2.4% vs. 1.6% (adjusted OR 1.31; 95% CI 1.12–1.55), readmission 3.2% vs. 2.5%, pragmatic 2-year recurrence 19.2% vs. 15.5%. Despite this, greater HerQLes improvement at one year (median 30 vs. 26.7). Surgical Endoscopy, September 11; oral presentation at SAGES 2026.
Why it matters: a voluntary, retrospective registry, but the size makes it necessary to incorporate sex into consent and into stratification of abdominal-wall trials.
https://link.springer.com/article/10.1007/s00464-026-13217-2

3. Perineal hernia after minimally invasive versus open abdominoperineal resection

[Meta-analysis] [Brazil]
Systematic review and meta-analysis (PROSPERO CRD420261422529) from Universidade São Caetano do Sul: 4 retrospective comparative studies, 763 patients (249 minimally invasive vs. 514 open). Perineal hernia OR 4.13 (95% CI 2.24–7.61), I² 0%; Bayesian analysis with 99.9% probability of higher risk with the minimally invasive route. Less bleeding (−156 mL) and shorter operative time (−42 min) with the minimally invasive route. Hernia, September 9, open access.
Why it matters: only 4 retrospective series with heterogeneous follow-up, but the signal is consistent and supports planned perineal reconstruction (mesh or flap) after laparoscopic or robotic APR. (Source in English, Brazilian authors.)
https://link.springer.com/article/10.1007/s10029-026-03841-1

Hepatobiliary and pancreas

4. Mesh-reinforced duct-to-mucosa pancreaticojejunostomy and clinically relevant pancreatic fistula

[Publication] [Spain / United Kingdom]
Retrospective cohort from Hospital General de Albacete (pancreaticoduodenectomy for adenocarcinoma, 2017–2022) with reinforcing mesh, adhesive and ductal stent, plus a meta-analysis of 10 studies and 1,013 patients. Pooled clinically relevant fistula 6.5% (95% CI 3.7–9.3); versus the conventional technique OR 0.35 (95% CI 0.15–0.80); length of stay 11.9 vs. 20.1 days. No differences in bile leak, delayed gastric emptying, hemorrhage or mortality. Ann Hepatobiliary Pancreat Surg, September 15.
Why it matters: the authors themselves conclude the evidence is insufficient and heterogeneous; a hypothesis for a trial, not a reason to change technique.
https://www.ahbps.org/journal/view.html?doi=10.14701/ahbps.26-150

Colorectal and digestive oncology

5. EAGLE-2: digital training in safe anastomosis and leak after right colectomy

[Publication] [International, 60 countries]
International prospective cohort (ESCP and NIHR Global Surgery Unit), 332 hospitals, 2,875 right hemicolectomies/ileocecal resections with a single anastomosis (June–September 2024). 30-day leak or collection 9.1% when the surgeon had completed the five free modules (90 min) of the EAGLE program vs. 16.4% without training; adjusted OR 0.56 (95% CI 0.41–0.78); also less reoperation (OR 0.64) and readmission (OR 0.65); mortality 2.9% vs. 5.0%. BJS, September 11, open access.
Why it matters: not randomized, and the untrained group had more emergencies (24% vs. 15%), but the magnitude and near-zero cost make it reasonable to ask the whole colorectal team, including residents, to take the course.
https://academic.oup.com/bjs/article/113/9/znag107/8790652

6. Compliance with Commission on Cancer standard 5.7 and technical quality in rectal cancer

[Publication] [USA]
National cohort (NCDB, 2020–2023) of 22,688 patients with stage I–III rectal adenocarcinoma operated on at 873 centers; 91% at hospitals meeting standard 5.7 (synoptic report of the mesorectal excision). Positive circumferential margin 12% vs. 14% (adjusted OR 0.82; 95% CI 0.68–0.99), incomplete mesorectal excision 9% vs. 14%, higher likelihood of complete mesorectum (OR 1.63). JACS, August 2026; featured in ACS Brief on September 15.
Why it matters: an association in an administrative database with no long-term oncologic outcome, but it supports the idea that systematically auditing the specimen improves technique.
https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/acs-brief/september-15-2026-issue/coc-rectal-cancer-standard-compliance-signals-higher-surgical-quality/

