Surgical Innovation最新文献

{"title":"Surgirack™: Laparoscopic Instrument Holder to Facilitate Instrument Exchange.","authors":"Jacob Chisholm, Benjamin Littlejohns","doi":"10.1177/15533506251360166","DOIUrl":"10.1177/15533506251360166","url":null,"abstract":"<p><p>Background/NeedLaparoscopic surgeons waste time with instrument exchange. This is due to the poor design of existing instrument holders or quivers.Device DescriptionWe developed an instrument holder for laparoscopic instruments, energy devices and suction irrigators which correct the design deficiencies of existing quivers.Preliminary ResultsFollowing the use of 3D printed prototyping a design was finalised and patented. Initial samples met all design objectives on mock patient testing.Current StatusMedsafe registration was achieved in New Zealand in September 2023. In December 2024 a Conformity Assessment Certificate was issued by the Therapeutic Goods Administration (TGA) along with an application for inclusion in the Australian Register of Therapeutic Goods (ARTG). The Surgirack™ can now be supplied in Australia and New Zealand.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"465-468"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592422","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":"HernIA: Real-Time Anatomical Structure Segmentation in Video Laparoscopic Inguinal Hernioplasties With AI.","authors":"Franco J Marcelo, Pablo Zalazar, Florisel Papasidero, Ciro Hernandez, Jorge Ruiz Todone","doi":"10.1177/15533506251352101","DOIUrl":"10.1177/15533506251352101","url":null,"abstract":"<p><p>BackgroundLaparoscopic transabdominal preperitoneal (TAPP) hernioplasty, a minimally invasive procedure, reduces postoperative pain and recovery time but faces challenges like the \"ping-pong effect\" (alternating focus between operative field and monitors) and a 1%-2% error rate due to anatomical misidentification, risking complications like vascular injuries.ObjectiveTo develop and validate HernIA, an AI-based system for real-time segmentation of anatomical structures in TAPP, targeting an Intersection over Union (IoU) ≥85% and error reduction ≥50% compared to manual identification.MethodsHernIA employs YOLOv11m-seg, trained on 21 443 annotated laparoscopic images from 45 TAPP procedures at Clinica Colón and Hospital de Campaña Escuela Hogar. Annotation by expert laparoscopists achieved high inter-rater reliability (Cohen's kappa = 0.87). Validation used 5-fold cross-validation and a 10 800-frame dataset.ResultsHernIA achieved an IoU of 89.4% (±2.1%), Jaccard Index of 81.2%, mAP@50 of 92.3%, and F1 score of 0.94 (confidence threshold ∼0.45). It reduced identification errors by 62% in a simulated TAPP environment (10 800 frames, 24 FPS, 42 ms latency). Clinical validation was limited to one case of bilateral hernia repair.ConclusionHernIA enhances surgical precision and training in TAPP, with potential to reduce complications. Multi-center trials are needed to confirm generalizability.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"442-449"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317884","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 Implementation of Data-Driven Assessment into Laparoscopic Skills Training: A Systematic Review.","authors":"Sem F Hardon, Tim Horeman, Sophie J M Reijers, Linda J Schoonmade, Freek Daams, Donald L van der Peet","doi":"10.1177/15533506251336824","DOIUrl":"10.1177/15533506251336824","url":null,"abstract":"<p><p>BackgroundTechnological innovations have significantly enhanced the objective assessment of technical skills in minimally invasive surgery, offering substantial potential for proficiency-based training. However, the integration of these innovative tools into surgical education curricula remains limited. This study aims to evaluate the adoption and implementation of data-driven assessment tools within laparoscopic simulation training.MethodsA systematic search of PubMed and Embase was conducted following PRISMA guidelines, identifying studies that employed objective assessments of technical skills in surgical training curricula. Eligible studies utilized data-driven assessment methods as part of structured training programs for surgical residents. A descriptive analysis was performed on the included studies.ResultsFrom 2814 identified articles, 718 were eligible for full-text screening, and 35 studies met the inclusion criteria. These studies described the implementation of 14 different data-driven tools in laparoscopic skills training. Most tools focused on assessing instrument handling, measuring parameters such as motion speed, path length, and accuracy. Only three studies evaluated tissue handling skills using metrics like knot quality, tissue handling forces, and anastomotic integrity.ConclusionsThe adoption of data-driven tools in laparoscopic simulation training is progressing slowly and exhibits considerable variability. Most technologies emphasize instrument handling, while tools for assessing tissue manipulation and force application are limited. To improve training outcomes, a combination of motion- and force-based assessment tools should be considered, enabling a more comprehensive evaluation of technical skills in minimally invasive surgery.