Minimally Invasive Therapy & Allied Technologies最新文献

{"title":"Transvaginal versus transabdominal extraction techniques in laparoscopic surgery: a systematic review and meta-analysis.","authors":"Liliana Galli, Laura Luka, Massimo Piergiuseppe Franchi, Pier Carlo Zorzato, Anna Festi, Alberta Ricci, Francesca Magni, Antonio Simone Laganá, Mariachiara Bosco, Stefano Uccella, Simone Garzon","doi":"10.1080/13645706.2026.2653713","DOIUrl":"10.1080/13645706.2026.2653713","url":null,"abstract":"<p><strong>Background: </strong>In laparoscopic surgery, specimen retrieval can require enlarging abdominal incisions, reducing the minimally invasive benefits. Transvaginal specimen extraction (TVSE) can offer a safer, more cosmetic alternative for women. This systematic review and meta-analysis evaluated the safety and outcomes of TVSE compared with transabdominal extraction, regardless of surgical indication.</p><p><strong>Methods: </strong>EMBASE, Scopus, PubMed, MEDLINE, Web of Science, and the Cochrane Library were searched from inception to April 2025. Studies were grouped by design, surgical specialty, and extraction method (port enlargement versus mini-laparotomy) to explore heterogeneity.</p><p><strong>Results: </strong>Twenty-five studies were included for 2751 patients (1144 TVSE, 1607 transabdominal extraction) in general, urologic, or gynecologic surgery. TVSE was associated with lower postoperative pain (mean difference -0.98, 95%CI -1.30 to -0.66), rescue analgesia use (OR 0.38, 95%CI 0.28 to 0.51), postoperative complications (OR 0.55, 95%CI 0.34 to 0.89), shorter hospital stays (mean difference -1.04, 95%CI -1.77 to -0.30), and higher cosmetic satisfaction (mean difference 0.91, 95% CI 0.46 to 1.35), especially versus mini-laparotomy. Blood loss, intraoperative complications, and dyspareunia did not differ.</p><p><strong>Conclusion: </strong>TVSE is associated with improved postoperative outcomes when it replaces mini-laparotomy, whereas less benefit is observed versus laparoscopic port-site enlargement. Further randomized controlled trials are needed to confirm these findings.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"298-320"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147839969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial experience with limited gastric resection and nodal basin lymphadenectomy guided by fluorescence for early gastric cancer in a Western center.","authors":"Martina Bonafede, Andrea Celotti, Luca Mattia Quarti, Luigi Totaro, Antonio Tarasconi, Giovanni Crotti, Nicolò Turco, Arianna Dendena, Ilaria Benzoni, Roberto Grassia, Gian Luca Baiocchi","doi":"10.1080/13645706.2026.2652467","DOIUrl":"10.1080/13645706.2026.2652467","url":null,"abstract":"<p><strong>Background: </strong>With the increasing age of patients and the higher incidence of proximal gastric tumours, it is important to offer early gastric cancer (EGC) treatments that minimise post-operative morbidity and preserve quality of life. While several endoscopic and laparoscopic approaches have been established as standard treatments, total or subtotal gastrectomy with D2 lymphadenectomy remains the standard in Western countries, except for T1a lesions smaller than 2 cm. This study aims to explore the feasibility of stomach-preserving techniques combined with fluorescence-guided nodal basin harvesting in a Western setting for EGC.</p><p><strong>Methods: </strong>From July 2021 to November 2023, 12 patients (mean age 75, range 59-87) with cT1N0M0 gastric cancer underwent sentinel nodal basin harvesting after peritumoral injection of indocyanine green (ICG). Stomach-preserving surgery was performed in all patients: intraoperative endoscopic resection in two cases, stapler resection in four, and partial gastrectomy <i>via</i> gastrotomy in six cases. Lymphatic basins were dissected according to tumour location, and fluorescent nodes were separately analysed. Follow-up included CT scans and upper gastrointestinal (GI) endoscopy every six months for two years.</p><p><strong>Results: </strong>A total of 151 nodes were harvested (mean 12 per patient, range 5-22). Eleven cases were staged pT1N0; one 82-year-old patient with severe schizophrenia had pT3N2 disease, for which a completion total gastrectomy was suggested but declined. One patient experienced a Clavien-Dindo grade II complication. Mean hospitalisation was four days. After a median follow-up of 21.9 months (range 8-36), no recurrence was observed. Mapping confirmed that all metastases remained within the sentinel basin.</p><p><strong>Conclusions: </strong>Fluorescence-guided nodal basin harvesting combined with limited gastric resection is technically feasible in a Western context and does not compromise short-term oncological outcomes. Patient selection, meticulous staging, and consideration of possible secondary surgery are essential. Long-term oncological safety requires further investigation.