Surgical InnovationPub Date : 2025-06-01Epub Date: 2025-01-26DOI: 10.1177/15533506251314605
Francesco Celotto, Niccolò Ramacciotti, Giacomo Danieli, Federico Pinto, Gaya Spolverato, Luca Morelli, Francesco Maria Bianco
{"title":"Learning Curve for Robotic Inguinal Hernia Repair With da Vinci Single-Port Robotic System.","authors":"Francesco Celotto, Niccolò Ramacciotti, Giacomo Danieli, Federico Pinto, Gaya Spolverato, Luca Morelli, Francesco Maria Bianco","doi":"10.1177/15533506251314605","DOIUrl":"10.1177/15533506251314605","url":null,"abstract":"<p><p>BackgroundTransabdominal pre-peritoneal inguinal hernia repair using the da Vinci Single-Port robot (SP-TAPP) is currently performed in few centers. We aimed to define the learning curve for SP-TAPP by analyzing operative times.MethodsThe operative times of 122 SP-TAPP performed between 2019 and 2024 were retrospectively analyzed. The following phases were analyzed: docking time (DT); pre-robot time (PRT, from skin incision to side cart placement); flap closure time (FCT); console time (CT), and overall time (OT). Cumulative sum analysis (CUSUM) was used to analyze learning curves. Surgical and 30-day outcome were analyzed.ResultsThe DT has remained constant over time (<i>P</i> > 0.9). PRT was divided into 3 phases with n1 = 5, n2 = 95 and n3 = 4, in which there was a progressive decrease in time (14.8 vs 11.9 vs 6.8 min; <i>P</i> = 0.08). In FCT and CT, 3 phases were identified in which times remained stable (<i>P</i> > 0.9 and <i>P</i> = 0.7). CUSUM analysis of OT identified 3 phases consisting of n1 = 13, n2 = 100 and n3 = 9 in which there was a progressive decrease in times (82 vs 72 vs 62 min; <i>P</i> = 0.3). Analysis of complications and early surgical outcomes did not differ except for estimated blood loss, although this was a clinically insignificant finding.ConclusionsThe learning curve for SP-TAPP is rapid and it shows how the technical skills are transferable between the multiport platform and the da Vinci Single Port robotic system for an experienced surgeon. An improvement is evident in PRT and OT, also compared to multiport systems, showing a potential for the platform to increase surgical activity.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"253-261"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047952","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}
Surgical InnovationPub Date : 2025-06-01Epub Date: 2025-02-13DOI: 10.1177/15533506251321209
Muheem Khan
{"title":"LigaSure in Breast Surgery: A Paradigm Shift With Unresolved Questions.","authors":"Muheem Khan","doi":"10.1177/15533506251321209","DOIUrl":"10.1177/15533506251321209","url":null,"abstract":"","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"317"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410629","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}
Surgical InnovationPub Date : 2025-06-01Epub Date: 2025-02-06DOI: 10.1177/15533506241313242
Wardah Rafaqat, Abiha Abdullah, May Abiad, Matthew McEvoy, Shannon McChensey, Hanjoo Lee, Baryalay Khan, Alexander T Hawkins, Aimal Khan
{"title":"Evaluating Outcomes of Same Day Discharge After Minimally Invasive Colectomy: A Nationwide Analysis.","authors":"Wardah Rafaqat, Abiha Abdullah, May Abiad, Matthew McEvoy, Shannon McChensey, Hanjoo Lee, Baryalay Khan, Alexander T Hawkins, Aimal Khan","doi":"10.1177/15533506241313242","DOIUrl":"10.1177/15533506241313242","url":null,"abstract":"<p><p>BackgroundAdvances in Enhanced Recovery After Colectomy protocols have enabled same day discharge (SDD) in some patients. Current literature is limited to single institutions limiting generalizability. We employed a nationally-representative dataset to compare outcomes between SDD patients and patients with a short-term hospital stay (discharged on postoperative day 1 or 2).MethodsWe conducted a retrospective study using the American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) Targeted Colectomy Participant User Files (2017-2021). We included patients ≥18 years who underwent elective minimally invasive colectomy. We excluded patients with severe comorbid conditions or in-hospital complications. We performed a 1:1 propensity-match adjusting for patient, diagnosis, and procedure- type characteristics. Our primary outcome was 30-day readmission and secondary outcome was post-discharge complications.ResultsWe identified 22,482 patients, 740 (3.3%) of which were SDD patients. A higher proportion of patients with SDD underwent