Surgical Innovation最新文献

{"title":"Clinical Analysis of Gasless Single-Channel Laparoscopic Cholecystectomy for Elderly Patients With Cholecystolithiasis: <i>Retrospective Comparative Cohort Study</i>.","authors":"Jinlong Wei, Zhenglin Zhang, Jin Wang, Wen Jiang, Long Qian, Maoming Xiong","doi":"10.1177/15533506261434824","DOIUrl":"https://doi.org/10.1177/15533506261434824","url":null,"abstract":"<p><p>The retrospective comparative cohort study aimed to determine whether gasless single-channel laparoscopic cholecystectomy (GSLC) was associated with lower early postoperative stress and inflammatory responses than conventional carbon dioxide pneumoperitoneum laparoscopic cholecystectomy (LC) in older patients. Eighty geriatric patients (60 years old and older) were selected and compared (LC, n = 40; GSLC, n = 40). Stress biomarkers (norepinephrine, cortisol, and blood glucose) and inflammatory biomarkers (procalcitonin, C-reactive protein, and tumor necrosis factor-alpha) were evaluated before surgery and at 24 and 72 hours after surgery, as well as during the operative time, and related to estimated blood loss, postoperative complications, and length of stay. All in all, GSLC showed a steady reduction in postoperative increase in stress and inflammatory markers over time compared to LC, indicating a less intense physiologic perturbation during the initial phase of recovery. Results of the operation were more favorable to GSLC, with reduced operative time and less blood loss, and the postoperative endpoints showed fewer early complications and a shorter stay. These results indicate that gasless single-channel methods can be potentially helpful in physiologically vulnerable patients in the elderly, as they diminish the early postoperative stress and inflammatory processes; nevertheless, due to the retrospective study, standardized method of technique, and extended period of follow-up, prospective randomized trials are needed to confirm these relationships and to formulate clinical practice recommendations.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"15533506261434824"},"PeriodicalIF":1.6,"publicationDate":"2026-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147618773","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":"Investigating Hip Arthroplasty Femur Preparation Training Using a Haptic-Enabled Virtual Reality Simulation.","authors":"Justin M T Duncombe, Pierre Camaly de Brosses, Al-Amin M Kassam, David J Harris, Gavin Buckingham","doi":"10.1177/15533506251383830","DOIUrl":"10.1177/15533506251383830","url":null,"abstract":"<p><p>ObjectiveVirtual reality (VR) simulation training offers a promising solution to the growing challenges of acquiring operative experience in surgical skill development. As previous studies have primarily utilised VR systems without haptic feedback, there remains limited evidence on the impact of more immersive, tactilely responsive platforms. This study aimed to assess if haptic-enabled VR technology could accelerate the acquisition of hip arthroplasty skills.MethodsTwenty undergraduate medical students (12 Female, 8 Male; age = 20 ± 2 years) were randomly allocated to either a 60-minute haptic VR training session or a traditional mentor teaching session on hip arthroplasty. After training, all participants performed a SawBone simulated hemiarthroplasty procedure in a physical environment. Outcomes measured included implant depth error, which determined procedural success, operative time, and an objective evaluation of technical skills by a blinded Consultant Orthopaedic Surgeon.ResultsWe observed no difference in levels of implant depth error (<i>P</i> = .705), rated technical skill (<i>P</i> = .704), or operative time (for successful implant insertions; <i>P</i> = .551) between traditional and VR-trained groups.ConclusionsThese results indicate that VR may, at least, serve as a valuable adjunct to traditional early-stage training in complex open procedures like joint arthroplasty. The study also emphasized the importance of realistic VR training modules and illustrated the potential limitations of incorporating low-fidelity haptic feedback in VR training for such procedures.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"169-180"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145213842","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":"Clinical Safety and Effectiveness of COLO-BT™, an Intraluminal Fecal Diverting Device, as an Alternative to Defunctioning Ileostomy After Proctectomy.","authors":"Ho Yung Lee, Sung Il Kang, Sohyun Kim","doi":"10.1177/15533506251392444","DOIUrl":"10.1177/15533506251392444","url":null,"abstract":"<p><p>ObjectiveThis study aimed to evaluate the safety and effectiveness of an intraluminal fecal diverting device (FDD), COLO-BT™ as an alternative to defunctioning ileostomy in patients who declined stoma formation following proctectomy.MethodsWe retrospectively reviewed the medical records of patients who underwent proctectomy followed by placement of an intraluminal FDD (COLO-BT™) as a temporary substitute for ileostomy at a single tertiary care center between September 2017 and September 2021. Safety was assessed based on postoperative and anastomotic complications, as well as endoscopic findings of colonic changes at the FDD fixation site. Effectiveness was evaluated by the rate of permanent stoma formation.ResultsAmong 91 patients, 8 (8.8%) required surgical re-intervention. Of these, five patients experienced anastomotic complications necessitating stoma formation: rectovaginal fistula (n = 2), delayed anastomotic leakage (n = 2), and rectourethral fistula (n = 1). One patient developed severe ileus requiring surgery, which also resulted in stoma formation. Overall, six patients (6.6%) underwent permanent stoma formation during a mean follow-up period of 24 months. Endoscopic follow-up identified colonic luminal deformities in 15 patients (16.5%), most of which were asymptomatic mucosal edema or erosion (n = 12). Three patients (3.3%) had non-symptomatic ulcers at the FDD fixation site. All luminal deformities had resolved on follow-up sigmoidoscopy performed 1 year later.ConclusionThe intraluminal FDD (COLO-BT™) may offer a feasible alternative to defunctioning ileostomy following proctectomy in selected patients, with acceptable rates of postoperative complications and permanent stoma formation. Further studies are needed to confirm long-term safety and efficacy.