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"269-275"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extraperitoneal versus transperitoneal approach in vNOTES sacrocolpopexy: a comparative pilot study.","authors":"Kemal Gungorduk, Emre Biton, Berican Sahin Uyar, Serkan Ustuntas","doi":"10.1080/13645706.2026.2683925","DOIUrl":"10.1080/13645706.2026.2683925","url":null,"abstract":"<p><strong>Background: </strong>This pilot study aimed to assess the feasibility, perioperative safety, and short-term outcomes of extraperitoneal versus transperitoneal vNOTES sacrocolpopexy.</p><p><strong>Methods: </strong>Thirty-six patients with POP-Q stage III or higher who underwent simultaneous vNOTES hysterectomy, BSO, and sacrocolpopexy were retrospectively analyzed and categorized into extraperitoneal (Group A, n=14) and transperitoneal (Group B, n=22) groups. Anatomical success, quality of life, and recovery were evaluated using POP-Q, P-QOL, ICIQ-UI SF, QoR-15, and MESH-R scales.</p><p><strong>Results: </strong>Baseline characteristics were comparable between groups. Six-month anatomical success rates were similar (extraperitoneal 90.8% vs. transperitoneal 91.6%). The most notable procedural difference was Trendelenburg positioning: Group A was maintained at 10°-15° throughout, whereas Group B required 25°-30° during the sacrocolpopexy phase. Numerical trends favoring the extraperitoneal approach were observed in operative time (99.6 vs. 110.4 min; p=0.185) and time to first stool (27.7 vs. 34.5 h; p=0.552), but neither reached statistical significance. No rectal injuries or intraabdominal abscesses occurred in either group.</p><p><strong>Conclusions: </strong>Extraperitoneal vNOTES sacrocolpopexy is feasible and safe, yielding anatomical outcomes equivalent to the transperitoneal approach at six months. Its most substantiated advantage is the reduced Trendelenburg angle, which may lower physiological burden in high-BMI patients. Remaining potential benefits require confirmation through larger prospective trials.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"287-297"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148211819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of endoscopic ultrasound-guided hepaticoduodenostomy for intrahepatic bile duct drainage: a multicenter retrospective study in Western Japan.","authors":"Ken Kamata, Atsushi Okuda, Takeshi Ogura, Yuzo Shimokawa, Akihisa Ohno, Nao Fujimori, Masahiro Itonaga, Masayuki Kitano, Kazuyuki Matsumoto, Koichiro Mandai, Hideyuki Shiomi, Ryota Sagami, Hajime Imai, Hirotsugu Maruyama, Hideki Kamada, Mamoru Takenaka","doi":"10.1080/13645706.2026.2672451","DOIUrl":"10.1080/13645706.2026.2672451","url":null,"abstract":"<p><strong>Background: </strong>There are several biliary drainage procedures for biliary strictures, including endoscopic ultrasound-guided hepaticoduodenostomy (EUS-HDS). This multicenter retrospective study evaluated the safety and clinical outcomes of EUS-HDS for intrahepatic bile duct drainage.</p><p><strong>Methods: </strong>Consecutive patients who underwent EUS-HDS at 12 Japanese referral centers between January 2010 and December 2024 were enrolled. The primary endpoint was clinical success. Secondary endpoints were technical success, stent patency, and adverse events.</p><p><strong>Results: </strong>Thirty-five patients were analyzed. Perihilar biliary stenosis was observed in 91.4%, and right posterior sectoral bile ducts were targeted in 80.0%. Technical and clinical success rates were 88.6% and 68.6%, respectively. The cumulative incidence of stent occlusion was 6.7% at 30 days, 13.3% at 90 days, and 20.0% at 180 days. One case of mild peritonitis occurred.</p><p><strong>Conclusions: </strong>EUS-HDS appears to be a feasible and safe option for selected patients with malignant intrahepatic biliary obstruction and may provide clinical benefit as part of a complementary drainage strategy.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"276-286"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluorescence-guided lymph node identification for biopsy for suspected lymphoproliferative disease or excision of lymph node recurrence.","authors":"Salvador Morales-Conde, Maria Vannucci, Beatriz Gómez-García, Juan Bellido-Luque, Lorena Sobrino Brenes, Veronica Tamburi, Andrea Balla","doi":"10.1080/13645706.2026.2685184","DOIUrl":"10.1080/13645706.2026.2685184","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the feasibility of indocyanine green (ICG) fluorescence as an intraoperative tool for abdominal lymph-node localization in cases where fine needle aspiration cytology (FNAC), is not feasible. ICG was administered either 24 hours before surgery or at anaesthesia induction, and fluorescence findings were descriptively compared with preoperative imaging and histology.</p><p><strong>Materials and methods: </strong>This is a retrospective exploratory feasibility study. Patients undergoing excision of primary or metastatic lesions in areas not suitable for ultrasound-guided biopsy were included. Suspicious findings on computed tomography (CT) scan were confirmed with positron emission tomography (PET)-CT preoperatively. According to intravenous ICG administration, patients were divided into two groups: group A, 24-hours before surgery, and group B, at anaesthesia induction. Fluorescence visualization was descriptively assessed in relation to PET-CT findings and histology.