TOP IMPACT EDITING SERVICE REPORTJournal name and URL:
URL: Surgical Endoscopy / https://www.springer.com/journal/464
Manuscript Title: A novel, protective, flexible liver retraction method with clipping and suturing inlaparoscopic gastrectomy for gastric cancer
SummaryThis article is focused towards developing a novel liver retraction method during laparoscopic distal gastrectomy toachieve an optimal surgical field. The authors considered a healthy patient size to prove their clinical objective. The
surgical database was retrospectively analysed based on liver retraction method used. They identified a significantly
shorter operative time in the flexible liver retraction with clipping and suturing group. Also, there were no significant
rise in liver biomarkers as well as complications post operatively. This article is a first report of the liver retraction
technique that provided an optimal surgical field without inducing liver dysfunction.

Research Strength
Originality and Significance of Research [Rating: Excellent, Good, Fair, or Poor]
GoodThe study is novel and it can have multiple applications in clinical industry. This technique for liver retraction
has been detailed by the authors in a clear manner, and as such would be of interest to the journal’s target
audience. However, there are few sentences that are insufficiently framed and hence, affects the overall flow ofresearch in the paper. The research content is acceptable but the study would be highly beneficial and would
have better prospectus, if all revisions as mentioned are done.
- The article has all the required sections for a complete paper, but needs revisions as suggested in thecomments box inside it. Based on existing literature, this study could be an innovative surgical approach toretract liver for an optimal surgical field without inducing liver dysfunction.

Content Review
Title, Abstract, and Keywords
The title adequately reflects the theme of the paper and is informative. However, the title can be improved as
the current tile has the word ‘optimal’ that has no critical basis of inclusion in it. In addition, while the meaningof “suturing” is self-evident, that of “clipping” is not.
Please consider this title instead: “A novel liver retraction method in laparoscopic gastrectomy for gastriccancer.”
If you choose to use it, please change it in the cover letter as well.
- This journal targets a wide audience including general surgeons, gastroenterologists, endoscopists andgastroenterologic surgeons. The title and the topic in general would be attractive to the readers of this journal.
- Short running head should be no longer than 40 characters. A better running title would be “Liver retraction
during laparoscopy.”
Add the following details:
1. Author names and affiliations
2. Corresponding author name
3. Address of corresponding author, including email ID, telephone and fax number

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The abstract does clarify the purpose and significance of the study. The journal requires a Structured Abstract ofnot more than 300 words stating Background, Methods, Results, and Conclusions. The current abstract fulfils
these journal requirements; it has a well-defined structure, and has 300 words.
- However, ‘Conclusion’ needs to be changed to ‘Conclusions’ as there is more than one conclusion (2sentences) in this section.
- Statements for Purpose, Methods, Results, and Conclusions are stated and are adequate, although theabstract is understandable, it is difficult to read. The abstract needs to be substantially improved for bothlanguage and grammar.
- Up to 6 keywords are allowed. Manuscript currently has 6 keywords. Other detailed similar comments havebeen added in the manuscript file. The author should address all mentioned issues accordingly.

Introduction and Literature review
Sufficient background information has been provided along with appropriate references. The limitations of thestudy need has been described well. There is no word count criteria for the main text.
The Introduction is of appropriate length. Also, the purpose of the study is mentioned clearly. This sectionneeds to be substantially improved for both language and grammar.
Relevant literature has been summarized in introduction and discussion sections.
The language of the article needed revisions, which we have now addressed in the edited manuscript. We havealso made the article more concise to avoid unnecessary lengthy discussions. Many vital details have not beenaddressed.
The limits and the future prospectus of the study are also not discussed. The author should refer to the detailed
comments for sections applicable and revise.

Methods and Statistical analysis
There is no description of IRB approvals in this section of the manuscript. There is no description who or how
many investigators were involved in extracting data. The primary and secondary outcomes of interest havebeen described. Study inclusion criteria has been provided. Statistical analysis section is appropriate anddetailed.
PSM needs to be spelled out in the sub header “PSM analysis” Surgical procedure and liver retraction
techniques have been adequately described.
Figure 2 has been referred to in Methods section. This should be Figure 1. This section needs to be substantially
improved for both language and grammar. We have edited this section to enhance the overall readability andpresentation of content. The author has not mentioned anything about the many shortcomings in theprocedures and the research rationale. For details, kindly refer to the Comments section in the manuscript.

Results and Discussion
Figure 1 in PowerPoint file should be Figure 1 and should be referred to in text ideally in the first section of
results “patient characteristics after PSM analysis”. This section should be renamed as “Patient characteristics”.
We have made this revision of the heading in the manuscript.
- The last statement in this section, “No significant differences…………………..AST, ALT” is redundant. This can beseen in Table 1 and also after propensity score matching one would expect no differences between the twogroups. We have reframed the sentences accordingly for better presentation of the context.
- All figures in the ppt file should be referred to in text at appropriate places in consecutive order.
- “No liver inflaction was found in both groups”. Is inflaction meant to be infection?
- In text POD should be in full form at first instance. This section needs to be substantially improved for bothlanguage and grammar. We have edited the manuscript extensively to remove such grammatical errors.
Overall, all relevant information needed has been provided.