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"123-130"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920675/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337616","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":"Assessment of Skill Transfer From a 3D-Printed Knee Arthroscopy Simulator: A Randomized Controlled Trial.","authors":"Paul André Alain Milcent, José Aguiomar Foggiatto, André Luís Mion, Carolline Popovicz Nunes, Camila Peixoto Fabri Milcent, Alynson Larocca Kulcheski, Mário Namba, Edmar Stieven Filho","doi":"10.1177/15533506251391050","DOIUrl":"10.1177/15533506251391050","url":null,"abstract":"<p><p>IntroductionArthroscopic surgery demands specialized skills, traditionally acquired via supervised clinical practice. Simulators offer a controlled training alternative. This study introduces a 3D-printed knee arthroscopy simulator and evaluates its effectiveness in skill transfer and acceptance in medical education, aiming to assess its utility for real arthroscopic procedures among medical students.MethodsForty final-year medical students with no prior arthroscopy experience were randomized into a simulated training group (3D-printed simulator) and a control group (video instruction). All participants performed a supervised diagnostic arthroscopy. Performance parameters (completion time, lookdowns, instrument loss, triangulation time, interventions) and Arthroscopic Surgery Skill Evaluation Tool (ASSET) scores were analyzed. Simulator acceptance was assessed via a Likert scale. Data were analyzed using appropriate parametric (Student's t-test) and non-parametric (Wilcoxon, McNemar) tests, with a significance level of 5%.\"ResultsThe simulated training group outperformed controls, completing arthroscopy 39% faster (<i>P</i> < .001), with 60% fewer lookdowns (<i>P</i> = .001), 59% fewer supervisor interventions (<i>P</i> < .001), 35% shorter triangulation time (<i>P</i> = .019), and 50% fewer instrument losses (<i>P</i> < .001). ASSET scores were significantly higher in all domains except safety. Participants strongly endorsed the simulator's utility and supported its integration into medical education.ConclusionThis study demonstrates the effectiveness of our low-cost, reproducible 3D-printed knee arthroscopy simulator as an effective tool for skill acquisition and transfer in individuals without prior arthroscopy experience. Training with the simulator significantly improves performance in real arthroscopic procedures.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"158-168"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303333","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":"Evaluation of the Ergonomics of Surgical Instruments Across Surgical Specialties: Responses From 459 Surgeons.","authors":"Maria Elze, Georg Osterhoff, Alice Wermke","doi":"10.1177/15533506251388259","DOIUrl":"10.1177/15533506251388259","url":null,"abstract":"<p><p>BackgroundThe ergonomic design of surgical instruments plays a pivotal role in the efficiency, safety, and comfort of surgeons. Studies confirm that poorly designed instruments can lead to physical discomfort, premature fatigue, and decreased dexterity. This study aims to assess the current usability of surgical instruments to identify problematic designs and highlight areas for ergonomic improvements.MethodsAn anonymized online questionnaire with 18 questions was distributed via email to various surgical societies, professional associations, and the mailing lists of surgical departments at the University Hospital Leipzig. Data on gender, glove size, clinical background, surgical subspecialty, and experience were collected. Participants were asked about physical discomfort, fatigue, precision, and safety issues when using surgical instruments and devices.ResultsA total of 459 surgeons participated, most of whom specialized in orthopedics and trauma surgery (81.48%). Gender differences were noted in glove sizes and frequency of complaints. Women reported significantly more difficulties, such as fatigue and imprecise handling, compared to men. Overall, 88.1% of women and 59.9% of men considered the development of ergonomic instruments important. Only 13% had experience using ergonomic instruments, with nearly half of the participants reporting significant improvements.ConclusionsThe study demonstrates that surgical instruments with inadequate ergonomics, particularly for users with smaller glove sizes, result in physical strain, fatigue, and reduced precision. The findings underscore the necessity for ergonomic modifications to meet the physical requirements of surgeons, ensuring a more efficient and safer surgical workflow.