</p><p><strong>Results: </strong>Eight patients were included in group A and nine in group B. ICG fluorescence enabled intraoperative visualization of 13 out of 17 lesions overall (76.5%), including six out of eight in group A (75%), and seven out of nine in group B (77.8%), including retroperitoneal, mesenteric, and supraclavicular locations. Because PET-CT positivity was part of the inclusion pathway, descriptive concordance indicators are reported for descriptive purposes only. Visualization rates were comparable between the two protocols.</p><p><strong>Conclusions: </strong>Fluorescence appears to be a feasible and safe intraoperative adjunct for lymph-node identification in anatomically challenging regions. Administration at anaesthesia induction simplifies perioperative workflow while maintaining similar visualization rates. These findings are exploratory and hypothesis-generating and should be interpreted considering the small sample size and the selection bias related to PET-positive inclusion criteria.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"260-268"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148211846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic management of invasive retained products of conception: a case series.","authors":"Michal Mára, Marie Švehelková, Zdeňka Lisá, Vojtěch Lukavec, Kristýna Hlinecká, Zdeněk Žižka","doi":"10.1080/13645706.2026.2653199","DOIUrl":"10.1080/13645706.2026.2653199","url":null,"abstract":"<p><strong>Background: </strong>Prostaglandins and other uterotonics are first-line medical management for retained products of conception (RPOC), with transcervical surgery reserved for failed conservative management. In the rare setting of invasive retained products of conception (iRPOC), however, these approaches may not achieve complete evacuation. This study assessed laparoscopic resection as a fertility-preserving treatment for iRPOC.</p><p><strong>Methods: </strong>This case series included all eligible patients who underwent laparoscopic resection for iRPOC at a single tertiary centre between January 2012 and June 2024. Effectiveness was defined as complete resection on intra-operative transvaginal ultrasound scan (TVUS), no requirement for re-intervention, and no evidence of residual RPOC on follow-up TVUS 4-6 weeks post-operatively. Safety and post-operative fertility were evaluated as secondary outcomes.</p><p><strong>Results: </strong>Sixteen patients with iRPOC were included, with a mean age of 34.9 years and a mean follow-up of 61 months. Eight cases followed miscarriage or termination of pregnancy, and eight followed birth. Ultrasound-guided laparoscopic resection with uterine reconstruction was successful in all cases. Mean operative time, blood loss, and hospital stay were 69.6 min, 271.9 mL, and 1.9 days, respectively. Three patients attempting pregnancy subsequently conceived uneventfully.</p><p><strong>Conclusions: </strong>Laparoscopic management of iRCOP seems to be a feasible, effective and safe management option.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"321-329"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative hydrodissection for predicting extrathyroidal extension in thyroid tumors.","authors":"Yeseul Kim, Jae Ho Shin, Sung-Hye You, Bo Kyu Kim, Byungjun Kim, Kyeong Jin Kim","doi":"10.1080/13645706.2026.2668521","DOIUrl":"10.1080/13645706.2026.2668521","url":null,"abstract":"<p><strong>Background: </strong>We aimed to evaluate diagnostic performance of preoperative hydrodissection and grey-scale imaging (US) in predicting extra-thyroidal extension (ETE) of subcapsular thyroid lesions.</p><p><strong>Methods: </strong>The retrospective study evaluated hydrodissection between September 2023 and March 2025 for subcapsular thyroid nodules. Biopsy specimen with atypia of undetermined significance and thyroid tumors without surgery were excluded. For US, ETE was determined based on following features: capsule disruption, bulging contour, and perithyroidal infiltrations. For hydrodissection, ETE was determined positive if resistance was encountered. Diagnostic performance comparing US and hydrodissection in predicting ETE was performed for K-TIRADS 5 nodules and thyroid tumors.</p><p><strong>Results: </strong>A total of 40 nodules per 33 patients (age: 50.2 ± 12.7; female: 28/33, 84.9%) were included. Out of 40 nodules, 18 nodules were tumors, of which 15 nodules (83.3%) were malignant. Four malignant nodules demonstrated ETE. For K-TIRADS 5 nodules (n = 28), hydrodissection demonstrated better diagnostic performance in terms of specificity (0.96 vs. 0.63, p = 0.008), accuracy (0.93 vs. 0.61, p = 0.004), and AUC (0.854 vs. 0.563, p = 0.013). For thyroid tumors (n = 18), hydrodissection demonstrated higher accuracy (0.89 vs. 0.56, p = 0.031) and higher AUC (0.839 vs. 0.536, p = 0.016).</p><p><strong>Conclusion: </strong>Hydrodissection demonstrated better specificity, better accuracy, and higher AUC in predicting ETE than US.