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"450-464"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402525/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on \"Minimally Invasive Treatment of Pelvic Fractures With Titanium Elastic Nailing: An Innovative Technology\".","authors":"Marco Antonio Altamirano-Cruz","doi":"10.1177/15533506251351461","DOIUrl":"10.1177/15533506251351461","url":null,"abstract":"","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"478"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267255","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":"Quantitative Perfusion Assessment Using Indocyanine Green in Lower Extremity Perforator Flaps.","authors":"Lasse W P Van 't Hof, Isabelle T S Koster, Richard M Van den Elzen, Mark-Bram Bouman, Matthijs Botman, Caroline Driessen","doi":"10.1177/15533506251339929","DOIUrl":"10.1177/15533506251339929","url":null,"abstract":"<p><p>BackgroundIndocyanine-Green Fluorescence Angiography (ICG-FA) is widely used in reconstructive surgery, providing real-time visualization of flap perfusion. Accurate assessment of perfusion is especially critical in lower extremity reconstructions, where complications like necrosis and venous congestion can lead to poor outcomes, including amputation. Although ICG-FA is commonly available, its interpretation remains subjective and heavily reliant on the surgeon's experience. These challenges underline the importance of integrating objective, data-driven assessment tools into surgical practice.MethodsAs part of a larger, ongoing prospective study, three illustrative cases of lower extremity reconstructions using perforator-based fasciocutaneous flaps were selected. Intraoperative ICG-FA was performed using a surgical microscope with integrated fluorescence imaging. Fluorescence-time-curves (FTCs) were generated using specialized software, and associated quantitative perfusion parameters were compared across three cases: two patients with perfusion-related complications and one patient without complications.ResultsIntraoperative clinical assessment appeared satisfactory in all cases, and no changes in surgical management were made based on the subjective interpretation of ICG-FA. In contrast, quantitative analysis of ICG-FA revealed abnormal perfusion patterns in the two flaps that developed complications, identifying perfusion deficits not evident through conventional assessment.ConclusionThese findings suggest that FTCs derived from ICG-FA data can predict perfusion-related complications. Integrating quantitative ICG-FA analysis into clinical practice may yield a significant advancement in reconstructive surgery, especially in lower extremity reconstructions.Clinical trial nameICG Indocyanine Green in Reconstructive Surgery (ICG-R).ClinicalTrials.gov IDNCT06129669 (https://clinicaltrials.gov/study/NCT06129669?cond=NCT06129669&rank=1).</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"435-441"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retroperitoneal Laparoscopic Repair of Primary Lumbar Hernia Using Self-Gripping Mesh.","authors":"Huadong Du, Yingmo Shen, Huiqi Yang, Yilin Zhu","doi":"10.1177/15533506251348535","DOIUrl":"10.1177/15533506251348535","url":null,"abstract":"<p><p>ObjectiveThe aim of this study was to explore the safety and efficacy of retroperitoneal laparoscopic repair of primary lumbar hernia using Self-Gripping mesh.MethodsThis retrospective study included 11 patients with primary lumbar hernias who underwent retroperitoneal laparoscopic repair with Self-Gripping mesh from May 2020 to October 2023 in our hospital. Observation indicators were intraoperative measured diameter of hernia ring defect, operation time, length of hospital stay, postoperative follow-up, complications, postoperative visual analogue scale (VAS) score, chronic pain.ResultsThe operations were completed successfully in 11 cases. The mean diameter of hernia ring was 2.57 ± 0.49 cm (ranged from 2.0 to 3.0 cm), the mean operation time was 53.31 ± 19.33 min (ranged from 35 to 90 min), the intraoperative blood loss was 3.01 ± 1.43 mL (ranged from 2 to 10 mL), and the mean postoperative hospital stay was 2.43 ± 1.41 days (ranged from 1 to 4 days). The mean postoperative VAS scores at 24 h were 1.10 ± 0.32 (ranged from 1 to 2). All cases were followed up for 21.05 ± 16.73 months (ranged from 3 to 42 months) without seroma, hematoma, incision or mesh infection, recurrence and obvious chronic pain.ConclusionRetroperitoneal laparoscopic repair of primary lumbar hernia using Self-Gripping mesh is safe and feasible. Its efficacy in the short term is favorable.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"428-434"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310443","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 Gilbreth Contribution to Operating Room Management and Surgical Ergonomics.","authors":"Tina Bharani, Divyansh Agarwal","doi":"10.1177/15533506251362370","DOIUrl":"10.1177/15533506251362370","url":null,"abstract":"<p><p>BackgroundThe early 20th century saw pioneering work by Frank and Lillian Gilbreth, regarded as the founders of surgical ergonomics, which brought scientific management in surgery and operating rooms. Through time and motion studies, their research helped improve the operative workflow and surgical efficiency.MethodsTo document the historical work of Gilbreths in surgical ergonomics, we conducted primary archival research at the Purdue University Archives and Special Collections (West Lafayette, IN), and integrated a collection of secondary sources across various formats and modalities.Results and ConclusionWe describes the early works of Gilbreths in surgical ergonomics and highlight how their motion research in the operating room evolved to incorporate ergonomics and decrease operative fatigue. The Gilbreths were proponents of promoting the adoption of management practices for operating rooms and standardization in hospital design, equipment, and patient records to improve efficiency in health care delivery. Through analysis of their published and unpublished work, we describe how their ideas are still in widespread use today to eliminate unnecessary motions and foster ergonomics in the operating room and in the field of surgery in general.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"469-477"},"PeriodicalIF":1.