right colectomy (76.4% vs36.4%, <i>P</i> < 0.001) and carried a diagnosis of a benign neoplasm (53.0% vs18.1%, <i>P</i> < 0.001). After propensity matching there was no significant difference in the rate of 30-day readmission between the 2 groups (3.4% vs4.7%; <i>P</i> = 0.23). Additionally, there was no significant difference in rates of anastomotic leak (0.7% vs0.8%; <i>P</i> = 0.58) or colonic ileus (1.4% vs1.8%; <i>P</i> = 0.58). Post-discharge bleeding complications were higher in SDD patients (0.5% vs0%; <i>P</i> = 0.045).ConclusionsSDD following minimally invasive colectomy is not associated with higher readmission, anastomotic leak, or SSI when compared to patients discharged on postoperative day 1/2. SDD after minimally invasive colectomy may be considered for patients without severe comorbid conditions.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"235-241"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365996","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}
Surgical InnovationPub Date : 2025-06-01Epub Date: 2025-01-30DOI: 10.1177/15533506251317283
Sahar Darian, Juan S Malo, Joseph S Lim, Joseph F Buell, Houssam Osman, Travis Van Meter, D Rohan Jeyarajah
{"title":"Yttrium-90 Radioembolization for Intrahepatic Cholangiocarcinoma: Non-University Tertiary Care Center Experience.","authors":"Sahar Darian, Juan S Malo, Joseph S Lim, Joseph F Buell, Houssam Osman, Travis Van Meter, D Rohan Jeyarajah","doi":"10.1177/15533506251317283","DOIUrl":"10.1177/15533506251317283","url":null,"abstract":"<p><p>BackgroundIntrahepatic cholangiocarcinoma (ICC) presents a significant clinical challenge due to its high fatality rate and limited surgical candidacy. With only 30-40% of patients eligible for surgery upon diagnosis, alternative therapies are imperative. This study assesses the efficacy of Yttrium-90 (Y-90) radioembolization for unresectable ICC patients in a non-university tertiary care center (NUTCC).MethodsA retrospective analysis of 15 unresectable ICC patients treated with Y-90 radioembolization was conducted. Tumor response, survival, and adverse events were evaluated using RECIST criteria.Results60% of patients exhibited partial response, and 20% showed stable disease, with notable tumor size reduction and a median survival of 14 months. Minimal adverse effects were observed, indicating Y-90's favorable safety profile.ConclusionY-90 radioembolization shows potential in reducing tumor burden and enhancing survival rates with minimal adverse effects for unresectable ICC. Larger prospective studies are needed to confirm its efficacy and define its role in ICC treatment protocols.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"229-234"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067591","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}
Surgical InnovationPub Date : 2025-06-01Epub Date: 2024-10-02DOI: 10.1177/15533506241282529
{"title":"Corrigendum to \"ThermoBlock® Endovenous RF Ablation is Effective and Safe in Great Saphenous Vein Reflux Treatment\".","authors":"","doi":"10.1177/15533506241282529","DOIUrl":"10.1177/15533506241282529","url":null,"abstract":"","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"318"},"PeriodicalIF":1.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142366601","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":"Trends in Mesh Materials for Ventral Hernia Repair: A 17-Year Nationwide Registry-Based Study.","authors":"Usamah Ahmed, Jacob Rosenberg, Jason Joe Baker","doi":"10.1177/15533506251345275","DOIUrl":"https://doi.org/10.1177/15533506251345275","url":null,"abstract":"<p><p>BackgroundMesh reinforcement is recommended for ventral hernia repair and can include various materials in different combinations. This study analyzed the mesh materials used and their temporal trends in ventral hernia repair in Denmark over the past 17 years.MethodsThis study utilized prospectively collected data from the Danish Ventral Hernia Database, maintained from its inception in 2007 to 2023. The data were cleaned and organized by mesh material. All ventral hernia repairs with mesh were included.ResultsA total of 47,716 operations were included, utilizing many different mesh materials. Polypropylene meshes were used in 62% of the repairs, polyester in 26%, and fully absorbable meshes in 0.7%. Per- and polyfluoroalkyl substances (PFAS)-based meshes were most commonly used from 2007 to 2011 but then experienced a marked decline, followed by a slight