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"330-339"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The transanal legacy and the future of organ-preserving rectal surgery.","authors":"Alberto Arezzo","doi":"10.1080/13645706.2026.2701673","DOIUrl":"10.1080/13645706.2026.2701673","url":null,"abstract":"","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"243-247"},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in medicine: a clinician-oriented guide and operational framework to evaluate new AI devices.","authors":"Gabriel Szydlo Shein, Serban C Tudosie, Stefan M Jensen, Ronit Brodie, Sylvain Lecler, Michele Diana, Yoav Mintz","doi":"10.1080/13645706.2026.2703160","DOIUrl":"10.1080/13645706.2026.2703160","url":null,"abstract":"<p><strong>Background: </strong>Artificial Intelligence (AI) is rapidly transitioning from experimental research to daily medical practice, yet the medical community's understanding of these tools remains largely confined to visible 'front-end' applications with which the clinician can directly interact (such as decision support systems and conversational agents). This perspective overlooks the proliferation of 'back-end' AI, the algorithms that are embedded within devices, systems, and hospital infrastructure that silently reconstruct data while remaining invisible to clinicians. This paper presents a clinician-oriented framework that distinguishes between these two categories and proposes a clinically oriented guide for their evaluation.</p><p><strong>Methods: </strong>We performed a narrative review of AI applications in minimally invasive therapy and medical imaging to categorize systems into 'front-end' (interactive/visible) and 'back-end' (embedded/invisible) modalities. We synthesized evaluation metrics from computer science and engineering literature, selecting those relevant for clinical safety and decision-making to create a practical literacy guide.</p><p><strong>Results: </strong>Front-end and back-end systems require distinct validation strategies to ensure safety. while front-end evaluation must prioritize decision quality, spatial precision, and human-computer interaction to mitigate risks like automation bias, back-end evaluation requires rigorous technical benchmarking of signal fidelity and temporal latency to ensure that algorithmic reconstruction does not distort clinical reality. To facilitate this, we developed a structured inquiry framework to guide clinicians in auditing these systems for data provenance, transparency, and failure modes. Crucially, we emphasize that mathematical optimization does not guarantee clinical efficacy; technical metrics must always be paired with specific clinical contexts to ensure they align with patient-centered outcomes.</p><p><strong>Conclusion: </strong>Clinical safety in the AI era demands 'algorithmic literacy'. By applying this front-end/back-end framework and understanding key technical metrics, medical professionals can better identify failure modes, ensure data integrity, and maintain clear lines of clinical accountability, shifting from passive consumers to active evaluators of medical technology.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-18"},"PeriodicalIF":1.8,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unsupervised multi-modal variational autoencoder for anomaly detection in coronary angiography.","authors":"Emanuele Frassini, Rick M Butler, Benno H W Hendriks, Maarten van der Elst, John J van den Dobbelsteen","doi":"10.1080/13645706.2026.2705585","DOIUrl":"https://doi.org/10.1080/13645706.2026.2705585","url":null,"abstract":"<p><strong>Background: </strong>Coronary angiography (CAG) is among the most common procedures in catheterization laboratories. Patient-specific vessel tortuosity may require additional catheter exchanges, increasing procedure duration and complication risk. Detecting such workflow disruptions automatically is challenging because anomalies are subtle and difficult to capture using a single data modality.</p><p><strong>Methods: </strong>We propose a novel unsupervised multi-modal anomaly detection framework based on a variational autoencoder (VAE). Video and pose data from 191 real-world CAG procedures were segmented into 10-second clips. Features extracted with 3D convolutional networks were fused through modality-specific LSTM encoders. Reconstruction error (mean squared error) was used as the anomaly score, and thresholds were calibrated on a held-out dataset.</p><p><strong>Results: </strong>Procedures requiring additional catheter exchanges accounted for 29.8% of the dataset and had a 34% longer mean duration than normal procedures (47.6 vs. 35.5 min). The multi-modal VAE outperformed unimodal models, achieving an F1-score of 0.83, AUC-ROC of 0.88, and AUC-PR of 0.90. Detection performance peaked during the period when anomalies most frequently occurred.</p><p><strong>Conclusions: </strong>This study demonstrates the effectiveness of multi-modal fusion for unsupervised anomaly detection in complex surgical workflows. These findings support the development of intelligent workflow monitoring systems for catheterization laboratories.</p>","PeriodicalId":18537,"journal":{"name":"Minimally Invasive Therapy & Allied Technologies","volume":" ","pages":"1-8"},"PeriodicalIF":1.8,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}