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699570","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":"Minimally Invasive Surgery Fellowship: What is it Good for?","authors":"Tarek Hassab, Margaret Turlington, Stephen M Kavic","doi":"10.1177/15533506251328479","DOIUrl":"10.1177/15533506251328479","url":null,"abstract":"<p><p>IntroductionMinimally invasive surgery fellowship is a popular choice for general surgery residents in the United States, but it serves an unclear role in an era where laparoscopic surgery has become commonplace. In this study, our goal was to examine the case volume for common open and laparoscopic surgery procedures for general surgery residents over the past 20 years to better understand the training needs that minimally invasive surgery fellowship can fill.MethodsWe reviewed the American Council on Graduate Medical Education (ACGME) Accreditation Data System to determine average case numbers for selected procedures among general surgery residents in the United States. Data was compared across 3 time points from 2002 to 2022. Descriptive statistics and chi-squared tests were used for analysis.ResultsResidents met our predefined competency threshold of twenty cases for 3 laparoscopic procedures in 2022 (cholecystectomy, colectomy, and inguinal hernia repair). There has been a trend towards increasing number of laparoscopic and decreasing number of open surgeries performed amongst our selected cases. Some procedures, including common bile duct exploration and splenectomy, remain rare over the entire study period.ConclusionsGeneral surgery residents receive good exposure to some laparoscopic procedures, but minimally invasive surgery fellowship serves a role in training for advanced laparoscopic cases, including anti-reflux and bariatric surgery.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"374-377"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050041","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":"Clinical Role of ICG Application in Bariatric Surgery; an Up-To-Date Literature Review.","authors":"Dimitra V Peristeri, Sai Sandeep Singh Rowdhwal","doi":"10.1177/15533506251339931","DOIUrl":"10.1177/15533506251339931","url":null,"abstract":"<p><p>BackgroundPost-operative anastomotic leaks (AL) are one of the most challenging complications of bariatric surgery and can be detrimental. Indocyanine green (ICG) is a fluorescence dye that can provide a real-time intraoperative assessment of organ tissue perfusion. Its use in bariatric operations is still being debated. The present review aims to evaluate the intraoperative utility of ICG during bariatric surgery to focus future research on a reliable tool to reduce the incidence of postoperative leaks.MethodsA systematic search of PubMed, EMBASE, MEDLINE, Scopus, and the Cochrane Library for published studies took place until December 2024, evaluating the use of ICG during bariatric surgical procedures. Studies were included if they assessed the ICG application in various bariatric operations to prevent and reduce AL rates.ResultsEleven studies were included, which involved a total of 887 patients. 643 patients underwent ICG-based intraoperative assessments, while 244 were in the control group. The mean age of participants was 43.8 years, and the mean BMI was 43.3 kg/m³. All included patients underwent various bariatric procedures. ICG was used alone in most studies, although it was mixed with methylene blue in one study. ICG administration protocols varied significantly. There were no reported complications from ICG administration. The utility of ICG has changed the intraoperative surgical decision-making of 4.2% of patients.ConclusionsICG is a promising technique for successfully preventing or timely managing AL in bariatric surgery. Large, randomised controlled studies are needed to confirm its utility for routine use in primary and revisional bariatric cases.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"392-403"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048413","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":"Enabling Robotic Capsule Endoscopy Through Effective in-Body Capsule Localization.","authors":"Muzaffer Kanaan, Memduh Suveren","doi":"10.1177/15533506251334690","DOIUrl":"10.1177/15533506251334690","url":null,"abstract":"<p><p>A critical problem for wireless capsule endoscopy is to be able to correlate a received image with a location, in order to more precisely locate a pathological condition (such as a lesion, or a tumor) inside the gastrointestinal tract and guide a potential subsequent surgical intervention. We treat the problem of determining the location and orientation parameters of a wireless capsule endoscope inside the human gastrointestinal tract through magnetic techniques. Considering the emerging trend in wireless capsule endoscopy towards remotely maneuverable robotic devices (also known as robotic capsule endoscopy), solving the problem of fast, accurate localization of the capsule becomes even more critical. It is also vital that the performance of different localization algorithms be characterized effectively in a repeatable manner in a controlled environment. Towards this goal, we present a design for a novel cyber-physical system to characterize the magnetic localization performance in robotic capsule endoscopy. We present some sample results for localization performance. The results indicate that highly accurate in-body localization of the capsule (with approximately 3.1 mm localization and 2.2° orientation error) is possible.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"353-363"},"PeriodicalIF":1.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035686","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}