7. Circulating tumor DNA in colon cancer: prognostic, yes — treatment guide, not yet

[Publication] [USA]
Review by the ACS colorectal Advisory Council (K. Mathis) of current data: postoperative positivity associated with about 10 times more recurrence (GALAXY); 5-year disease-free survival 28% vs. 77% (Alliance N0147); in DYNAMIC-III, de-escalation in ctDNA-negative patients did not reach non-inferiority (3-year DFS 85% vs. 88%) and escalation in positive patients did not improve outcomes. ACS Brief, September 15.
Why it matters: the test is prognostic but not predictive; NCCN does not recommend using it to decide adjuvant therapy or surveillance outside trials.
https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/acs-brief/september-15-2026-issue/ctdna-predicts-colon-cancer-recurrence-but-treatment-questions-remain/

Trauma, emergency surgery and bariatrics

No verifiable items this week: no trial, multicenter cohort or guideline dated between September 9 and 16 met the bar (the September 8 Healio report on GLP-1 and bariatric surgery could not be verified at the source).

General oncologic surgery

No verifiable items this week in breast, thyroid, melanoma, sarcoma or carcinomatosis. See item 9 (parathyroid and AI) under Cross-cutting.

Cross-cutting

8. Medtronic obtains FDA clearance for the LigaSure RAS Maryland on the Hugo robot

[FDA regulatory / Industry] [USA]
September 16 announcement: the first LigaSure instrument operated from a robotic console; seals and divides vessels and lymphatics up to 7 mm in about 2 seconds, only with the Valleylab FT10 generator. Already in use in Europe under CE mark since 2025. Hugo remains cleared in the US only for urology; 510(k) applications for general surgery (including hernia) and gynecology, filed in June, remain pending.
Why it matters: a manufacturer release with no new clinical data; relevant only as a signal that the platform is preparing for general surgery in the US. (Secondary source; the original release is on Medtronic's newsroom.)
https://www.unite.ai/medtronic-wins-fda-clearance-for-ligasure-ras-maryland-on-hugo-robot/

9. Deep learning with infrared autofluorescence to distinguish diseased parathyroid glands

[Publication] [USA]
ACS Brief featured on September 15 the work of Berber (Cleveland Clinic, JACS January 2025): 797 patients, 1,506 normal glands and 597 diseased; diseased glands show lower autofluorescence intensity and greater heterogeneity; the model reached 83.3% accuracy and sensitivity (area under the precision-recall curve 0.908).
Why it matters: an original 2025 study, single-center and without external validation; interesting, but it does not yet replace intraoperative judgment or rapid PTH.
https://www.facs.org/for-medical-professionals/news-publications/news-and-articles/acs-brief/september-15-2026-issue/deep-learning-may-help-surgeons-spot-diseased-parathyroid-glands/

Upcoming meetings and dates

ACS Clinical Congress 2026 (October; confirm dates and venue at http://facs.org/for-medical-professionals/conferences-and-meetings/clinical-congress-2026/). No other society dates were verified for the coming four weeks.

Automated curation. Always verify the primary source before applying any data to clinical practice.

Monthly general surgery bulletin — September 16, 2026

Nine verified items from BJS, ACS Brief, Springer and regional open-access journals, in a week when JAMA Network, PubMed, Medscape and General Surgery News blocked automated access.

Three worth your time:
• EAGLE-2: completing five free training modules cut 30-day anastomotic leak after right colectomy from 16.4% to 9.1% across 332 hospitals — a near-zero-cost intervention worth asking the whole colorectal team to take.
• ACHQC registry (32,956 patients): women have higher surgical site infection and 2-year recurrence after elective ventral hernia repair, yet report better quality-of-life gains — a case for stratifying trials by sex.
• Circulating tumor DNA in colon cancer remains prognostic, not predictive: DYNAMIC-III found de-escalation in ctDNA-negative patients did not reach non-inferiority.

Full bulletin: https://boletinesmedicos.com/en/cirugia-general/2026-09-16.html

#GeneralSurgery #ColorectalSurgery #HPBSurgery #SurgicalOncology #AbdominalWallSurgery

General surgery bulletin, Sep 16: EAGLE-2 training cut 30-day leak after right colectomy from 16.4% to 9.1% (332 hospitals); ACHQC: women have more complications but better QoL gains after ventral hernia repair. 9 verified items with critical reading: https://boletinesmedicos.com/en/cirugia-general/2026-09-16.html