The authors declare no conflicts of interest. The data that support the findings of this study are available from the corresponding author upon reasonable request. Video S1: A novel, small-incision, gasless videoscope-assisted necrosectomy (VANE) for infected walled-off necrosis. The video begins with preoperative contrast-enhanced computed tomography (CE-CT) showing infected walled-off necrosis (WON) spreading in three directions. Following insufficient clinical improvement after initial interventions, a transabdominal VANE was performed on Day 52. Based on ultrasound marking, a 3-cm transverse incision was made, and the Ootsuki fukukyo tube was inserted after digital exploration. The surgical team employs a coordinated “four-hand” technique: the surgeon operates the videoscope and forceps, while the assistant provides a dynamic operative field by multi-directionally manipulating the Ootsuki fukukyo tube and performing atraumatic peeling of necrotic debris using the Kodama Dai-suction. This gasless approach ensures a clear, stable field of view without CO2-induced fogging, eliminates the risk of CO2 gas embolism and enables effective bulk removal of substantial necrotic debris. Postoperative CE-CT shows successful resolution of the WON. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Sasanuma et al. (Sat,) studied this question.