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"131-137"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12920700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355795","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":"Cadaveric Feasibility of A 3D-Printed Vaso-Stent for Sutureless Anterior Interosseous Artery-Cephalic Vein Anastomosis: A Novel Approach to Arteriovenous Access Creation.","authors":"Sara Saffari, Esther Ochoa, Daniel Colchado, Amy Liao, Justin M Sacks, Mohamed A Zayed, Xiaowei Li","doi":"10.1177/15533506251383671","DOIUrl":"10.1177/15533506251383671","url":null,"abstract":"<p><p>Arteriovenous fistulas (AVFs) are the gold standard for vascular access to facilitate hemodialysis, yet traditional surgical techniques are technically demanding, time-intensive, and costly. Additionally, limited suitable AVF sites, due to patient anatomy, vessel quality, and prior access exhaustion, necessitate exploration of novel options. This cadaveric proof-of-concept study introduces the anterior interosseous artery-cephalic vein as a novel AVF site and evaluates the feasibility of a 3D-printed sutureless anastomotic device, the Vaso-Stent, compared to conventional handsewn techniques. Fresh-frozen cadaveric upper limbs were procured to test the surgical feasibility of the proposed AVF model. Surgical exposure of the interosseous artery and adjacent cephalic vein were uncomplicated. A 3D-printed Vaso-Stent was manufactured and facilitated efficient anastomosis in under 1 min, compared with the 4.5 min required for a standard handsewn technique. The device demonstrated ease of placement, robust structural integrity, and resistance to tensile forces. These findings highlight that the Vaso-Stent can provide a simple alternative for AVF creation that reduces operative time and highlight the anterior interosseous artery-cephalic vein configuration as a new and unique hemodialysis access opportunity.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"186-189"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145201372","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":"Subcutaneous Islet Delivery in a Porcine Model With Potential for Future Pancreatic Islet Transplantation.","authors":"Eric J Charles, Faisal A Shaikh, Zoltan H Nemeth","doi":"10.1177/15533506251387443","DOIUrl":"https://doi.org/10.1177/15533506251387443","url":null,"abstract":"","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":"33 2","pages":"194-195"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842951","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":"Critical Appraisal of Validating a Novel 3D Printed Depth Gauge with Mandible Models.","authors":"Malaika Aijaz, Maryam Ayesha, Kertee Goswami","doi":"10.1177/15533506251383822","DOIUrl":"10.1177/15533506251383822","url":null,"abstract":"","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"190-191"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192950","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":"Data, Algorithms, and Ethics in Virtual Reality Based Medical Education.","authors":"Hana Abbasian, Avani Nooka, J Wesley Boyd","doi":"10.1177/15533506251389305","DOIUrl":"https://doi.org/10.1177/15533506251389305","url":null,"abstract":"","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":"33 2","pages":"192-193"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842973","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":"Efficacy of Ultrasound Compared to Magnetic Resonance Imaging for the Preoperative Mapping of Pilonidal Sinus Disease: A Proof of Concept Study.","authors":"Nicolas De Hous, Eline De Smet, Frederik Bosmans, Maarten Spinhoven, Tom Hendrickx, Marie Gaillard, Sylvie Van den Broeck, Niels Komen","doi":"10.1177/15533506251387881","DOIUrl":"10.1177/15533506251387881","url":null,"abstract":"<p><p>BackgroundRecurrence of pilonidal sinus disease (PSD) after minimally invasive surgery remains a significant challenge to surgeons and may be explained by incomplete obliteration of the sinus. Preoperative imaging could play an important role in addressing this problem. Magnetic resonance imaging (MRI) is considered the modality of choice but is costly and time-consuming. The objective of this study was to determine if ultrasound (US) is a feasible alternative to MRI in preoperative PSD mapping.MethodsA prospective, proof of concept study was conducted on patients treated with laser ablation in 2 Belgian hospitals between Jan 2023 and Dec 2024. The patients underwent a preoperative US and MRI. Sinus characteristics were described according to a predefined protocol. The agreement between US and MRI was quantified using the intraclass correlation coefficient (ICC) for the measurement of 3 sinus dimensions (length, depth and width) and Cohen's kappa coefficient (k) for the detection of side branches.Results30 patients were included with a median age of 27 years (IQR 20-35). Median sinus dimensions were 3.3 cm (IQR 1.5-5.6), 0.5 cm (IQR 0.3-0.8) and 0.7 cm (IQR 0.4-1.2) on US, and 1.9 cm (IQR 1.5-3.9), 0.4 cm (IQR 0.2-0.6) and 0.4 cm (IQR 0.2-0.7) on MRI for length, depth and width respectively. Side branches were detected in 6 (22%) patients on US and in ten (40%) patients on MRI. The level of agreement between US and MRI was moderate for sinus length (ICC 0.74, 95% CI 0.49-0.87, <i>P</i> < 0.001), and poor for sinus depth (ICC 0.30, 95% CI -0.05-0.60, <i>P</i> = .041) and width (ICC 0.36, 95% CI -0.03-0.66, <i>P</i> = .008). The level of agreement for the detection of side branches was moderate (k 0.46, 95% CI 0.11-0.82, <i>P</i> = .013).ConclusionPreoperative US is not suitable for the preoperative mapping of PSD when compared to MRI. MRI remains the preferred imaging technique in our clinical practice especially for complex PSD.</p>","PeriodicalId":22095,"journal":{"name":"Surgical Innovation","volume":" ","pages":"115-122"},"PeriodicalIF":1.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145303340","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}