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The limitations of the study have been described well. Study findings may be limited to variability in surgeon
expertise. This limitation is not listed. Please check.
The authors have convincingly supported and discussed the results of the study. Length of the discussion isappropriate. Also, the current relevant literature has been adequately described and referenced.

Figures and Tables
The authors have not cited the patient selection figure in the text. Figure numbering is jumbled and should becorrected.
Figure 4:- Is not cited in the text.
- Y-axis description is missing- Describe in legend……what is Pre-OP and POD. If 1,3,5 and 7 are days the instead of 1M use 30 days.
Figure 1 has spelling mistakes. All the abbreviation should be described in full in figure legend below for thereaders to be able to correlate the content inside the figures with the research promptly.
All figures, should be uploaded into Editorial Manager as individual figures separately from the text.
The legends are not explanatory as it had several grammatical errors that hindered the overall intended
research presentation. We have extensively edited the figure legends to make it free of any language andgrammatical errors.
All tables are cited in the text. They conform to the journal guidelines. However, in Table 1, describe age
units…..median or mean? Range or IQR? The BMI units are missing, ‘Clinical’ is misspelled, Description of cN andcT are missing in Table legend. All full forms of abbreviations should be provided in the legend of the table.
Table 2: If only one person had Clavien-Dindo class III or higher complications, we might as well mention whatclass complication he had. Please check and revise accordingly.

Conclusion
The conclusion is concise. However, the conclusion statement needs to be improved for language andgrammar.
Conclusion is backed by evidence. Future investigation approaches have not been discussed. Besides revising
the sentences as suggested above, the authors should also mention about future prospectus of the study toappeal the wider readership about the implications of his findings.

References
The references are appropriately cited in the text. The font style of the body of the manuscript is different fromthe font style of references. We have made this format uniform across the paper.
Citation format is consistent across all references.

Structure, Style, andand Format Review
Clarity of Presentation
The quality of presentation in the article is poor. The writing throughout the article is not clear and concise.
The purpose of this article is clear. However, there are several errors throughout the manuscript in terms ofsentence formation and grammatical accuracy. The manuscript would need substantial rework by writer who isfluent in English or is a native English speaker. We have done extensive revisions in the manuscript to remove
all the grammatical errors and to enhance the research presentation to appeal the readers.
Many sections as pointed out in the comments needed major revision/rephrasing which we have addressed.
Please check and confirm if the research presentation is in line with your experimental makeup of the study.

Organization and Structure
The article is structured into logical sections. The authors have provided a well presented and clearly sectioned
manuscript in which different parts of the paper are easily identifiable.

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Format and Style
The length of the article is as per standard guidelines of a journal that publishes similar research concepts.
However, the running head exceeded word limit of 40 characters which we have made concise to meet thejournal’s specifications. The format of the Abstract adheres to journal guidelines. There is no word limit for themain text.
Structure of the main text is according to the journal guidelines. However, the article needs major revision in all
sections mentioned above, especially for English language and grammar before submission. It had poorreadability due to this drawback.
The sections in main manuscript should be numbered. Divide the article into numbered sections. Subsections
should be numbered 1.1 (then 1.1.1, 1.1.2, ...), 1.2, etc. We have formatted the manuscript according to thejournal’s instructions.

Authorship
It complies with the journal’s guidelines; however, the author should provide a declaration of interest. It is
mandatory for the journal.

SUITABILITY TO JOURNAL INSTRUCTIONSJournal Scope‘Surgical Endoscopy’ is a unique journal that publishes articles that are at the interface between various medical andsurgical disciplines. The topics covered under this journal includes surgical aspects of interventional endoscopy,ultrasound, and other techniques in the fields of gastroenterology, obstetrics, gynaecology, and urology. SurgicalEndoscopy serves as a focal point for the international surgical community to exchange information on practice,theory, and research.
The clinical application of the novel FLICS liver retraction method which is the major proportion of the work
reported will find a better appreciation by the journal’s audience.

Journal Quality and Coverage•••

Impact factor – 3.209
Indexed databases – Science Citation Index, Science Citation Index Expanded, EMBASE, Medline, andScopus.
Quartile ranking – Q1 ranking

Manuscript Compatibility (based on journal’s scope, quality and coverage)
The scope of this study is in line with the aims/scope of the recommended journal. However, the author shouldmake all the revisions as suggested. The manuscript is a pioneer in the field of surgery, especiallygastroenterology and many similar studies have been published recently.
The journal’s indexing in well-reputed databases will ensure wide readership.
This journal specifically publishes data on effective intraoperative techniques to overcome gastrointestinal
complications and this fits well with the scope of the current study.