increase in 2023. While the use of other absorbable components in semi-absorbable meshes followed a rise-and-fall pattern during the study period, only polylactic acid (PLA) showed a steady increase from 2013 onward.ConclusionA wide range of mesh materials and composites have been utilized for ventral hernia repair from 2007 to 2023. Polypropylene-based meshes were most commonly used, followed by polyester. The use of various absorbable composite materials varied considerably over time. The diversity of mesh materials and substantial temporal variations highlight gaps in evidence-based clinical practice and the need for improved regulations. These findings emphasize the importance of developing standardized guidelines for mesh selection in ventral hernia repair.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506251345275"},"PeriodicalIF":1.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174068","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}
Muhammed Said Dalkılıç, Abdullah Şişik, Mehmet Gençtürk, Merih Yılmaz, Hasan Erdem, Chetan Parmar
{"title":"The Effect of Prophylactic Intraoperative Tranexamic Acid Use on Bleeding After Laparoscopic Sleeve Gastrectomy With Omentopexy: A Prospective Cohort Study.","authors":"Muhammed Said Dalkılıç, Abdullah Şişik, Mehmet Gençtürk, Merih Yılmaz, Hasan Erdem, Chetan Parmar","doi":"10.1177/15533506251344055","DOIUrl":"https://doi.org/10.1177/15533506251344055","url":null,"abstract":"<p><p>BackgroundLaparoscopic sleeve gastrectomy (LSG) is the most widely performed bariatric procedure. While advancements like staple line reinforcement (SLR) have reduced hemorrhagic complications, bleeding risks persist. Tranexamic acid (TXA), an antifibrinolytic agent, has shown promise in mitigating bleeding risks in various surgical disciplines, but its efficacy in LSG with SLR remains unexplored. This study aims to evaluate the effect of intraoperative TXA administration on postoperative bleeding outcomes in patients undergoing LSG with oversewing and omentopexy.MethodsThis prospective observational cohort study included 233 patients undergoing LSG with oversewing and omentopexy. Patients were divided into 2 groups: 1 received 1 g of TXA intraoperatively, while the other did not. Hemoglobin differences at 24 and 48 hours postoperatively were the primary outcomes. Secondary outcomes included blood transfusion necessity, re-intervention rates, and 30-day surgical complications.ResultsThere was no statistically significant difference in hemoglobin changes at 24 hours (TXA group: 0.8 ± 0.7 g/dL, 95% CI: 0.67-0.93; control group: 0.9 ± 0.9 g/dL, 95% CI: 0.74-1.06; <i>P</i> = 0.125) or at 48 hours (TXA group: 1.4 ± 1.5 g/dL, 95% CI: 1.12-1.68; control group: 1.5 ± 1.4 g/dL, 95% CI: 1.25-1.75; <i>P</i> = 0.167) between the groups. No patients required transfusions or re-interventions. Five patients in the control group exhibited hemorrhagic drainage exceeding 150 mL, while none in the TXA group experienced similar complications. Length of hospital stay and operative time were similar between the groups (<i>P</i> = 0.124 and 0.746, respectively).ConclusionsTranexamic acid may not significantly impact major bleeding complications following LSG with oversewing and omentopexy but appears to reduce minor hemorrhagic events.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506251344055"},"PeriodicalIF":1.2,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151351","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}
Lasse W P Van 't Hof, Isabelle T S Koster, Richard M Van den Elzen, Mark-Bram Bouman, Matthijs Botman, Caroline Driessen
{"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":"https://doi.org/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":"15533506251339929"},"PeriodicalIF":1.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sem F Hardon, Tim Horeman, Sophie J M Reijers, Linda J Schoonmade, Freek Daams, Donald L van der Peet
{"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":"https://doi.org/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":"15533506251336824"},"PeriodicalIF":1.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","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":"https://doi.org/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/m<sup>3</sup>. 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":"15533506251339931"},"PeriodicalIF":1.2,"publicationDate":"2025-05-01","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}